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The number for each year consists of those treated under the Council's scheme,
with the addition of those reported at re-inspections to have been treated by various
agencies outside the scheme. It will be seen that, of the present children leaving
school, at least one in five has had an operation for tonsils and adenoids.
Two reasons are advanced for the falling off in the numbers during 1932.
Firstly, it was decided that, on 1st April, 1932, the charge to the parents for
operation should be increased from 2s. to 5s. This may have affected the readiness
of parents to consent to operations, though this is unlikely as the care committees
have power to remit the charge whenever the circumstances justify this. Secondly,
the extension of in-patient arrangements made possible by the use of the general
hospitals transferred to the Council from the guardians of the poor resulted in the
overtaking of arrears during 1930 and 1931 so that the number of children
suffering from enlarged tonsils and adenoid growths at recurrent medical inspections
in schools has become much fewer. Thirdly, there is the tendency to adopt a
waiting attitude in certain cases instead of recommending immediate operation.
Continued use has been made of the Council's general hospitals during the summer
months and facilities have been given at St. Charles', Mile End, St. John's and St.
Leonard's hospitals.
So closely knit are the operations for the two conditions that it has not hitherto
proved possible to separate the figures into operations for (i) tonsils only, (ii) adenoids
only, or (iii) tonsils and adenoids together.
It will be seen from Table II in the appendix that nose and throat cases noted at
the medical inspections as requiring treatment, are divided into the three categories
referred to above.
Of the total number of cases the percentage of cases referred for (i) enlarged or
unhealthy tonsils only was 72 per cent., (ii) adenoids only 7 per cent., and (iii) tonsils
and adenoids together 21 per cent. Assuming that these percentages were applicable
to the cases aotually operated upon, the number of operations performed during
the year, viz., 13,765, would be divided as follows: (i) tonsils only, 9,910; (ii)
adenoids only, 964; and (iii) tonsils and adenoids together, 2,891. Endeavours are
being made to secure more accurate information in the future.
It is essential that all children should be taught the proper method of breathing
through the nose, and this is especially necessary where children have been operated
upon for enlarged tonsils and adenoids, for, in almost all cases of enlarged tonsils and
adenoid growths, the child has acquired the habit of mouth breathing. Breathing
exercises classes have therefore been formed at the various treatment centres, and
are undertaken by one of the nurses under the supervision of the aural surgeon.
With a view to uniformity instructions have been drawn up for the use of the nurses
concerned and a leaflet on more simplified lines has been issued for the parents so
that the exercises may be continued in the homes.
Breathing
exercises.
The special aural staff consists of Mr. A. G. Wells and nine part-time assistant
aurists who attend at eleven special aural clinics.
Aural
clinics.
The following is the substance of the report submitted by Mr. Wells:—
The figures returned by the five divisions for the year under review are set out in tables
I and EL
From the figures in table I it will be seen that the percentage of cases cured is 67.4, and
that each case averaged five attendances.
From table II it will be seen that the percentage of cases cured was 30; partially relieved
10; unrelieved 3.8; and that each case averaged four attendances.
In addition 56 cases of nasal defects were also treated.
Table III gives a detailed analysis of all the cases of otorrhoea treated and shows the number
of "acute" ears, the cause of persistence of discharge in the "chronic" ears, the number cured,
the number requiring operation, those lost sight of and the number still under treatment on
31st December, 1932.
Statistics.