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up of chronic suppurative otitis media, and its allied complications, by
his introduction, for the first time of the zinc ionization method of
treatment. At that period there were in these areas, as in many others
throughout the country, an enormous number of chronic discharging
ears among the school population for whom there was little or no
effective treatment. These areas with one or two others in outer London
(Wood Green and Walthamstow), became the pioneer centres for the
establishment of this new method of treatment under the care of Mr.
Friel. The excellent and rapid results obtained by ionization, indeed
in very many instances, spectacular, in the clearing up of the majority
of those hitherto "incurable" cases of chronic otorrhoea are now well
known and have been widely published in medical journals and in
leading text books both here and in America. In the course of a few
years the many cases of chronic discharging ears among school children
in these Boroughs had considerably lessened. Since that time and with
the marked reduction—almost disappearance—of chronic otorrhoea,
the scope of the work of these special aural clinics has extended into a
much wider field. A very important advance was made when it was
decided to include in the scope of the E.N.T. Clinics, the pre-school
child.
While the early work of these clinics was concerned mainly with the
most urgent problem of clearing up the existing mass of chronic ear
disease it was also apparent that its cause and chronicity was closely
related to general ill-health and abnormal conditions of the nose and
throat. In a large number of instances these complicating conditions
required attention and correction before it was possible to effect a
permanent cure of the chronic ear disease. In order to maintain the
success now achieved of practically freeing the school population of
chronic otorrhoea and its disabilities it became necessary that the work
of the clinics should be widened to include the treatment of any diseased
conditions of the ear, nose and throat common among children. Among
the abnormalities referred to here, and common among school and preschool
children are "nasal obstruction" and its many wide-spread effects;
infection of the nasal sinuses; rhinitis in its different forms; recurring
sore throats (usually secondary to untreated nasal disease); acute
infection of the ear, with or without external discharge.
At present and for a number of years past the work of these aural
clinics has included the examination and treatment of the common
affections of the ear, nose and throat in school and pre-school children.
Cases requiring operative in-patient treatment, of which there are
relatively few, are referred to hospital.
Reviewing the work of the aural clinics during the year 1954, I find
that the nature of the defects found among those children referred to
the clinic, and the methods of investigation and treatment follow much
along the lines of previous years. One very noticeable fact in these
clinics is the extremely few cases now seen of chronic otorrhoea. This is
a most important advance in the reduction and prevention of deafness.
Certain factors have materially contributed to this near diappearance of
chronic otorrhoea, namely, the discovery and successful treatment of
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