Otitis media, the medical term for an ear infection, is a painful inflammation of the middle ear space, located just behind the eardrum. Before the mid-20th century, this common ailment represented a serious, life-threatening condition. The infection, often triggered by a preceding cold or respiratory illness, would cause immense pressure and pus buildup behind the tympanic membrane. Without a way to reliably kill the bacteria, historical approaches focused on managing the intense pain, draining the accumulating fluid, and relying on traditional remedies.
Early Attempts at Pain Relief and Understanding the Cause
The immediate and primary concern for anyone suffering from otitis media was the agonizing earache, which was often relentless. Since the understanding of infectious disease was incomplete before the widespread acceptance of germ theory, historical attempts to relieve pain were often guided by theories like the balancing of humors or the effects of cold exposure. The management of pain frequently involved applying external heat to the affected area to soothe the discomfort and theoretically draw out the inflammation.
Common methods included placing hot compresses, cloths soaked in warm water, or bags filled with heated salt or grains near the outer ear. For internal relief, traditional healers and physicians often relied on substances like alcohol-based tinctures or opiates to dull the intense throbbing. A frequent method involved dripping warm, mild oils, such as olive or almond oil, directly into the ear canal, which was believed to provide a temporary, soothing effect against the pressure. These actions were aimed purely at symptom management.
Invasive Medical Procedures and Drainage
When the body failed to resolve the infection and the pressure became overwhelming, formal medical intervention by a physician was required to prevent the infection from spreading. The primary surgical procedure was the myringotomy, a procedure involving a small incision or puncture of the bulging eardrum to allow the pus and accumulated fluid to drain. This drainage was intended to immediately relieve the severe pain and pressure, and prevent the eardrum from rupturing spontaneously.
If the infection was not contained, it could spread from the middle ear into the adjacent mastoid bone, a condition known as mastoiditis. The mastoid is a honeycomb-like structure behind the ear, and once infected, it rapidly became a reservoir of pus and bacteria. By the early 20th century, up to 20% of acute otitis media cases progressed to mastoiditis, demanding a drastic intervention called a mastoidectomy. This complex operation required the surgeon to drill or chisel away the infected bone behind the ear to remove the diseased tissue and drain the abscess. While often life-saving, the procedure carried high risks of long-term complications, including permanent hearing loss, facial nerve paralysis, and the danger of the infection spreading further into the brain, resulting in fatal meningitis or brain abscesses.
Common Home and Herbal Remedies
Families often turned to various traditional and herbal remedies for treatment at home. These treatments were often based on anecdotal evidence, local folklore, or the perceived antimicrobial properties of common ingredients. One popular remedy involved using garlic, which contains a compound called allicin, believed to have natural antibacterial properties. Garlic was often crushed and mixed with warm oil, such as mullein oil, and then gently dropped into the ear canal as an ear drop.
Other folk methods included creating poultices, where heated, crushed onions or garlic were wrapped in cloth and placed against the external ear to draw out the infection. Some practices involved applying the extracted juice of herbs like basil around the outer ear. However, these approaches lacked a scientific basis and, in some cases, risked introducing foreign matter or irritants into an already inflamed ear canal.