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medical examination of children immediately prior to leaving school; (ii.) extension
of dental treatment and treatment of minor ailments ; (iii.) extension of in-patient
treatment for enlarged tonsils and adenoids; (iv.) further provision for ear disease
cases; (v.) further provision for remedial exercises; (vi.) further provision for
bathing of children at borough council baths and for cleansing of verminous
children; (vii.) further medical services in connection with open-air education,
anæmic and tuberculous children, schools for mentally defective, places of
detention, classes for backward children, physical education (classes for teachers).
Personal
hygiene.
2,059,590 examinations were made at rota visits by the school nurses. The
percentage of verminous conditions found was 16.1, the lowest figure yet recorded.
The number of scabies cases treated was 2,155, the lowest figure recorded since 1914.
Infectious
diseases.
The waves of prevalence of scarlet fever and diphtheria which had attained
maximum height in 1921, showed in the following year marked diminution as regards
scarlet fever, and rather less marked diminution in the case of diphtheria ; there
was a further considerable fall in 1923, when the cases of scarlet fever amounted
to 10,047, and those of diphtheria to 10,301. In 1924, there was a slight rise to
11,350 in scarlet fever and a very slight rise in diphtheria to 10,431. The deathrate
from diphtheria in 1924 was very slightly less than in 1923. A report was
prepared by Dr. J. Graham Forbes in 1924, detailing the action taken in America
and elsewhere in recent years with regards to toxin antitoxin protective inoculation,
see p. 98.
In London an outbreak of measles matured in the early months of 1924,
attaining its maximum in March. Whooping cough was beginning to show increased
prevalence at the close of 1924. Influenza reached the crest of a wave, as
estimated by the number of deaths, in the seventh week of 1924, and towards the
end of the year was again manifesting signs of increasing prevalence. The striking
feature of 1924 was, however, the behaviour of encephalitis lethargica. This
disease was for the first time made notifiable as from 1st January, 1919, and between
that date and the end of 1924, 1,261 cases had been notified, of which 322 were
children of school age (3-14). The heaviest incidence of the disease was in 1924,
when 610 cases were notified, as compared with 86, 149, 243, 72 and 101, in the
five preceding years.
The Ministry of Health's circular of 1st December, 1924, sets out the arrangements
now in force for the early diagnosis and treatment in London of paralysis,
following attacks of poliomyelitis, in children. The question has also been raised
with the Ministry by the Council and the Metropolitan Asylums Board as to
similar arrangements being made for the treatment of children suffering from the
after results of encephalitis lethargica. These difficult cases have been specially
studied by Dr. Shrubsall, and the subject is discussed on p. 109. Dr. Shrubsall
presided over the section of anthropology (H), at the Toronto meeting of the
British Association in 1924, and he was asked to make his visit to America the occasion
for obtaining particulars concerning procedure in connection with the newly
established Juvenile Courts in Canada and the United States. This report appears
on p. 112.
Routine
inspections.
Results of Medical Inspections.
The number of children inspected in the three statutory age groups was
192,885. This was 4,442 fewer than in 1923. The entrant infants numbered 65,231,
the eight-year old group 62,318 and the twelve-year old group 65,336. The lowered
birth rate during the War accounted, of course, for the somewhat smaller numbers
examined. In addition, 1,486 children in special schools were examined in the
eight- and twelve-year old groups.
Special
inspections.
In addition, 63,861 children not in the age groups came under inspection by
the school doctors for various reasons, either brought forward by head teachers