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These figures are very interesting in view of the fact that only
33 cases of chronic otitis were found in a total of 396 children
referred to the aural clinic. The number of cases of chronic
otorrhœa has declined remarkably in the last decade and this
decline is mainly due to the concentration of attention on the
early recognition and efficient treatment of otitis in its
earliest stages and especially on the treatment of the predisposing
factors to this condition, especially affections of the nose or
throat. The largely increased number of children, many under
school age, now seen and treated for nose and throat affections,
has a very important bearing on the number of otitis cases
occurring in the school population. Preventive treatment and
treatment in the very earliest stages is strongly emphasised in
the whole school medical routine. The detection of defects
amongst school children is always important but prompt and
practical treatment is doubly important.
Unfortunately, a pood deal of disorganisation affected the
clinic, like all the other clinics, during the year, on account
of the persistent bombing which went on during most of the year.
Large numbers were evacuated, which interupted the set course of
treatment, and various attendances were not kept owing to
immediate local raids and bombs, so that we found an unduly high
number of children could not complete their treatment. It is
hoped that we will be able to contact most of these cases in the
coming year as they return and sessions become more normal, and
resume, where necessary, the suspended treatment.
The main princirles of treatment have been carried on as in
previous years. We would wish to call attention here to the
marked improvement in the successful treatment of acute otorrhœa
by the use of suction. The prompt cure of acute otorrhœa is
so important that we now insist on every case, where it is
possible, attending the clinic for special treatment. The
customary method of giving the parents "drops" and directions for
use at home is not satisfactory, as the majority of the parents,
with the best intentions, are not able to carry out the
essential details necessary for successful treatment. The clinic
has every facility and the staff are trained in this particular
work and the end results are altogether much more satisfactory.
The suction method is a valuable accessory to our equipment.
The middle ear can be emptied of the irritating discharge, the
perforation kept patent to allow drainage and a mild protective
inflammation produced which helps healing considerably and a
better contact allowed between the antiseptic used and the
affected parts. For chronic otorrhœa we invariably use zinc
ionisation with adjuncts such as silver nitrate cautery,
antiseptic packs, Sulzberger powder in the cases of old post
mastoid operations, with granulations etc. For rhinitis and
nasal catarrh the Gautier method of Diastolisation is largely
employed with or without installations of colloidal silver.
We have treated during the year, 46 cases of 'unhealthy' or
hypertrophied tonsils by conservative methods; tonsil suction,
(1eters method); tonsil painting combined with nasal treatment.
The conservative methods., especially suction, has a definite
place in the treatment of tonsils In suitable cases the
results are remarkably good 46 cases of diseased tonsils were
referred for operation, but nearly half this number were those
from the waiting lists of previous years which had to be cleared
up. In certain instances amongst very young children where the
tonsils and especially the adenoids have become, as a result of
their hypertrophy, definitely obstructive and are diseased, there
is no satisfactory alternative to removal.
Taking the total number of children seen during the year
generally, we must say that the general standard of health,
physique, nutrition has been well maintained and quite satisfactory
we have not noticed any obvious deterioration in general health,
10.