London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1912

[Report of the Medical Officer of Health for London County Council]

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Annual Report of the London County Council, 1912.

Otitis. This condition was not found at routine inspection as often as would be expected. The total number returned was equivalent to 0.9 per cent. There appears to be little difference in the classes of schools except in the infants' departments.

Schools.Infants.Boys 8.Girls 8.Boys 12.Girls 12.

Enuresis was only found in 0.7 per cent. of cases. Special enquiry was not made in every case as to its presence so that possibly the percentage is really higher. The C schools are worse than the A. This may be due to a greater reticence of the parents of the children, but more probably is due to less careful training in the C class.

Schools.Infants.Boys 8.Girls 8.Boys 12.Girls 12.

Spinal curvature was present in 1.2per cent. of the children examined. In some schools it was much more marked than in others and in one school 9 cases were found in a series of 53 children examined. There does not appear to be any special incidence in the classes of Schools.

Schools.Infants,Boys 8.Girls 8.Boys 12.Girls 12.

Dr. Pinchin suggests that the treatment of these cases cannot be very satisfactorily attempted,
as only the worst cases can be sent to the physical exercise department of a large hospital. Good
results in the less pronounced cases, however, have been obtained, as will be seen in the section of this
report dealing with physical exercises, by means of experimental classes carried out by teachers in
the schools and the extension of these classes is being carefully watched.
Dr. Pinchin also points out, as has been noticed by most other observers in the schools, how
poor an idea most of the children have of expanding their chests; when told to breathe deeply they fix
their chests and make strenuous efforts with the accessory muscles of respiration; it is Surprising that
this should be the case in view of the fact that the children have breathing exercises in the schools.
The further examination of children with doubtful signs in the chest.
X-ray examination
early tuberculosis.
Dr. A. G. L. Reade has carried out a series of examinations of the chests of delicate children
by X-rays, especially in relation to early tuberculosis. He points out that there is a class of child
whom the school medical inspector is frequently asked to examine, who is generally delicate and
ana?mic, whose nutrition may be classified as "3" or "4," and who, the parents say, suffers from
headache, loss of appetite and general ill-health.
In addition there may be some cough, which is usually worse at night; very often the children
are languid, the parents stating that the children are always tired. There may be frequent fainting
attacks, while night sweats occur in a certain number of cases.
On examining these children by the ordinary physical methods of examination, if may be found
that they are the subjects of early pulmonary tuberculosis, but in the vast majority of cases no
physical signs are observed.
A number of these children have been examined by X-rays, some in conjunction with Dr. Caley,
at Queen Mary's Hospital for Children, whither they have been sent either for a period of convalescence
or as early cases of pulmonary tuberculosis, the remainder selected from routine examination in
school or from a special examination of delicate children, recommended for open air schools in the X-ray
department of the Mildmay Mission Hospital, Bethnal Green.
In some of these children the examination showed evidence of definite tubercular disease of the
lungs as shown by—
(a) Poor movement of the chest or diaphragm on one or both sides, according to whether
disease is present on one or both sides.
(b) Lack of illumination on deep inspiration in some parts of the lungs.
(c) Definite mottling due to disease.