[Report 1934] / Medical Officer of Health and School Medical Officer of Health, Swindon Borough.

  • Swindon (Wiltshire, England). Borough Council.
Date:
1934
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1934] / Medical Officer of Health and School Medical Officer of Health, Swindon Borough. Source: Wellcome Collection.

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    13 results and were seldom undertaken injudiciously. But with the rise of preventive medicine, those who formerly dealt solely with the diseased imagined, completely erroneously, that measures which produced excellent results in the mitigation of the results of disease would be suitable also for preventing those diseases from arising. So operations for tonsils became common as a preventive measure, to prevent the possibility of disease of the tonsils arising and to prevent those forms of illhealth which were alleged to be con¬ current with, or consecutive to it. As our knowledge of physiology advanced, especially when physiology itself was recognised to be a detail of general biology, the prevention of disease, which was a dream, evolved into the maintenance of health, which is a reality. So a new conception of prevention came into being, a conception which even now is not generally known, nor appreciated. In this conception, the removal of any structure to prevent it from be¬ coming diseased can find no place, so a re-action against the re¬ moval of tonsils, except on proof that they are actually harming health, began to filter into medical philosophy. But it was not philosophy but finance which brought about the reaction against the wholesale removal of tonsils and adenoids. In the present state of the controversy, reduction in the numbers of throat operations is therefore sought largely to save expense and not ' wholly upon the grounds of physiological soundness. During the | past few years much research has been undertaken which is on the | whole unfavourable to throat operations, but it must be under¬ stood that the validity of operations for the relief of definite present disease is not assailed. The operation is required somewhat extensively, not in the interests of preventive medicine, but r because our knowledge of prevention is rudimentary and therefore t its practice frequently fails. With our present knowledge we have gone as far as we can to limit operations on the throat to these cases in which the advantages of the procedure obviously out- j weigh the disadvantages and we can make no further progress i until we know more of tonsillar function and the part played by [ the tonsils and allied structures in the struggle for existence. Here our knowledge might be greater than it is and our teaching ] much improved if we paid more practical attention to epidemiology i and accepted without equivocation that infection is not disease and 1 the reaction to it normally a physiological and not a pathological 1 process. In reaction, especially that to the endemic parasites [ spread usually by droplets, the tonsils and associated structures * play a conspicuous part though it must be admitted that the I meaning of their play is not altogether clear. The behaviour of 1 the tonsil and its associated lymphatic structures in scarlet fever ) suggests a line of research which might be profitable. Scarlet i fever is one of the commonest reactions to the commonest of ; human parasites and usually at the present time is a reaction 1 which may well be considered within the limits of physiological