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112
As far as suppurative otitis media is concerned, the picture
is not very clear but it does appear to be a continuing cause of
deafness. Clinical impressions lead one to believe that the
disease, at least in its chronic form is less common and more
efficiently treated and it is to be hoped that fewer cases will
require to attend special schools in the future.
Admissions then are likely to be more and more confined to
the group of congenital defects, It is of interest to note that
in no case of the group of congenitaily deaf children (Table A)
did the mother give a history of rubella in pregnancy, and in only
one case (in the nursery group) was there a history of erythroblas
tosis foetalis, a much more easily diagnosed and remembered
condition. Of course, congenital deafness of hereditary origin
is often a diagnosis of exclusion but it is of interest to note
that of the 25 cases of congenital deafness (Table A) ten gave a
family history and of the remainder four were Jewish children.
As far as absolute numbers are concerned, the above considerations
would lead one to expect a drop in the total number of deaf
children but the national figures (Health of the School Child
1954 55) do not yet support this and perhaps it is too soon to
expect it. It may be, too that fuller ascertainment partially
accounts for this.
The Physically Handicapped Child

Only in groups 4, 6, 9 and probably in 5 and 8 can there be
said to be an infective origin, a total of only 9 out of 46 children.
All of these groups show a declining incidence, apart from poliomyelitis
which will probably give way soon to prophylactic technique.