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(iv.) There is definite improvement in operated cases, compared with those
not operated upon, in all the general symptoms, including mouth breathing,
otorrhoea, deafness and liability to colds.
(v.) Children with rheumatic tendencies were slightly benefited by operation,
but showed an increased liability in comparison with non-rheumatic children
to growth and re-infection of tonsillar remains where present.
Dental decay.
Other enquiries have been carried out under the general supervision of the
school medical officer at the request of the Dental Decay Committee. Dr. Norman
Ainsworth inspected the children in several schools, and the result of his researches
is to be published shortly by the Medical Research Council.
Following up and Re-inspections.
The immense amount of following-up resulting from the inspections in the
schools will be appreciated when the attendances at the treatment centres are
considered. Appointments were made for 146,394 children for dental treatment,
1,431,850 attendances were made at minor ailment centres, 12,980 appointments
were kept at aural sessions and 32,747 at refraction sessions. In addition, large
numbers received attention at general and special hospitals, and were convalescent
in the country with the aid of the Invalid Children's Aid Association and other
Organisations.
The transference of children to special schools for the physically defective, for
the mentally defective, for the blind and the partially blind, for the deaf and for
the hard of hearing, attendance of children in stammering classes, at open-air schools,
playground classes, the provision of spectacles, administration of milk and cod liver
oil at school, attendance at tuberculosis dispensaries, all necessitate a volume of
work which cannot be estimated fully. The preparation of children for visits to
the convalescent camp schools alone necessitates a very large amount of clerical
labour and visitation to homes. It may be pointed out that 16,296 boys have been
sent to the King's Canadian Camp School at Bushy Park since it was opened in
1919.
A very large share of the work of following-up falls upon the voluntary school
care committees. The annual reports of the Local Association of Care Committees
give important indications of the progress of school medical work and of the difficulties
experienced in carrying out the work. The Hackney and Shoreditch
Associations remark that the number of free dinner cases does not differ materially
from last year, though in Hackney the number of free milk meals is about 200, and
in Shoreditch 470 a week in excess of last year's figure. In the opinion of the Association
the increase is due to the greater care which is being given to the detection
of really needy cases. The Hackney Association think the following-up results are
extremely satisfactory, but they press the desirableness of providing additional
accommodation for treatment so as to permit of the retention of children at a centre
for 24 hours after an operation for tonsils and adenoids. The Marylebone Local
Association state that a larger number of children have been treated at a reduced
rate. " It must not be denied that occasionally the remission of charge is used
as a lever to obtain treatment in the arduous struggle with prejudice and ignorance."
There has been a marked rise in the number of children receiving dental treatment,
and the general attitude towards dental treatment is encouraging. A note
is made of the frequency of requests for appointment made by the younger mothers.
The large number of children paying for milk is commented upon; in two
Marylebone schools 445 children pay for milk in school prescribed by the school
doctors. The children of Marylebone appear to be exceptionally fortunate in that
in addition to Bushy, Margate and Bournemouth and the children's country holiday
fund which sent away 650, numerous other agencies have sent children to the country
or seaside; the guardians, the Invalid Children's Aid Association, the Charity