OPHTHALMOLOGY

187 school hours ; the visits count as part of school attenDr. F. J. PRIME discussed bronchiectasis from a physiodance. Thus, everything possible is done to encourage of It he uneven ventilaview. causes, said, logical point the pupil, parent, and teacher to cooperate, particularly tion of the lung resulting in arterial suboxygenation. when regular daily treatment over a period is needed. The carbon dioxide content, however, is not usually It is hoped that these centres will be allowed to continue raised unless some secondary condition is present, such In examinations of bronchiectheir good work unhampered. Children permanently as severe emphysema. but not totally deafened should be given the opportunity tatic subjects he found that both the vital capacity and to use a’Medresco’ hearing-aid, supplied under the the maximum breathing capacity were below normal. In the discussion which followed, several speakers pointed National Health Service. In one centre a fairly large out that the term bronchiectasis was loosely used, and group of partially deaf children was trained in the use of this aid, and it was found that both they and their all made a plea for a more rigid classification. The section joined the section of otorhinolaryngology parents quickly appreciated its value. Moreover, the teachers reported that all the -children showed genuine in a discussion of Carcinoma of the Larynx (see below). pleasure in using an aid, that their speech was improved, OTORHINOLARYNGOLOGY and that they were much more alert mentally. There were no complaints from this group of children President : Mr. I. SIMSON HALL about the size and weight of the aid ; and the incidence Treatment of Carcinoma of the Larynx of repairs was no greater than among aids used by adults. It was refreshing and convincing, at this joint meeting, Another speaker reported that in a residential school to hear at last such a wide measure of agreement between for the deaf, a quarter of the children were found capable surgeons and radiotherapists on the management of of benefiting by the use of aids and were supplied with patients suffering from carcinoma of the larynx. Mr. them. It was generally felt that so long as the demand C. P. WILSON, Dr. M. LEDERMAN, Prof. V. LAMBERT, for medresco aids continues to exceed the supply, children and Dr. J. J. STEVENSON opened the discussion, in the should receive the first consideration. course of which particular emphasis was placed upon the value of collaboration of the two specialties, preOPHTHALMOLOGY ferably by joint consultation not only in deciding on President : Mr. A. MCKIE REID the right kind of treatment to adopt but also in following the progress of each case. The day is long past when the counter-attraction of the International Despite radiotherapy was regarded as a last hope, to be employed Congress of Ophthalmology, the meeting of this section only when surgery is impracticable or has failed. On was exceptionally well attended. the other hand, long trials with radiotherapy alone have shown, it was agreed, that in early cases irradiation or Radiation, Light, and Illumination Mr. J. N. ALDINGTON, PH.D., president of the Society of local excision each offer an equal prospect of freedom Illuminating Engineers, remarked that the eye had from recurrence ; whereas in more advanced cases, evolved through many ages under continuous radiation particularly when the growth has extended backwards from the sun. The subjection of the eye to other or downwards, radical removal gives the best results. sources of light might perhaps be thought to be associated Advances in technique and its use as a curative rather with risks of damage ; yet this had not proved to be so. than a palliative measure have greatly reduced the Up to about 1930 almost all light sources gave continuous Suldiscomfort attending treatment by irradiation. ; now the sodium lamp was the most efficient phonamides and antibiotics in combination with surgery, radiation of all the general illuminations in use. Investigation by lessening the incidence of postoperative infection, had revealed no harmful radiation from fluorescent For have led to a shorter and smoother convalescence. lamps. Dr. Aldington went on to cite several examples the same reason more extensive excisions can now be between ophthalmic research, safely carried out on growths which formerly would have of the close relationship his own work on illumination. and applied ophthalmology, been considered inoperable, and which irradiation was in the Colour-vision Central Fovea.-Great strides a to is confined the to cure. When unlikely growth are being made in the study of colour-vision ; and the anterior end of one vocal cord, a cure can be anticipated in more than three-quarters of the cases, either by surgery processes of photo-reception and of the mechanism of vision itself are coming to be better understood. Since or by irradiation. In such early cases, however, irradiathe publication of his book Retinal Structure and Colour tion may often be preferred because it leaves the patient Vision, Mr. E. N. W’iLLMR, sc.D., has continued his with a better voice. A growth extending forwards on to research work at Cambridge; and at the meeting he both vocal cords should be treated by irradiation. Any growth that extends backwards on to the arytenoid reported some new observations on the colour-vision of region of the larynx, or downwards into the subglottic the central fovea. area, particularly if it has led to fixation of the cord, GERIATRICS can be offered a better prospect of lasting cure by President : Dr. C. 0. STALLYBRASS laryngectomy. In discussing doubtful cases, speakers bore in mind that whereas unsuccessful irradiation can Care of the Aged sometimes be followed by a surgical cure, a postoperative The most significant thing which emerged from the recurrence rarely responds to subsequent irradiation. section of geriatrics was the agreement among general Deafness in Children practitioners that since the arrival of the National Health Mr. R. R. SIMPSON, Mr. J. H. OTTY, and Mr. T. S. Service it has been harder to get an elderly patient into LITTLER were the openers of a useful discussion. Perhospital. Dr. P. Y. LYLE. of Southport, found that twomanent deafness in children, it was noted, can in many thirds of his visiting-list was composed of patients over instances be prevented by prompt and appropriate sixty-five. City practitioners, such as Dr. A. FRANKLIN, attention directed towards the cause. In many urban of Liverpool, pointed out that this was chiefly an urban areas-Hull and London were particularly mentionedproblem because there seemed to be many more idle, the school medical services have schemes in operation lonely, and unwanted old people in the towns. Countryfor examining the ears and testing the hearing of all the men often continued with their accustomed work and pupils. Any child with defective hearing or diseased play well into the seventies and eighties, thus avoiding ears is referred to a special ear clinic for diagnosis and the sudden break of passing from activity to lack of any necessary treatment. These clinics are maintained occupation on retirement from work. Many doctors by the.local educational authority and are open during thought that they were too busy to attend to their