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14
Ear Disease and Defective Hearing.—I am indebted to the
Education Committee's Aural Surgeon, Mr. F. P. M. Clarke, for
the technical material contained in this Report.
The Aural Clinic has been conducted along similar lines as
regards organisation and treatment, to those established and practised
in Tottenham for many years by Dr. A. R. Friel, who retired at the
end of 1937. His pioneer work and the successful results of his
special line of treatment are well and widely known and plainly
manifest here in the rapidly diminishing number of chronic cases
which are found, after careful Routine School Inspection.
A factor of very great importance is the provision made in
Tottenham for the treatment of infants and pre-school children
at the Aural Clinic. It is well known that the majority of chronic
ear, nose and throat defects found in school children and adults
have their origin in pre-school life, chiefly as a sequel to the
exanthemata. Thus where the condition has been neglected or
inadequately treated in early life, the result is that when the child
reaches school age the defect is already firmly established and chronic,
leaving the hearing permanently impaired in direct ratio to the
progression of the disease. The Medical Officer of Health has
arranged for the departments concerned with infants and pre-school
children to refer all cases of ear, nose and throat affections to the
Aural Clinic; for when these defects are discovered in the early
stages and receive appropriate treatment, over 90 per cent, are
cured without any permanent impairment of function. The prevention
of chronicity and its sequelae in discharging ears almost
entirely depends on the correct and skilled treatment of the disease
in its early stages. Emphasis must be placed on the great advantages
of the Aural Clinic, for only too often, when treatment is prescribed
at home, it is neglected or imperfectly carried out, whereas the
treatment at the Clinic is carried out by those skilled in this work
and the patient is under constant observation.
The same Nurses who attend with the Aurist at the Clinic
sessions are also in charge of the continuation Treatment Clinics,
where the prescribed treatment is carried out. This arrangement
is ideal. The Nurses, who are trained in the work, see the cases
from the beginning and have personal instructions from the Doctor,