Riding in tunnels, especially in tunnels under water where the air pressure varies, has, through some recent investigation, been found to be injurious to the ears of a great many people.
Conductors and other trainmen who run through many tunnels are apt to have ear trouble, as are the men who work underground a great depth where they are in motion, such as miners running underground trains.
If you have an earache that continues for any length of time, take no chances, but consult a physician. And remember to care for the throat and nose, as ill conditions in those places result in ear troubles. Do not blow your nose too hard; it merely injures the inner sides of the ear drums. Adenoids in children frequently bring about a bad ear trouble. Even seasickness is due in a great measure to ear disturbances.
If you have a running ear, attend to it at once by visiting a doctor. So serious is this that life insurance companies will not insure people in that condition.
Earache.—When a child complains of earache its ear should be examined. In nearly every case of earache it is necessary to treat the throat, as this is, as a rule, the seat of the trouble. An antiseptic gargle of equal parts of Borolyptol and warm water is an excellent mixture. It should be used freely every two hours. Children suffering from earache should be kept indoors. If the examination should show that it is not necessary to lance the ear drum, some local measure may be adopted to allay the pain. Putting the child in bed with the head resting on a hot-water bottle may be all that will be necessary. The following procedure may be carried out, but only after a physician has made an examination and according to his directions: A hot water douche, given by means of a douche bag, is quite effective. The water should be 110° F.; the bag should be held about two feet above the level of the child's head, and the irrigating point should not be pushed into the ear, but held so that the water will find its own way into the ear.
When the earache does not respond to the above methods the ear should be closely watched and examined at intervals so that it may be opened at the right moment. This is very essential because, if it is neglected, the pus may find its way into the mastoid cells and set up the dangerous disease, mastoiditis. This disease may cause abscess of the brain and death. The moment a child develops fever in the course of an earache the ear should be examined and opened at once, if found necessary.
Inflammation of the Ear. Acute Otitis.—Inflammation of the ear seldom occurs in childhood, unless as a complication, or as a result of some infectious disease. Any disease which affects the throat in any way may be the cause of the inflammation of the ear. Such diseases are, "cold in the head," tonsilitis, grippe, "sore throat," or pharyngitis, measles, scarlet fever. It is much more common in children than in adults. The younger the child, the more liable it is to develop ear trouble when suffering from any of the above diseases. The presence of adenoids favors the development of ear complications.
Symptoms.—There is one symptom present in all cases of inflammation of the ear; that is, fever. Pain may or may not be present; it is present in a majority of the cases. Children with inflammation of the ear are exceedingly restless and do not sleep long at a time nor do they sleep soundly.
Treatment.—The treatment is to open the drum membrane, at the right time, which of course will always be done by a physician who has had some experience in this work.
After Treatment.—The after treatment consists of washing or syringing the ear every three hours with eight or twelve ounces of a 1:10,000 solution of corrosive sublimate. This will be kept up for four days; then the intervals between the washing will be extended to five hours, and kept up until the drum membrane closes. If the corrosive sublimate solution should cause any eruption around the ear, a normal salt solution (see page [ 627]) may be used in the same way, and in the same quantity as above. A running ear will run for from three to six weeks. It may heal up at any time after ten days. If the discharge should suddenly stop and the fever rise, it indicates that the opening has become plugged or healed too quickly. In either case it will have to be opened again. As soon as the ear begins running again the symptoms will disappear. After syringing the ear it should be dried thoroughly with pieces of sterile absorbent cotton.