THERAPEUTIC BEARING d5 



adenoid vegetations. 150 children aged 8 to 12 were 

 under clinical observation in private practice from six 

 months to five years after the operation, and the follow- 

 ing defects were observed : — 



Deficient nasal respiration ... ... 38 cases. 



Acute otitis media ... ... ... 21 ,, 



Bronchitis ... ... ... ... 49 ,, 



Bronchiolitis ... ... ... ... 22 ,, 



Pneumonia ... ... ... ... 15 ,, 



(9 of which occurred during the winter following 

 the operation.) 

 Rheumatic fever ... ... ... 11 cases. 



Endocarditis ... ... ... ... 7 ,, 



Chorea ... ... ... ... 6 ,, 



Diphtheria ... ... ... ... 3 ,, 



Enlarged cervical glands ... ... 15 ,, 



Zahorsky concludes : — '' The clinical impression that 

 tonsilectomy increases the tendency to bronchial and 

 pulmonary infection is corroborated by these figures, 

 although they are not conclusive, as no figures are 

 available as to the usual incidence of acute broncho- 

 pneumonia in children. That an attack of acute ton- 

 silitis renders the child temporarily immune to a variety 

 of dangerous infections seems probable. . . . My ob- 

 servation shows that the child beginning his school life 

 without the tonsils is in greater danger of acute diseases 

 than one who still has his tonsils." 



It may here be emphasised that it would be difficult 

 to show statistically that the loss of a finger was dis- 

 advantageous ; yet we can see the mechanism of digital 

 efficiency so clearly that we can have no doubt as to 

 . the reality of the disadvantage. Granted the mechanism 

 and utility of the subepithelial lymphatic glands, ad- 

 vocated in these pages, we can have little doubt as to 

 the disadvantages entailed by their loss. 



However, the body has such lar^e powers of com- 



