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61
It is probable that the increased number of children who
were found to be suffering from middle ear disease represents
previous cases who have attended for routine examination and in
whom the condition is still present or has recurred. It is also
possible that increased facilities for bathing due to the open-air
baths and sea bathing during the course of the hot summer of
1933 may be a slight contributory cause. If this be so, the increase
of five children over the number for last year is small, when
one considers the opinions frequently expressed that bathing in
the sea and in the swimming baths is a frequent cause of infection
of the middle ear.
Tonsils and Adenoids.—One thousand, one hundred and
twenty-one children had already had operation for removal of
tonsils and/or adenoids; 388 were found to have enlarged tonsils,
adenoids, or both.

I would call attention to the fact that the percentage of
children who have had their tonsils and adenoids removed is
steadily increasing and has now reached the figure of 39.1, whilst
correspondingly the number found to have enlarged tonsils and
adenoids or both has dropped to the figure of 13.5, which is little
more than one third of what it was in 1929. If one adds these two
percentages together it will be seen that the percentage of children
who have had or need this operation has remained fairly steady in the
district, the difference being that there is now a bigger percentage
of children who have had the requisite treatment. To those who
consider that this figure of 39.1 is high, I would again remark
that it compares with a figure of about 65 per cent, of children
in wealthy public schools who have had their tonsils and adenoids
removed before they enter school.
The procedure for removal of tonsils and adenoids was the
same as in previous years.