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4. Analysis and Comparison of Results.
No. of
cases: 1955 1954 1953 1952
(i) Completely dry 25 = 38'5% 41-6% 30% 22%
(ii) Very marked improvement 6
(i.e., less than 5 wet in 28 nights)
(iii) Marked improvement 9
(i.e., less than 14 wet in 28 nights)
(iv) Some improvement 9
(v) No improvement 7
(vi) Not yet re-attended 11
67 cases
(vii) Of the cases referred to the Clinic during 1954 and who were still
receiving treatment in 1955, a further 28 were discharged dry.

5. Conclusions.—It is interesting to note that in each year the
number of boys referred to the Clinic is approximately twice the number
of girls.
As in previous years, five factors have been common in those cases
which have been slow to improve, namely:—
(i) Frustration either at home or at school.
(ii) Overcrowding at home.
(iii) Mismanagement (by one or both parents).
(iv) Physical defect (this is uncommon amongst enuretics seen
at Ilford).
(v) Mental retardation.
The home background is invariably important in the etiology of
intractable cases, and where it has been possible to alter environment or
circumstance, there has often been a corresponding improvement in the
child's condition.
There still remain the few cases which, in spite of a good home and
co-operative parents, have been slow to respond. One of these cases was
treated (in co-operation with the General Practitioner concerned) with
"Disipidin" (posterior pituitary snuff) but no improvement occurred in
this isolated case.
In those cases which have responded, the "early-waking routin" has
revealed a considerable number of pre-waking enuretics.
Treatment with Amphetamine Sulphate.—During the last three
years, results have shown that if a dramatic response is going to occur,
it usually shows itself by a half to three-quarters of the number of nights
becoming dry by the second month of treatment.