Impaired hearing and tinnitus aurium are the two most common and distressing subjective symptoms of affections of the ear for which our aid is sought. Often the individual has reconciled himself to the impaired hearing, but is urgent for relief from the persistent torturing sounds of which he has the monopoly. The character of the tinnitus exciting most complaint is the ringing, buzzing, twittering, ticking or grating sound, which is as constant as the chronic progressive deafness with which it is associated, varying only in power or intensity at different times. Of the many causes of tinnitus aurium a number are promptly recognized, and have only to be understood to be relieved, viz., small objects on the drum membrane, or in the external meatus; obstruction of the Eustachian tube, or of the external auditory meatus; overdoses of quinia or of the salicylates; the use of tobacco or alcohol in some