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case is further complicated by the fact that in the infant school it is the breathing for voice which alone
is, in general, practised, and therefore at this impressionable period the children do not benefit by the
corrective whioh the general breathing exercises would supply.
The condition 01 the throat nas such a preponderant innuence upon me development or ear
disease and deafness that it is convenient to deal with the latter conditions next, in order.
Ear disease,
defective
hearing and
speech defects.
The percentage of children of the eight-year-old group referred tor treatment tor ear disease
was 11 in the case of both boys and girls and at the leaver age nearly the same.
The percentage of children examined at the earlier age referred for treatment for deafness was
0 5 per cent, in both sexes, and at the later age boys 0.6 and girls 0 .5.
The equal incidence upon the sexes of ear disease and deafness is in consonance with former
experience and with the equal incidence of unhealthy throat conditions. The percentage was slightly
lower than that of last year and considerably lower than those of former years. In fact, the reduction
in the number of children found in school to be suffering from deafness and ear disease has prooeeded
pari passu with the reduction pointed out above in unhealthy throat conditions.
In October, 1916, it was reported to the Children's Care (Central) Sub-Committee that during
1915 a special inspection centre for ear cases had been arranged in the south-western division and that
a special scheme of following up was in the summer term of 1916 extended to the north-western division
also. Dr. A. G. Wells, who has been responsible for the special inspections in the two districts named,
reports that at each inspection an assistant organiser is present to consult with the parents as to the
means of obtaining the special treatment indicated by the doctor. Note is made upon a special record
card of the condition found and the treatment advised. The School Care Committee in each case is notified
for the purpose of following up. Each assistant organiser has a list of the special ear cases attending
the hospital or centre at which she attends and reports to the Care Committee, without delay, any
irregularity in attendance or failure to carry out directions given. Much better results are obtained,
as might be expected, in cases which attend under the Council's scheme. From June, 1915, to June,
1916, 190 cases were seen in the south-western division, and 23.4 per cent, were discharged as cured;
from June, 1916, to June, 1917, 145 cases were seen and 30.8 per cent, were discharged as cured. Thus
the total number of cases was reduced and a larger proportion wero cured in the second year. As a
result of the success of the special inspection in these two divisions it was agreed to extend the scheme
to the other three divisions.
In my report of October, 1916, the need for in-patient treatment for some of the cases of ohronic
ear discharge was pointed out, and the Sub-Committee recommended that the Council should enter into
negotiations with the authorities of one or two hospitals in London with a view to arranging for the
reservation of five beds for this purpose at an expenditure not exceeding £260 a year. The Board of
Education did not see their way to agree to this proposal, which therefore fell through. The need of
such provision is, of course, just as urgent as it was, and the Council, at the close of 1917, asked the
Board to reconsider their decision
There has been no change noticeable in the proportion of children of either sex in each age group
found to be suffering from heart defects or anaemia, and the percentage referred for treatment for these
conditions is identical with that of the previous year. 1,222 boys (3.5 per cent.) and 1,258 girls (3.7
per cent.) at the age of eight years, and 1,197 boys (3.5 per cent.) and 1,542 girls (4-5 per cent.) were
noted as suffering from defects of the heart. 1,652 boys (4.8 per cent.) and 1.646 girls (4.9 per cent.)
were noted as suffering from anaemia at the earlier age, and 1.146 boys (3.3 per cent.) and 1,453 girls
(4.3 per cent.) at the later age. The excess of the incidence of both these conditions at the older age
upon girls corresponds with what has been experienced in all previous years and the explanation is to
be sought in the practice, towards the end of school life, of employing girls at home on household
drudgery while their brothers escape this to a greater degree and are free to engage in outdoor sports
and nastimes.
Heart defects
and ansemia.
There is no alteration apparent in the distribution of lung complaints other than tuberculosis,
which are found in about 4 per cent, of the younger and 3 per cent, of the older children, the incidence
being slightly higher at each age upon boys than girls.
The number of cases found suffering from phthisis in the course.of the routine age examination
Lung complaints,
phthisis and
other forms of
tuberoulosis.
remains exceedingly small. 296 children were found, forming a total of 0.1 percent, of those examined.
On the other hand, 438 additional children were discovered with phthisis at special and urgent
examinations. It is clear, therefore, that phthisis in school is detected at a relatively early stage, and
the children are placed under treatment before arriving at their next routine age group examination.
Tuberculosis of other organs than the lungs was found in 465 children in the age groups, or
0.2 per cent. ; as in the case of phthisis, a larger number were found at urgent and special examinations,
viz.. 511.
Contrary to the view expressed by some to the effect that air raids would be found to increase
generally the incidence upon school children of nervous complaints, there is no evidence at all in the
results of the age group examinations that there has been any general strain arising from this cause
falling upon the mass of the children, the figures being in all respects comparable to previous years.
That a limited number of children have been immediately affected is no doubt true, and this is reflected
in the figures of urgent and special inspections apart from the age group examinations. At such special
inspections 586 boys and 754 girls were reported to be suffering from nervous complaints, compared
with 508 boys and 606 girls similarly reported upon in 1916. It is unsafe to extend the results obtained
by one or two observers working in a limited and special field to the general mass of the population
and it can still safely be said that up to the end of 1917 there is no evidence that any portion of
the strain of war conditions had been allowed to fall upon the children of school age generally in London.
43316 u
Nervous
complaints.