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90
Annual Report of the London County Council, 1911.

In slighter cases of partial mouth-breathing there is evidently a tendency to recovery which
may be aided by reasonable care and breathing exercises. The advice which is so often heard as having
been given by the family doctor, that the child would "grow out of it" has therefore an element of
truth, provided the child escapes without more serious damage or without becoming the victim of a
slowly progressing hardness of hearing in later life. In Dr. Williams' observations of those children
who had handkerchiefs, three times as many showed improvement when compared with those who
were without handkerchiefs. In many schools the proportion with handkerchiefs is as low as 10 per
cent., but this may be raised to 70 per cent, by teachers who establish " handkerchief drill."
Dr. Wells has taken a series of children whose ages vary from 3 to 13 years of age, all scholars
of Council schools, on whom he operated for tonsils and adenoids at the St. George's Dispensary, Blackfriars.
The first 50 were operated on between 18 and 24 months before the last note taken and the
second 50 between 12 and 18 months previously. In eliciting the symptoms before operation the
parents were always asked to describe these as far as possible so as to avoid any suggestions being
made as to the existence of particular symptoms. Most of those recorded were, therefore, actually
noticed by the parents and should be noticeable to an observant person. Certain other symptoms
noticed at the time, apart from the throat, are also recorded. In several cases where the nasal septum
was deflected, or the mucous surfaces of the turbinate bones either hypertrophied or atrophied, the
conditions were found unchanged later. In one case, a girl of 13 had suffered nocturnal incontinence
regularly till operation, after which it had only occurred once in twelve months. The chronic gastrointestinal
catarrh, called mucous disease by Dr. Eustace Smith, which is common in these cases was
present in twelve cases, but had disappeared when examined later. The symptoms noted by Dr.

Satisfactory as these results appear it is to be remembered that they are the results of one skilled
operator, and that from the small number of serious complications in the form of turbinate hypertrophies
or rhinitis they probably represent an unconsciously selected class of cases sent from the
schools to the dispensary, although Dr. Wells thinks his selection was quite unbiassed and that the
results are chiefly due to the careful following up possible in the clinic.