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knows that earlier and more efficient treatment is being obtained
now, and many cases clear up before reaching the Ear Clinic.
Although otorrhœa remains a difficult disease to cure it is being
approached in a more active and hopeful way now than formerly.
It is also reasonable to assume that the earlier and better treatment
of septic tonsils and adenoids will prevent a certain amount of
otorrhœa. The comparative mildness of scarlet fever is another
factor which must operate favourably.
The thirty active cases were treated as follows:—
Two were ionised and the discharge ceased; in one case
after one application, in the other after two.
Nine were treated by the iodine and boric powder, and
all cleared up.
Eight cleared up without any special treatment.
Five were referred for removal of tonsils and adenoids.
Three were referred to the Croydon General Hospital.
Two are still under treatment.
One left the Borough.
Besides the two new active cases referred to above, eight
others were referred to the General Hospital. All attended.
Ionisation of a few cases in the Borough Hospital has been
done during the year. The chief impression gained is that the
treatment of otorrhœa in a fever hospital and at a school clinic
are two very different things. At a school clinic one applies
ionisation once a week, and a dry ear after two, three, or four
applications is considered satisfactory. In the fever hospital every
week added to the normal period in hospital is serious, both to
the hospital and the patient or his relatives; so that a dry ear after,
say, three weekly applications, is a different matter. In hospital
it is possible to apply the careful daily cleansing and application
of drops or powder that cannot be so readily applied outside. However,
one ionisation in favourable cases often suffices, and it is
worth while applying it after the acute stage has passed, if there
are no complicating factors, such as enlarged tonsils or adenoids.
The iodine and boracic treatment carried out is as follows:-
The powder consists of iodine resublim. grs. 3.6 and boric
acid powder to one ounce. The iodine is rubbed down in a mortar
with a few drops of spiritus vini rect. until solution is effected,
and this is gradually incorporated with the boric acid. The powder