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89
Report of the County Medical Officer—Education.
The number of cases suffering from skin disease reported was 4,080 or 1.8 per cent., as compared
with 1.9 per cent. in 1913. Boys show a higher percentage of skin complaints than girls and the cases
are most frequently met with in the entrant group.
Skin
diseases.

The figures given in the table below are the percentages of those cases of enlarged tonsils and
adenoid growths which are producing symptoms of such a character as to necessitate reference of the
children to treatment centres for operation. The total number of such cases was 15,526 or 6.8 per cent.,
compared with 5.8 per cent. in 1913 and 9.07 per cent. in 1912.
Entrants. 8-9. Leavers.
Boys, 1914 8.8 6.7 4.7
1913 8.3 6.1 5.3
„ 1912 10 .73 8.76 '7.92
Girls, 1914 7.7 6.3 5.4
„ 1913 7.4 6.3 5.8
„ 1912 9.2 8.6 8.68
Adenoids,
and enlarged
tonsils.
These figures are more reliable than percentages based on figures merely representing all degrees
of defect, however slight or severe.
It has already been pointed out that the proportion of children now found with adenoids and
enlarged tonsils is less than it used to be. So much so, that the facilities for treatment, based on former
experience, have proved to be slightly in excess of present requirements and have been, in consequence,
curtailed. The figures for the present year correspond very closely with those of the previous year, but are
much below the 1912 figures. The greater reductions at the older ages lend some force to the contention
that the facilities for treatment have played a direct part in improving the health of the children.
Other diseases of the nose and throat referred for treatment amounted to 1,476 or
0.6 per cent.
Enlarged glands of the neck were reported in 20,293 instances or 8.8 per cent. as compared
with 10.5 per cent. in 1913. Of this large number, however, only 1,001 were considered serious enough
to require special measures of treatment.
Enlarged
glands of
the nock.
Renewed attention has of late been paid to abnormalities of the thyroid gland in children of
school age. Hitherto, investigation has been chiefly directed to conditions in which there is a deficiency
of thyroid secretion. The profound effects of this deficiency, leading in the worst cases to idiocy and in
the milder cases to retardation of mental and physical growth are well understood, and the marvellous
results of administration of extract of thyroid gland to the sufferers have been often demonstrated.
Of late an attempt has been made to trace the relationship of thyroid deficiency to the condition of
rickets, and observations are being made in the schools in this connection. The effects of over-action
of the thyroid gland, in adults, in the production of the group of symptoms constituting Graves' disease
or exophthalmic goitre are known, but little attention has been paid to the existence of the beginnings
of this condition in children of school age.
Abnormalities
of the
thyroid
gland.
Before leaving the Council's service to take up work as chief school medical officer to the Transvaal
Government. Dr. Louis Leipoldt devoted a considerable amount of attention to this question. Out
of 5,000 children examined at routine inspections Dr. Leipoldt found 52 cases in which it was
possible to detect symptoms of over-action of the thyroid gland. The percentages of enlarged
thyroids and of cases showing symptoms of over-action are:—
Enlarged Thyroids. Over-Action of the
Thyroid.
Boys 1.4 per cent. 0.8 per cent.
Girls 3.4 per cent. 1.2 per cent.
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