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ADENOIDS, or ADENOID GROWTHS (from Gr. Abevoetbi7s,glandular) , masses of soft, spongy tissue between the back of the nose and throat, occurring mostly in young children; blocking the air-way, they prevent the due inflation of the lungs and the proper development of the chest. The growths are apt to keep up a constant catarrh near the orifice of the ventilating tubes which pass from the throat to the ear, and so render the child dull of hearing or even deaf. They also give rise to asthma, and like enlarged tonsilswith which they are often associatedthey impart to the child a vacant, stupid expression, and hinder his physical and intellectual development. They cause his voice to be " stuffy," thick, and unmusical. Though, except in the case of a cleft palate, they cannot be seen with the naked eye, tney are often accompanied by a visible and suggestive granular condition of the wall at the back of the throat. Their presence may easily be determined by the medical attendant gently hooking the end of the index-finger round the back of the soft palate. If the tonsils are enlarged it is kinder to post-pone this digital examination of the throat until the child is under the influence of an anaesthetic for operation upon the tonsils, and if adenoids are present they can be removed at the same time that the tonsils are dealt with. Though the disease is a comparatively recent discovery, the pioneer in its treatment being Meyer of Copenhagen, it has probably existed as long as tuberculosis itself, with which affection it is somewhat distantlyconnected. In the unenlightened days many children must have got well of adenoids without operation, and even at the present time it by no means follows that because a child has these post-nasal vegetations he must forthwith be operated on. The condition is very similar to that of enlarged tonsils, where with time, patience and attention to general measures , operation is often rendered unnecessary. But if the child continues to breathe with his mouth open and to snore at night, if he remains deaf and dull, and is troubled with a chronic " cold in his head," the question of thorough exploration of the naso-pharynx and of a surgical operation should most certainly be considered. In recent years the comparatively simple operation for their removal has been very frequently performed, and, as a rule, with marked benefit, but this treatment should always be followed by a course of instruction in respiratory exercises; the child must be taught regularly to fill his lungs and make the tidal air pass through the nostrils. These respiratory exercises may be resorted to before operation is proposed; and in some cases they may render operative treatment unnecessary. Operations should not be performed in cold weather or in piercing east winds, and it is advisable to keep the child indoors for a day or two subsequent to its performance. To expose a child just after operating on his throat to the risks of a journey by train or omnibus is highly inadvisable. Although the operation is not a very painful one, it ought not to be performed upon a child except under the influence of chloroform or some other general anaesthetic. (E. O.*)
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