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89
recorded and, in a certain proportion of cases, the blood pressure measured by
sphygmomanometer. The heart condition is investigated by palpation and
auscultation, not only as regards presence or absence of actual disease, but with a view
to assessing reserve powers for physical strains. If there is any doubt about heart
or lung conditions, the pulse and respiration rates, and, when necessary, also blood
pressure, are compared both before and after standard exercises, and a note made as
to the ability to tolerate exercise without risk or distress. As a routine measure,
abdominal conditions are not physically examined, but patients are questioned to
elicit any stomach, liver or kidney symptoms, or any signs of local inflammation,
appendicitis, hernia or pelvic troubles. The commonest hindering defect here is
visceroptosis, usually readily diagnosed by posture and appearance. Further
questioning follows and inspection is made as regards varicose veins, knee or joint
troubles, swelling of ankles after exercise or flat-footedness. Where any suspicion of
disease or defect arises, it is followed up by thorough investigation, save that X-rays
are not at the disposal of the examining doctor, and, apart from radioscopy, every
reasonable care is taken to detect anything likely to be a hindrance or to cause
unusual risk in the practice of the physical exercises.
On the transfer, in June, 1922, of the Public Health Department to the County
Hall, arrangements were made whereby medical aid and advice could be given in the
event of cases of accident or sudden illness occurring at the Hall. From June to the
31st December, 1922, aid was rendered and advice given in 37 cases. Generally,
the cases were of a minor character, such as faintness, bruises owing to falls,
sprains, foreign bodies in the eyes and poisoned wounds; there were in addition
a few cases of serious burns.
Accidents
and sudden
illnesses ac
County Hall.
Supervision of dietaries.
In connection with the scheme for the provision of dietary to necessitous and
other children, the systematic examination of milk meals has been continued during
the year. The total number of samples dealt with was 1,074, the results must be
considered as satisfactory, only 6.4 per cent. of the samples examined being reported
to contain added water or to be deficient in fat. This figure compares with 5.5 per
cent. during 1921; the apparent increase is, however, due to a higher requirement
of the Council's contract as regards the amount of fat, viz., 3.25 per cent. instead of
3.0 per cent. Calculated on the basis of 1921, the percentage of unsatisfactory
samples would have been as low as 4.3 per cent., the lowest figure reached since
systematic examination was carried out. The maximum addition of water found in
any one sample examined during the year was 17 per cent., whilst the maximum
abstraction of fat was 35 per cent.
Samples of meals other than milk meals have again been systematically examined
this year. In a number of cases the meal has been found to be below the
recognised standard in nourishing constituents.
Defective children.
The total number of examinations conducted under the Education Act during
the year was 23 128.
4,843 admission examinations were held as compared with 5,371 in 1921.
1,439 children (742 boys and 697 girls) were deemed suitable to attend elementary
schools, 89 (45 boys and 44 girls) schools for the blind, 291 (121 boys and 170 girls)
schools for myopes, 102 (54 boys and 48 girls) Swanley, 898 (439 boys and 459 girls)
P.D. schools, 1,172 (663 boys and 509 girls) M.D. schools, 4 (3 boys and 1 girl) open
air schools, 67 (33 boys and 34 girls) schools for hard of hearing, 134 (53 boys and 61
girls) schools for the deaf, 33 (17 boys and 16 girls) were epileptic, 466 (197 boys and
269 girls) invalided from school attendance, 133 (80 boys and 53 girls) imbeciles,
and 15 (9 boys and 6 girls) were idiots.
10161 G
Admission
examinations.