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The scientific value of this investigation is considerably
diminished due to the fact that no single medical examiner has been
responsible for all the clinical notes in any one ease. None of
the medical officers was aware of the need for special care in
investigation and certain facts, which would have been of importance,
may have been omitted in some cases. It is thought,
however, that these statistics and conclusions may be of some
value because, on examining carefully the records of some 2,750
children, sufficient continuity in the clinical histories was obtained
to justify the view that most school medical officers agree regarding
the state of the nose, throat and general health of a child although
they may not always agree regarding the type of treatment
indicated.
Procedure in Individual Cases.
At the initial inspection cases were classified in one or another
of the main groups and sub-groups (detailed below), and recommended
for either "observation" or "operation."
At subsequent re-inspections progress was recorded in one or
other of the three categories "improved," "stationary" or
"worse."
After re-consideration of the progress of cases originally
recommended for observation, a revised or subsequent recommendation
was made as at the initial inspection. The appropriate
records of progress were then made.
Of course, a large number of these children, when the records
were examined, had ceased to be seen by the school medical officer,
having either left school or left the district ; but roughly 1,220 of
these are children who are at present under observation or have
recently ceased to be so. The remaining 1,500 case records were
of children who had either been discharged as "clear" or had
left school within the period 1929-1932. The figures show that, out
of a school population of over 15,000 8 per cent. of the children are
kept under observation for defects of throat and nose.
Classification of Cases.
The cases under review were classified into five main groups,
each group being divided into four sub-groups, as follows:—
Group I. Enlargement of tonsils—first degree.
i.e., tonsils extending beyond anterior pillars of fauces
but not obscuring posterior pillars, with no undue
increase in depth of tonsillar tissue.