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14
EXAMINATION OF INFANTS.
The following tables show the result of the routine examination of 221 infants of 3, 4, and 5 years
of age, representing the new children admitted to several infant departments in Islington schools of
average type. Each child was examined by Mr. Cecil Rowntree, as fully as is possible without removing
the clothes except in special cases. The general nutrition, the condition of the teeth, excessive dirt,
etc., were noted in each case, and any departure from the normal, however slight, was recorded. Ill
boys and 110 girls were examined with the following results :
Of the total number (221) only 115 could be regarded as absolutely normal, while 46 per cent,
of the boys and 38 per cent. of the girls had some definite defect of a nature that could be classified.
The remaining 12 were noted as being below "par," either physically or mentally, but showed no actual
lesion. The following table shows the above figures in full:

Cervical Glands.—Of the 21 cases of enlarged cervical glands tuberculosis was the cause in
2, enlarged tonsils and adenoids in 10, very bad teeth in 3, and in the remaining 5 no special cause could
be discovered.
The largest number of defects is constituted by what may be termed the naso-pharyngeal cases,
those suffering from tonsils or adenoids, nasal obstruction or mouth-breathing. These were 20 per cent.
of the total number examined and 47 per cent. of those with defect. The incidence of naso-pharyngeal
conditions was 30 per cent. higher in the boys than in the girls, but the numbers dealt with are too
small to warrant deductions. It was in these children that the greatest number of defects was discovered,
some of the cases presenting two, three, or even more lesions—usually more or less co-related.
For instance, some of them were mouth-breathers, with deviated nasal septum, tonsils and adenoids,
septic mouths, and were suffering from deafness, otorrhœa, impetigo and blepharitis; this with possibly
the addition of a squint is by no means an overdrawn picture of cases frequently met with. The figures
given in these tables do not reveal the full importance of naso-pharyngeal defect, as it is in later childhood
that the gravest consequences of this condition show themselves, viz., the deafness, otorrhœa,
dental caries and other conditions which are known to be intimately associated with it. For example,
only seven cases of deafness were detected, three of whom had otorrhœa; a percentage far below what
would be found if the same children were re-examined a few years later.
Teeth.—A study of the condition of the teeth in these cases reveals no new fact, but confirms
what has already been pointed out on previous occasions—
(1) The increasing amount of caries from three years of age and onwards;
(2) The fact that girls have slightly better teeth than boys.
The cervical glands were markedly enlarged in 20 cases, the enlargement was in nearly every
case either associated with carious teeth or with naso-pharyngeal conditions. Impetigo was met with
in 15 children, but hardly calls for special note beyond the fact that it appears much more common in
infants than in older children.
Eyes. —Systematic examination of the eyes from the point of view of acuity of vision was not
carried out, but systematic vision testing of children between the ages of six and seven just before their
transfer to the more exacting visual conditions in the boys' and girls' departments, would be of great