your health: deafness
Monday, 30 November -0001

YOUR HEALTH Dr James Le Fanu: 12 October

Deafness, and how medicine today still lacks effective solutions; and the latest thinking on countering painful cellulitis

Written by Dr James Le Fanu
There are only two types of deafness,' observed the Dublin surgeon Sir William Wilde, father of the famous Oscar. 'One is caused by wax and is curable. The other is not due to wax and is not curable.'

As for the first, life has few more gratifying experiences than the exclamation of surprise of the previously deaf when they can hear again after the brown plug of wax has been dislodged with a fine jet of water. The situation with the 'not curable', known as presbyacusis, or age-related hearing loss, should be rather better than in Sir William's day when the best he could suggest was an ear trumpet to amplify sounds.

Now, thanks to the wonders of the microelectronic age, we have computerised, pill-sized hearing aids – but they are costly and many find difficulty in operating them. Indeed, less than one fifth of the nine million deaf people in Britain have them, and even fewer use them. They would, in short, be better off with Sir William's ear trumpet.

It is a most curious situation, which a section of the Royal Society of Medicine writing in its Fellows Journal attributes to two factors. First, the drive for ever-smaller devices is based on the assumption that the main priority for the deaf is to conceal their impairment. Not so: they want to hear.

Secondly, the manufacturers appear to operate a cartel in Britain charging up to £4,000 for aids that can be purchased for a fraction of the cost in Europe or the US.

Calming cellulitis
There is little difficulty in recognising the hot, red, swollen and painful leg of a person with the infection under the skin known as cellulitis. This is common, especially in the overweight and immobile and surprisingly difficult to treat.

First, the infection frequently fails to respond to oral antibiotics, resulting in about 80,000 hospital admissions a year – often for a week or more – for them to be given intravenously. There is a high rate of recurrence, with half the patients having further episodes. Hence the considerable interest in devising an effective method of prevention, probably best achieved, suggests an article in the BMJ, by taking a daily dose of the antibiotic penicillin V or erythromycin for up to a year.

This week's medical problem comes courtesy of a lady from Brighton writing on behalf of her husband, recently turned 80, who finds, when holding a pen for writing, or a pencil for sketching, that his fingers tend to curl up making the task impossible. He has, on the other hand, no difficulty playing the piano. This finger-curling is almost certainly the fascinating condition Focal Hand Dystonia, which is due, it is presumed, to a disturbance of the neural circuits in the brain involved in intricate motor tasks such as typing or writing. There is no magic cure, though the drug Artane is reported to be of value. It may be helpful for him to see a consultant neurologist.

Hair Solution

Hair is ideal for removing grit from the eye where a small noose can be used to flick out the offending foreign object without fear of damaging the cornea. Perhaps less well appreciated, hair can also counteract the exquisite pain and copious tears for those who accidentally rub the eye after touching a chilli pepper. 'I once experienced these symptoms when in the company of several Mexican friends,' recalls geneticist Dr Richard Roberts from Texas. 'They urged me to put hair in the affected eye. Though incredulous I grabbed for my wife's hair [his own being too short] and the pain and tears cleared immediately. I cannot explain this.'

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