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tissue has definite functions, and proliferation thereof may be a
protective measure. Sometimes the proliferation increases to
such an extent as to bring about complications of its own. If this
occurs then surgical measures may be necessary : —
(a) Tonsils which are enlarged and septic, especially if in
conjunction therewith the tonsillar glands are also
enlarged.
(b) Obstruction to breathing through one or both nostrils.
(c) The presence of mouth breathing.
Strict adherence to these standards obviates the unnecessary
removal of tonsils. Provided the tonsils are not interfering with
any normal function and are not a focus of septic poisoning, there
is no proof that their removal is of any benefit to a child. The
number of cases operated on shows a decline.
The Inspection Clinic.
This is held on Wednesday, Friday and Saturday mornings.
Friday is reserved for rheumatic cases, and a special report by
Dr. O'Connell respecting the latter is given later in this report.
The object of the Inspection Clinic is (a) to examine children
referred bv parents or teachers for special examination ; (b) children
sent by school attendance officers for an opinion as to their
fitness or otherwise to attend school; (c) children referred for
examination under the provisions of the Education Act, 1918,
Sec. 15; (d) cases in whom a further examination is desired after
routine medical inspection; (e) children referred under the
luvenile Employment regulations. 1,380 attendances were made
by children during the year.