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79
faults that have escaped the notice of the most observant mother.
Because prevention is so much less spectacular than cure, an
atmosphere of confidence and efficiency is essential to retaining
that intangible but important thing, the goodwill and cooperation
of the laity.
So far as orthopaedics is concerned, I think that the
essentials to success are the following :—
(1) Careful inspection of school children and infants—which
involves a certain discrimination between the trivial and the
significant departures from the normal. It is now known, for
example, that so-called flat foot may be ignored if a child walks
normally, wears his shoes evenly, and has no pain or rigidity of
the feet. On the other hand, a little pain in the hip always merits
serious attention.
(2) The intelligent conduct of the orthopaedic clinic. It is
essential that the nature of a potential deformity be explained,
in simple language, to the parent in every case. This generally
ensures friendly co-operation. The conditions grouped under
that strange word orthopaedics, are so diverse that I doubt if
we shall ever be able to tell the public very much by means of
the pamphlets so valuable in the prevention of diphtheria, or
dental disease. The spoken word is best.
(3) The demonstration that treatment given at the clinic
produces results. This is a most eloquent appeal; it is here
where an attractive well-equipped clinic is so valuable, and the
treatment must be in the hands of a competent masseuse. These
conditions are now happily fulfilled at Brentford. Although
good buildings are not essential to the practice of good medicine,
one cannot but regard an imposing health centre as a great asset.
(4) In the comparatively few cases where hospital treatment
is required, the treatment should be such that the patient and
his relatives will have the highest regard to the hospital and the
clinic working with it.
In these ways we shall give to orthopaedic surgery its proper
place in the scheme of preventive medicine.