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6,451 children were found with non-tuberculous lung defect, being 3.3 per cent,
against 34 per cent, in the previous year. The incidence upon entrant children is
far higher than at other ages. The great proportion of lung troubles which comprise
a mild bronchitis associated with rickets are found to a greater extent amongst
entrant boys than any other group.
Pulmonary tuberculosis, definite and suspected, was reported in only 106
children, and other forms of tuberculosis in 152, in each case being less than 1 in
1,000 of those inspected. On the other hand, 367 children inspected as special cases
were notified as tuberculous (definite or suspected).
101 children in the three age groups were recorded as epileptic, 185 as suffering
from chorea and 146 with paralysis.
Signs of rickets were noted in 1,242 children (0.6 per cent.); naturally the
greatest number being in entrant infants; the proportion of entrant boys with
definite rickets being reported as 1.3 per cent, of the total examined.
It must be remembered that school medical inspection is a practical institution
introduced for practical purposes. It has to be carried through with a due regard
to economy of time and under conditions which are vastly different from the consulting
room of the specialist. Refined diagnosis of disease is therefore not to
be expected or required, nor is it necessary to record minute departures from
the normal resulting from past illness or from congenital causes. The chief
function of inspection is to draw attention to those defects which require immediate
treatment, to divergences from health which require skilled investigation by others
than the school doctor himself and to the beginnings of disease, which, left disregarded,
may develop into serious illness threatening the life or working capacity
of the child in later life.
Had a school doctor unlimited time to give to each individual child, and were
his aim merely to add to scientific knowledge, the number of children, particularly
entrants, in whom, by careful investigation, signs of past rickets could be ascertained
would be very greatly increased. Distinction, therefore, must always be drawn
between the results of routine medical inspections and those of scientific surveys,
and it will prove futile to base comparison between one part of the country and
another upon the returns of medical inspection unless the survey in each case is
carried on under uniform direction and with agreed standards of observation.
Deformities other than rickets were recorded in 2,599 children in the age groups
(1.4 per cent, of all examined). Of these 931 related to spinal curvature with incidence
especially marked, as usual, upon the older girls. These curvatures are chiefly
postural in nature and, for the most part, are such as can be corrected by appropriate
exercises daily carried out in school.
29,981 boys and 30,316 girls were inspected immediately before leaving school
as an additional group. Not only is the examination of this group of great importance
in relation to the after-care conference and the placing of children in occupations
suitable to their physical condition, but it also gives the final result of the efforts
continued throughout school life to prevent, ameliorate and remove those physical
defects which will prove a handicap to the child in later life. The school care
committees pay special attention to the examinations of these children and, in their
case, concentrate especially upon intensive following-up, for no further opportunity
can arise to exert their influence. Even these results, therefore, cannot reveal the
whole of the remedial work which is effected by the school organisation, since the
children leave school before they can be re-inspected, and the final result of the
last intensive efforts be ascertained. The leaving children prove from the returns
made to be better nourished than any other age group, only 4.5 per cent, of boys
and 3.7 of girls being undernourished. In cleanliness and personal hygiene they
are superior to the twelve-year-old group, 91.9 per cent, of the girls having their
hair completely free from trace of verminous infestation. Their dental condition
Lung defects
Tuberculosis.
Nervous
diseases.
Deformities.
Other
deformities.
The health of
the leaving
child.