Disease of the middle ear.—­The ordinary cold in the head rarely runs its course without one of the eustachian tubes at least is involved to some extent.

Simple inflammation of the eustachian tube.—­Causes.—­Acute colds, inflammation of the nose and pharynx, tonsilitis.

Symptoms.—­The ear may feel full and numb, roaring in the ear may occur.  There may be pain on swallowing, shooting up through the tube.

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Treatment.—­Remove the cause.  Treat the nose and pharynx.  Spray and gargle with solutions advised for throat trouble.  If it continues the throat should be examined for adenoids, enlarged turbinate bones and so on.

Acute catarrhal inflammation of the middle ear.  Causes.—­Acute coryza, acute pharyngitis, influenza, scarlet fever, inflammation of the eustachian tube, gargling, bathing, employing the nasal douche or violently blowing the nose.

Inflammation of the eustachian tube is, in many cases, simply the first stage or onset of this disease.  The congestion extends beyond the tube and involves to a greater or less degree this cavity.  If it continues for a few hours or an entire day, the watery elements of the blood will begin to escape from the distended vessels into the tissues of the mucous membrane and ooze out upon its free surface.  If this is copious enough pressure may be developed within the cavity, middle-ear, to cause pain.  These cases vary much in severity.  In the mildest ones there may be a few twinges of pain in the affected ear, but nothing more; and even in the most severe cases the pain does not last longer than a few hours, although it may return on several successive days.  Very many of the earaches of young children, from two to ten years of age, are due to this disease.  The pain is very likely to come on late in the afternoon or during the night, while earlier in the day the child may be free from pain.  In the milder forms the condition of the drum is similar to that existing in inflammation of the eustachian tube.  It is not then much changed from normal.  There may be more congestion than in this condition.  In a fairly severe case the membrane (drum) a few hours after the onset presents a most striking change.  It is a picture of obstructed venous (dark blood) circulation of a high degree.  In some cases one or more of these distended veins may rupture and form a blood tumor in the external ear canal.  The drum is red and more or less swollen.

Treatment.—­Very little is needed for this kind, except care and watching.  Use the simple hot water in the ear carefully or poulticing when there is pain with onions, bread and milk, and puncture of the drum if it bulges or is too tense.  Hot water for gargle, steaming of the pharynx.  Keep the patient in a room with an even temperature.  The patient must not take cold as it might extend farther.