The Eustachian tube is continuous with the middle ear, and extends downward and forward about an inch to connect it with the pharynx, where it opens by a trumpet-like expansion, just above the soft palate, at the junction of the throat and nose. It serves to carry off the excess of fluid from the middle ear and to preserve the equilibrium of the pressure between the gaseous contents of this cavity and the atmosphere. The walls of the Eustachian tube are in close contact, but they are normally opened during every act of swallowing, yawning, etc., when the air finds its way into the middle ear. A stoppage of the nose reverses the process, and when the tubes are not likewise stopped up, every swallowing motion draws air out of the tubes. If the openings of the tubes become closed, deafness, dizziness, and subjective noises will result. The middle ear is the seat of about two-thirds of all aural troubles, and, since much of this could be prevented, this becomes a matter of great practical importance. _Causes of Impairment of Hearing._—The majority of the affections of the middle ear originate from extensions of catarrhal inflammations, from the nose and throat, through the Eustachian tubes. In children adenoids are the most frequent cause of deafness. The so-called hereditary deafness is probably due to an inherited configuration of the septum of the nose, a bending of the septum to one side, or a tendency to catarrhal affections of its mucous membranes. Every cold in the head tends to mechanically involve the ears, and, while recovery may seem complete, there is likely to be some unrelieved trouble which insidiously but steadily increases—first one ear, and then the other, shows signs of defective hearing. If only one ear is involved, the condition may progress seriously before the patient is aware of the trouble. _Preventive Measures Against Deafness._—From what has been said, it naturally follows that the preventive measures must be chiefly those already given against taking cold. If one does take cold, instead of leaving it to run its course, as is too often done, proper therapeutic measures should be at once adopted to bring as speedy a cure as possible. _Impacted Ear-wax and its Removal._—A healthy ear should never show more than enough wax to render the hairs within soft, and the individual should be unconscious of the wax coming away. Wax does not collect in a healthy ear. When it does occur, there is a stopped-up feeling in the ears, due to the occlusion of the meatus by wax. The only procedure that is safe to follow in order to remove the wax from the ear is to gently douche the ear with warm water, at a temperature from 105° to 110° F. If this does not suffice, a physician must be consulted, as all efforts to remove the wax after it has become impacted are dangerous and futile except in skilled hands.