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unnoticed by parents), recurring attacks of earache or otitis media
which is often the precursor of serious deafness, nasal obstruction
and its many sequelae, e.g., mouth breathing, impaired hearing,
colds, eye effects, effect on lungs and chest and general health, etc.
" Very often the importance of the early recognition and treatment
of symptoms such as occasional discharge from the ear, sore
throat (often the result of diseased nasal conditions), early cases of
sinusitis (usually referred to by the parents as a ' chronic cold in the
head' or ' chronic catarrh') is not sufficiently appreciated by
parents. All these conditions and symptoms require immediate
correct diagnosis and appropriate treatment to prevent later serious
permanent disability. The aural clinic provides the necessary
examination and treatment and the results obtained have been, in
the main, very satisfactory. It has also the advantage of easy access
for the children, without the risk of long travelling and the minimum
of inconvenience for the parents because the majority of the
children over seven years are able to attend for treatment without
the parents. Practically all the required treatments are carried
out at the clinics and the parents are saved the worry and trouble of
trying to undertake treatments correctly, which is indeed impossible
for them in most cases.
" The majority of children referred to the clinic during the year
were primarily cases of nose and throat affections. The number of
instances of chronic discharging ears now seen at the clinic is very
small, about half a dozen, and most of these are post operative
mastoids of long standing with periodical recurrence of discharge.
For most cases of chronic otorrhoea without mastoid complications,
the zinc ionisation method of treatment is undoubtedly the most
rapid and efficient. Post-operative mastoids with much granulation
tissue are not suitable for ionisation. I have found during the year,
two such cases to do very well and become ' dry' with Chloromycetin,
used locally and daily for 10 to 12 days. It is of course
essential in these cases to see that the naso-pharynx is healthy and
if not the abnormal condition must receive the necessary correction.
" During the course of the year a certain number of children
with impaired hearing were seen at the clinic. In some of these
children the hearing defect was slight but in others well marked.
Except in the case of two patients who had a definite history of ear
disease and previous discharge, the hearing loss in the others was
due to diseased or unhealthy conditions in the naso-pharynx
secondarily affecting the ear. After a course of diastolisation and
ear inflation the hearing loss was restored. Most of these early cases
of deafness without serious complications are amenable to treatment
and will recover their hearing, but it is vitally important that they
should be discovered and treated as early as possible. These cases
are very important, for here is the beginning of chronic deafness
later. The origin is usually an unhealthy naso-pharynx and this