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have been in the main very encouraging. Improvement is not seen
immediately, but at a subsequent inspection, months or even a year
or two later, general improvement has been noted in physique and
nutrition, and in the absence of enlarged glands of the neck.
Mothers often volunteer the statement that the child has been
much better since the operation, eating and sleeping better, and
Head Teachers usually report improvement in school work.
An essential feature in the success of operative treatment of
Tonsils and Adenoids is the after treatment. This consists in
giving the child a good environment, fresh air and good food,
and— most important—in establishment of nasal breathing. Alas
in many cases poverty and overcrowding make it difficult to obtain
the first two, and the ignorance or carelessness of the parents
prevents the latter. It is in these cases that there is little improvement
noted after the operation. Every opportunity is taken to
show parents the importance of nasal breathing in the maintenance
of health, because it is in the home that good, or bad habits, are
established. Breathing exercises in school and at the Clinic are
helpful, but are not enough unless the good work is continued in
the home.
Vision.
Dr. Roberts, the Assistant Medical Officer, continues in charge
of the Refraction Clinic, which is held weekly. From time to time
extra clinics have been necessary in order to keep the work up to
date. The attendances at the Clinic remain satisfactory.
291 cases of visual defect were submitted for refraction at
the Clinic, whilst 16 children were treated privately or at hospitals.
In 218 cases spectacles were prescribed and provided by the Education
Authority, and 14 children obtained spectacles privately.
Spectacles are provided at an all round price of 5/6 a pair, and
a definite scale of charges for repairs is issued when spectacles are
prescribed. Necessitous cases are referred to the Medical
Inspection Sub-Committee, and spectacles are supplied free or al
a reduced cost, according to the circumstances.
Dental Defects.
1,277 children were treated by the School Dentist under the
Local Education Authority's Scheme and 541 re-treated. Further
86 attended the Dental Clinic and were referred elsewhere for