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enlarged tonsils should he removed by operation, but
personally I doubt if such practice is justifiable. The
practice in the Bromley School Medical Service is to
refer for operation only those cases with enlarged tonsils
or adenoids, which suffer from a secondary effect of the
enlargement, such as enlarged glands, discharging ears,
or a general impairment of the physical condition of the
child.
Mr. Beney's report, which follows, will indicate the
work of the Ear, Nose and Throat Clinic during 1931:—
The increase in the number of clinics held during the
year under review has been fully justified by the results.
Occasional Inspection Clinics have been instituted. This
has enabled special treatment to be undertaken for nasal
and aural conditions not requiring surgical intervention.
Out of the total number of 329 cases referred to me by
the School Medical Officer, 198 required operation for
the removal of tonsils and adenoids; 177 of these were
successfully operated on at the Clinic, 21 cases being
referred to their own doctors for operation or admitted
to my beds at the Hospital. Of the latter 7 required
operation for acute and chronic mastoid disease, and in
4 cases intranasal operations for sinus disease were necessary.
The remainder of 131 cases received non-operative
treatment. No cases of any serious complications arising
after operation have been reported to me.
I cannot speak too highly of the efficient and loyal
co-operation of the Nursing and Voluntary Staff, without
whose care these results could not have been achieved.
Charles Beney, m.a., m.b., ch.b. (camb.), m.r.c.s.
Minor Ailment Clinic.
A Medical Inspection Clinic is held each week-day
morning, except Tuesdays, at the School Clinic, Station
Road, Dr. G. H. Stinson being in attendance. Cases
are referred to this Clinic by head teachers, school attendance
officers, school nurses, or from routine medical
inspections at schools. Cases occasionally attend direct
from the parents without having been referred by head
teachers; this can only be avoided by the establishment
of an out-patient department at local hospitals. Until