taken
that all the air is first removed from the syringe. To straighten the
canal, the pinna should be pulled upwards and backwards by the left
hand. It may be necessary to exert some considerable degree of force
before the plug becomes dislodged, but this must be done with caution.
The ear should then be dried out with cotton-wool, and a small plug
of wool inserted for a few hours. If pain is complained of, or if the
wax is hard and cannot be readily removed, the syringing should be
stopped, and means taken to soften it by the instillation of a few
drops of a solution of bicarbonate of soda (10 grains to the ounce of
water or glycerine), or of peroxide of hydrogen, several times daily.

#Eczema of the external meatus# is often associated with eczema of the
auricle and of the surrounding parts. Not infrequently there also
exists a chronic middle-ear suppuration, which may be the cause of the
eczema. Intense itchiness is the most characteristic symptom, and a
watery discharge may also be complained of. Deafness and tinnitus are
dependent upon the accumulation of epithelium and debris. After the
ear is syringed the skin may present a dry, scaly appearance, while
sometimes fissures and an indurated condition of the outer end of the
meatus may be noted. Rarely is the outer surface of the tympanic
membrane itself involved.

_Treatment_ consists in keeping the ear clean by syringing and careful
drying. Probably the best local application is nitrate of silver (10
grains to the ounce of spiritus aetheris nitrosi). This is applied by
means of a grooved probe dressed with a small piece of cotton-wool.
Care should be taken that none of the fluid is allowed to escape upon
the cheek, otherwise staining of the skin occurs. A plug of
cotton-wool is inserted, and the solution is re-applied at the end of
a week. Sometimes the condition is very intractable.

Occasionally the vegetable parasite _aspergillus_ is present in the
external meatus, and produces a condition that is liable to be
mistaken for eczema. Strong antiseptic lotions are required to kill
the fungus.

#Furunculosis# or #Boils#.--Boils in the ear may arise singly or in
crops, and may be associated with eczema of the meatus or with chronic
suppuration of the middle ear. Pain is the chief symptom complained
of, and it may be very acute. Deafness ensues when the meatus becomes
completely blocked by the swelling. The boil occurs in the
cartilaginous meatus, and it is to b