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suppurative otitis media and its allied complications, by his introduction,
for the first time of the zinc ionization method of treatment. At that
period there were in these areas, as in many others throughout the country, an
enormous number of chronic discharging ears among the school population for
whom there was little or no effective treatment. These areas with one or two
others in outer London (Wood Green and Walthamstow), became the pioneer
centres for the establishment of this new method of treatment under the care
of Mr. Friel. The excellent and rapid results obtained by ionization, indeed
in very many instances, spectacular, in the clearing up of the majority of
those hitherto 'incurable' cases of chronic otorrhoea are now well known and
have been widely published in medical journals and in leading text books both
here and in America. In the course of a few years the many cases of chronic
discharging ears among school children in these Boroughs had considerably
lessened. Since that time and with the marked reduction almost disappearance
- of chronic otorrhoea, the scope of the work of these special aural
clinics has extended into a much wider field. A very important advance was
made when it was decided to include in the scope of the E.N.T. Clinics, the
pre-school child.
While the early work of these clinics was concerned mainly with the most
urgent problem of clearing up the existing mass of chronic ear disease it was
also apparent that its cause and chronicity was closely related to general
ill health and abnormal conditions of the nose and throat. In a large number
of instances these complicating conditions required attention and correction
before it was possible to effect a permanent cure of the chronic ear disease.
In order to maintain the success now achieved of practically freeing the
school population of chronic otorrhoea and its disabilities it became
necessary that the work of the clinics should be widened to include the treatment
of any diseased conditions of the ear, nose and throat common among
children. Among the abnormalities referred to here and common among school
and pre-school children are 'nasal obstruction' and its many wide-spread
effects; infection of the nasal sinuses; rhinitis in its different forms;
recurring sore throats (usually secondary to untreated nasal disease); acute
infection of the ear with or without external discharge.
At present and for a number of years past the work of these aural
clinics has included the examination and treatment of the common affections of
the ear, nose and throat in school and pre-school children. Cases requiring
operative in-patient treatment, of which there are relatively few, are
referred to hospital.
Reviewing the work of the aural clinics during the year 1954, I find that
the nature of the defects found among those children referred to the clinic,
and the methods of investigation and treatment follow much along the lines of
previous years. One very noticeable fact in these clinics is the extremely
few cases now seen of chronic otorrhoea. This is a most important advance in