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6,622 children (3.4 per cent.) were found to have heart.defect and 6,762 (3.5 per cent.) were
found to be anaemic. In each case there was an excess of incidence in girls over boys, becoming more
pronounced the older the children grow. 4.9 per cent. of the older girls have heart defect compared with
3.8 per cent. of the boys at the same age. This has been commented upon in previous years; it is a constantly
recurring feature of these reports and it must be associated with the more confined and inactive
regime to which the girls, compared with the boys, are subjected both at school and in the home.
Heart
defects and
anæmia.
9,071 children (4.6 per cent.) were noted as presenting some defect of the lung. In contradistinction
to heart defect the incidence is by far the heavier upon the younger children. 6.8 per cent. of entrant
infants were found with some lung trouble as compared with 3 per cent. of the oldest group. Not only
is the age incidence reversed, as compared with heart defect, but also the sex incidence, for boys are
found to suffer more frequently than girls. The excess of lung defect in entrant infants is due to bronchial
affections associated with rickets and influenza, and although still comparatively high in 1919, is less
than it was in 1918, the great influenza year. Fortunately the greater number of cases clear up with care
and , like other catarrhal conditions, bronchitis tends to become rarer as school life proceeds. Nevertheless
such conditions must not be lightly treated, for a very high proportion of children suffer from
tuberculous bronchial glands, the original cause of which is to be found in such temporary affections
of the lungs.
Lung
iisease.
486 cases of phthisis were detected at routine medical examinations, forming 0.2 per cent, of all
those examined. In addition 550 (0.3 per cent.) children were found with other tuberculous conditions.
These percentages are identical with those of the previous year. With the system of care for children's
health which now obtains it is unlikely that children, except in the very earliest stages of the disease,
will be found at routine inspections to be suffering from phthisis, and it is noteworthy that as great a
number are detected among the 60,000 children specially examined as among the 200,000 at routine
insnections.
Phthisis and
other tuber.
ouious conditions.
Rickety manifestations were found chiefly in entrant boys, there being no less than 1,114, or 3.2
per cent. of these with rickets as compared with 649, or only 1.9 per cent. among entrant girls. The
excess of rickets upon entrant boys is a recurring feature year by year and is in consonance with clinical
experience at the hospitals.
Rickets.
Other deformities than rickety on the other hand increase during school life and fall heaviest by
far upon the elder girls, of whom 2.7 per cent. present deformities (chiefly spinal curvature), as compared
with 1.9 per cent. of twelve.year old boys. It is to be feared that household drudgery must be the
out of school lot of many girls as they approach school leaving age, and accounts in no small measure for
the more unhealthy condition of the girls generally as compared with boys on leaving school.
Deformities
other than
rickety.
It is ominous that the proportion of children with serious malnutrition has increased from .5
per cent. in 1918 to 1 per cent. in 1919 (compare the figures given above for nutrition). It may mean
a returning stringency of economic stress which it will be necessary to watch lest the health of the children
be prejudiced.
Malnutrition.
In last year s report reference was made to a successful class for stammering children, held under
the auspices of the Westminster Health Society. As a result of the success of this class the Council
has decided to institute a number of classes for stammering children on similar lines. It was computed
from the medical inspection returns that there would be about 1,000 stammering children in the London
schools and that the boy stammerers would outnumber the girl stammerers in at least the proportion of
three to one. In preparation for the establishment of these classes the teachers of all the schools were
asked to forward the names of all the stammering children under their care. Tney were also asked
to estimate the degree of the infirmity under the headings acute, moderate and slight. The total number
of notifications received was 914, of which 682 related to boys and 232 only to girls.
Stammering
children.

It is obvious that where the same two age groups are examined year by year a point will arrive
when the older children examined in the current year are the identical children examined during a former
year in the younger age group. Before the war that point had not arrived; during the war, time and
space forbade enlargement of the report to discuss this Question. It is now verv desirable to do so. The
Comparison
of the condition
of
same children
in 1915
and 1919.
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