In  the  early  stages,  the  local  treatment  is  directed  to  the  relief
of  any  irritation  in  the  nose,  nasal  space  and  Eustachian  tube.
Inflation  with  the  Politzer  bag  or  Eustachian  catheter  should  be
given  every  other  day  until  all  evidence  of  improvement  has  ceased.
Stricture  of  the  tube  can  usually  be  relieved  by  inflation,  and  if  too
dense,  resort  must  be  made  to  hard  rubber  or  electrolytic  bougie.
Many  solutions  are  recommended  as  an  injection  for  the  pro-
motion of  absorption  of  adventitious  bands.  The  following  is
highly  recommended  by  Lake:

1$     Red  iodid  of  mercury,  gr.  iv,       .24  gm.
Lanolin,  5  f>        2.40  c.c.
Parololeine,  5i,         30.  c.c.
M

Sig.     A  few  drops  to  be  injected  into  the  middle  ear,  followed  by  oto-
massage.
Politzer  recommends,  in  the  adhesive  stage  of  the  disease  com-
bined with  swelling  of  the  Eustachian  tube,  the  tubal  injection  of


DISEASES   OF   THE    MIDDLE    EAR.  22$

five  to  six  drops  of  a  one  to  two  per  cent,  solution  of  pilocarpine,
also  the  fumes  of  sal  ammonium  and  turpentine  vapors.  Hot,
medicated  air  is  recommended  by  Lermoyez  and  Mahu.
In  the  early  stages  of  the  disease,  oto-massage  is  of  special  value;
however,  as  the  disease  progresses,  results  from  this  form  of  treat-
ment are  unsatisfactory.
Thiosinamine,  one  to  three  grains  after  meals,  is  indicated  for
the  absorption  of  the  fibrous  bands  and  if  continued  for  a  long  time,
is  very  efficacious  in  many  cases.
Lucae's  pressure  probe  is  frequently  of  value  where  there  is  a
drawing  inward  of  the  membrana  tympani.
