1885 v. 28 - Lane Medical Library Digital Document Repository

JVeio Books. 39
passage connected with the auricle. The latter usually does not
occupy a position to that of a normal auricle, bat is either nearer
the cheek or pushed downwards toward the throat, and is movable
in all directions with the neighboring skin. This is an important
fact to bear in mind, if there is any disposition to make an
artificial auditory canal."
It applies still more forcibly to the removal of foreign bodies
which have lodged in the external auditory canal, because of its
greater frequency. Every practitioner of medicine should know
that nineteen out of every twenty foreign bodies in the canal may
be removed by simply syringing the ear with warm water. It
should be persevered in for a long time. Although the author
does not mention it, a continuous stream is far more efficacious
than an intermittent one for dislodging foreign bodies, such as
that which may be produced by the ear-pump used in Hinton's
clinic at Guy's Hospital.
This pump may be fastened to the table by a clamp, and the
lever operated by one hand, while the other directs the nozzle.
An air chamber in the body of the pump serves to make the
stream continuous, and subject to very slight changes of force.
The modus operandiof dislodgement of the object, especially if
it is well impacted, is doubtless due to small quantities of water
being, little by little, forced past the foreign body, and having no
outlet, owing to the membrana tympani on one side and the foreign
body on the other, and the small inlet for the water being
continually pressed against by the non-intermittent stream from the
pump, the body of water behind the object gradually increases,
the warmth and moisture relax, the water distending the canal;
there being no resistance outward to the escape of the water or
the foreign body, the latter is slowly forced outward, and finally
gently expelled.
We cannot recommend that a solution of nitrate of silver containing
480 grains to the ounce of distilled water should ever be
dropped into the auditory canal when perforation of the membrane
tympani exists, as the author describes on pp. 326 and 327.
Milder solutions (never over 20 grains to the ounce) will accomplish
better results, if persevered with a sufficient length of time.
If the pedicle of a polypus cannot be seen, it were better to inject
the substance of the polypus before its removal, in the hopes
of destroying its vitality in that way, than to run the risk of causing
dangerous inflammation to the middle, and perhaps internal,
ea,r, by the introduction—by dropping—of esoharolics.