View report page

171
of contributing new knowledge, as with a view to obtaining information
which might be of guidance in recommending appropriate
forms of treatment in the case of school children seen in the course
of medical inspection.
My experience in a children's hospital (both as a Resident and
as an Out-patient Physician) had led me to believe that unhealthy
tonsils were the direct or contributing cause of various illnesses
and that, if such tonsils were not removed, then the child's health
would be seriously impaired. As a school medical officer, however,
I examined many apparently healthy children who had tonsils
just as pathological in appearance as those whose removal seemed
so necessary in the case of the sickly hospital child. What, therefore,
was the true state of affairs ? Was the unhealthy tonsil the
precursor of debility, otorrhœa, nasal catarrh and bronchitis;
and did these apparently healthy children ultimately develop such
ailments ?
Previous Preliminary Investigation.
In his Annual Report for last year the Medical Officer of
Health published the results of my preliminary investigation of
some 2,750 cases. Although no attempt was made to draw any
conclusions from the results of that investigation, the figures
showed that, among children recommended for surgical operation,
the symptoms cleared up in half of the cases without the operation
having been performed.
Scope of Present Investigation.
This analysis of the different clinical types of tonsillar and
associated defect, and of the progress made a-s the result of different
forms of treatment, is an endeavour to supply answers to the
following questions:—
1. Which type of tonsillar defect is most permanently harmful
to the child?
2. Which type of defect is most likely to improve without surgical
operation?
3. To what extent can the unhealthy condition of the tonsils be
regarded as the cause of the other defects (e.g., bronchitis,
otorrhoea, debility, etc.) which may be found in children with
unhealthy tonsils?
4. What harm, if any, results from surgical removal of the tonsils?