Читать книгу The Deaf - Harry Best - Страница 19

In respect to present activities for the prevention of adventitious deafness, we find the situation very much like that of marking time. Deafness, since the beginning of time, has largely been accepted as the portion of a certain fraction of the race, and any serious and determined efforts for its eradication have been considered for the most part as of little hope.[22] With the auditory organs so securely hidden away in the head, entrenched within the protecting temporal bone, and with their structure so delicate and complicated, the problem may well have been regarded a baffling one even for the best labor of medicine and surgery. Hence it is that after deafness has once effected lodgment in the system, a cure has not usually been regarded as within reach, though for certain individual cases there may be medical examination and treatment, with attempts made at relief. For deafness in general, it has been felt that there has been little that could be done in the way of prevention or cure beyond the preservation of the general health and the warding off of diseases that might cause loss of hearing.

As a matter of fact, however, altogether too little attention has been given hitherto to the possibilities of the prevention of deafness. Without question there is much at the outset that can be accomplished towards the prevention of those diseases that cause deafness. A large part, perhaps fully a third, as we have seen, are due to infectious diseases, and it is probably here that measures are likely to be most efficacious. A considerable portion likewise are the result of diseases affecting the passages of the nose and throat, and help should be possible for many of these if taken in hand soon enough. In certain diseases also, as scarlet fever, measles, typhoid fever, diphtheria, and others, there are not a few cases which, so far as deafness as a development is concerned, would prove amenable to skillful and persistent treatment. At the same time due attention to primary ear troubles would in a number of instances keep off permanent deafness. Indeed, it is possible that some thirty or forty per cent of adventitious deafness is preventable by present known means.[23]

Aside from direct medical treatment for those diseases that cause deafness, there are other measures available in a program for the prevention of deafness. One of the foremost essentials is the report to the health authorities of all serious diseases that are liable to result in deafness. In this way proper medical care may be secured, and due precautions may be taken to isolate infectious cases. Even with meningitis, which is so hard usually to deal with and which is so severe in its ravages, there is often some concomitant trouble, and if made notifiable in all cases deafness from it might be checked in no inconsiderable measure. The report of births is also especially needed, and as it becomes obligatory in general, with the consequent detection of physical ailments or disabilities, early cases of deafness may come increasingly to notice, and timely treatment may be availed of. Particular attention is likewise necessary in respect to the medical examination of school children. The proportion of such children with impaired hearing is not slight, even though no great part of them become totally deaf. A committee on defective eyes and ears of school children of the National Educational Association in 1903 found that of 57,072 children examined in seven cities, 2,067, or 3.6 per cent, were extremely defective in hearing.[24] An investigation of the school children in New York City has disclosed the fact that one per cent have seriously defective hearing.[25] Under proper and adequate medical inspection of schools, not only would the need of treatment for adenoids and similar troubles be brought to light, with the result that a number of incipient cases might be stopped in time, but in some instances of deafness already acquired beneficial treatment might be possible.[26]

There is thus a considerable sphere for action towards the prevention of adventitious deafness both by legislation and by education. For the ultimate solution of its problems, however, we have to look mainly to the medical profession. In recent years medical science has won some great triumphs, and in the field of the prevention of deafness no little may be in store to be accomplished in the years to come.[27] Even now, with more particular attention to the diseases of children, and with stronger insistence upon general sanitary measures, the probabilities are that there is less deafness from certain diseases than formerly—a matter which we are soon to consider.

Though as yet there has been little direct action for the prevention of adventitious deafness, there is an increasing concern in the matter, and in this there is promise. By medical bodies in particular is greater attention being given to the subject,[28] and in the widening recognition of their part as guardians of the public health it may be possible for them to do much for the enlightenment of the public. In one state legislative action has been taken expressly for the protection of the hearing of school children. This is Massachusetts, which requires the examination of the eyes and ears of the school children in every town and city, the state board of education furnishing the tests.[29] In some states also general inspection of schools is mandatory by statute, and in others permissive, while in several there are local ordinances with the force of a state law.

In combating adventitious deafness, then, our attack is to be directed in the largest part upon those diseases, especially infantile and infectious diseases, that cause deafness; and it is upon the checking of their spread that our main efforts for the present have to be concentrated. At the same time the better safe-guarding of the general health of the community will insure a proportionate diminution of deafness. Beyond this, we will have to wait upon the developments of medical science, both in the study of the prevention of diseases and of their treatment; and can trust only to what it may offer.[30]