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66
Ear diseases.
was therefore 28 per cent., while upon those who had been operated upon for tonsils
and adenoids, this incidence was only 4.8 per cent. There were numerous examples
where a child who had been operated upon was intimately exposed to infection
subsequently without contracting the disease.
The presence of ear disease or defect was noted in 3,366 children (1.7 per cent.),
compared with 4,294 children (2.1 per cent.) in the previous year. Of these 2,207
(1.1 per cent.) were referred for treatment. Defect of hearing was recorded in
1,292 children (.7 per cent.), but in only 606 of them was it considered that benefit
could be obtained by treatment. The number of children found the previous,
year with defect of hearing was 1,572 (.8 per cent.). These figures may be compared
with those of 1913, when ear disease was present in 2.4 per cent, of the children
examined, while 1.7 per cent, were found with defective hearing. Thus the proportion
of children found at routine inspection with defective hearing has during
the last ten years been halved.
Visual acuity.
There was little difference from the previous year in the figures of visual acuity.
Those for the eight-year-old children (this is the earliest opportunity the school
medical service has of testing the vision of the scholars) were returned as practically
identical in the two years, but the older children at the age of twelve showed a
slight improvement. 58.7 per cent, of boys and 53.6 per cent, of girls passed the
normal test, as compared with 57.1 per cent, and 52.5 per cent, in the previous
year, while boys with higher degrees of defect of vision fell from 20.3 to 19.7 per
cent., and girls from 22.2 to 21.5 per cent. Some improvement, therefore, continues
to take place, although it is due rather to correction of defect by spectacles than to
any natural improvement. The superiority of the boys' vision over that of the
girls remains striking, but no one will hear of sewing being taught in the morning
when the light is good, and much sewing in the winter continues to be done by
artificial light.
Enlaced glands.
Some discussion took place during the year with regard to the nature of enlarged
cervical glands. It was felt that it was generally unsatisfactory to record merely
the existence of enlarged glands while not indicating the cause, and thereby indicating
the steps that should be taken to alleviate the condition of the child. No fewer than
7,729 children (3.9 per cent.) were found to have enlarged cervical glands, and this
condition was commoner in boys of the two earlier age-groups than in older boys
or in girls. The same high incidence in younger boys was found in the previous
year, when no less than 9,331 children (4.7 per cent.) wer3 recorded with enlarged
glands of neck. The special age and sex incidence renders it pretty certain that
decayed teeth with oral sepsis are the chief determining causes.
Dr. E. J. Boome investigated the aetiology of enlarged cervical glands in the
children at Cork Street School, Camberwell. There were 996 children in the school,
and every case where palpable glands were found in the neck was recorded. They
amounted to 114 children of whom 53 were boys and 61 girls. Dividing these into
categories in relation to degree of enlargement, in 22 the glands were merely palpable,
in 59 they were moderately enlarged, and in 33 they were considerably enlarged,
and amongst the latter boys preponderated. (It is clear that Dr. Boome's "considerable
enlargement," corresponds to the degree of enlargement usually reported
by the school medical staff.) The ostensible causes were as follows:—Dental
caries and oral sepsis, 46; unhealthy condition of nose and throat, 32; eczema
associated with ear discharge 3; skin disease and verminous condition of the
scalp, 18 ; no cause found, 15.
Dr. Boome also took careful note of the presence of cervical glands in boys
who suffered from debility and were candidates for the Council's Camp School at
Bushy. 136 or about one half of the boys were found with glands of the neck
palpable or definitely enlarged, in 16 the enlargement was considerable. Here, too,
dental decay with oral sepsis was found to be the leading cause, with unhealthy
nose and throat conditions second in frequency.