William Hegel, who is pictured on page 48, before his tonsils and adenoids were removed was described by his father in this way: "When playing with other boys on the street he seems dazed, and sluggish to grasp the various situations occurring in the course of the game. When he decides to do something he runs in a heedless, senseless way, as if running away,—will bump against something, pedestrian or building, before he comes to himself; seems dazed all the time. When told something by his mother he giggles in the most exasperating way, for which he receives a whipping quite often." The father said the whipping was of no avail. The child was restless, talkative, and snored during sleep. He had an insatiable appetite. He was removed or transferred from five different schools in New York City. To get redress the father took him to the board of education, whence he was referred to the assistant chief medical inspector of the department of health, whose examination revealed immensely large fungous-looking tonsils and excessive pharyngeal granulations (adenoids). He was operated on at a clinic. The tonsils and adenoids removed are pictured on the opposite page, reduced one third. After the operation the child was visited by the assistant medical inspector. There was a marked improvement in his facial expression,—he looked intelligent, was alert and interested. When asked how he felt, he answered, "I feel fine now." It required about fifteen minutes to get his history, during all of which time he was responsive and interested, constantly correcting statements of his father and volunteering other information. Eleven days after the operation he was reported to have had no more epileptic seizures. "Doesn't talk in sleep. Doesn't snore. Doesn't toss about the bed. Has more self-control. Tries to read the paper. His immoderate appetite is not present."

Reason Enough For Mouth Breathing: Adenoid And Tonsils Reduced One Third

While the open mouth is a sure sign of defects of breathing, it is not true that the closed mouth, when awake and with other people, is proof that there are no such defects. Children breathe through the mouth not because they like to, not because they have drifted into bad habits, not because their parents did, not because the human race is deteriorating, but because their noses are stopped up,—because they must. A mouth breather is not only always taking unfiltered dirt germs into his system but is always in the condition of a person who has slept in a stuffy room. What extra effort adenoids mean can be ascertained by closing the nostrils for a forenoon.

For many reasons it is perhaps unfortunate that we can breathe at all when the nose is stopped up. If we could see with our ears as well as with our eyes, we should probably not take as good care of our eyes. In this respect the whole race has experienced the misfortune of the man of whom the coroner reported, "Killed by falling too short a distance." Because we can breathe through the mouth we have neglected for centuries the nasal passages. When a cold stops the nose we necessarily breathe through the mouth. Unfortunately children make the necessary effort required to breathe through the nose long before other people notice the lines along the nose and the slow mind. Mouth breathing will show with the child asleep, before the child awake loses power to accommodate his effort to the task. Therefore the importance of a physical test at school to detect the beginnings of adenoids and large tonsils before these symptoms become obvious to others.

No child should be exempted from this examination because of apocryphal theories that only the poor, the slum child, the refractory, or the unclean have defects in breathing. This very afternoon a friend has told me of her year abroad with a girl of nine, whose parents are very wealthy. The girl is anæmic. Her backwardness humiliates her parents, especially because she gave great promise until two years ago. High-priced physicians have prescribed for her. It happens that they are too eminent to give attention to such simple troubles as adenoids that can be felt and seen. They are looking for complications of the liver or inflammation of muscles at the base of the brain. One celebrated French savant found the adenoids, assured the mother that the child would outgrow them, and advised merely that she be compelled to breathe through the nose. The mother and nursemaids nag the child all day. The poor unwise mother sits up nights to hold the child's jaws tight in the hope that air coming through the nose will absorb the adenoids. The mother is made nervous. Of course this makes the child more nervous and adds to the evil effects of adenoids. If the mother had the good fortune to be very poor, she could not sit up nights, and would long ago have decided either to let the child alone or else to have the trouble removed.