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186
As only 19 per cent, of the cases exhibited other defects, unhealthy
tonsils cannot be regarded as the invariable precursor
of such ailments as are detailed above. However, cases suffering
from catarrh, tonsilitis, debility and frequent colds benefit from the
removal of tonsils and adenoids; and children with such defects
and an unhealthy condition of the naso-pharynx should be advised
operation.
4. What harm, if any, results from surgical removal of the tonsils?
It appears that the risk to the child's health is slight. Five
children in this analysis suffered adversely from the operation and
24 appeared to derive no benefit from it. The operation can therefore
be regarded as relatively safe.
SCARLET FEVER.
School Exclusion and Home Treatment.
In view of the comparatively mild type of scarlet fever now
prevalent, the Medical Officer of Health and School Medical Officer
submitted the following report in December to the Education and
Public Health Committees:—
Memorandum on Closure oe and Exclusion from School.
This Memorandum is issued under the joint auspices of the Ministry of
Health and the Board of Education. It contains suggestions regarding
the closure of public elementary schools and the exclusion of individual
children from such schools on account of infectious disease; and the
"Regulations" in force in this area for the exclusion of school children on
account of infectious disease are based on the procedure recommended in
the Memorandum.
The Memorandum lays down as a general principle that if the power to
exclude individual children be used to the best advantage, it is only in
special and quite exceptional cases that it will be necessary to close a school
in the interests of public health. Later it states that school closure interferes
seriously and unjustifiably with the education of the scholars, and it
deprives the Medical Officer of Health and the School Medical Officer of
information respecting attacks in their early stage or illness of a doubtful
nature which would be obtainable if the schools were kept open, and I
contend that the same objection applies to the exclusion of individual
children.
When a person is notified to be suffering from infectious disease
(e.g., scarlet fever) and the home conditions are considered satisfactory
for isolation at home, all school contacts in the house are excluded from
school for a period of six weeks, whereas contacts other than school children
are allowed to go to work, etc. To me such procedure appears to be ridiculously
inconsistent. If the patient is isolated satisfactorily, then there
should be no need to exclude school children from school. If, on the other
hand, the isolation at home is unsatisfactory, then the other contacts
should be excluded from work, etc., i.e., if we believe in the conveyance of