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122 Annual Report of the London County Council, 1913.
failure were refusal on the part of parents, or neglect or inability on their part to take advantage
of opportunities offered or to persevere with treatment when once begun—

(*) Two cases were referred to the special officer, care committee organisation.
(†) One case was referred to Invalid Children's Aid Association.
(‡) One case was overlooked owing to confusion between two sisters.
(¶) In one case there were special home difficulties.
(**) Four cases were referred to the special officer, etc.
Defective hearing.— Among younger children accurate testing of hearing is impracticable under
school conditions, but in older children the whisper test is applied if there appears to be any sign of
deafness. Defective hearing was noted in 3,429 children (1.7 per cent, of the number examined) and
1,233 cases were referred for treatment. Many of these cases are associated with adenoid growths.
The older age group showed a higher percentage (2.3) of cases. Girls showed a slightly higher
percentage than boys. Among leavers the proportion in Shoreditch was over 6 per cent, and in
Bermondsey about 2.8 of those examined, while in Marylebone and Paddington it was 0.1 and
0.4 per cent.
Tuberculosis.— Phthisis was reported by the school doctors in 809 cases, 0.4 per cent, of the
children examined, 393 being referred for treatment. In many of the cases the symptoms were slight,
and under the conditions necessarily existing at school inspections, difficulty was experienced in
coming to a definite diagnosis. The number of children notified under the Tuberculosis Regulations
(B) by the school doctors during the year as suffering from tuberculosis was 161 boys and 161 girls
with the pulmonary form of the disease, and 337 boys and 232 girls with other forms of
tuberculosis. An examination of contacts is carried out in some districts by the school doctor, and particulars
of these contact cases will be found under" special and urgent examinations. The incidence
of this disease was highest among "leavers" though the severe cases were about evenly distributed
among the 3 age groups. The percentage of cases is the same for boys and girls in each age group.
Other forms of tuberculosis (including tuberculosis of bones and joints and tubercular glands)
were found in 623 cases, 0.3 per cent, of the children examined. Symptoms were slightly more
frequent among boys than among girls, but each age-group was equally affected.
Rickets.— Under this head are classed all deformities definitely stated to be due to rickets.
4,212 cases (2.1 per cent, of the children examined) were reported, but only 246 cases were referred
for treatment; many of the cases were children with some irremediable defect or condition due to
past rickets. Naturally the infant group presented the largest percentage of cases, and the results
of the disease were least frequently detected among the elder children. Boys were more frequently
found affected than girls, the percentages being 3.6, 2.3, and 2.3 in the infants, middle age-group
and leavers as compared with percentages of 2.0, 1.2, and TO among girls.
Deformities.—4,035 children with deformities were found i.e. 2 per cent, of the children
examined. 737 cases were said to need treatment. The incidence was higher among boys in the