Identifier: pediatricshygien03dunn (find matches)
Title: Pediatrics : the hygienic and medical treatment of children
Year: 1917 (1910s)
Authors: Dunn, Charles Hunter, 1875-1926 Rotch, Thomas Morgan, 1849-1914
Subjects: Pediatrics
Publisher: Troy, N. Y. : The Southworth Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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yed. In this early stage, examination ofthe drum membrane will usually show congestion only, but nobulging. The ear should be syringed every two hours, with eithera saturated solution of boric acid, or normal saline solution, at atemperature of iio°-F. Sodium bromide, in doses of two grainsevery four hours to a child of two years should be given. I believethat bromide has a most favorable influence, both on the restlessnessand discomfort of the child, and on the inflammation. Under thistreatment, in a certain number of cases, the congestion of the drumwill subside and the temperature will fall. It is not wise to allow otitis media to exist more than forty-eighthours without operation. If, after twenty-four to forty-eight hours,the temperature has not fallen, and the evidences of pain have notsubsided, or if within this period, the temperature has become higherand the evidences of pain have increased, operation should be, considered. The most reliable guide is neither temperature, nor
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Otitis Media 151 symptoms, but the appearance of the drum membrane. If thecongestion of the membrane does not subside, or at any time if thereis any bulging of the membrane, paracentesis should be performed.The presence of mastoid tenderness is always an indication forimmediate incision of the drum membrane. If bulging is present, the incision should be made at the mostprominent point; otherwise, it should be made in the lower posteriorquadrant, extending upward through Shrapnells membrane. Incases incised for persistence of congestion or symptoms, the dischargewill usually consist only of blood, but nevertheless marked reliefwill be afforded. In early cases with fluid, the discharge will usuallybe serous, while in later cases it will be purulent. After incision, the syringing with hot normal saline, or saturatedboric acid solution should be continued at two to four hour intervalsaccording to the amount of discharge. In the majority of cases thedischarge will cease in from one to thre

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