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26
APPENDIX I.
REPORT by Mr. A. R. FRIER, Aural Surgeon.
It is interesting to notice the change in the complaints
treated at the Aural Clinic from the time when it was begun in
in 1921. It was opened then for children suffering from chronic
otorrlirea, and equipment was provided for treating suitable cases
by zinc ionization. Every ear was examined to ascertain what
was keeping up the suppuration, and if this was found to be
sepsis in an accessible position, the ear was treated at the ( linic.
If it was found to be sepsis in an inaccessible position, such as
the mastoid, the parent was told that an operation was needed
in hospital. It was left to the parent to decide which hospital
to take the child. Also it was impressed on the mother that
there was not much difficulty in having the operation done, but
that the after-attendance would impose a severe strain on her
and that if, owing to distance or to the care of a number of young
children, her attendance could not be regular, it would be better
to defer the operation till the child was older and able to go on
its own. Very few mothers of children in elementary schools
have maids and if the mother has to leave home for several hours
regularly the work of the home becomes disorganised, meals
unsatisfactory, and the health and comfort of all the members
suffer. The actual time spent on dressing the ear is not great,
but the delay in waiting for this is often great. It leads to
irregular attendance, and an unhealed mastoid operation means
more suffering than a mastoid which has not been operated upon.
When the cases at the Clinic of long-standing otorrhoea had
heen disposed of, there was opportunity for every child to be
treated within a few days if he suffered from discharge from the
ear. It was then easy to treat, and in the majority of cases
ceased in a short time.
Opportunity was then available for children — babies and
todrllers—attending at infant welfare centres to be treated at the
School Aural Clinic. Lifelong ear trouble often begins in the
Pfe-sehool age. Measles, scarlatina and colds are attended with
inflammation of the nose. Little children who suffer from these
r,ften get their noses blocked by the inflammation and by the
discharge, which cannot escape freely either by the nostrils or