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250
IONIZATION CLINIC,
This Clinic for the treatment of chronic otorrhœa was opened
in July, 1928, and Dr. J. D. MacLaggan, of the London County
Council, was appointed the part-time specialist officer. I am
indebted to Dr. Watson, the deputy school medical officer, who
is in charge of the Clinic, for the particulars given below.
The continuous nature of the treatment and observation of
cases makes a report on the work of any one year unsuitable or
even impossible. This report, therefore, refers for the most part
to the work of the Ionization Clinic since its inception in July,
1928. Sessions have been held weekly in 1930, and there has
been no lack of patients. It was hoped that as time went on a
dwindling waiting list would allow of regular reinspection of old
cases. This hope has been only partially realised. At one time
during the year the waiting list was reduced and old cases began
to be called up, but with a persistent influx of new cases it is now
only possible to see a few old cases at irregular intervals, and it
is not possible to see every old case at intervals of six months, as
is desirable. At the end of the year there were 31 cases on the
waiting list. The continuous flow of fresh cases is somewhat
astonishing after the existence of the Clinic for two and a half
years. There is certainly a definite improvement as regards duration
of the disease (see Table XXVI), but many long-standing
cases are still brought to light. It would be almost impossible
without a special investigation, involving the examination of all
school children, to estimate the incidence of otorrhoea in the
school population. Figures obtained at routine inspection are
misleading because, if the condition is quiescent or intermittent,
interrogation is the only means of ascertainment, and neither
children nor parents give reliable information about otorrhoea.
Many of the cases coming on the waiting list are intermittent,
thus accounting for the continued influx of old chronic cases as
activity recurs. Also, otorrhoea is accepted with such unconcern
by some parents that treatment is not sought, and it is only the
coincidence of a school inspection with activity of the otorrhoea
that enables the case to come under treatment.
Before showing statistically the work of the Clinic it is permissible
to give a general impression of its value and at the same
time refer to the important period between the times when the
respective terms "dry at end of treatment" and "cured" can be
used; a period which is all-important to the clinician in his assessment
of results, but which is difficult to portray statistically. A