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(b) Tonsils and Adenoids.
A clinic for the operative treatment of children with enlargeu
tonsils and adenoids is held at the Croydon General Hospital.
The operations and the administration of anæsthetics are undertaken
by eight local medical practitioners working in pairs, and
in rota for periods of three months.
The clinic was held on one afternoon in each week during
the earlier part of the year, and later on two afternoons in each
week. Before attending the clinic, children with dental sepsis
undergo appropriate treatment at the school dental clinic. The
children are then seen by the surgeons at three successive sessions
of the throat clinic. On the first occasion the child is inspected
and ascertained to be fit for operation, and the preparations needed
are explained; on the second the operation is performed; and on
the third, the surgeon verifies the result obtained from the operation.
During the year 193 children underwent operations at the
clinic on account of unhealthy conditions of the naso-pharynx.
The children are then drafted on to a class held for mouthbreathers,
in connection with the Remedial Exercises Clinic. They
attend daily for four weeks, the lesson lasting about half-an-hour.
Parents attend on the first and last days of instruction, when the
child is examined by a medical officer. The general arrangements
have proved very satisfactory.
253 children attended the breathers' class during the year, and
of these 235 had undergone operations for tonsils and adenoids
at the throat clinic or at various London Hospitals some two weeks
before admission to the class. The children showed with great
uniformity a marked gain in weight and a corresponding increase
in chest expansion, associated with a general improvement in
physique by the end of the period of instruction.
(c) Tuberculosis.
All children in whom the presence of tuberculosis is suspected
are referred to the Tuberculosis Dispensary for further
examination, and for such action in respect of treatment or continued
observation as may be appropriate.
During 1923, 49 Children were referred to the Tuberculosis
Officer by the school medical inspectors, and 46 children through
other channels. 28 were ascertained to be tuberculous, 4 others,
after a period of observation, were found to be free from the
disease, while the remainder were under supervision at the end
of the year. In addition, 183 contacts of these cases were examined.
The total number of attendances at the Tuberculosis Dispensary
by children of school age was 3,594, as compared with 3,227
in 1922.
Sanatorium or hospital treatment was provided in suitable
cases. In others, milk or cod liver oil was prescribed. Advice
was given to parents at the Dispensary by the Tuberculosis Officer,
and at the homes bv visits of the health visitors.