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For cases of chronic otorrhœa (chronic 'running'
ears), which are now very few, zinc ionisation is regularly
employed with satisfactory results.
The greater proportion of children seen were those
with affections of the nose and throat. Nasal catarrh,
rhinitis and 'mouth breathing' form the largest number
of these cases. Sinus infection was also found in a relatively
considerable number. All these cases were
treated at the clinics during the year. Diastolisation, a
French method of intra nasal massage, has been used here
extensively for nasal catarrh, rhinitis, mouth breathing,
deafness, etc., and the results have been remarkably good.
For the 'sinus' Proetz 'nasal displacement' method is
employed; this is a comparatively recent and valuable
method of diagnosing and treating sinus infections.
A conservative line has been adopted in regard to the
operation for the removal of tonsils. I have found that
a very large number of children who have had tonsils
removed for one reason or another, have derived little or
no benefit from the operation and indeed, frequently, the
condition sought to be improved by the operation is
aggravated. 'Enlarged tonsils' is not a local disease,
per se, just confined to the tonsils, but usually the sequel
to a descending infection from the nasal accessory sinuses.
The tonsils function as a protective trap to prevent free
spread of infection into the general system. They also
serve in children, the purpose of producing an autogenous
immunity and resistance to bacteriological infections.
The complete extirpation of organs of such importance is
a serious consideration, and the removal of tonsils alone,
without adequate attention to the factors involved in the
production of this condition, is meaningless and unscientific.
A very thorough examination is made of each case
of 'suspected' tonsils and adenoids, both throat and nose,
and a careful account is taken of any present or previous
throat or nasal defect. Mere enlargement alone, unless
so gross as to cause obstruction, is not taken as an