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88
the parents and in securing facilities for the operation, without which our massage
and exercises were almost entirely valueless.
"The following paragraphs summarise the work done at the clinic during
the year:
"The total number of children referred was 234, including 117 boys and 117 girls.
Of these, 186 received treatment, and 48 were referred to other agencies for the supply
of surgical instruments, convalescent treatment, instruction in home exercises, or
hospital treatment. The attendances numbered 6,815. During the year 118 cases
were discharged—8 as cured, 38 much improved, and 72 improved.
"The defects treated may be classified as follows, the first figure representing the
new cases, whilst the figure in brackets represents the numbers remaining over from
the previous year: Postural defects, 42(9); lateral curvature, 11(12); kyphosis,
13(10); kypho-lordosis, 5(1); lordosis, 2(0); depressed sternum, 0(1); deficient
chest expansion, 10(6).
"Cases referred for massage, etc., were: Infant paralysis, 9(12); club foot, 4
(4); knock knee, 5(5); bow legs, 26(8); other effects of rickets, 17(2); flat feet,
17(5); fractures, 9(1); wryneck, 0(2); injuries, 4(8); muscular weakness, 16(2);
deformities, 2(0); chronic constipation, 4(0); rheumatism, 2(0); synovitis, 0(2);
Erb's palsy, 2(1)."
Classes for
stammerers.
During 1926, 266 children passed through the stammering centres; of these 59
were discharged cured, 29 were discharged provisionally cured. The term "provisionally
cured" covers the class of child who might stammer under stress, but
whose confidence has so far been re-established as to justify removal from the classes.
Ten children who were under observation as having relapsed during the year were
brought back into the classes for further treatment.
The class at the Jews Free School is carried on under excellent conditions.
Most of the boys are already attending the school and can be followed up and
returned for treatment if necessary without any difficulty. The Headmaster of this
school writes: "I should like to take this opportunity of saying that the training
received in the stammering class has in many cases proved most effective and, in
some cases, positively astonishing. One of my boys who was a bad stammerer
before attending the class, gained a first prize in an elocution competition and shows
no signs of defective speech." The instructress at this class, Miss M. A. Richardson,
reports that she recently saw nine of the boys who formerly attended this class
and that nearly all of them are continuing to practise the exercises and were
eager and interested when shown any alteration or improvement of exercises, evolved
since they had been in the class. Miss Richardson adds that they were "all keen
to show how well they could talk and to tell of occasions when speaking was now
easy where it has previously been difficult or impossible."
Rheumatism in childhood.
The very important question of rheumatism in childhood was fully dealt with
in last year's annual report. Rheumatism is the only widespread menace to the
school child's health in which the power of appropriate administrative action is
still lacking. It now takes first place as the cause of chronic invalidity in childhood,
not because it has increased in incidence or severity, but because, while administrative
measures have diminished other scourges, such as tuberculosis, and have supplied
the means of appropriate action in individual cases, the fortress of rheumatism
stands where it did, unmenaced and unsubdued.
The statistical records of the school medical work show that in 1919, 20.5 per
cent. of the chronic invalidity in London school children was due to tuberculosis
and 14.5 per cent. was due to rheumatism; in 1926 only 12 per cent. was due to
tuberculosis, while 24 per cent. was due to rheumatism. These figures are staggering.
But it must be reiterated that they are not due to an increase in rheumatism. They