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a small number which required radical mastoid operations - due to
their long-standing chronicity - were healed and "dry" and as a
result, the hearing in most cases was remarkably improved. This
was a great advance in solving what was, up till then, a most
intractable problem, Further, and an important point, the
results, with very few exceptions, were lasting.
Dr. Friel realising that the successful treatment of such
ear conditions as otorrhoea, deafness, etc. depended, apart from
the local treatment of the ear itself also on the recognition and
removal of any complicating factors, frequently present in the
nose and throat decided to recommend enlargement of the scope of
the ear clinic by making it a complete unit for ear, nose and
throat affections. The required equipment for this unit was
installed.
Diseased or abnormal conditions in the nose and throat are by
far the most common factors in the causation of ear disease, and
consequently their successful removal is the first and most
important step in the prevention and cure of deafness. To meet
this situation, special methods of treatment, found to be the most
successful, many of them new and quite different from those usually
employed, were adopted at the clinic. These included,, in addition
to zinc ionization, the new method of diastolization, a French
procedure invented by the late Dr. Gautier of Paris,, and introduced
to London by Mr„ A. G. Wells, F.R.C.S., Ear, Nose and Throat Consultant
London County Council, adopted for the treatment of
certain nasal conditions and impaired hearing: aural suction for
acute otorrhoea: Proetz "sinus displacement" for the diagnosis
and treatment of sinus suppuration. Wells' (New York) nascent
iodine vapour inhalation for infections in the nasopharynx and
sinuses: Peters' tonsil-suction treatment for diseased tonsils,
as well as a number of certain prescriptions and medicaments
found to be of exceptional value.
These methods are still being employed at the clinics,
modified, of course, from time to time, over the years, as experience
in their use and the discovery of new preparations suggest.
Audiometry
From the beginning, the question of impaired hearing played
an important role in the function of the clinic and the school
medical inspections. Special emphasis was laid on the prevention
as well as the cure of deafness for herein lay the best means and
most hopeful prospect of reducing the incidence of defective