Recovery.—­The result of this disease cannot be told at the outset.  The majority of such attacks end favorably, with care and treatment; this in persons of good constitution and health.  It may run ten days to three to six weeks.  In tuberculous patients the result is not so favorable.  Recovery follows as a rule in this disease following scarlet fever and measles, but not so quickly, and there may be a discharge for some time, due to chronic disease of the ears, etc.

Complications and results.—­In the majority of cases, in ordinarily healthy persons, this disease runs its course without doing any great amount of damage to the organ of hearing, and without involving any structure lying outside of the middle ear proper.  In scarlet fever, measles, la grippe, or nasal diphtheria, actual destruction of tissue often takes place in some part of the middle ear before it is recognized.  Sometimes it results the same way even when it is discovered in time.

Caution.—­A person who has had this disease should be very careful not to take cold.  The patient should take plenty of time to get well and strong.  The diet should be liquid mostly.

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Chronic suppurative inflammation of the middle ear.—­An inflammation that forms pus; hence called suppurative.  This is an inflammation that has become chronic (continued) and has one characteristic at least that is very noticeable, and that is the discharge.  This may last for an indefinite period.  The acute suppurative (pus-forming) inflammation just described in the foregoing pages, may have inflicted various kinds and degrees of damage upon the mucous membrane which lines the cavities, and as a result of the conditions thus established there will be a discharge which may last an indefinite time.

Causes.—­Improper or lack of treatment for the acute suppurative inflammatory attack.  This is the chief cause.  The first attack may have been caused by scarlet fever, measles, etc.  They are prone to become chronic, especially if not recognized early and treated properly.

Symptoms.—­The main symptom is the discharge from the ear.  This may be abundant or scanty.  It may stop for a time and begin again.  The hearing may be slightly or seriously impaired.  Such patients are not accepted by life insurance companies.

Treatment.—­Cleanliness of the parts and perfect drainage must be secured.  Syringing with one to fifty carbolic acid solution (acid one part, warm water fifty parts) is good treatment.  The opening in the drum should be made large enough to give free discharge to the pus in the middle ear.

The patient’s strength must be built up if necessary.

Inflammation of the mastoid’ cells. (Acute or Chronic Mastoiditis).—­This disease represents one of the most serious terminations of an acute or a chronic suppurative inflammation of the middle ear.  This is fortunately a comparatively rare event.  There are, however, quite a good many cases of this terrible disease.