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often markedly so, and they remained free from colds and sore throats for
perhaps two or three years. In 1931, however, considerable research was
made into the total results after the ten years of intensive operative treatment.
It was found, taking 100 children, 50 of whom had had tonsils removed and
50 left alone, that those whose tonsils had been removed were having more
colds and sore throats after ten years than those that were left alone.
In the face of these facts, Sir George Newman recommended that no child
should be sent up for removal of tonsils and adenoids unless and until it had
been undei the care of the School Medical Officer for at least six months, and
local treatment had been tried without huccess, or unless the condition of the
nose and throat or further complications were seriously interfering with the
child's health and well-being, and operation was the only means of cure.
I have followed his recommendations throughout 1933: the results have
been:—Operation was performed in 109 cases only as against 261 for 1932.
Of these, only one was performed apart from the Authority's scheme for tonsils,
87 under the scheme for tonsils only, 4 for adenoids only, and 17 for tonsils
and adenoids together.
An interesting factor in the reduction was the response of the tonsils to
a line of treatment specially stressed this year, namely, that of painting the
tonsils.
Owing to the necessity of dealing with a larger number of diseased
unremoved tonsils this year, a special attempt was made for the reduction of
the tonsils by local intensive treatment. The Nurses cariied this out at the
Clinics with a paint consisting of tannic acid and glycerine, applying it daily
for 2 or 3 weeks according to results. In most cases the tonsils lost their
inflamed appearance: they also shrank in size and no longer led to the
re-infecting of the nasal passages from germs previously held within their folds.
(c) Tuberculosis.
At the routine school inspections, only one case of suspected tuberculosis
of the lung was found requiring treatment, and one of non-pulmonary tuberculosis.
At the Clinics one definite case of lung tuberculosis was found by
me to require treatment and one for observation; suspected cases were 19 and
1, respectively.
Of tuberculosis elsewhere than in the lung—in two cases the disease was
situated in the glands; and one of "other forms" was found requiring treatment
and one for observation in "other bones and joints" apart from spine.