254 THE TREATMENT OF DISEASES. 



of iron (Prs. 1, 2, 3, 7, or 63) may afford relief. The strong quinine mixture (Pr. 

 10) frequently proves efficacious in these cases. Often enough neuralgic earache 

 depends on decayed teeth, and then either they should be extracted, or gelseminum 

 (Pr. 41) should be given. Five grains of croton-chloral-hydrate dissolved in an 

 ounce of water and taken every four hours for some days, is an excellent remedy. 

 It is not the same as common chloral, and acts quite differently. 



Singing in tJie Ears. This is a most distressing s} r mptom which often attacks 

 those who are in bad health or in the decline of life. It varies in degree in different 

 cases from a slight humming, of which the patient is conscious only when everything 

 is quiet, to a noise of a most aggravated character. The sounds in the ears of which 

 patients complain are variously described : some speak of a ringing of bells, others 

 liken them to the murmur of trees, the hum of a tea-kettle, &c. ; one old lady said 

 her noise was like the low singing of birds. The descriptions which people give of 

 the noises they hear depend to a certain degree on their fancy, their power of graphic 

 expression, and not infrequently upon their rank in life and the sounds with which 

 they are most familiar. An Irish writer once said : " Persons from the country or 

 rural districts draw their similitudes from the objects and noises by which they have 

 been surrounded, as the falling and rushing of water, the singing of birds, the 

 buzzing of bees, and the waving or rustling of trees ; while on the other hand, 

 persons living in towns, or in the vicinity of machinery or manufactories, say they 

 hear the rolling of carriages, the hammerings and the various noises caused by steam- 

 engines. Servants almost invariably add to their other complaints that they suffer 

 from the ringing of bells in their ears ; while in the country, old women much given 

 to tea-drinking sum up the category of their ailments by saying that * all the tea- 

 kettles in Ireland are boiling in their ears.' " 



Singing in the ears is often associated with deafness, but it may exist for a time 

 in people in >vhom the hearing power is not defective, and with them many causes 

 may suffice to produce it, such as anxiety and annoyance, mental fatigue, over-work, 

 prolonged suffering, and so on. With many persons a few doses of quinine will 

 quickly produce singing in the ears. It is by no means an easy complaint to treat 

 successfully. In the first place, the ear should be examined for wax with a speculum, 

 ind should there be any accumulation, it should be removed by judicious syringing. 

 Then the general health should be carefully inquired after, and should any error be 

 detected, that should if possible be remedied before anything else is done. After 

 this preparatory treatment, remedies may be resorted to, directed especially against 

 the complaint itself. When the noises are associated with deafness, small doses of 

 quinine or tincture of pulsatilla may be given. When the noise is buzzing or loud 

 like a steam-engine, tincture of digitalis is said to be the best remedy. Plumbago, 

 the black-lead of our pencils, is reputed to be of service when the noises are roaring 

 or thundering ; it may be given in five-grain doses every four hours. Sometimes the 

 bromide of potassium mixture (Pr. 31) will succeed as well as anything. 



Deafness occurs as a symptom of many ear diseases, such for instance as rupture 

 of the membrane. Sometimes it is due to an accumulation of wax in the ear. It 

 is said to be nervous deafness when it depends on general torpor and debility, is 

 better sometimes than at others, especially in fine weather and when the patient is 



