Adenoids and Diseased Tonsils Part 6

TABLE III

Gain in weight, 6 months, 21 pairs

N[16] Test Group (A) Control Group (B) Lbs.

Test 1 Test 2 Gain Test 1 Test 2 Gain A-B

8 608 633 25 454 521 67 -42 2 409 429 20 523 574 51 -31 28 713 755 42 742 798 56 -14 6 438 445 7 506 525 19 -12 11 478 475 -3 416 425 9 -12 1 504 542 38 535 572 37 1 7 399 410 11 384 387 3 8 9 506 532 26 598 614 16 10 12 480 525 45 410 445 35 10 14 560 620 60 819 860 49 11 5 450 470 20 562 570 8 12 21 707 765 58 624 670 46 12 4 511 542 31 494 510 16 15 10 489 514 25 471 475 4 21 16 560 570 10 512 500 -12 22 24 585 625 40 600 610 10 30 3 550 595 45 615 629 14 31 25 555 595 40 633 638 5 35 19 900 963 63 524 544 20 43 13 900 980 80 747 768 21 59 26 638 745 107 642 670 28 79

Av. 5686 6061 376 5624 5860 239 137

M 38 19 12 75%ile 58 46 31 25%ile 20 9 1 Q 19 185 15 P. E. (distribution) 176 139 163 P. E. (average) 38 30 48 ---------------- Av. =285 P. E.

M. =280 P. E.

[16]: Numbers refer to cases as listed on Table II.

of the test group growth is greater than that of the control group. The three nutrition pairs show the following records of growth,--in number 7, the test case shows a growth of.6 in. more than his control. Number 10 is the pair in which the growth is equal. In number 11 the test case again exceeds in growth by 6 of an inch.

More reliable than height and weight considered separately, as an index of physical welfare, is weight in relation to height and age. Table V shows the improvement in this relationship for the two groups. The numbers in columns 1, 2, 4 and 5 show the per cent under or over weight of the individual cases, in relation to their respective heights and ages. The authority upon which the figures are based, is the table published by the American Child Health a.s.sociation, giving standard weights for height and age in boys.

There was an average loss of 28 per cent in the weight-height-age relationship for the test group, and of 211 per cent for the control group. The average improvement of the test group in excess of the control group is, then, 183 per cent. The median improvement of test group over and above control is 400 per cent. The test group is more variable than the control in improvement. The greatest improvement, 8 per cent, is found in both groups.

TABLE IV

Gain in Height--6 Months, 19 Pairs

N[16] Test Group (A) Control Group (B) Inches

Test 1 Test 2 Gain Test 1 Test 2 Gain A-B

9 481 494 13 519 552 33 -20 4 475 492 17 489 520 31 -14 5 449 452 3 466 481 15 -12 6 431 439 8 454 473 19 -11 2 425 441 16 452 470 18 -2 28 549 558 9 534 545 11 -2 16 516 523 7 487 495 8 -1 10 461 477 16 456 472 16 0 25 500 508 8 502 509 7 1 1 460 476 16 464 478 14 2 3 470 484 14 517 529 12 2 8 508 518 10 468 476 8 2 14 510 516 6 579 583 4 2 7 429 448 19 419 432 13 6 11 458 477 19 436 449 13 6 19 577 590 13 467 472 5 8 26 516 543 27 514 523 9 18 22 530 564 34 568 581 13 21 13 615 650 35 568 578 10 25 Av. 4926 5079 153 4920 5062 136 16 M 14 13 2 75%ile 190 175 65 25%ile 78 8 -43 Q 56 48 54 P. E. (distribution) 53 44 44 P. E. (average) 12 10 16 Av.=1 P. E.

M=125 P. E.

The greatest loss, 10 per cent, is in the control group. Eight cases show a loss in comparison to their controls, and nine reveal a gain. On the whole, there is some significance in the small net improvement manifested by the test group. The average is 202 P. E.'s, and the median 440 P. E.'s.

The dynamometer results show no gain in strength of grip six months after operation. Indeed the average of the gains of the operative cases is slightly less than the average gain of the controls. Comparing the test group with the control, we find the average of the differences to be -24. But the variability is so high (P. E. = 48) as to render this figure unreliable. The greatest loss in strength of grip is found in the control group, but the greatest gain is also in this group. Seven cases in the test group show a loss, as compared with only three control cases. In eight, or one-half of the sixteen cases, the control member of a pair gained more than the test member. Considering the three pairs of nutrition cases, we find that in pair number 7 the test case loses 15 Kg. when compared with the control; and in pair number 10, 65 Kg., while the test case in pair 11 gains 4 Kg. The conclusion from the data would seem to be that, within the s.p.a.ce of six months at any rate, operation for adenoids and tonsils brings about no increase in strength of grip.

TABLE V

Showing change in per cent over or underweight for height and age, 18 pairs

A B A-B

N[16] 1 2 3 4 5 6 7

8 - 1 - 1 0 -13 - 5 + 8 - 8 11 - 3 -12 -9 - 9 -11 - 2 - 7 10 - 1 - 5 -4 - 6 - 8 - 2 - 2 28 - 7 - 7 0 0 + 2 + 2 - 2 13 -13 -19 -6 -11 -15 - 4 - 2 19 + 6 + 8 +2 + 1 + 5 + 4 - 2 6 + 2 - 3 -5 + 5 + 1 - 4 - 1 14 -13 - 9 +4 - 5 0 + 5 - 1 7 - 8 -15 -7 - 7 -14 - 7 0 2 - 8 - 6 +2 + 9 +10 + 1 + 1 3 + 6 + 8 +2 - 5 - 8 - 3 + 5 16 -16 -15 +1 -13 -17 - 4 + 5 25 - 8 - 7 +1 + 4 - 1 - 5 + 6 5 - 4 - 1 +3 + 8 + 4 - 4 + 7 9 - 8 -11 -3 - 7 -17 -10 + 7 26 - 1 + 5 +6 + 1 0 - 1 + 7 4 - 7 - 7 0 -15 -23 - 8 + 8 1 0 + 8 +8 + 8 + 4 - 4 +12

Av. - 467 - 494 - 28 - 306 - 517 - 211 + 183 M + 5 - 35 + 400 75%ile +2 0 65 25%ile -2 - 45 - 2 Q 2 225 425 P. E. (distribution) 3 239 133 P. E. (average) 71 57 91

Av.=202 P. E.

M.=440 P. E.

Is there, after operation, an improvement in motor control and attention, and a lessening of fatiguability as these may be demonstrated in the tapping test? Table VI gives the number of taps in the first half minute of tapping for both groups before and after the six months interval. The test group suffers an average loss of 224 taps, and a median loss of 2. The average loss of the control group is 233, and the median 2.

TABLE VI

Gain in Grip--6 Months--16 Pairs

N[16] Test Group (A) Control Group (B)

Test 1 Test 2 Gain Test 1 Test 2 Gain A-B

10 125 11 -15 10 15 5 -65 27 9 6 -3 8 9 1 -4 1 13 12 -1 11 13 2 -3 14 16 15 -1 22 24 2 -3 2 9 9 0 10 12 2 -2 9 105 13 25 165 21 45 -2 7 7 65 - 5 9 10 1 -15 16 19 175 -15 10 10 0 -15 3 128 145 17 14 15 1 7 13 265 285 2 22 23 1 1 24 19 20 1 15 15 0 1 19 22 21 -1 15 12 -3 2 22 18 225 45 195 215 2 25 11 11 15 4 115 115 0 4 21 165 165 0 19 15 -4 4 23 115 155 4 145 14 - 5 45 Av. 1458 1522 62 1419 1506 875 - 24 M 0 1 -10 75%ile 3 2 225 25%ile -1 0 -25 Q 2 1 238 P. E. (distribution) 158 102 249 P. E. (average) 40 26 48

Av.= -50 P. E.

M.= -208 P. E.

There is practically no change then in the tapping ability of either group. The high unreliability of the difference (P. E. = 310) is noteworthy. It would seem that incidental causes have a much greater effect upon tapping ability than can be demonstrated as resulting from the removal of adenoids and tonsils.

Use of the tapping test as a measure of the decrease in tendency to fatigue similarly brings out no indication of any improvement in the operative group of cases. The measure of fatigue was taken as a ratio; namely, the number of taps in the first, minus the number in the second half minute over the number of taps in the first half minute. Then, if there is a greater number of taps in the second, the ratio will be minus, indicating that fatigue effect is so small as to be overcome by practice effect. This was a fact in only four cases. Since what we are measuring is improvement, the ratio for test 2 is subtracted from the ratio for test 1 to find the gain in overcoming fatigue. Table VIII shows the average gain for group one to be -0196, and the median -045.

That is, there is an average increase in fatiguability of 0196 units and a median increase of 045 with a P. E. of 02. This increase in fatiguability occurs also in the control group, average 0, and median 03 with P. E. of 03. The average gain of test group over control group is -02 and the median gain is -015. Again variability is relatively large, P. E. being 104, so that the median and average gains are -50 P. E. and -38 P. E. respectively.

We may say, then, that the capacities brought out by the tapping test seem to undergo no improvement in six months after removal of adenoids and tonsils.

The main line of interest in the present experiment lay with the relation of adenoid and tonsil defects to general intelligence. The results of the two tests dealing more specifically with this side of the problem are here set forth. Table IX shows the I.Q.'s. of the two groups before and after the six months' interval, together with changes plus or minus in I.Q., and a comparison of the separate pairs in respect to improvement.

We find that the test group shows an average gain in I.Q. of 225 points. The median gain is 2 points, the total range 18 points and P. E.

of the average is 99. The control group shows an average gain very slightly higher, 325 points, the median gain being 3. The range in this case is 32 points, but P. E. is only 47. The average of the compared gains of separate pairs is -1035. These numbers are so small as to be insignificant. Actually, we may say that the operative group as a whole showed no gain over the control group. If we examine individual cases we find that the greatest loss in I.Q. was in the control group, (8 points) but the greatest gain (24 points) also appears in this group. In the test group 11 cases

TABLE VII

Gain in number of taps in one-half minute, 21 pairs--right hand

N[16] Test Group (A) Control Group (B)

Test 1 Test 2 Gain Test 1 Test 2 Gain A-B

14 190 138 -52 175 175 0 -52 10 68 88 20 70 135 65 -45 23 150 141 - 9 122 140 18 -27 1 135 120 -15 106 115 9 -24 9 149 135 -14 144 150 6 -20 21 152 132 -20 140 138 - 2 -18 22 164 183 19 120 157 37 -18 24 157 142 -15 155 155 0 -15 27 108 97 -11 115 112 - 3 - 8 20 105 110 5 150 155 5 0 15 172 170 - 2 140 137 - 3 1 26 137 138 1 125 125 0 1 25 140 150 10 148 151 3 7 3 136 139 3 135 129 - 6 9 13 160 142 -18 150 122 -28 10 18 133 135 2 100 84 -16 18 28 150 162 12 178 170 - 8 20 8 113 110 - 3 131 101 -30 27 11 125 98 -27 155 101 -54 27 2 105 112 7 152 114 -38 45 17 90 150 60 125 121 - 4 64

Av. 13519 13295 - 224 13647 13414 - 233 09

M - 2 - 2 0 75%ile 65 45 160 25%ile -15 -14 195 Q 1075 925 1775 P. E. (distribution) 1224 733 1809 P. E. (average) 266 159 310

Av. = 03 P. E.

M. = 0 P. E.