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an older age or parents seen on their own. There is no doubt that
the mother of a very young child has far less rigidity in her personality
and is more able to make changes because of her maternal
feelings than at any other time in her life. Therefore, psychiatric
work with this age group is possibly the most valuable that can be
done from the point of view of public health and preventive
medicine, particularly as modern scientific work emphasises that
these years are the important formative years for the child's personality.
It would seem, therefore, from the economic point of view,
that work of this nature produces a far better return for the
expenditure involved than any other in the psychiatric field.
Unhappily, only an insignificant number of pre-school children can
be seen in the ordinary way at the Hornsey and Tottenham centres
and it must be said that the lack of psychiatric help readily available
for them is a most serious defect in the present service."
Tuberculosis in School Children
During the past year an attempt has been made to devise a plan
for epidemiological action when a case of tuberculosis is discovered
in a school.
Notified cases are classified as infectious or non-infectious. If the
case is infectious and the contacts are over the age of 14 years, a chest
X-ray is advised. If the case is infectious and the contacts are under
14 years, a patch test is given and if the result is positive an X-ray is
advised together with a search for undiagnosed infectious home
contacts ; should the patch test be negative no further action is taken
When a case of non-infectious tuberculosis is discovered in a school
child, the source of infection is sought in the child's own family, but
if two or more children attending the same school are notified as
tuberculous or if no infecting contact is found at home, arrangements
are made for epidemiological investigation of the school, as if an
infectious case had been notified.
The following epidemiological investigations were carried out during
1953 :—
Tollington Grammar School
389 boys and 24 staff were X-rayed following the discovery of a
case of open tuberculosis in a 17-year-old boy attending the school.
As a result of the X-rays one boy is under observation at the Chest
Clinic though he is not a notifiable case of tuberculosis. It is unlikely
that this boy's infection was acquired in a school because two older
brothers are suffering from the disease.
Tottenham Grammar School
Following a diagnosis of tuberculosis in a master at the school,
533 boys and 23 staff attended for X-ray. As a result, one inactive
case of primary tuberculosis was found and two boys are being kept
under observation at the Chest Clinic.
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