The new personal experience made a deep impression upon my friend's mind. He wanted everybody to know how easy it was to overlook a child's distress. One person after another had a story to tell him; even the janitor said: "You'd ought to have seen our John at sixteen. He spent a week by the hospital." The only people who do not seem to know more than the new convert are the mouth breathers whom he religiously stops on the street.
The indexes to adenoids and large tonsils for the teacher to read at school are:
1. Inability to breathe through the nose.
2. A chronically running nose, accompanied by frequent nose-bleeds and a cough to clear the throat.
3. Stuffy speech and delayed learning to talk. "Common" is pronounced "cobbéd"; "nose," "dose"; and "song," "sogg."
4. A narrow upper jaw and irregular crowding of the teeth.
The adenoids and large tonsils discovered at school are an index:
1. To children needlessly handicapped in school work.
3. To whole classes held back by afflicted children.
5. To homes where children's diseases and tuberculosis are most likely to break out and flourish.
6. To parents who need instruction in their duty to their children, to themselves, and to their neighbors, and who are ignorant of the way in which "catching" diseases originate and spread.
The riot that occurred when the adenoids of children in a school on the "East Side" in New York City were removed without the preliminary of convincing the parents as to the advantages of the operation was merely a demand for the "right to knowledge," which is never overlooked with impunity. Reluctance to permit operation on a young child, and the natural shrinking of a parent at seeing a child under the surgeon's knife, require the teacher or school physician or nurse to answer fully the usual questions of the hesitant mother and father.
1. Is the operation necessary? Will the child not outgrow its adenoids? Usually the adenoid growths atrophy or dry up after the age of puberty. Adenoids are not uncommon in adults, however. The surgeon general of the army reports that during the year 1905, out of 3004 operations on officers and enlisted men in service, there were 225 operations on the nose, mouth, and pharynx, 103 of which were operations for adenoids and enlarged or hypertrophied tonsils. Allowing the child to "outgrow" adenoids may mean not only that he is being subjected to infection chronically but that his body is allowed to be permanently deformed and his health endangered. Beginning at the age of the second dentition, the bones of jaw, nose, throat, and chest are undergoing important changes--nasal occlusion. Adenoids left to atrophy--if large enough to cause mouth breathing--may mean atrophy of this developing process, permanent disfiguration of face, and permanent deformity of chest and lungs.