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Do occur, but these are not so marked as the diversity of views
by the different persons who are responsible for the inspection.
This becomes apparent when a comparison is made between the
fjgures of neighbouring areas.
A few years ago we published certain figures culled from the
annual reports of school medical officers of districts around London
it was interesting to note to what extent the personal factor
just have entered. Some might say that there is need of accepted
standards, but it is difficult to set up any standards which will be
accepted by all. The widest variation was noticed in the number
cf children who were stated to be suffering from enlarged tonsils
and adenoids and required tonsillectomy.
Tonsils and Adenoids.
During 1932, 58 children were operated on for removal of
lonsils and adenoids under the Authority's scheme, as compared
with 160 cases during 1931.
This great difference in the numbers needs some explanation
and the time seems ripe to enunciate the principles which have
guided us in the selection of cases during the present year.
It is also well to look back on some of our past cases, and
try to assess the value which the children have received from
the operation.
108 cases which had been operated on under the Authority's
scheme were followed up. A large number of these children were
generated on at the request of the family doctor, or on the advice
of one of the hospitals. The reason why the operation was considered
necessary was sought, and the parents were asked whether
there was any improvement in the condition for which the operation
performed.
Of the 108 cases, 37 were improved, 41 were definitely no
better, 6 were worse, and in the remaining cases the parents were
so that in these cases there was evidently no outstanding
benefit from the operation.
The first thing that strikes us in the investigation is the
diversity of symptoms for which the operation was performed.
For instance, 34 children were operated on because they
were subject to colds. Only 14 of these were improved in any way.
14 were operated on for tonsillitis, many of them after one
back only. 7 only, showed definite improvement and all of these
were in the 11-12 age group.