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in each case, the cause of chronicity, the number cured, the number referred
to hospital for a mastoid operation, the number of "lapsed" cases (i.e., those who
left school while treatment was in progress or for some other reason were lost to
view), and the number still under treatment at the end of the year. From these
figures it will be seen that the percentage of "cured" cases, after deducting those
that lapsed, is 66 per cent., or including the "cured" cases operated on for mastoid
diseases, 71.7 per cent.
The following are the details of the work done at the After-Care Clinic, Kentish
Town, in connection with the mastoid cases:—
Patients. Ears.
(a) No. of cases discharged from Downs Hospital in 1928 193 214
(b) No. of cases discharged from Downs Hospital in 1927 and
treated in 1928 50 59
1928 Cases—
No treatment required after leaving Downs Hospita 11 12
Treated at Kentish Town and "cured" 93 99
Treated at L.C.C. clinics and "cured" 8 11
Still under treatment at Kentish Town 69 80
Still under treatment at L.C.C. clinics 3 3
Referred back to Downs Hospital for further operation 6 6
Lapsed 2 2
Not yet attended 1 1
193 214
1927 Cases continuing into 1928—
Treated at Kentish Town and "cured" 45 54
Referred back to Downs Hospital for further operation 2 2
Lapsed 3 3
50 59
Cases not operated on (1928)—
Treated at Kentish Town and "cured" 48 55
Still under treatment on 31st December, 1928 18 22
There were 214 mastoid operations done during the year 1928 at the Downs
Hospital.
Diastolisation.
It will be remembered that this method of treatment for various nasal conditions
was introduced in the year 1926. The most suitable conditions are those
of defective nasal respiration due to inflammation, congestion and swelling of the
soft tissues of the nasal chambers. It is surprising how common these nasal conditions
are in the London County Council school child, and they are mainly due to
the lack of proper attention to ordinary nasal hygiene and the neglect of common
catarrh. The opinion is held that, not only would these nasal conditions be less
frequent, but that the sequelae such as adenoids, otorrhœa, etc., would have a lower
incidence if the principles of nasal hygiene formed a regular part of the child's education,
if the children were taught to keep their noses in a cleanly state and to breathe
habitually through the nose. Generally insufficient attention and time are devoted
to this subject, and it is urged that a progressive policy be adopted along these lines.
Further, among the children suffering from these conditions, experience of the
use of diastolisation has been sufficient to support the view that great improvement
may be produced, and frequently complete relief, by the employment of this technique.
It is surprising how some habitual mouth breathers—due to various degrees of nasal
obstructions—acquire the ability to breathe nasally after a few administrations of
this treatment. It would be well to see this method very greatly extended, as it is
employed in Paris, where there are special clinics for diastolisation for the school
children.
Out of a series of 85 cases suffering from some of the many symptoms associated
with catarrhal conditions and obstructions 45 were completely relieved, 25 were