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Report of the County Medical Officer—Education
119
It is seen that an appreciably higher proportion of mentally defective children sulfer from
complaints of this nature.
Speech.— The information with regard to defects in speech is classed under two headings—
stammering and other defects of speech. The number of cases of stammering noted during the year
was 625, and 1,939 other defects of speech were reported. Among both boys and girls stammering
was most frequently found in the oldest age group, whilst other defects of speech were most prevalent
in the youngest group. Of the children examined infants showed a percentage of stammerers
of 0.24 boys and 0.10 girls; the intermediate age.group 0.44 boys and 0.15 girls, and leavers 0.88
boys and 0.24 girls. The total 625 (0.32 per cent, of the children examined ) was made up of 473
boys and 152 girls, and the cases for treatment were 14 and 5 respectively. Stammering among
boys appears to be three times as prevalent as among girls. Other defects of speech occurred in
1,939 cases (0.98 of the number examined), 1,135 were boys and 804 girls. 39 cases were referred
for treatment, 25 boys and 14 girls.
Mental condition.— The mental condition of children is classified in three groups—(1) normal,
(2) dull or backward, (3) mentally defective.

The percentages relate to the total number examined in each age group. It must be remembered
that children suffering from mental defect come under observation and are drafted into special schools
as a rule before the intermediate age is reached. 88 per cent,, of the children were classed
as normal, and 11.8 per cent, as dull or backward. Islington showed a percentage of 6.4 backward
children among leavers, but this is probably due to the standard adopted by the school doctor in
estimating the mental condition.
Heart and circulation.— The school doctors take special note of disease of the heart and give
directions for the guidance of the teacher as to care in physical exercises, swimming, etc. A special
note of this condition is also made when selecting children for school journeys and country excursions.
During the year valvular lesions and other defects of the heart were reported in 4,336 cases (2.2 per
cent, of the children examined). 533 of these cases (0.3 per cent, of those examined) were referred
for treatment. It is further to be noted that children suffering from heart disease form a large group
amongst those admitted to special schools for the physically defective, and that the most numerous
group of children out of school for prolonged periods falls into this category.

The incidence of heart disease rose from 1.5 per cent, among entrants to 3 per cent, among
leavers, girls being more frequently affected than boys. Anaemic children were most common in the
middle age group, as was noted also in last year's report, although the more pronounced cases were
highest among the elder girls.
Lungs.— Diseases of the lungs other than phthisis were reported in 9,951 cases (5.1 per cent, of
the children examined). 2,630 (1.3 per cent, examined) were noted for treatment. The percentage
was 6 9 among entrants and 3.8 in the other age-groups. The incidence on boys was slightly higher
than on girls. Bronchitis is mainly responsible, and in the borough of Islington, where the cases have
been analysed, this complaint accounts for 86 per cent, of the cases among the entrants having disease
or defect of the lungs. Pneumonia and pleurisy, being acute conditions, are rarely discovered in
children attending school, and asthma is comparatively rare, only seven cases being reported in the
whole of the Islington schools (nearly 14,000 children examined).
Nervous Diseases.—2,179 cases of nervous diseases were found (1.1 per cent of the children
examined) and 377 of these (0 2 per cent of the examined) were recommended for treatment.
Amongst entrants 0.8 per cent had nervous complaints, but in the older age-groups the percentage