DR. MACLEOD YEARSLEY'S PAPER 441 



assistance to the realization of the excellent aims 

 which this Conference has in view. 



Those concerned with the prevention of deafness 

 find themselves confronted with a double problem : 

 the prevention of congenital deafness and that of the 

 acquired form. The former is, perhaps, the more 

 difficult task, but it is one which will have to be faced 

 in the near future, and I do not propose to deal with 

 it upon this occasion. The prevention of acquired 

 deafness is, at present, much more within the range 

 of practical politics and will form the subject of this 

 short paper. If we are to be successful in the pre- 

 vention of acquired deafness in the adult, we must 

 attack it in the child, and to be successful in the 

 child we must attack first causes in the infant. The 

 child we can reach now through the school, the 

 infant before school age we must get at by such 

 organizations as yours. 



Nearly all cases of deafness in infancy and child- 

 hood are caused by one of three great groups of 

 causes: the infectious fevers, meningitis, and pri- 

 mary ear disease. Among the first-named, scarlet 

 fever, diphtheria, measles, and congenital syphilis are^ 

 the most responsible. Reference to the Annual 

 Report of the Metropolitan Asylums Board for 1911 

 shows (pp. 118 to 120) that, during that year, ear 

 complications occurred in the following percentages : 

 scarlet fever, 11-42 ; diphtheria, 5-38 ; measles, 14-10; 

 whilst enteric fever and whooping-cough were 3-5 

 and 4*9 respectively. These aural complications of 

 the exanthemata are always serious and always dan- 

 gerous. They not only destroy hearing, but they 

 tend to kill, although a fatal result may be delayed 

 for years. Their treatment taxes the skill of the 

 otologist to the utmost, but by timely care and 

 prompt intervention they can be prevented. The 

 medical officers of fever hospitals are all good men, 

 but they cannot know everything, they cannot be 



