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23
The Results of Medical Inspection.
Altered procedure
with
regard to
inspeotion of
infants.
The entrant children were not, as formerly, examined in detail; all entrants were submitted
to a preliminary inspection by the school doctor, and only those selected by him were summoned for
detailed inspection, and the parents informed. The normal number of entrants in an ordinary
year is about 85,000; during the present year 84,088 entrants were inspected under the
new procedure, and out of these 13,222 boys and 12,746 girls—i.e., 30 per cent, were in fact
selected for detailed inspection. There must necessarily be some apprehension that by this method
a certain number of children, who may be the subject of hidden defect, may escape notice. A comparison
of the results with those of the years immediately preceding, shows that there has been good
ground for apprehension on this point, and it will be necessary to revert to the former practice of examining
each entrant infant in detail as soon as the conditions of National Service make it possible to do-so.
In 1914, 94,723 entrants were examined in detail, and out of these 33,532, or 35 per cent., were found
to have defects necessitating advice. In 1915, 83,419 entrants were examined, and 29,249, or again,
35 per cent., were referred for treatment. During the present year, out of 84,088 entrants originally
presented to the school doctors for preliminary inspection, only 19,076, or 22.7 per cent, were finally found
to require medical advice. The difference between 22.7 per cent, and 35 per cent, is too great to be
explained on any other ground than that of a less effective method of procedure during 1916, and
although it might be that most of the 12 per cent, or so, of children who were missed, represented the
slighter and less serious cases, and therefore the alteration in procedure may be looked upon as justifiable
as a war measure, it is not safe to assume that every child among the 12 per cent, was free from serious
defect of the internal organs such as the heart and lungs; the more so as the superficial defects of skin,
ear, nose, and eyes which are often slight, would nevertheless be detected at the preliminary inspection.
A closer analysis of the figures bears out this view; while most cases of anaemia and malnutrition
appear to be detected at preliminary inspections, many cases of ear disease, tuberculosis, and other
diseases of the lungs do not come to light. Thus in 1915 ear disease was found in 2.6 per cent, of the
infants, while in 1916, only one-lialf of this proportion—viz., 13 per cent, was detected. Lung complaints
in 1915 were found in 6.5 per cent., but in 1916, onlv in 2 4 per cent.
Routine
inspection
of older
children.
With regard to the routine examination of the older children, 42,965 boys and 42,811 girls were
inspected at the intermediate age, and 43,301 boys and 43,682 girls as leavers.

Attendance
of parents at
the inspections.
Owing to the new and urgent claims on the parents' time, a falling off was experienced in 1915
in the numbers of parents meeting the doctor at the time of inspection. It is satisfactory to note that
the falling off this year, as compared with last, is so small as to be almost negligible. In 1915, the
percentage of parents present was 56.6; this year, it was 55.2.
The figures still show greater solicitude on the part of the parents in regard to the entering babies,
in fact, the falling off in the attendances of the mother in these cases, as compared with pre-war
experience, is very slight, and this may be looked upon as further argument for a return as soon as
possible to the former procedure of complete inspection.

Indices of
the eflects of
economic
conditions.
It was pointed out last year that the analysis of the figures relating to the clothing and footgear,
to nutrition and to cleanliness, affords important indications with respect to the home circumstances
of the children, and, since every one of the quarter 'of a million children examined each year is placed
in one of these categories, which may be described as good, fair, and poor, it is possible to use the
figures as indices of the effect of economic conditions on the life of the people. Dr. C. J. Thomas
has analysed the figures for the present year, together with those of the three previous years, and they
are given on page 24, in extenso, for the two older age groups.
It is possible to see at a glance that the steady improvement of previous years in clothing and
footgear and in cleanliness has been fully maintained during the present year, and that in regard to the
nutrition of the children there has been no receding from the high-water mark reached last year.
This fact is presumably attributable in some measure to improved economic conditions, but,
is no doubt largely due to the maintenance of the medical and cleansing work now carried on for some
years past in the schools.
* These splendid results, which show that none of the horrors of war have been allowed to affect
the general condition of the children, or to interfere with the growth of that solicitous care for their
welfaie, which has distinguished recent years, are a matter for profound joy and satisfaction. They
may well encourage us to face the future with complete confidence, for a community that can thus protect