the palm of the hand, as is too commonly done. If it is snuffed too forcibly, it is forced into the upper part of the nasal cavity, where it is very irritating, often causing headache and irritation of the eyes. The best and simplest way to use the soda solution is to bury the nose entirely in the cup of fluid, and then gently suck the solution into the nose, at the same time holding the mouth widely open. There is no risk of choking if the mouth is open and the head thrown forward, as it necessarily is in doing this, for all the fluid will run out through the mouth. A few trials will readily demonstrate the advantage of this method over all others.
Probably all the laity, so to speak, when first they realize that their hearing is diminished, believe that the wax has accumulated and has blocked the auditory canal. The sensation to them is certainly one of obstruction, and they seem justified in picking at the canal of the ear in attempting to remove the obstructing substance.
With very rare exceptions, deafness is never due to wax alone. In the majority of cases it is really due to obstruction, but this is very much farther in the head than any patient can reach, and often of too dense a nature and too long duration for even the specialist in otology to successfully eradicate. Even where there certainly exists a mass of wax entirely blocking the auditory canal, with it is always associated an underlying catarrh of the drum of the ear without any discharge from the ears whatever. The effect upon the hearing is like that caused by closure of the canal, and wax alone is suspected. In the effort to remove the suspected obstruction, matches, toothpicks, hair-pins, etc., are used in the ears, and perhaps a little of the normal wax which belongs in the canal is removed, and the patient's suspicion seems to be verified.
It must be emphasized right here that the ear-scoops and ear-sponges for sale in all drug-shops are worse than useless; they are positively dangerous. Many are the ears that have been incurably injured by such instruments. There is more wisdom than humor in the old saying that we ought to put nothing in our ears but our elbows. At any rate, let no one put anything into the auditory canal but the end of the little finger wrapped with a handkerchief or a towel.
If deafness is of sudden occurrence, accompanied by a dull, rumbling sound in the ear, similar to that caused by temporarily closing the canal of the ear by the finger, with a sensation of fullness of the canal, and absolutely painless, obstruction from accumulated wax may be suspected. But there is no means of positively determining this, except by having the ear carefully examined by some competent observer.