Cy
In a well managed pool ~ith edequate residual chlorine this occurrence is
probably quite unusuel. The organisms ~hich ceuse the trouble are usually those:
which are already present in the nose or throat of the swimmer and are carried
into the sinuses and midéle ear by veter,

If bathers will recall that they ere no longer as ~ell adapted to ~ater -
as were their ancestors of the Mesozoic Age and will exercise proper precautions,
they may save themselves a good deal of trouble. Then in the pool they should
breathe through the mouth of avoid getting water and nasal secretions into the
sinuses. Estachian tubes, or nasal passages. If they will exhale through both
the nose and mouth they vill have a quicker end stronger exhalation than through
either alone,

The opening of the mouth relieves the undue pressure which may force
infected material into the nasal passages. It also permits air end vater to flow
into the nose end mouth with a minimum amount entering the sinuses and Eustachian
tubes. Improper exhaling “ith the head submerged may cause them to become in-
fected. Vigorous blowing of the nose after emerging from the ~ater may so force
vater into the sinuses and Bustachian tubes that inflammation may result.

In diving the diver should inspire before entering the water and not ex-
hale at all until again on the surface, This vill largely prevent getting veter
into the sinuses and Eustachian tubes. By holding the breath the entire time the
diver is in "high pressure", a nearer equal force is exerted on both sides of the
eer drums, Deep diving causes considerable pressure on the ear drums and thus
forces air out of the Eustachian tubes. “hen the diver comes to the surfece this
pressure is relieved and air again enters them. If the breath is held until
the diver emerges for air less water enters the nasal passages when the Fustachian
tubes are again inflated and the denger to the middle car is correspondingly
decreased,

It would seem that the nerrer constent the inner-outer pressure remains
on the ear drums, ~hen the breath is held in diving, the less sudden the disten-
tion by means of water pressure. “ith no exhalation under water the inner pressure
necessary for nasal expiration which might force water end secretions into the
sinuses end Bustachian tubes is absent.

When the breath is held under ~ater the inner-outer pressure on the ear
drums, though uneven, remains constant so thet there is less reverse distension
than if the exhalation took place below the surface. If on rising to the surface
the diver vromptly expires through both the nose and mouth, the sudden entry
of more air into the Eustachian tubes bv the removal of outer rater pressure
does not cause suction of vater and secretions. Diving feet first may permit
~eater to enter the nose forcibly.

Persons who have had repeated ear infections or recurrent sinusitis should
avoid swimming or exercise special precautions. Those vith damaged eer drums
end mastoid operations are, on the whole, better off out of water. Individuals
“ith colds should not dive and should keep their heads out of the ~ater in swimming,
Yor the benefit of themselves, es well as for the good of others, they should
stay avay from the pool until free of their resviratory infection. Divers should
“ear rubber ceps over the ears or plug them vith greased cotton to prevent in-
fection of the drums end external auditory canals.

Swimming end Skin Disease

Svimming hos a four-fold relationship to sin diseases. It may cause
itching, a pruritis, resulting from contact with water. The condition lasts from
a fev minutes to a half hour. Young edults with dry skin are most subject to this
disturbence, It is usually of no significance end responds well to treatment.