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95
with and upset these normal functions in later life are clearly discernible on close
examination of the nose and naso-pharynx during school age.
"Nasal obstruction" on account of its far-reaching and serious effects is
perhaps one of the most frequent and important nasal defects to look out for during
a school child's medical examination. It is very common and is, unfortunately,
only too frequently overlooked.
It is surprising how little understood are and how little attention is given to
the widespread detrimental effects of defective nasal breathing; and it is all the
more so when it is realised that a large number of the symptoms of nasal obstruction
and impaired hearing originate during childhood and if at this stage were detected
and correctly treated the whole train of widespread ill-effects and disease set up
by their progressive development could be eliminated.
It is well to emphasise here the importance and urgency of "following-up"
the very earliest symptoms of ear trouble, otitis media and impaired hearing.
Orthopaedic Service, Tottenham
I am indebted to Mr. E. Hambly, F.R.C.S., for the following report:-
"This clinic has been well attended during 1958- Any operative cases were
done at the Prince of Wales5s General Hospital and referred back to the clinic
again afterwards.
The clinic has also provided for children from the Vale Road School for
Physically Handicapped Children. These are mainly advanced cases of progressive
muscular atrophy, spastic paraplegia and infantile paralysis all requiring
most complicated splints and, in some cases, operative procedures.
Dr. Dunham, who is in charge of the spastic unit at Vale Road School, is a
very pleasant colleague to work with. Team work is the essence of treatment in
the difficult cases, which comprise the majority of children in Vale Road School.
I would like to pay tribute to the excellent work of the physiotherapists both
for their work at the clinics and at the Vale Road Day Special School".
Orthopaedic Service, Hornsey
I am indebted to Mr. E. Palser, M.R.C.S., for the following report:-
"During the year attendances at the Orthopaedic Clinic have been 698 for
examination and 1,281 for treatment by the physiotherapist.
The number of new cases was 283, and the number of discharges was a
comparable figure.
This represents an increase in the total work of the clinic, but a reduction
in the number of new cases seen during the year.