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presumably remedied. Walnut Tree.walk presented a much smaller class of this kind, and this was the
case in several schools. By careful supervision from the head teachers, and co.operation of the class
teachers, many parents had been informed of children's defects, and persuaded to have them remedied,
and it appeared to be due to such supervision that the numbers had been brought so low in these
particular schools.
Dirt conditions are the most obvious and very harmful, especially to the eyes, nose and ears,
ulceration of the surface of the cornea often leaving permanent damage. In many cases the parents
will do nothing even when asked by the teachers. In one class were three children with vision less than
due to phlyctenular inflammation, which had been existing for months in spite of the parents
having been frequently asked to have the condition attended to. These dirt inflammations in children
of debilitated condition are the chief disease conditions of the slum schools, and in many cases for remedy
require removal to a different environment as in a residential country school. In the schools attended
by children of the well.to.do artizan, the clerk, and small shop.keeper the children are often over.clothed
coddled and pampered, and lymphatic conditions from want of exercise, enlarged tonsils, adenoids and
anaemia are essentially the troubles of these better class schools.

In five schools of Hammersmith and Fulham Miss Janet Campbell inspected the new admissions
to the infants departments together with a few older children, and actually recommended 196 out of 909
examined to have some form of medical treatment.
Of the 104 newly admitted infants at Campbell.street, Mr. Elmslie noted 46 as having defects
requiring remedy.
The age of new admissions varies much with the district, as pointed out by Dr. Marion Hunter,
in reporting on six Wandsworth schools. She classified them as poor, medium and better class schools
and worked out the average ages of the newly admitted children presented to her as 3 9/12, 4 5/12. and
5 years old.
The methods of examination and making returns are shown from these enquiries to require some
standardising.
If it is decided to extend medical inspection to each child the best method will be to adopt a card
system, having a card filled up at the time, or better, previous to admission to school. A definite but
simple scheme of examination being followed under uniform conditions, investigating matters likely to
in any way affect the child's school life and avoiding all matters, whether statistical or anthropometrical,
which might be regarded as merely of scientific interest. It will probably be legal in London under the
General Powers Act to inspect any child as to person or clothing. The value of the first examination
varying from two to ten minutes for each child, would be much enhanced if the mother could be present,
and give an account of the child's history, especially as regards infectious disease. It would save the
admission to school of cases with dirty heads, impetigo, ringworm, pediculi, seriously enlarged tonsils,
or adenoids, defective vision, or contagious eye disorders, also the deaf, blind or physically defective
and reduce the bulk of after inspection and the necessary staff required. The attention of teachers
would also be directed to children from the very outset, where special treatment was required on account
of nervous or other disorders, so that friction, suffering and even some of the risks of school life would
be diminished. The institution of a weekly clinic at the Head Office for the detailed examination,
under manageable conditions, of the various difficult cases arising during the week in the special schools
examinations has greatly simplified and relieved administrative treatment. From this experience
it may be taken as a necessity for many cases that they should be completely examined in detail as
regards eyes, ears and certain other matters. Probably such examinations will be best conducted at
special centres where large numbers can be rapidly and effectively handled.
The establishment of general medical inspection means sooner or later the establishment of school
clinics for treatment in quite restricted and defined ways. This treatment would be of the common
cases, for instance, of abnormal refraction of the eyes requiring retinoscopy to ascertain whether the help
of spectacles was indicated, the fitting of such with spectacles, the cases with discharging ears, cases of
skin diseases like ringworm, favus or verminous conditions and scabies ; cases requiring dental treatment.
Without such treatment mere medical inspection is incomplete, and in the majority of cases
time and trouble wasted.