Thus far we have recited those disorders of the eyes, in which medicines are most efficacious; we must now proceed to the ears; the part, which nature has bestowed upon us next in usefulness to the eyes. But in these the danger is much greater. For the mischief arising from the distempers of the eyes is confined to themselves; whereas inflammations and pains of the ears sometimes occasion madness and death: which makes it the more necessary to administer speedy relief in their beginnings, to prevent any greater danger.

Wherefore, when a person first feels a pain, he ought to fast, and observe a strict regimen; the day following, if the disorder increases, to clip the hair of his head, and anoint it all over with ointment of iris warm, and to cover it. But a violent pain attended with a fever, and watching, requires also bleeding. If particular circumstances prevent that, the body must be kept open. Hot cataplasms too, frequently changed, are serviceable; either of the meal of fenugreek, or lint-seed, or any other, boiled in mulse. Spunges also squeezed out of hot water are proper to apply now and then. When the pain is eased, cerate made either of iris or cyprine oil ought to be put round it. In some, however, that which is made of oil of roses, succeeds better. If a violent inflammation prevents sleep entirely, to the cataplasm ought to be added half its quantity of poppy heads toasted and powdered; and then these may be boiled together in passum, or mulse. It is proper too to infuse some medicine into the ear: which ought always to be made tepid first, and is most conveniently dropped in by a strigil(9). When the ear is filled, soft wool is to be put into it to keep the liquor from returning. And these are general remedies.

Now the medicines for injection are the juice of roses, and the roots of reeds, and oil, in which worms have been boiled, and the liquor of bitter almonds, or that, which is pressed from a peach kernel. The compositions for alleviating the inflammation and pain are generally these; of castor, poppy tears, equal quantities powdered, and afterwards mixed with passum. Or equal quantities of poppy tears, saffron, and myrrh are beat, rose oil and passum being added alternately. Or the bitter part of an Egyptian bean is powdered, and rose oil added to it: with which some also mix a little myrrh, or poppy tears, or frankincense with breast milk, or the juice of bitter almonds with rose oil. Or castor, myrrh, and poppy tears in equal quantities, with passum. Or of saffron p. i. *. myrrh, scissile allum, each p. iii. *. and in powdering these, three cyathi of passum are to be gradually mixed with them, and less than a cyathus of honey. This is one of the principal remedies. Or poppy tears with vinegar. We may also use Themison’s composition, which consists of castor, opopanax, poppy tears with vinegar, each p. ii. *. aphronitre p. iv. *. which being powdered are incorporated with passum, till they be of the consistence of cerate; and so laid by. When they are wanted for use, the medicine is again rubbed down by a pistil, with the addition of passum. This is a constant rule, whenever a medicine is too thick for dropping into the ear, that liquor must be added, with which it ought to be compounded, till it be sufficiently fluid.

But if there is pus in the ears, it is proper to infuse lycium by itself; or ointment of iris; or juice of leek, with honey; or juice of centory with passum; or juice of a pomegranate warmed in its own shell, with the addition of a small proportion of myrrh. A proper mixture is also made of the myrrh called stacte p. i. *. the same quantity of saffron, twenty five bitter almonds, a cyathus and half of honey; which being rubbed together, are to be warmed in a pomegranate shell, when they are to be used. Those medicines, which are compounded for an ulcerated mouth, are equally sanative to ulcers of the ears. If these be of pretty long standing, and there is a great discharge of sanies, the proper composition is that generally ascribed to Erasistratus. It contains of pepper, saffron, each p. i. *. myrrh, misy calcined, each p. ii. *. calcined copper p. ii. *. These are rubbed down with wine; when they are grown dry, three heminae of passum are added, and they are boiled together. When they are to be used, honey and wine are added to them. There is also a medicine of Ptolemaeus the surgeon; which contains mastich, galls, of each p. i. *. omphacium p. i. *. juice of the pomegranate. That of Menophilus is very efficacious, which consists of the following things; of long pepper p. i. *. castor p. ii. *. myrrh, saffron, poppy tears, Syrian nard, frankincense, pomegranate bark, the inner part of an Egyptian bean, bitter almonds, the best honey, each p. iv. *. When they are powdered, the sharpest vinegar is added, till the whole be of the consistence of passum. There is also a composition of Crato’s; of cinnamon, cassia, each p. i. *. nard, lycium, myrrh, each p. i. *. aloes p. ii. *. honey, three cyathi, wine a sextarius. Of these the lycium is boiled with the wine; after that mixed with the other ingredients. But if the quantity of pus be great, and there is a bad smell; of rasile verdigrease, frankincense, each p. ii. *. honey, two cyathi, of vinegar four, are boiled all together. When the composition is to be used, it is mixed with sweet wine. Or scissile allum, poppy tears, juice of acacia are mixed in equal quantities, and to these is added juice of henbane less than half the quantity of any of the other ingredients; and these being powdered are diluted with wine. The juice of henbane too by itself is pretty good.

Asclepiades compounded a general remedy against all disorders of the ears, which is now approved by experience. In it there are of cinnamon, cassia, each p. i. *. flowers of round cyperus, castor, white pepper, and long, amomum, myrobalans, each two scruples, male frankincense, Syrian nard, fat myrrh, saffron, aphronitre, each p. ii. *. Which being powdered separately, and afterwards mixed, are rubbed down with vinegar; and being thus preserved are diluted with vinegar when used. In the same manner, the sphragis of Polybus liquified with sweet wine, is a general remedy for disorders in the ears; which composition is contained in the former book.

But if sanies is discharged, and there is a tumour, it is not improper to wash it with diluted wine by a syringe; and then to infuse rough wine mixed with oil of roses, and the addition of a little spodium, or lycium with milk, or the juice of the blood herb, with oil of roses, or juice of pomegranate with a very small proportion of myrrh.

If there are also foul ulcers, it is better to wash them with mulse; and after that, some one of the compositions mentioned above, that contains honey, is infused. If the pus flows more plentifully, in that case, the hair of the head is to be clipped close, and plenty of warm water poured over it; also gargarisms must be used, and walking to lassitude, with a sparing diet. If blood likewise appears from the ulcers, lycium with milk ought to be infused; or a decoction of roses in water; with the addition of the juice either of blood herb, or acacia.

But if a fungus has grown upon the ulcers, which is fetid, and discharges blood, it ought to be washed with tepid water; and after that, the composition infused, which is made of frankincense, verdigrease, vinegar, and honey; or honey boiled with verdigrease. Copper scales too with sandarach, powdered, is proper to be dropped in by a pipe.

When worms are generated there, if they be within reach, they must be drawn out with a specillum oricularium(10), if farther in, they must be killed by medicines; and means used to prevent the breeding of more. White hellebore powdered with vinegar, answers both these intentions. The ear ought to be washed also with a decoction of horehound in wine. Thus, the worms being killed slide down into the entrance of the ear, from whence they may be taken out with very great ease.

If the orifice of the ear be straitened, and a thick sanies is contained within, the best honey ought to be put into it. If that does little good, to a cyathus and half of the best honey must be added of rasile verdigrease p. ii. *. which are to be boiled together, and made use of. Iris also with honey is good for the same purpose. Likewise of honey and oil of roses two scruples. Also of galbanum p. ii. *. myrrh with honey, and ox-gall, each p. ii. *. wine a sufficient quantity to dilute the myrrh.

When a person grows dull of hearing, (which most commonly happens after long pains of the head) in the first place, it is proper to inspect the ear itself. For there will appear either a crust, such as grows upon ulcers, or a collection of the cerumen. If there is a crust, either warm oil must be infused, or verdigrease with honey, or juice of leek, or a little nitre with mulse. And when this crust falls forward, it must be washed with tepid water, that after it has fairly disengaged itself it may be the easier pulled out by the specillum oricularium. If there be cerumen, and this is soft, it must be taken out with the same instrument. But if it be hard, vinegar, and a little nitre with it must be injected; and when it is softened, the ear should be washed in the same manner, and cleansed. And if a heaviness of the head remain, the hair must be clipped, and the head gently rubbed, but a long time, with the oil of iris or laurel, and with either of these may be mixed a little vinegar: then the patient must take a long walk, and after anointing, foment the head gently with warm water; and make use of food of the weakest and middle class, and more especially take diluted drinks; sometimes use gargarisms. Into the ear must be infused castor, with vinegar and laurel oil, and the juice of radish rind, or the juice of wild cucumber, with the addition of rose leaves powdered. The juice also of unripe grapes infused with oil of roses, is pretty good against a deafness.

The disorder is of a different nature, where there is a noise within the ears themselves: and this prevents them from receiving an external sound. This is slightest, when it proceeds from a gravedo; worse, when it is occasioned by a distemper or inveterate pains of the head; worst of all, when it is the harbinger of some violent disease, and particularly of an epilepsy. If it happens from a gravedo, the ear ought to be cleansed, and the patient hold in his breath, till some frothy moisture issue from it. If, from a distemper, or pain of the head, the same rules as prescribed in a dulness of hearing, must be practised with regard to exercise, friction, pouring on of cold water, and the use of gargarisms; no food but such as extenuates must be used; juice of radish, with oil of roses, or with the juice of the root of wild cucumber, must be infused into the ear, or castor with vinegar and laurel oil. Hellebore is also rubbed with vinegar, then incorporated with boiled honey, and being made into a collyrium, is introduced into the ear. If it has begun without these, and therefore gives reason to fear the approach of some terrible disease, castor ought to be infused into the ear with vinegar, or oil, either of iris or laurel; or together with the last, castor and the juice of bitter almonds; or myrrh and nitre with oil of roses and vinegar. But a proper diet is more serviceable in this case too. And the same rules are to be observed, which I prescribed above, even with greater exactness; besides which, the patient must refrain from wine, till the noise cease.

But if, at the same time, there are both a noise and an inflammation, it is sufficient to inject laurel oil, or that, which is expressed from bitter almonds; with which, some mix either castor or myrrh.

It sometimes happens too, that something falls into the ear, as a small stone, or some animal. If a flea has got into it, a little wool must be pressed in; and if it comes upon that, it is drawn out along with it. If it has not followed it, or it be any other animal, a probe wrapt in wool must be dipped in the most adhesive resin, particularly turpentine, and this is to be introduced into the ear, and turned round there: for it will certainly catch hold of it, and bring it away. But if it be any lifeless thing, it must be drawn out by the specillum oricularium, or a blunt hook, but little bent. If these means do not succeed, it may be drawn out by resin, in the same manner as directed in the preceding case. Sternutatories also are very proper to force it out, or water strongly injected by a syringe. The following method is also practised in this case; a board is laid down(11), supported in the middle, with both ends hanging over, and the patient is tied upon that, lying on that side, the ear of which is affected, so that he does not reach over the board; then the end of the board, where his feet are, must be struck with a hammer, and thus by shaking the ear, what is within it drops out.