OTITIS EXTERNA. 199 
If this treatment is not speedily successful, an ointment consisting of the 
ointment of ammoniated mercury and vaselin, in equal parts, should be substi- 
tuted, and used two or three times daily. 
Where the redness and swelling extend over all or the most of the ear-flap, 
and the ear passage is also more or less swollen, the inflammation within gen- 
erally subsides as improvement occurs in the outermost parts. 
Even when the ear-flap is much inflamed sometimes the passage is not seri- 
ously affected. Itis a fact also that in the most severe cases of inflammation 
deep within the passage the ear-flap may not share in that inflammation and if it 
does become reddened and inflamed this condition is generally attributable to 
the shaking of the head and flapping of the ears. 
When a dog exhibits these symptoms, — shaking the head and flapping the 
ears —and the ear-flap is not much reddened or inflamed, it may safely be 
assumed that there is trouble deep within the ear passage or beyond the drum 
membrane. 
If the passage does not appear inflamed and swollen it may be that there is 
a fungus growth, or dirt, gravel or other foreign body that is causing this dis- 
comfort, and a syringe should be called into service. 
Were skilled hands to use it the form of the syringe would not be very 
important, — that is, it might be large or small, of glass or rubber, etc. — but for 
common use the safest and best is the so-called “ Fountain Syringe.” But even 
this will require some modification, because the smallest end-piece or nozzle, 
being of hard rubber, cannot be used to advantage. 
In all drug shops there is on sale very small rubber tubing which is com- 
monly used on nursing bottles. A piece of that, or the smallest tubing obtain- 
able, three or four inches in length, should be drawn onto the smallest nozzle. 
The free end of this can then be inserted into the ear passage, and being flex- 
ible and soft, will adjust itself to the passage, enter deeply, and do no harm. 
The capacity of an ordinary fountain syringe is about two quarts, and it 
should be filled with clean, warm water, the temperature of which must be right, 
because it would do harm were it too high or too low. 
One’s cheek near the nose is very sensitive, and after the syringe has been 
filled with water that feels comparatively warm to the hand, and the water 
allowed to flow away until all within the long tube has been changed, the stream 
should be directed against the face, and the temperature adjusted if not right. 
-This done, the reservoir or bag of the syringe should be hung on a nail five 
or six feet from the floor, and the small, soft rubber tube, that has been drawn 
over the end of the smallest nozzle, should be gently inserted as deeply as 
possible into the ear passage, and the water allowed to run in. 
When the flow has stopped, remove all the water that remains in the ear 
passage by having the head of the dog so twisted that the affected ear is on the 
under side, and then the outside of that ear gently kneaded or rubbed with the 
