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changing, and this is not in the best interests of the clinic. I think
that the time has come when we should consider having at Jeast one
full-time nurse at each clinic, the same to be on the permanent
staff of the Council.
Tonsils and Adenoids.—Operations for the surgical treatment
of tonsils and adenoids are carried out by arrangement with Queen
Mary's Hospital, Stratford, and St. Mary's Hospital, Plaistow.
From time to time I have submitted that children should be
detained in hospital for some days after the operation has been
performed for the removal of tonsils and adenoids.
This operation is not such a minor one as is commonly supposed.
It entails not only the physical derangement consequent on an
anaesthetic and loss of blood, but also constitutes a real shock to the
nervous system.
I advise you to make arrangements for children to be received
into hospital at least the afternoon of the day preceding the operation
and to remain in hospital three days after the operation
Tuberculosis.—The treatment of tuberculous children is in the
hands of the County Council. As I said last year, there is a lot of
overlapping.
The diagnosis of tubercle in children similarly is in the hands
of the County Council and this leads to even still further overlapping.
In the case of diagnosis, the consequences of this overlapping
are at present to a certain extent mitigated by your own Medical
Officer being Tuberculosis Officer, and, although it may be somewhat
farcical, the one officer playing a sort of "Box and Cox" all
by himself, sometimes being Medical Officer of Health and sometimes
being Tuberculosis Officer, this system has worked moderately
well, but the idea of a separate Tuberculosis Officer under the
County and not under yourself undertaking this work is not a sound
one for such a compact administrative unit as Barking.