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160
clear that under conditions of nature there would be no such drop, but rather
a level of incidence maintained throughout the school period, with specially
marked prevalence at the age of 5, followed by a definite rise in incidence
up to the age of 10 years, with a comparatively high incidence continuing
up to 13 (Table on page 47, Section C, line 9). " Both sexes show the same
general curve of incidence, except that in boys the maximum incidence is
spread over a somewhat longer period, 9 to 11 years of age.
It may, therefore, be concluded, with a reasonable degree of probability,
The work of the throat clinic has altogether altered the age distribution
of severe adenoids, making it now appear to be a disease most prominent in
early school life; whereas its incidence, apart from surgical interference,
would probably increase to a maximum at the ages of about 9 to 11 years.
(c) Sex incidence.
At almost every age period of school life there is a clear excess among
boys as compared with girls suffering from definite adenoids needing operation
or observation, or having undergone operation for this condition. Taking
all ages together,
Some 7 per cent. of boys and 6 per cent. of girls have, or have had,
definite adenoids during school life.
It is of some interest to note, however, that the proportion of girls who
need, or who have undergone, operation for adenoids approximates more
nearly to, and may even exceed, the proportion among boys at the higher
ages (Table, page 47, Section C, lines 3 and 8); while the proportion of
girls with a slighter degree of adenoids needing only observation, though
equal to, or greater than, that among bovs at the lower ages, becomes steadily
less than that among boys with advance in years. It seems reasonable to
assume that a number of the cases at first needing observation have later
become cases for operation, and thence to conclude that:—
There is some evidence than in girls adenoids are not only somewhat
less prevalent, but also reach a given degree of severity somewhat later in
school life than in the case of boys.
(d) Incidence in relation to social status.
In consultation with Mr. Morgan, the Committee's Inspector of Schools,
two groups of schools were selected as representing types distinctly above
the average and below the average respectively of the schools as a whole,
in regard to the social status of the children in attendance.
The group regarded as above the average contained 6 schools and 15
departments; that below the average contained 7 schools and 17 departments.
The records of the inspections at these schools made by the four
medical officers concerned have been compared and found to tally closely,
so that the differences to be noted' in the next paragraph are not due to
differences of medical standards in the two groups.
The Table (pages 45-46, Sections A and B, line 6) shows that throughout
school life there is a definite and considerable excess of adenoids among the
school departments attended by the poorer children than among those
attended by children on the whole of a distinctly more prosperous class.
This statement is true of all the children considered together, of each sex
taken separately, and applies also—allowing for the fluctuations inseparable
from small numbers—whether only those needing operation are considered,
those needing merelv observation, or all who have, or are known to have had,
adenoids, whatever the degree. It is therefore justifiable to onclude that