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cent. had cleared up naturally or were considered not amenable to treatment, and 42 1 per cent. were
untreated and still required treatment. Thus 48.2 per cent. of the cases were discharged at first-reinspection,
and 51 8 per cent. were marked for further following up.

School-leaving examination.
At the final or leaver age group inspection, the school doctor indicates in an appropriate space
upon the medical record form whether a further examination is desirable immediately before the child
leaves school. The children thus indicated are presented to the doctor in the term preceding that in
which they are due to leave. The school doctor enters upon the record card a final opinion relative to
suitability for employment, and this is transferred by the head teacher to the school-leaving form (or if
desired, entered upon this form by the school doctor himself) for the information and guidance of the
Juvenile Advisory Committee.
Report by
Dr. Chaikin
on the
medical work
in connection
with the
Juvenile
Advisory
Committee
of which he is
a member.
Boys and girls may come before a Juvenile Advisory Committee in different ways. It is usual for
them to be referred by the school after-care organisation, or they may come direct to the Labour
Exchange, after having already been in an employment of their own finding. In the first-named
circumstances, the school-leaving form is frequently at the Exchange before the applicant appears.
The medical record side of employment, in so far as the Exchange is concerned, begins with the
school-leaving form. Dr. Chaikin insists upon the importance of filling it in so that it should convey
to everybody likely to read it the physical condition of the child. Technicalities are best omitted. Not
only should it state defects, as for example, " heart disease," " very bad sight," but the child's physique
should be summed up in such terms as " robust," " delicate," " tendency to chest trouble," " rheumatic,"
etc. Work on a rota committee demonstrates the utility of this.
Employment is selected by the rota members, working with the officers, who are experts conversant
with all labour problems. Medical questions arising as to the suitability of a particular employment
for a certain boy or girl, provide the work for the medical member, who, of course, also sees the
applicant on the question of employment generally.
Certain of the rotas are set apart for seeing and talking to those already in employment, as well as
for advising new applicants, and there is thus an opportunity for the medical member to advise individuals
on the question of health maintenance in relation to work. His presence may often help to
throw light on difficult medical questions, e.g., there may be a physical cause for continual change of
employment—the " rolling stone " type of case. At the meetings of the Committee special medical
questions may come up in the course of discussion. Medico-legal topics may also arise.
The experience gained at the labour exchange is of help, too, in other spheres of school medical
work. As an example might be mentioned the interest taken by interim tuberculosis care committees
in the work of consumptives who have returned from sanatoria.
Education (Provision of Meals) Act.
In connection with the regulations issued by the Board of Education in 1914 one of the questions
upon which stress is laid is the extent to which the service is co-ordinated with the school medical service.
In regard to this question among the points set out in the instructions of the Board for the guidance of
their medical officers at the forthcoming inspections of the arrangements were supervision of dietary,
medical inspection of individual children, and arrangements for ascertaining and recording the effect
of the meals on the physical and mental condition of the children.
Supervision
of dietary.
All questions of alterations and modifications of the menus are referred to the school medical
officer. Actual samples of meals provided are forwarded to the public health department from time to
time for analysis and the results of analysis are transmitted to the education officer with recommendations
as to improvement of the dietary in cases where this appears to be inadequate. Similar provision exists
for examining samples of milk supplied to the schools.
In connection with proposals for retrenchment a number of the menus in use have been submitted
for revision, particularly in relation to the question of substitution of other forms of food for meat. It