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59
district in London, complaining that, although the child was teething,
there was no discharge from the ears as had been the case with
all her other children.
It is of interest to look through our school reports and in the
earlier ones we find the same sort of story. In 1908 we were complaining
that treatment was difficult, as the children had suffered
for years from the complaint and it was hard to convince the
mothers that the disease was not a necessary accompaniment of
teething and bronchitis.
Frequently the smell was so objectionable that the teachers
requested us to exclude the children from school attendance, and
occasionally this was adopted, but we found this of little service
as no complaint led to such a prolonged absence from school.
One of our difficulties in those early days arose from lack
of co-operation from the mothers, and their diffidence in obtaining
treatment. The first step to improve matters was taken in 1910
when a school nurse was appointed, but we soon found that the
mothers did not cany out the instructions of the nurse, and the
nurse herself could only carry out a part of the treatment. A second
nurse was apointed in 1913, and arrangements were made for the
children to come to the office daily to have their ears syringed. In
1914, the Minor Ailment treatment centre was opened, and since
then a great improvement has occurred. Arrangements were subsequently
made for the examination and treatment of cases by a
-pecialist, and our cases showed a welcome diminution in the number.
The same method of running the Ear Clinic has been followed
this year as previously, and the results have well repaid the labour
which has gone to making the work a success. As will be seen
from the subsequent analysis of cases, children are being sent for
examination on the slightest suspicion of ear trouble, as it will be
noted that many who are referred to the Clinic are found not to be
suffering from ear disease at all. Those who are found to be so
suffering are examined, treated, visited and not lost sight of until
they are either well or are referred to a specialist, if it is found that
success is not attending the efforts of the Clinic to cure the complaint.
There are two types of cases which constitute a problem
to any Ear Clinic. The first is the intermittent discharge which
clears up completely but begins again when the child gets a head
cold with infection extending to the middle ear. It is not always
easy to convince the patient and its parent that the nose treatment
advised is as important a part of the cure as the local treatment to