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95
Report of the County Medical Officer—Education.
The total pulmonary defects found in Bermondsey affected 2.0 per cent, of the contacts, and there
was a strong probability of pulmonary tuberculosis in 2.4 per cent. The proportions of contacts with
pulmonary defects to the total number of contacts were found to be as follows :—
2 occupants per room 10 out of 55 with pulmonary defects
3 ., ,, 10 „ 65 ,, ,,
4.....3 „ 15 ,, ,, ,,
5 6 „ 12
In Greenwich the number with pulmonary defects amounted to 10.5 per cent., including a percentage
of 2.85 with probable pulmonary tubercle. Of the contacts suffering from pulmonary defects :—
Bermondsey. Greenwich.
17 out of 34 were in a poor state 3 out of 11 were in a poor state of
of nutrition. nutrition
25 out of 34 were below the average 7 out of 11 were below the average
weight for age weight for age
The percentage of contacts showing enlarged tonsils and adenoids and enlargement of cervical
glands was higher in Bermondsey than in Greenwich, and was also higher in the case of thsoe with
pulmonary defects than when no pulmonary signs were present. Further these defects would appear
to be more common among tuberculosis contacts than among all London school children.
The number of children returned as suffering from rickets was 3,928 or1.72 per cent, as compared Rickets,
with 2.1 per cent, in 1913 and 1.69 per cent, in 1912. The following table gives the age and sex distribution
of cases of rickets per cent, of children examined for this and the two former years.
Entrants.
8—9.
Leavers.
Boys, 1914 2.8 2.0 1.6
1913 3.6 2.1 2.3
1912 2.77 2.47 1.19
Girls, 1914 1.5 1.16 0.82
1913 2.0 1.2 1.0
1912 1.44 1.37 0.8
At each age the results of rickets are much more often met with in boys than in girls, and, as
school life progresses, they become in each sex more difficult to recognise as such.
The number of cases of deformities other than those definitely recognised as rickets was 4,297 Deformities,
or l-88 per cent, compared with 2.0 per cent, in 1913 and 1.6 per cent, in 1912.
The age and sex distribution is given in the following percentages :—
Entrants.
8—9.
Leavers.
Boys,
1914
1.5
2.1
2.5
,,
1913
2.0
2.1
2.4
,,
1912
1.35
1.87
1.61
Girls,
1914
0.8
1.82
3.05
,,
1913
1.3
1.9
2.9
,,
1912
0.74
1.97
2.32
The gradual increase in non-rickety deformities during school life is here well shown, and also
the changing sex incidence from being heaviest in boys at entrance to school, to being heaviest in girls
on leaving school. This exceptional incidence in older girls is due to spinal curvature, and is associated
with the hygienic defects in the training of girls as compared with boys, producing in the former an
excess of severe visual defect, of anaemia and of heart defect as school life proceeds. During the first
term out of 56,366 leavers examined, 102 boys and 257 girls were found with lateral curvature of the
spine.
Malnutrition as a pathological condition was reported in 1,107 cases or 0.48 per cent, compared Malnutrition.
with 0.6 per cent, in 1913 and 0.44 per cent, in 1912.
All cases in which the doctor finds malnutrition (group " 4 ") are made the subject of a special
investigation. The child is again weighed and measured at re-inspection and in the meantime special
enquiries are made by the Care Committee into the home circumstances, the suitability of the child's
diet, the family history, the amount of sleep, and into anything that may tend to throw light upon the
cause of the malnutrition. These enquiries have been narrowed down somewhat during the year under
review, being limited to cases in which the poor degree of nutrition amounts to a definite pathological
condition. The number of cases noted at ordinary inspection during the year was 225 or just less than
1 case in 1,000 examined. The cases of malnutrition that came under review during the year included
many which were noted at inspections during the previous year. Of 330 cases re-inspected during the
year the home conditions were said to be very good in 16, good in 96, fair in 60, poor in 79, very poor
in 4 ; in the remaining 75 cases the Care Committee did not supply information on this point.