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53
the X-rays. Perhaps one is not in a position to say
with absolute certainty that this could in no circumstances
occur but so far as I am aware it has never been
seriously brought forward that this is a possibility
which has to be reckoned with, and all the evidence
seems to point to the fact that no such effect is
produced.
4. Adenoids and Enlarged Tonsils.
These defects bulk largely in all school medical
reports. The number in this district cannot be considered
unduly high. A good deal of discussion has
taken place as to the proper treatment of these conditions
and extreme statements have been made both for
and against operative treatment. In my opinion two
facts are indisputable, firstly, that many children have
been subjected to the operation unnecessarily and
secondly, that with regard to a considerable proportion
of cases there can be no reasonable doubt that operation
is the proper treatment. Such cases are those which
show the defect in a very marked degree, those in which
the general health is obviously suffering and those
which are associated with ear complications. Personally
I recommend operation only where I feel convinced
that less radical measures will not be successful, and
that successful treatment is imperative. In such cases
the great benefit resulting from operation is not open
to question. Over and over again parents have
volunteered the information that the health of the
children has been very much better since the operation
and that they are very glad that they were persuaded
to undertake it, a statement which is entirely in keeping
with one's own observation.
An agreement between the Hendon Education
Committee and the Hendon Cottage Hospital for the
operative treatment of these cases at a cost of 10/0 per
head has now been concluded and it is hoped that the
great majority of cases requiring the treatment will in
future obtain it.
5. Visual Defects.
The number found was considerable but is about
the average for residential districts and much below
the average for industrial districts as shewn in the