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Also the immediate after care of the child at home presents
another problem—in many cases there is overcrowding, and often
the mother goes out to work.
The actual number treated this year is 99 out of 248 marked
for treatment, making 40% against 25% last year, and 50% in
1927, and 33% in 1926.
For the past few years it has been the practice to refer only
well marked cases for operative treatment, although there have
been many children with unsatisfactory conditions of the nasopharynx.
In such cases advice is given as to the carrying out of
proper nasal hygiene, and to improving the general health of the
child. "Sneezing " has been tried with success in a few cases,
but without the intelligent co-operation of the mother it is useless.
A clinic where such treatment and instruction could be given
would undoubtedly save some of the earlier cases from the need
of operation. It would also be useful in helping to establish
nasal breathing after operation. Unfortunately the establishment
of such a clinic is at present impossible owing to the Nurses' time
being fully occupied with other work.
The results of operation 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 absencc
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 the 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, and it is here that a Clinic,
as mentioned above, would do good work.