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between the school medical and child welfare services and make provision
for the inclusion of pre-school children in the specialist school clinics.
This is important particularly in the case of the detection and treatment
of defective hearing and its potential causative factors.
It is very gratifying to be able to record that Tottenham was again
among the earliest authorities to make provision for the inclusion of
infants and pre-school children in its ear, nose and throat clinic scheme.
The wisdom of this decision has been amply proved over the years in the
results obtained by the discovery and removal of many defects in their
early stage in pre-school life, which, if left untreated, would have insidiously
progressed into a state of chronicity by the time the children
had reached school age and this advancement of the disease, in certain
instances, would inevitably tend to make its final cure much more difficult
and uncertain.
At the present time and for a number of years past the ear, nose and
throat clinic provides for the examination and treatment of all children,
infants, pre-school and school. It is fully equipped to deal with the
varying ear, nose and throat diseased conditions met with among these
children, with the exception of those cases, a small number, which require
operations in hospital.
The defects most commonly found among the clinic patients are those
due to the ill effects of 'nasal obstruction', such as deficient nasal respiration
and mouth-breathing; rhinitis in its different forms, sinusitis,
impaired hearing, otitis media (with or without discharge), functional
hypertrophy of tonsils, etc. Cases of chronic otorrhoea which used to be
very common some years ago have become greatly reduced and only a
comparatively small number is now seen.
A detailed account of those various ailments, their effects, immediate
and remote, complications and treatment is not included here as this is
not intended to be a clinical article.
Local authority specialist clinics conveniently situated have many
advantages. The travelling problem, as regards safety, distance and
time is much less acute than if these young patients were obliged to
attend, say, the out-patient department of a hospital. At the local clinics
children may attend for treatment, by themselves after the first one or
two attendances with a parent, thus saving the parent's time.
A most important point is that the administration of these clinics is
under the supervision of the school medical officer who is well acquainted
with the particular conditions of the patients attending and the treatment
given, and can link this up with his general overall direction of the public
health of the community for which he is responsible as medical officer
of health.
Further, the full clinical records of all the patients attending the clinic
are within easy access of the medical officers and staff when an urgent
enquiry is made for the clinical record of any child, as often happens".
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