thickening of this membrane, or from an accumulation of wax upon its
outer surface. The increased thickness is usually the result of
inflammation, either acute or chronic. The proper treatment is such as
is efficient to remove inflammatory action.

_Observations._ 1st. The introduction of heads of pins into the ear is
a frequent cause of chronic inflammation of the membrana tympani.
Hence this practice should never be adopted, and if acquired, should
be abandoned.

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973. On what does acute hearing depend? 974. State effects on the
hearing in some conditions of the brain. How relieved? 975. Of the
effect on hearing when the bones of the ear or the labyrinth are
destroyed? Is medical treatment of any avail? 976. What conditions of
the drum of the ear may impair hearing? How relieved? What is said of
the introduction of pins to cleanse the ear?

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2d. The accumulations of viscid wax may be softened by dropping some
animal oil into the ear, and then removing it by ejecting warm soap
suds a few hours subsequent to the use of the oil. This may be
repeated for several successive days.

977. Hearing may be impaired by obstruction of the Eustachian tube.
The closure of this canal diminishes the vibratory character of
the air within the tympanum, in the same manner as closing the
opening in the side of a drum. For the same reason, enlarged
tonsils, inflammation and ulceration of the fauces and nasal
passages during and subsequent to an attack of scarlet fever, and
the inflammation attending the "sore throat" in colds, are common
causes of this obstruction.

978. The treatment of such cases of defective hearing, is to have the
tonsils, if enlarged, removed by a surgeon; for the inflammation and
thickening of the parts remedial means should be applied, directed by
a skilful physician. The nostrums for the cure of deafness are
generally of an oleaginous character, and may be beneficial in cases
of defective hearing caused by an accumulation of wax upon the drum of
the ear, but in this respect they are no better than the ordinary
animal oils.

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What is the remedy where there is an accumulation of wax? 977. What is
the effect on hearing if the Eustachian tube is obstructed? 978. What
is the treatment when deafness is caused by inflammation or ulceration
the fauces? What is said of the nostrums used for deafness?

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