View report page

263
Of the 25 non-rheumatic children, tonsillectomy had been performed
on 5:20 not having been submitted to this treatment.
The influence of tonsillectomy in preventing or curing
rheumatism is uncertain. Although in many cases in childhood
rheumatic infection may enter the system through the tonsils, it
has not been proved that, rheumatic infection does not enter children
from whom the tonsils have been removed. The figures for
most school medical departments show that the percentages of nonrheumatic
and rheumatic children who have had this operation are
about equal.
The figures in Table XLII. for 1930, as well as for 1928 and
1929, indicate that tonsillectomised children do not escape the
graver complications of rheumatism in any greater proportion than
those who have not had this operation.
On the other hand children who have been recommended by
the Medical Officers at the Clinic to have tonsils removed, and
whose advice has been acted upon, have shown distinct improvement
thereafter. In advising tonsillectomy for any child belonging
to the Rheumatic group, the state of the child's throat.in relation
to the general health must be carefully considered.
Simple hypertrophy of the tonsils is not a sufficient reason to
advocate removal; and no ca.se was recommended operation unless
the condition of the nose and throat was such as to have a detrimental
effect upon the child's general health and so be likely to
assist or aggravate the Rheumatic condition.
214 re-inspections were carried out. In 34 of these, the condition
had become worse; 44 were thought to be non-rheumatic ; and
136 were definitely improved and had become quiescent.
Environment and other Conditions in Rheumatism Clinic Cases.
Wards.—Cases were drawn from all wards in the town to the
numbers shown: Woodside, 26; Whitehorse Manor, 20; West
Thornton, 22; Upper Norwood, 8; Broad Green, 16; Waddon, 18;
Addiscombe, 25; Thornton Heath, 32; East, 15; South Norwood,
10;Bensham Manor, 12; Central, 8; Norbury, 11; and South, 7.
Housing Conditions: Subsoil.—No relationship was found to
exist between the type of subsoil and the incidence of rheumatic
infection. This finding was similar to the findings of the two
previous years.