Identifier: pediatricshygien03dunn (find matches)
Title: Pediatrics : the hygienic and medical treatment of children
Year: 1917 (1910s)
Authors: Dunn, Charles Hunter, 1875-1926 Rotch, Thomas Morgan, 1849-1914
Subjects: Pediatrics
Publisher: Troy, N. Y. : The Southworth Co.
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ward, it is easy to feel whether the cavity of the naso-pharynxis clear or whether it is more or less filled by a soft, spongy mass,the hypertrophied pharyngeal tonsil. There is usually a little bloodon the finger when it is withdrawn, as the growth is friable andbleeds easily. In passing the finger over the base of the tongueit is necessary to be careful to get the finger behind the soft palate,and not to push it upward and backward, for in this case the softtissues of the palate may feel like an adenoid growth. The childcan be prevented from biting the finger by simply keeping the cheekpressed between the teeth as has just been described. TREATMENT.—The only effective treatment for adenoids isremoval by surgical operation. The question which the physician has to decide is when operationis indicated. The mere presence of adenoid vegetations in the vaultof the pharynx is not necessarily an indication for operation. Largeadenoid growths may be present in certain cases, without giving
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Fig. 235—Position in the examination for adenoids Hypertrophied Tonsils 143 rise to symptoms. The existence of nocturnal mouth breathing,snoring and a certain amount of disturbance of sleep, without othersymptoms, and without impairment of the general health, is not anindication for immediate operation. Proper hygienic management,as described in the prophylaxis of acute rhinitis, or a change ofclimate, will usually suffice in these cases. The removal of adenoids is indicated under the following conditions. 1. When obstructive symptoms are marked. If the child is amouth breather by day as well as at night, or if the adenoid facies ispresent, or if the disturbance of sleep at night is marked or appearsto be influencing the general health, the operation should berecommended. 2. If the child has a chronic nasal discharge, or is subject tofrequent colds. 3. When there is any deafness, or a chronic discharging ear, orrecurrent attacks of acute otitis media. 4. When the child is subject to

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