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268
There were 34 operating sessions at the Croydon General
Hospital. The work is done by a rota of 4 general medical
practitioners working in pairs, as surgeon and anjesthetist, for
periods of 3 months, and remunerated by the Education Committee.
All other expenses of the Clinic are also borne by the
Committee.
The cases were examined at the Throat Clinic the week prior
to the operation.
203 children were operated upon, a decrease of 199 on 1933.
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. If needful,
children are kept longer. All children are conveyed home by
ambulance. 196 children were detained for the night after the
operation. In all there were 143 non-attendances.
Of the 203 children operated on 108 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 53 percent,
compared with 54 per cent, in 1933.
18 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 'n
conjunction therewith the tonsillar glands are also
enlarged.
(b) Obstruction to breathing through one or both nostrils.
(c) The presence of mouth breathing.
The strict observance of this standard has resulted in a big
decrease in the number of children referred for operation.
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.