A text-book of practical therapeutics . o be performed. Should true septic otitis media de-velop and drainage of the middle earbecome impossible through blockingof the Eustachian tube, then thephysician must very gently irrigatethe external auditory canal with ashot water as can be borne, andrender it aseptic by insufflationsof boric acid powder. These irri-gations should be frequently prac-ticed, and if the pain persists and the tympanic membranebegins to bulge, paracentesis must be performed in the mostbulging part of the lower quadrant. After the paracentesis needleis withdrawn the discharg
A text-book of practical therapeutics . o be performed. Should true septic otitis media de-velop and drainage of the middle earbecome impossible through blockingof the Eustachian tube, then thephysician must very gently irrigatethe external auditory canal with ashot water as can be borne, andrender it aseptic by insufflationsof boric acid powder. These irri-gations should be frequently prac-ticed, and if the pain persists and the tympanic membranebegins to bulge, paracentesis must be performed in the mostbulging part of the lower quadrant. After the paracentesis needleis withdrawn the discharge should be allowed to flow freely. Thecanal is then to be well irrigated with hot 1: 2000 permanganate ofpotassium or hot carbolized water (1:50), and as the discharge isconstant a thin piece of sterilized gauze should be inserted andallowed to act as a drain (not as a packing) and removed as oftenas soiled. In a case of eczema of the ear, hot irrigation, followed by theapplication of powdered iodoform, is perhaps the best application. Fig. 129.—Aural irrigator. 766 DISEASES for temporary treatment. In furunculosis of the ear hot irrigationsand free incision, with an iodoform dressing, are useful. When foreign bodies cause the pain, they are best removed byrepeated and gentle syringing with hot water. Forceps are danger-ous instruments in the hands of a novice treating the ear. In earache due to neuralgia a small compress wet with chloroformmay be applied to the skin in front of and behind the ear. ECZEMA. This is probably the most common form of skin disease which thephysician is called upon to treat, with the exception of acne. Dermatologists divide it into many forms and stages, but in thisbook a consideration of its forms is out of place, and only the treat-ment for its stages is proper. In the first place, it may be stated that the treatment is a quadrupleone—namely, dietetic, hygienic, external, and internal. In regard to diet, the patient should be told to avoid sal
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