[Report 1934] / School Medical Officer of Health, Essex County Council.

  • Essex County Council
Date:
1934
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1934] / School Medical Officer of Health, Essex County Council. Source: Wellcome Collection.

    40/56 (page 38)
    (iv) Suggestions. Diagnosis. It would apy)ear that the present methods of diagnosis of diseases of the ear in use at routine school medical inspections need revision. A small room, containing several persons and surrounded by the noises of a school at work or play, is not an ideal place in which to conduct hearing tests, and under such conditions the “ watch and whisper ” tests cannot give accurate or reliable results. The ideal is to test the children . “ en masse ” by means of the gramophone audiometer. This method has the advantage of mechanical standardisation, thus eliminating the human factor on the part of the examiner. It cannot be too highly stressed that in all cases the routine examina- tion should include an examination of the ear with an electric otoscope. Adoption of these methods will lead to the detection of many cases • of minor hearing deficiencies and, in addition, a large number of ca.ses of chronic otitis media. Treatment. The treatment of the original acute condition is outside the province of this report, but it cannot be dismissed without the observation that, in the writer’s opinion, it is at this stage that the ultimate prognosis is very largely determined. The Local Authority, therefore, while under no obligation to provide treatment, is faced with the problem of dealing with a serious and established condition. For it to provide the specialised resources of an Ear and Throat Hospital is neither practicable nor desirable, yet every affected child should have access to those resources which the vigorous and determined treatment of his condition demands. That specialist treatment is attended with the greatest chance of improvement is evinced by the statistics. 46 per cent, of the cases attended hospital and 13 per cent, were im])roved. Furthermore, in the group who were subjected to “ Various forms of treatment, culminating in a Mastoid Operation,” is found the only instance of treatment in which the percentage of patients who improved outnumbered those who did not, in the proportion of 4 to 3. It may also be noted that in 56 per cent, of the cases the disease wa» present before the child was of school age, so that any com])rehensi\o scheme must include the ])re-school child. Scheme for Treatment. An adequate and systematic scheme could be evolved by the estab- lishment of Sessions for Ear Hiseases at the existing School Clinics,