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57
the spring of 1922, the Board of Education decided to make a comprehensive review
of the work of medical inspection and treatment in London. In the light of
certain suggestions made by the Board's officers, opportunity was taken to revise
the agreements between the Council and Committees of Treatment Centres and
bv general consent important modifications were made (seep. 71).
Medical
inspection,
During the year 199,812 children in the three statutory age groups were
examined by the school doctors in elementary schools, and of these 75,874 were
found to require treatment for one or more defects; 40,331 children approaching
the age of ] 4 were examined in the first two terms of the year, but the examination
of this group of children was discontinued upon the closing of the day continuation
schools. A further 2,002 children in the age groups were inspected in the special
schools, and 67,471 children not in the age groups were specially examined. In
addition the school medical staff inspected 4,813 children for scholarship awards,
and 17,742 children in connection with their specific defect in special schools. A
detailed analysis of results by Dr. C. J. Thomas is given on pages 58 to 65.
Medical
treatment.
The number of children treated under the arrangements made by the Council
was 193,854, as compared with 212,579 in 1921. There was a decrease from 94,177
to 84,848 in the number of children treated for dental defects, which was no doubt
largely due to conditions referred to above. Towards the end of the year, however,
the numbers improved considerably. There was also a decrease of 6,823 in the
number of children treated for ear, nose and throat defects. This is accounted for
in part by the fact that the steady progress made during the past twelve years has
reduced the number of children referred for treatment.
Re-inspections.
The number of re-inspections was 178,964. The combined results of first and
second re-inspections showed that 77.7 per cent. of the cases reviewed had been
dealt with, as against 78.2 per cent. in 1921. In view of the many difficulties which
were experienced during the year, this result may be regarded as very satisfactory.
In the London County Council (General Powers) Act, 1922, increased powers
were given to the sanitary authorities for dealing with the homes of persons infested
with vermin (including fleas, bugs, hoe and itch mites). This will remove some of the
difficulties which have hitherto been experienced owing to re-infestation due to bad
home conditions. The school doctors' examinations show that there has been a
considerable improvement in the cleanliness of the children during the year. The
decline in the prevalence of scabies has continued, thus to some extent relieving the
pressure at the cleansing stations, and enabling the staff to deal with increased
numbers of verminous children.
Personal
hygiene.
The behaviour of scarlet fever and diphtheria during the year was watched with
great interest. The waves of prevalence of these maladies, which, speaking broadly,
rise and fall coincidently, had swelled to a considerable height in the autumn of 1920
and a still higher level was attained in the autumn of 1921, when scarlet fever reached
almost to the mark of the epidemic of 1893 and the diphtheria cases actually
exceeded those of that year. In 1922, in accordance with the precedent of 1894
(the year after the maximum year in the great prevalence of nearly thirty years
ago), the scarlet fever figures markedly fell and there was an almost complete absence
of autumnal rise betokening apparently, in 1922 as in 1894, a considerable reduction
in the number of susceptible children at risk. The decline last year in diphtheria
was not so marked as in the case of scarlet fever and the London figures remained
unusually high throughout 1922. The question arises as to how far the maintenance
of this high level is due to the wide use of bacteriological methods of examination,
for quite a number of notified cases showed no definite clinical signs of diphtheria;
and how far to the inclusion of so-called "diphtheritic" sore throats, which may
not have really been examples of true diphtheria.
London has in the recent prevalence suffered disproportionately from diphtheria
in comparison with the rest of England and Wales, though the higher incidence upon
London is much more marked as regards cases than in respect of deaths.
Infectious
diseases.
10161
E