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12
The main disabilities dealt with, details of which will be
found elsewhere, are:—
(1) Debility, anaemia and malnutrition;
(2) enlarged tonsils and adenoid growths at the back
of the nose;
(3) inflammation of the middle ear, frequently with
chronic discharge and deafness;
(4) bronchial catarrh;
(5) impetigo and other skin diseases.
The privilege of being able to take to the Clinic a child
because it is not thriving or not looking well is greatly appreciated
by the mother, and is of great importance to its future welfare.
Various factors have to be considered as possible causes
of variations in the standard of health in young children. These
may be classified under three headings:—
(1) Heredity;
(2) defective feeding;
(3) defective hygienic conditions due notably to bad
housing and overcrowding.
Without denying the importance of either of the first two
factors, defective hygiene conditions, as represented by absence
of fresh air and sunlight, the breathing of vitiated air, and the
lack of the opportunity of exercise in the open, are the great
factors leading to impaired development in the adult.
The standard of feeding of the children in Hornsey must
be considered as good. The cases where one suspected gross
ignorance or negligence in feeding were systematically followed
up by the nurse or other viaitors.
In a certain numb or of the children where the condition
of the child seemed to demand it, milk has been supplied at
school frequently with the greatest benefit. When the child
is suffering from lack of nourishment the regular supply of milk
in this way is much more effective than the administration of
cod liver oil, although malt and cod liver oil are often very
beneficial. This is also given at the school when recommended
by the Medical Officer. It is a mistake to suppose that every
delicate child requires cod liver oil. Many have too much
greasy and fatty focd in their ordinary diet, and when the child
is pale and anaemic and suffering from indigestion and loss of
appetite (Parrish's) chemical fowl has been frequently used
with great benefit. This also has been given at school to many
children during the past year.