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67
The incidence of heart disease is heavier upon girls than boys (in common with
other rheumatic manifestations) and falls especially upon the older girls amongst
whom 1,130 (3.5 per cent.) were recorded with cardiac defects. Altogether 5,208
children were returned with heart defect, being 2.6 per cent., compared with 2.8
per cent, in 1922, 3.7 per cent, in 1921, and 4.1 per cent, in 1920.
There was a considerable fall in the number of children recorded with anaemia,
viz., 5,130 or 2.6 per cent., compared with 6,058 (3 per cent.) in 1922, and 4.1 per
cent, in 1920. Here, again, girls suffer much more than boys at the twelve-yearold
period.
Children with lung complaints numbered 6,685 (3.4 per cent.), compared with
7,151 (3.6 per cent.) in the previous year. The incidence is very high upon the
entrant infants, many of whom are found to be suffering from bronchitis. Phthisis
is very rarely discovered now in the children attending elementary schools examined
in the routine age-groups. Only 175 children were found with phthisis, and
142 were found with tuberculous diseases other than phthisis. The teachers are
alive to the manifestations of ill-health in children, who are also constantly under
the eyes of the members of the care committees and are examined at least once a
term by the school nursing sisters. A child who is flagging in health no longer
sits in school waiting for a routine examination, but receives medical attention
forthwith.
The number of children found suffering from nervous disease is not high, being
1,575 in the age-groups, that is less than 1 per cent. There is, therefore, no evidence
from the statistical returns that nervous conditions amongst children are on the
increase, in fact, there appears to be a slight decline corresponding with the general
improvement in health all round. 162 epileptics were noted at routine inspections,
but a larger number were brought up at special inspections and naturally most of
these children are excluded from school. Similarly while 175 children in the agegroups
were found with chorea, 422 not of the age-groups were seen at special
inspections.
Rickets was reported in 1,975 children (1 per cent.), but the incidence upon
entrant boys was noted as 1.6 per cent. Other deformities amounted to 2,542
(1.3 per cent.), being chiefly accounted for by noticeable degrees of spinal curvature
found in the older girls (2.4 per cent.).
Skin diseases are slightly less prevalent, 2,258 children being noted as suffering,
or 1.1 per cent., compared with 1.3 per cent, in 1922, and 1.5 per cent, in 1921.
External eye disease was found in 5,237 children, or 2.7 per cent., compared with
2.8 per cent, in the previous year and 3 per cent, in 1921.
The analysis of the statistics relating to the 200,000 children examined in the
age-groups shows that the steady continuous work of the school medical service
continues to bear fruit in improving conditions of health in the London school
children. Over a period of years the improvement is very striking. Though slow
in some directions the improvement is sure. The greatest advances have been
in general cleanliness, and improvement of dental conditions, yet in these directions
most still remains to be done.
The incidence of various forms of disease upon the different ages and the two
sexes shows that there is one set of preventable conditions which falls heaviest
upon boys of eight and another set falling heaviest upon girls of twelve. The former
set is associated with grave dental decay leading to oral sepsis with enlarged cervical
glands and under nourishment, while the latter set constitutes a syndrome in which
defective eyesight, anaemia and spinal curvature are the prominent features. Both
sets of conditions require further tackling from the standpoint of prevention.
Dental hygiene must be prosecuted with energy from the earliest ages, and further
efforts must be put forward to secure that girls get the same share of open-air life
as boys and more freedom from tasks which not only prevent this, but also involve
prolonged stooping and eye-strain under unhygienic conditions.
Heart defect
and ancemia.
Lung complaints
Nervous diseases.
Deformities.
Skin diseases
and external
eye diseases.
Summary of
result of routine
inspections.