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15
value and would in all probability diminish the large number of cases of astigmatism and myopia at
present, met with in older children. It is extremely rare to find an infant, who has been provided
with spectacles; in the infants' department of a fairly good class school with a roll of 350 only one child
was found wearing glasses.
The above figures do not fully represent the amount of disease present in children of the age
under consideration, as many who would have been classed among the defectives have escaped
observation owing to absence on account of "delicacy" or some more definite defect.
On the other hand, included among what may appear an excessive number of defectives, are
many in which the defect was very trivial, such as impetigo, or in which medical treatment could do
but little as in the case of old rickets, mental defect, and physical inferiority, the results of improper
feeding, defective hygienic surroundings and the environment that goes to complete the picture of
poverty, dirt and misery.
ENLARGED GLANDS.
The lymphatic glands about the head and neck, which guard the various entrances to the body,
are of interest as they show the effects of any invasion. In the debilitated they become chronically
inflamed and may pass into diseased conditions. The causes so far as they could be ascertained have
been investigated by Miss A. M. Roberts who examined 750 boys and 750 girls distributed evenly in
the Council's schools.

In some cases of enlarged glands the cause is tubercle, but in many there is an irritant acting
before the tubercular infection, some cause such as the irritation of pediculi, the catarrhal changes
induced by enlarged tonsils or adenoids, carious teeth or eczematous conditions of the face, blepharitis,
conjunctivitis and other contagions of low infective power. From the table it is seen that the number
of cases among the girls is more than double that of the boys, partly from the healthier tone from more
energetic exercises among the boys and partly from the less frequent pediculous irritation of the scalp.
Whilst 50 per cent. of the boys had decayed teeth without enlarged glands, this occurred in only 13 percent.
of the girls, evidence of the large part pediculi play in causing such irritation. Where tubercle
effects a lodgment in such chronically inflamed glands there is always risk of its progress, so that the
brain, lungs, or peritoneum may ultimately become affected. The result of this enquiry shows the
extreme importance of the cleanliness which we are trying to effect in the schools, and the necessity for
treatment of carious teeth and of chronically enlarged tonsils or adenoids. Among the 1,500 children only
2 had had conservative treatment of the teeth. Some figures are also given on p. 14 relating to the
condition of the lymphatic glands in very young children.
ADENOIDS.
Early in 1908 the managers of certain schools being anxious to follow up any cases requiring
treatment in the matter of enlarged tonsils, adenoids or obstructed breathing, Mr. Yearsley undertook
the selection of such cases at Walton-street, Marlborough-road and Cook's-ground schools. At
Walton-street the number on the roll was 119 mixed, and 114 infants. Of these. 84 were selected for
detailed examination and 19 of the mixed and 41 infants were returned as suffering from enlarged
tonsils and adenoids, or adenoids alone. There were 10 infants and 11 from the mixed department
requiring immediate treatment. At Marlborough-road senior and junior mixed departments with a
roll of 827, 231 were selected, 94 having adenoids with or without enlarged tonsils, and 40 probably
adenoids; immediate treatment was required by 32. The infants' department had 303 examined, 105
being judged as having adenoids and 26 probably; the number requiring immediate treatment was
34. At Cook's-ground every child was examined : of the 274 infants, 60 had adenoids and 32 probably ;
of the 297 girls, 81 had adenoids and probably: 30 others; and of the 317 boys, 77 had adenoids
and 22 probably. 14 girls, 1 boy, and 2 infants had had adenoids removed during the twTo preceding
years, and 40 girls, 15 boys, and 22 infants required immediate treatment.