I am quite sure, from careful observation, among my own patients as well as of those of other physicians, that the common custom of both the laity and of the profession of using gargles for throat difficulties is a productive cause of serious ear complications in otherwise trivial diseases of the throat.
The reason for this conclusion is plainly apparent. It is not difficult to force, by this means, water and injected mucus or pus up into the internal ear through the eustachian tubes. Someone has said that these tubes close during the act of gargling. All I ask is that you desist from the use of gargles, using more sensible means, and notice how few of these suppurative ear cases develop. If you must use a wash for the mouth and throat allow water to be held in the pharynx by throwing the head well back. After holding the fluid this way for a moment expel it and repeat the process if necessary.
E. E. MYERS, M. D.
Ellingwood's Therapeutist, Vol. 2, 1908, was edited by Finley Ellingwood M.D.