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(e) A special form was used for recording the results of examinations.
(/) Health visitors subsequently undertook the work of enquiring into a
variety of home conditions in the case of children found to be suffering from
adenoids in a degree needing operation.
Extracts from Annual Report for 1921 (page 56) of Chief Medical
Officer, Board of Education :—
" The School Medical Officer should take into consideration
the following points:—
(i) That the condition is not merely temporary, and may subside
in due course
(ji) That the condition is not due to some cause (such as carious
teeth or other disease or defect), which, when removed, will
lead to subsidence of the enlargement.
(iii) That the condition is either causing, or likely to cause, injury
to the child's health Speaking generally, the
chief forms of local or constitutional injury brought about
by adenoids and which suggest operation are:—
(a) Ear complication, deafness;
(b) Hypertrophic rhinitis, mouth breathing, obstructed
respiration;
(c) Recurring tonsillitis or tonsillar abscess;
(d Deformity of face or chest (" adenoid fades,"
" adenoid voice ");
(e) Recurrent catarrh, asthma, or septic infection ;
(f) Retardation of physical or mental growth. . .
Reliability of data collected.
1.—Reference to the table on page 47, summarising the data obtained,
will shew that the survey covered some 18,000 children—about 600 of whom
had indications of definite adenoids. The data are such as to allow of
reasonable accuracy in deductions in regard to individual age-groups, to the
sexes separately, and to the selected groups of schools referred to in that
table.
2.—The data collected by the four medical officers concerned in the
enquiry were compared, and showed that approximately the same standard
had been adopted by all in regard to the children needing operation for
adenoids. One medical officer had included a somewhat larger proportion
than the rest under the heading of children needing observation, but this
does not invalidate such conclusions as are drawn on this point in the
following paragraphs.
3.—The data in this report refer only to definite adenoids (as judged on
the basis set out in (c) on page 34), and not to enlarged tonsils, apart
from adenoids. It is well known that, in the absence of direct examination
of the back of the throat by the finger or by a mirror—methods of examination
inapplicable under the conditions of school medical inspection—it is
possible to diagnose adenoids only with very considerable probability, and
not with absolute certainty; to that extent there is an unavoidable margin
of error in the data collected.
Prevalence of adenoids.
(a) General.
The work of the Committee for a number of years past in providing
radical cure, through its Throat Clinics, for cases of adenoids invalidates