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139
has been going on for months, it is found that a good proportion of cases
will clear up in two or three weeks, and will remain healed. The first
attack usually yields more rapidly than a relapse. The first sign of
improvement is a lessening of the nasal discharge and of catarrhal
symptoms of the nose and air passages. We believe that the out-of-door
treatment plays a great part in bringing this about. In infants nursed
at the breast the ability to obtain milk sometimes shows a remarkable
increase in a few days as the nasal passages become free from obstruction.
Nutrition improves and this probably has a bearing on the tendency
of the infection to subside.
If it is obvious that there is obstruction by adenoids, its removal by
operation is advocated as soon as is practicable, and the same is recommended
if otorrhoea persists despite treatment in the open air. The
amount of adenoid growth found as early as a year or eighteen months is
sometimes remarkable. If the discharge persists after the operation,
the treatment by drops and open air is continued. Most cases do heal
on this plan, but a proportion do not, and these are referred direct to a
nose and throat surgeon at a children's hospital, with full details of their
history. It is suggested that in this way a more concentrated attack on
the disease can be instituted than is possible when the child's home is
distant from the hospital, and most of the treatment is bound to devolve
on the parent. The good effect of keeping the child in the open is in line
with what occurs in other respiratory infections and in part is due to the
improvement in nutrition which sets in, especially in the very young.
H. K. WALLER,
Senior Medical Officer.
Free Milk Scheme.
Milk is supplied to expectant and nursing mothers and children
under 3 years of age (in special circumstances 5 years), under the Ministry
of Health Circular 185.
As reported in the Annual Report for 1927, dried milk is supplied
under the scheme, with the exception that Grade "A" (Tuberculin
Tested) milk is supplied in special cases (infants) where the Medical
Officers in charge of the Council's Child Welfare Clinics consider its use
specially desirable.
During the 52 weeks ended 2nd January, 1932, 10,562 applications
for free milk were received, of which 8,816 were granted. (The number of