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The first case on which B.I.P.P. was used was an old Tubercular double Mastoid of
6 years' standing. This case is given at length below. It was seen almost daily for some time
so as to watch the reaction to B.I.P.P. The result exceeded all expectations, as in one
application the discharge almost ceased and all smell vanished. As the condition improved
and fewer treatments were necessary (twice weekly and finally once weekly) the child was at
last able to forget her ear, with very good results on her psychological and also her physical
condition until unfortunately later she showed signs of abdominal Tuberculosis.
Twenty-one cases in all (19 Otitis Media and 2 of post Mastoidectomy discharge) were
treated with B.I.P.P. last year—14 treated with B.I.P.P. only and 7 long standing cases
which had had other treatment. These are detailed below.
Of the 14 treated with B.I.P.P. only—12 cleared up entirely, and up to date (March,
1933) there has apparently been no recurrence, i.e., children have not been sent again to the
Clinic.
Four children had one application.
Six children had two applications.
One child had three applications.
One child had five applications.
Of the remaining two, one had 9 applications and had not completely cleared up when
he left school, although there was only an occasional small amount of discharge. The other had
one application, and 7 days later there was no discharge—the child was then absent from the
Clinic and turned up again early in 1933 with slight discharge, having had Influenza in the
interval.
Although the 12 healed results are satisfactory, one cannot say that they would not
have cleared up in the same amount of time with other treatment, but it is absolutely certain
that they would not have done so with so few treatments. Hydrogen Peroxide requires at
least daily treatment at the Clinic, and usually has to be used once or twice daily at home.
It would be very rare for a case to clear up within a week, and most of them drag on for very
much longer, making a large number of treatments.
Of the seven old standing cases, two were discharged as healed, three remained with
the ear moist and occasionally slight discharge and two went to hospital for other complaints
with the ear still discharging. The number of applications, however, was much greater than
those in which B.I.P.P. only had been used. See details below.
In all the cases treated, only one child complained of the ear running during the interval
after treatment. In cases where discharge persists it is of a mucoid character, and does
not overflow into the meatus, and there is no unpleasant smell, therefore the children and
their associates can forget that the ear trouble exists. This is an enormous gain—the sight
and smell of a child with aural discharge is definitely offensive, and Hydrogen Peroxide only
removes the smell for a short time, and it recurs with fresh discharge which soaks up the
wool plugs. Consequently such children tend to be shunned, and even their parents complain
bitterly about the smell. The psychological effect on a sensitive child must be definitely bad,
and the incessant treatments necessary to keep an ear clean are wearisome to all concerned.
B.I.P.P. does away with all this—children are seen once or twice weekly at the Clinic and
treatment given when necessary. There is no treatment at home, no smell and in most cases
no appearance of discharge.
Summary.
1. B.I.P.P. has not proved a perfect cure for discharging ears, but it does at once
ameliorate the condition and effects a cure at least as quickly as other agents used at the
Clinic.
2. It reduces the number of treatments enormously, which is of great value in saving
the Nurses' time at the Treatment Clinics, and since the child attends Clinics less often there
is less disturbance of School Attendance.
3. It does away with treatment at home which is an advantage, as home treatment
is often neglected or inadequately performed.
4. It removes all offensive smell at once and permanently.
5. In most cases there is no visible evidence of discharge from the beginning of treatment,
and therefore no outward sign of aural trouble.
Old Standing Cases Treated with B.I.P.P. after other Treatment.
G.M. (17.7.21).
1926 Profuse discharge right and left—sent to a London Hospital.
1927 Double Mastoidectomy, considered Tubercular—later sent to Convalescent Home.
1928 Both ears continue to discharge.
1929 having Out-Patient treatment (Ultra Violet and Ionisation) at nearby hospitallater
returned to Ear, Nose and Throat Hospital in London for further operation.
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