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10
children was 9.2 and in Buckinghamshire, 34.8. Seaside towns
show similar differences for this age group, for example, 1.3 in
Swansea and 32 in Newport.
Appendix d . Page 57 , sets out the figures for Croydon
for 1960. These show a rise in comparison with the percentages
for 1959 and on the total of all children, who have undergone
tonsillectomy, the increase is just over 4%. Croydon must now
be amongst the areas of the country with the highest rates for
tonsillectomy.
I do not think this indicates that the children of Croydon
have particularly unhealthy tonsils, but that Croydon parents
tend to press for surgical treatment for symptoms and signs,
which in other parts of the country would be treated medically
or perhaps ignored.
This raises the query about differences in the health of
adults, who have or who have not undergone tonsillectomy. It
does not seem possible to have a properly controlled experiment
to answer this question. It is probable, however, that during
childhood, those who undergo the operation for valid reasons
benefit, but that changes after the age of puberty achieve for
many not having the operation, the same end result. In an area
where the operation is commonly performed and there are adequate
facilities, it requires considerable courage and persistence for
parents and family doctor to wait while the child "grows out of
it".
UNCLEANLINESS
Cleanliness inspections are carried out by the School Nurses
each term in most schools, so that the majority of pupils are
brought under review. The finding of slight infestation in unexpected
offenders leads to the issue of an informal letter to
the parents, setting out a method of treatment and offering a
supply of suitable emulsion. The appropriate formal notices are
sent to the parents of children previously found verminous.
Steel combs are sold or loaned where necessary. Endeavour is
made to serve notices on the parents by the School Nurse
personally, so that she has opportunity to emphasise that infestation
may be a family complaint and not limited to the
school child, and the need for constant cleanliness to prevent
relapses. A cleansing station is provided for the treatment of
scabies and very occasionally deals with other verminous
condi tions.