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The long-standing cases can nearly always be detected at a glance
by the child's typical facial appearance. These cases are not so
frequently seen now that medical inspections are held more systematically
and that teachers are familiar with the signs of obstruction to breathing.
The treatment is not always surgical. Mild cases often improve
considerably if the child can be broken of the habit of mouth-breathing.
For the marked cases, especially those associated with deafness,
surgical treatment at an early date is recommended. The Throat
Clinic established in 1918 at the Croydon General Hospital continues
to provide satisfactory treatment. If the child has decayed teeth it
first receives treatment at the hands of one of the school dentists.
When the child's mouth has been made clean, arrangements are
made for the child to go to the Throat Clinic. This institution saves
the parents much trouble and expense. Formerly many of the children
were taken to London hospitals, which often have long waiting lists.
The table on page 25 shows the operations performed at the Clinic.
GLANDS.
Glands in the neck were found slightly enlarged in 265 children>
markedly so in 178 Total per cent., 7.6 In a few cases the enlargement
was tubercular in origin; these children are nearly always
referred to the Tuberculosis Dispensary for treatment and observation.
Much more frequently enlarged glands are associated with
enlarged tonsils and adenoids, ear discharge, decayed teeth, or vermin
and nits in the head. In the latter conditions the glands quickly
diminish when the cause is removed.
EAR DISEASE.
50 children — .86% were found to be suffering from ear disease,
and 105 — 1.8% were deaf. Wax in the ear accounts for many cases
of deafness which can be readily cured. The serious and most
persistent cases are associated with enlarged tonsils and adenoids, or
date back to an infectious illness such as scarlet fever or diphtheria,
which both affect the throat and often the ears.
If necessary the throat must receive treatment as well as the ears;
consequently many of these children are sent to the Throat Clinic.
At the Treatment Centre numerous cases of ear disease are treated.
Parents often syringe a child's ears irregularly and imperfectly, and the
discharge n ay persist for many months. In very obstinate cases an
operation on the ear may be needed at the hands of a specialist.
DEFORMITIES.
Spinal curvature was present in 48 children. Deformities of
various types such as club foot, hip disease, occurred in 99. The
spinal cases, except those due to tuberculosis, are nearly always
recommended for special exercises. There are too many children to
be accommodated in Miss Appleton's Remedial Class, and a certain
number obtain their exercises at school.
There are numerous children suffering from deformities caused by
infantile paralysis, rickets, and other diseases, who would be benefited
by a course of massage or electricity. At present this is not provided
by the Local Education Authority, and there is no institution in
Croydon where it can be obtained.