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Asthma and Allergy Clinics
I am grateful to Dr. R Prothero, MD, LRCP, LRCS, DCH,
senior departmental medical officer for the following report
The number of cases supervised at the allergy clinic
remains at approximately 150, of these 36 were new referrals.
The most frequent allergic factors in new cases as
evidenced by skid testing were the grass pollens (40%) and
the house dust factor (60%). In only 20% were other
inhalants incriminated, though skin tests over a whole range
of inhalant factors were carried out.
Five of the more serious cases of pollenasthma had
pre-seasonal injections with Alavac-P and in 4 the result was
most successful. The failure was in a girl with marked
vasomotoric coryza even on days of low pollen count - it
finally emerged that she had been working in a pet shop
during the weekends in the summer season! Desensitisation
against dermatophoagoides is under consideration, as the
usual advice re 'dustcontrol' does not necessarily cause
abatement of the symptoms. INTAL remains THE
preventive against extrinsic asthma and has proved
successful in exertion induced bronchospasm, so that
children can lead a more normal sportive life, if the
Spinhaler is used prior to anticipated exertion.
All new patients with moderate and severe asthma
receive regular physiotherapy with marked subjective and
objective improvement as noted by the increase in the peak
expiratory flow rate.
Recently two cases of dermatitis were seen, where an
enzyme containing washing powder seemed responsible for
the extensive skin irritation.
A completely satisfactory treatment for Eczema itself,
though it is usually kept under control by hydrocortisone,
continues to elude the allergist.
Hearing Clinic
The number of cases seen at the Hearing Clinic during the
year was 831 of which 420 were new cases and 411 were
cases for re-examination. Due to staff changes the total
number of all children seen was reduced during the year
although the number of new cases seen had increased
significantly.
The practice of screening all children entering primary
school by screen audiometry was continued. The children
who fail the audiometric test are referred to the school
medical officer who decides whether the child should be
re-tested in the school clinic or referred for further
investigation. The number of tests performed during the
year is shown in Table 1.

The children seen in the chool clinic for special audiometry
were referred by school medical officers, speach
therapists, general practitioners and from the school
psychological service as shown in Table 11.

The audiometricians took a total of 533 impressions
during the year for use with hearing aids. 83 Medresco
(N H S) aids were issued during the year and 424 aids were
replaced or exchanged. A total of 20 commercial aids were
issued, 1 post aural and 19 body worn.
During the year the children at the Lindon Bennett and
Oaklands Schools were screened for a hearing loss by the
audiometricians, 50 hearing tests were performed and it
was necessary to see some of the children more than once
to make a satisfactory assessment of their hearing.
Mr. Wall senior peripatetic teacher of the deaf made a
total of 1134 visits to homes and schools during the year
He is responsible for hard of hearing children in both
Hounslow and Ealing. 15 children attend secondary school,
44 attend primary schools and 14 children of pre school age
were visited. Seven well attended parents' meetings were
held, enabling parents to discuss common problems.
During the year Mr. Wall spoke on parent guidance and
child management at six conferences and courses.
Dr. Fisch completed his work as chairman of the working
party on Old Age Deafness during 1971 and a report was
sent to the Ministry. Dr. Fisch is chairman of the
Association for Films on Hearing and Deafness. A film
was made in the clinic and special schools titled "How Deaf
Children Learn to Speak". The teaching activities of the
clinic continued, post graduate doctors from the Wolfson
Centre spent a day at the clinic also medical students from
St. Bartholomew's Hospital attended the clinic. Groups of
speech therapists and midwives also attended as observers
and groups of 8 students attending the London course for
teachers of the deaf visited the clinic as did students of the
Maria Gray College. At the request of the London Borough
of Hillingdon Dr. Fisch and Dr. Jepson spoke to Health
Visitors on the early detection of hearing loss and at the
request of the London Boroughs Association a two day
course was held in February for Health Visitors. A one day
symposium was also held in February for speech therapists
and in October a one day conference for the head teachers
of local schools was organised in an attempt to discuss the
problems of deaf children in normal schools.
Visitors from many parts of the world visited the clinic
during the year, these included members of the teaching
profession, doctors and administrators who were interested
in the working of an audiology unit.
There are now a greater variety of hearing aids available
with various possible combinations which fulfills the needs
of most types of deafness in children and therefore it is not
now necessary to issue so many commercial aids as in the
past. The difficulty in obtaining satisfactory inserts still
persists. We are investigating alternative arrangements for
the processing of inserts particularly of processing them at
the clinic.
Another booklet to assist the parents of hearing impaired
children by Dr. L Fisch has been added to our list, this is
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