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adopted there, which was an enema of soap and water on admission together with a
hypodermic of atropine administered prior to operation. The enema especially
tended to upset the digestion of the children afterwards and it was abolished.
" The children treated at the Wick have no preparation beyond an instruction
to the mother to give a dose of castor oil two days before admission. No hypodermic
is administered. The children are operated on at 2.0 p.m., on the day of admission.
The anaesthetic used is ethyl chloride (the best results are obtained when air is
given with it by a small pump fitted on to the face-piece of the bag). Removal of
the tonsils is done by the guillotine (reverse method) and the adenoids by a curette.
" At this centre the children are given nothing but ice-cream for 24 hours
after operation, a little bread and butter being allowed on the second day (when they
are discharged) if they ask for it. Ice-cream is made at the Centre and has been
found most admirable after-treatment. The children like it, it is easily and comfortably
swallowed, and is very nourishing. It also simplifies the catering.
"Of the 896 cases treated to the end of 1927—children of all ages between 5
and 14—only 4 have had serious complications. One case of endocarditis developed
on the second day—ultimately discharged after a week. One case of severe hemorrhage
which yielded finally to plugging and hemostatic serum. Two less severe
cases both yielded to adrenalin douching. One case contracted broncho-pneumonia
on the day of discharge and had to be retained in the Centre for a week but ultimately
recovered. Two other children remained longer at the centre at parents' request
owing to home conditions. Minor cases of hemorrhagic oozing were reported, but
were all checked by sitting up in bed and spraying with adrenalin.
"None of the children suffered from the gastric disturbances which are reported
from other centres. These are probably due to the enemas given there, and for that
reason are not used at the Wick. Only in one instance has an ' accident' happened
on the operating table, and it is better to risk that than incur the risk of gastric
shock which the giving of the enema often causes in young children."
(e) Dental defects.—62 part-time inspecting dentists (51 men and 11 women)
take part in the inspection of the teeth of children in the schools, and 2,025 sessions
were devoted to this work. There are now 60 dental centres, not including Bushy
Camp School, where dental treatment is provided separately for 1,540 children,
and arrangements were made during 1927 at these 60 centres for the treatment
of 126,830 children. In all 226,146 children were inspected by the school dentists
and of these 158,456 (70 06 per cent.) were found to require treatment. 124,992
children were treated at the Council's centres.
Dr. Livingston's
report
on the dental
treatment.
"The return of the dental treatment for the year ended 31st December, 1927,
shows a considerable increase (11,060) in the number of new cases passing through the
dental surgeons' hands. Keeping pace with the increase in new cases is an increase
in the numbers of necessary extractions, more particularly of the temporary teeth,
the actual figure being about 46,000, but it is pleasant to be able to record that the
number of extractions of permanent teeth does not show a pro rata increase to the
numbers of new cases treated. The number of fillings placed remains practically
steady compared with 1926 ; there is a slight decrease in the number of other operations
performed, such as the application of silver nitrate. There has been a consequent
increase in the numbers of general anaesthetics administered keeping pace with the
increase in the numbers of teeth extracted, and the natural parental demand for
painless dentistry.
"It is very interesting to compare the returns of dental treatment for the year
ended 31st December, 1912, with the returns for the year 1927 just finished. The
interval is 15 years; in 1912, the first year for which figures were set out according
to the present method of returning, five centres had already been established and
during that year two otheis began treatment. 9,799 new cases attended. For these
children an average of 3.26 extractions were performed. 1.65 fillings were placed