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about 90 per cent. of adolescents show evidence of
"tuberculisation," or infection with tubercle bacilli. Only a
small proportion of these ever develop tuberculosis.
Thus, though the disease, tuberculosis, is steadily
diminishing in its incidence on the community, there is no
evidence that the infective agent is any less disseminated
throughout the populations of towns. The ultimate
eradication of this great scourge may, indeed, be through a
naturally acquired racial immunity—a state of "universal
tuberculisation with tuberculosis."
If this modern conception of tuberculosis is correct, it
indicates that further progress will be achieved, not so much
by attempts to prevent children being infected as by taking
measures to ensure the development of a sound and permanent
immunity response to tuberculisation. Of these the
most important is sound nutrition. Definite cases of tuberculosis
in children of school age are now few and far between.
The total of 8 cases entered in Table III. has been arrived at
after careful consideration of the records in consultation with
Dr. Dobson, Tuberculosis Officer of the Middlesex County
Council.
(b) Cripple Children.—Under this heading are included all children
with any physical defect of body, or limbs, or heart severe
enough to make attendance at an ordinary elementary school
a matter of difficulty or danger for the child. The present
number of cripples is 14, of whom 3 are at Certified Residential
Cripple Schools, 4 at Certified Day Cripple Schools, and 7 at
other Institutions.
In addition to these there is a number of children in the
elementary schools who are technically crippled, but whose
crippling defect does not call for special school provision.
Examples of these are—healed tubercular disease of bones or
joints, leaving stiffness of a joint, or possibly some shortening
of a leg, causing the child to walk with a limp; old infantile
paralysis, leaving a weak arm or leg: or accidents causing loss
of a limb, and so on. These children are kept under special
observation by the School Medical Staff, get such treatment
as may be required under the orthopaedic scheme, and do
perfectly well in the ordinary elementary school.