“Pseudodoxia Pediatrica”

Under the heading “pseudodoxia pediatrica” Bakwin calls attention to a number of doubtful practices in current use among pediatricians. The worst offender among these, he believes, is indiscriminate tonsillectomy. The American Child Health Association, some ten years ago, surveyed a group of 1,000 children 11 yea rs of age from the public schools of New York City; 61 per cent had had their tonsils removed. The remaining 39 per cent were subjected to examination by a group of physicians who, in turn, selected 45 per cent of these for tonsillectomy and rejected the rest. The rejected children were reexamined b y another group of physicians, who recommended for tonsillectomy 46 per cent of those remaining after the first examination. When the rejected children were examined a third time, a similar percentage was selected for tonsillectomy, so that after three examinations only 65 children remained who had not been recommended for the operation. Apparently the chance that a child would be recommended for operation depended principally on the physician rather than on the status of the child’s health. In groups of children with severe dental caries and visual handicaps for which nothing had been done, about 60 per cent were submitted to tonsillectomy. Another operation often performed without sufficiently specific indications is myringotomy. The author showed at Bellevue Hospital, before the use of sulfonamide drugs, that the incidence of purulent otitis media in infants coul...
Source: JAMA - Category: General Medicine Source Type: research