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furnished by the writer, this criterion has been adopted. It
makes the number of chronic cases appear large if one were
to adopt a time limit of weeks or months for the acute condition.
The writer considers the criterion adopted to be more
satisfactory.
"The audiometer has been used to detect cases of defect
in hearing. It has become gradually clear that if we are
to diminish greatly the number of ears suffering from this
defect efforts should be concentrated on examining and
treating the young children. Deafness beginning in the older
children is not so frequent. It certainly sometimes occurs,
e.g., in the acute fevers or in such diseases as influenza. These
older patients are able to make their complaints known and
can ask for treatment. The defects in young children, on
the other hand, have to be detected, and if not detected in
the beginning, life-long defect in hearing is very often
established. A defect, if not treated soon after its onset,
tends to be permanent. Inflammation in a joint if it were
not respected would be permanent, and it is just the same in
the ear with the difference that the inflammation in a joint
is usually the only condition, but in the ear is usually an
extension from the nose or throat. Consequently these must
be treated also. It is quite plain that it is better to treat
the nose and throat before the inflammation has extended to
the ear, and this is the reason why " colds " in the head in
young children should be treated if they do not recover
quickly. A chronic cold, or frequently recurring colds, are
liable to cause inflammation to a greater or less degree in
the ear. If the inflammation is severe and leads to discharge,
we say that the ear is suffering from suppuration. If the
inflammation is not so severe we call it catarrhal inflammation.
Both conditions lead to deafness.
Deafness, due to wax, is easily treated if it is detected.
In 109 patients with deafness detected by the audiometer
it was considered that 45 suffered from deafness due to
catarrhal inflammation and 38 to former or present suppuration;
in four others there had been suppuration in one ear
and catarrh in the other. Twenty-two were due to wax."
(g) Dental Defects.—Staff: Circular 1444 issued by the
Board of Education on the 6th January, 1936, states that
Authorities should aim at securing an initial dental inspection
of every child on its entry to school life, to be followed by
an annual re-examination until the child ceases to attend
school. On this basis the Board estimate that, with a normal
number of acceptances for treatment, a minimum standard