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136
Annual Report of the London County Council, 1913.
attending the neglect to remedy such conditions. It is the school doctor who is pre-eminently in
a position to arrive at a judgment on these points. Aural surgeons are agreed as to the predominance
of the existence of unhealthy overgrowth of the adenoid tissue of the throat among the causes of
disease of the middle ear in children with consequent suppuration and ear discharge. A considerable
proportion of school children suffer from the latter condition; when established, not only does it lead
to progressive deafness but it also brings about the most profound disturbance of the general health
and it is directly responsible for many deaths in young children from that most terrible of diseases,
meningitis. The presence of adenoid growths apart from production of ear disease of a gross kind is
responsible for attacks of temporary deafness in children. It is a noteworthy fact that in several
cases in which children have been killed by traffic in the street it has been found that the record of
medical inspection shows the presence of adenoids with or without slight deafness. A recurring
transient deafness is thus a particularly dangerous thing in a child. A permanently deaf child is
wary and avoids danger, but a temporarily deaf child is accustomed to rely upon its hearing, and
thus may easily be run over by swiftly moving and heavy vehicles. Apart from the dangers arising
from ear disease and deafness the effect of adenoid over-growths in producing faulty habits of
breathing with consequent ill development of the chest and predisposition to tuberculous infection is
in itself a reason for strongly advising treatment for the condition in all cases in which obstruction to
nasal respiration exists.
Dr. Muirhead
Martin's
report on the
examination
and
treatment of
children in
the Aural
Department
at the
Hackney
School Treatment
Centre
for the nine
months
ending July
3lst, 1913.
In view of the fact that the question has recently been raised as to the advisability of referring
for treatment all children suffering from these unhealthy conditions of the throat the following report by
Dr. Muirhead Martin on the work of the aural department at the Hackney School Treatment Centre
will be read with interest.
In reviewing the results of the examination of children suffering from ear, nose and throat
defects made at the Hackney School Treatment Centre it should be mentioned that the examinations
were systematically carried out, and as gross defects alone were looked for and recorded, the tablets
show only such conditions as were undoubtedly harmful to the boys and girls from the standpoint
both of physical health and scholastic efficiency. The figures under-estimate rather than exaggerate
the amount of disease present. It may perhaps be said that the number of boys and girls examined
is too small to be of great statistical value. Nevertheless the figures do give some idea of the
relative prevalence of diseases of the ear and throat among school boys and girls coming for medical
supervision to a school treatment centre.
There were 162 boys and girls examined and 122 were operated upon for tonsils and adenoids.
Dr. Martin points out that as his report is merely a preliminary one, it is yet too soon to speak in a
final manner concerning good effects which may accrue from the treatment. The method adopted
was first of all to ascertain the trouble complained of by the parents, and then to note the result of the
examination. In 549 per cent. of the cases the mothers had nothing to complain of in the health
of their children, but had simply followed the advice of the school doctor in seeking treatment. In
the other cases the following symptoms were indicated:—
Complaint. Percentage.
(a) Discharging ears 11.7
(b) Deafness 13.5
(c) Earache 4.3
(d) Snoring 3.7
(e) Mouth breathing 1.8
(f) Sore throats 6.1
(g) Nasal discharge 3.08
(h) Enlarged neck glands 1.2
(i) Blocked nose 3.08
(j) Night terrors 0.61
(k) Defective speech 1.8
(l) Difficult breathing 1.8
(m) Sleepwalking 0.61
(n) Irritable 1.2
(o) Cough 1.2
On examination the following conditions were revealed:—
Objective. Percentage.
(1) Rhinitis 35.8
(2) Wax 17.81
(3) Chronic suppurative otitis media 35.8
(4) Adenoids 87.03
(5) Enlarged tonsils 67.9
(6) Enlarged turbinals 37.6
(7) Deflected septum 35.3
(8) Perforation of drum or old cicatrix 6.79
(9) Nasal diphtheria 0.61
(10) Furunculosis (ears) 0.61
(11) Aural polypus 3.7
(12) Eustachian catarrh 0.61
(13) Bifid uvula 1.2
(14) Eczema of ears 1.8
(15) Old mastoid (unhealed) 0.61
(16) Post nasal catarrh 4.9
(17) Conjunctivitis and debility 1.2