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of the simplest nature, extractions or fillings, no regulation cases or special operations being undertaken.
The limited variety in the nature of the work, and the class of officer required, almost demand that
the dentists should be part time officers, rather than full time. An assistant medical officer who has
also practical dental experience is highly desirable now to make observations and enquiries and prepare
information for the Council when they come to consider this very important subject.
SPINAL CURVATURE.
Elementary Schools.—In the course of the investigation into tuberculosis Dr. Annie
Gowdey noticed the condition of the backs in 410 young girls at Addison-gardens school. These were
children of ages varying from 6-16. 262 (64 per cent.) showed some abnormality. Fifty-eight were cases
with round backs, and 204 (50 per cent.) had the scapulae " growing out," with or without some lateral
curvature. There are evidently causes during school life, which should be remediable, and which bring
about this condition. The matter must be further enquired into, although there are difficulties in the way.
Meanwhile the attention of the teachers, who take drill especially, might be directed to the many causes
which have been assigned for this condition, such as school-room lighting, desks, ways of sitting crosslegged,
of standing with the weight always on one leg, defective eyesight, nail-biting, and the custom
of always carrying books in satchels on the same side, the importance of broad-soled, low-heeled shoes.
The enormous prevalence of deformity of the back among girls as compared with boys, however, points
to some specific cause, and probably there is a want of regular development of the trunk muscles, induced
by various constrictions and supports in the way of binders and corsets, which may be one of the causes.
The carrying of infants by young girls may possibly be a contributing cause.
Secondary Schools.—In examining the girls of the secondary schools and training colleges
Miss Campbell has gone into this question in regard to the general physique of the girls, and with more
detail than was found possible in regard to the notes on the elementary school children. Out of 604
examined, 138 cases showed definite lateral curvature. This is a smaller percentage than has been
reported by Continental observers. Definite osseous deformity, which did not admit of correction,
was presented by seven of these girls. Their ages were about 12, 13, 15, 20 and 22. In all the other
cases the deformity could be made to disappear by placing the patient in particular attitudes of body
and limbs. In the majority one shoulder was noticeably higher, in half the cases this was the right.
The angles of the scapulae were prominent and there was a double curve, the waist being higher on one
side. In a few cases the whole spine was convex laterally. The girls are mostly drawn from the elementary
schools, and their average standard of physique is not high. As they have all been previously
examined medically many defects have already been remedied. The 138 girls with spinal curvature
had 10 above, 91 average, and 37 below the average physique. Anaemia was present in 50 per cent. of
the cases, and very pronounced in some, of whom 8 (6 per cent.) showed decided listlessness and want
of energy. Seriously defective vision was noted in 8, and deafness or discharge from the ears in 6,
enlarged tonsils and adenoids being present in 7. As regards corsets, common sense seems prevalent.
The ordinary corsets were worn by 47, rational stays with a few or no bones by 75, whilst 16 did
without any artificial supports.
The numbers are too small to give a sufficient statement of the age incidence, but 12-13 seemed
the most prevalent time. As suggested above, the condition is to a great extent a temporary trouble
of growth, as the numbers do not markedly increase with age, and many cases improve.
The chest development is poor in nearly all these girls. They require, in the secondary schools,
special remedial exercises to strengthen the muscles of the back, develop the chest and improve the
general physique. These exercises, to be valuable, should be carried out under the supervision of the
drill mistress at least twice a week, and should be done regularly at home. The girls need individual
attention and separate exercises, so that large classes are almost useless.
In most of the schools remedial classes have been formed for the more urgent cases. At
present the drill mistresses have not sufficient time to give to this side of the work. More time should
be given, as it is required not only for girls with spinal curvatures, but for the large number with rounded
shoulders, and narrow flat chests, predisposing to consumption, which are not included here.
At Greystoke-place College more time is required for physical development. Most of the students
play no games and have time for very little exercise. Only the drill necessary for teaching purposes
is included in the course.