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402 children were operated upon, an increase of 115 on 1932.
The cases referred have all come within the terms of the three
definitions given below. All cases are kept in hospital for at least
one night after the operation unless the parent expressly desires
otherwise and is prepared to take all responsibility. All children
are conveyed home by ambulance. 381 children were detained
for the night after the operation. In all there were 129 nonattendances.
Of the 402 children operated on 216 attended the Remedial
Exercises Clinic for post-operative breathing exercises. This is a
very important complement to the operation. The percentage of
children operated on, who attended for exercises, was 54 per cent.,
compared with 57 per cent. in 1932.
The percentage is by no means as high as might be wished.
The distance some of the children have to come is a deterrent.
58 cases came to the knowledge of the department for whom
the parents had obtained treatment from another source; the
majority at a London hospital. In these cases the expenses are
defrayed by the parent and not by the Local Education Authority.
Only the following conditions are considered to warrant the
reference of a child for operation:-
(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 Inspection Clinic.
This is held on Wednesday and Saturday mornings. The
object of the Inspection Clinic is (a) to examine children referred
by 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