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tonsils and adenoids' referred to hospital for operation. This is
a very small number, relatively, to the numbers that are usually
referred from other sources for tonsil operation.
We again wish to emphasise the necessity and advisability
of restricting the number of tonsillectomies. If a detailed examination
is made of every case referred as a ' potential tonsillectomy'
and all the co-existing and contributory factors, such as
nasal and nasal sinus infections, hygienic and nutrition conditions
carefully looked into and corrected, it will be found that a surprisingly
large number of 'cases suitable for operation' do not
require operation. The operation by itself will not cure or benefit
these cases. There is ample evidence of this in the number of
post-operative cases, where the original symptoms still persist, which
one sees amongst the school population during the course of medical
inspections and at the clinics. While awaiting operation any cases
which are referred from the clinic are periodically reviewed and
given conservative treatment such as throat painting or nasal
treatment where indicated. In most instances the operation is
delayed several months on account of the long waiting lists at the
hospitals.
It is of the first and vital importance to treat and correct any
pre-disposing or exciting cause of 'diseased tonsils' before deciding
on tonsillectomy. First things come first and care must be taken
not to mistake the ' sign ' for the ' disease.'
During the course of the year a number of children were
found to have nasal sinus infections and these were treated chiefly,
except for a few cases which required other special treatment, by
first, a short course—about 6 to 8 applications—of hydrostatic
nasal douches, using warm normal saline solution ; each douche
was followed by nasal instillations of 10 to 20% argyrol. After
6 to 8 douche treatments they were then given a course of Proetz
'nasal sinus displacement,' using, after the initial weak ephedrine
solution, a 10% solution of Albucid (Scherings). We have found
this line of treatment to give very satisfactory results.
One hundred and fifteen cases were treated by Gautier's nasal
diastolisation for various nasal conditions, including 'nasal catarrh';
rhinitis, mouth-breathing, obstruction, impaired hearing, etc. The
results from this treatment, carefully and correctly carried out.