View report page

19
and diagnosis shall be made available—anaemia, marasmus, inanition,
debility, etc. The suspicion remains in one's mind that the diagnosis
of these is a cloak to cover ignorance. Sufficient care has not
been taken to seek out and ascertain the underlying conditions tnat give
rise to the symptom that is given the title of " diagnosis." Probably
it is beyond the scope of the Minor Ailments Clinic to inquire exhaustively
after the metabolic irregularities that would account for anaemia
and the rest, but it is not a sufficient answer to the difficulties to give
Parrish's Food or Cod Liver Oil and Malt, and await developments.
This "expectant" treatment should only be permitted after every
channel of information as to the fundamental causes of the ailment has
been explored. The pale complexioned child is not necessarily "anaemic."
Before that appellation is applied, the hæmocytometer and haemoglobinometer
should have revealed whether there is a deficiency of erythrocytes or
haemoglobin, or both. This and kindred lines of inquiry are the
directions along which advances might profitably be conducted.
(b) Tonsils and Adenoids.
Hitherto operations for these conditions were conducted at the
School Clinic, Bruce Castle. In July, 1924, the Education Committee
entered into a contract with the North Middlesex Hospital for these
operations to be performed in that Institution. The results have been
entirely satisfactory. The children, after having been seen by the
throat specialist there, are given appointments. On the appointed
day the child, prepared for operation according to a leaflet, a copy of
which is given below, is taken in the morning to the hospital. The
operation is performed in the forenoon under prolonged anaesthetic.
Chloroform and Ether is employed as the anaesthetic and the enucleation
of the tonsils from their bed is effected with deliberation. The duration
of the anaesthetic enables a thorough clearance of the post-nasal space
to be made and a digital examination to give assurance that the operation
is complete. Thereafter, the children are put to bed for a period
of several hours and are only released when there is no apprehension of
after-trouble. The children are taken home by ambulance in the
custody of a nurse.
Children who are not, in all respects satisfactory and fit for return
home, are detained as long as is necessary, the agreement making provision
for hospital residence in such cases.