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80
Throat and Nose Conditions.—4.7% had slight
adenoids, and in 1.2% these were marked.
Some care has been taken in advising the operation for
the removal of enlarged tonsils and adenoids. Most cases
of enlarged tonsils are associated with carious teeth, which
should first be treated. Many slight cases can be improved
by suitable breathing exercises, and a circular describing
these is being issued where necessary. Further, the operation
is by no means free from risk, especially when it is
done, as so frequently, in an out-patient department, and
the child allowed to return home the same day. The conditions
under which it has been urged have been:—
(1) Chronic nasal obstruction with adenoids.
(2) "Running ears" with enlarged tonsils or adenoids.
(3) Deafness with adenoids.
(4) Frequent attacks of tonsillitis. A moderately
enlarged tonsil may cause these, and is only to be
adequately removed by dissection and not merely
cutting the tonsil.
(5) Much enlarged cervical glands with no other
apparent cause than enlarged tonsils.
Even when the operation has been performed little
benefit may be expected unless after-treatment is carefully
carried out in the shape of breathing exercises, and the
School Nurse will in future give printed as well as oral
directions. The habit of mouth-breathing has a serious
effect on the mental development of the child, and is only to
be remedied by much parental patience.
Diseases of the Heart.—In 25 children organic
disease of the heart was discovered—in most cases of
rheumatic origin and the fact of its presence unknown to the
parent.