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number continues to make heavy demands on our resources as it is no longer
considered desirable that the operation for removal of enlarged tonsils and adenoid
growths should be treated as a minor affair which can be carried out under outpatient
conditions. Considerable improvement is effected during school life and the
percentage of 12.year.old children found to require operation for these conditions is
3.2 in boys and 4.1 in girls.
Ear disease
and hardness
of hearing.
In 1928 otorrhcea (running ears) was found in 2,228 childern, or 1.1 per cent,
a distinct improvement upon the previous years. In 1927 there were 2,463 children
noted with running ears, this being 1.3 per cent. Here again, entrant infants contributed
a greater proportion than any other age group. Hardness of hearing is,
unlike otorrhcea, too often incurable, and to those already suffering at entrance to
school life are added those in whom deafness arises later so that a cumulative effect
is produced. 803 children, 0.4 per cent., were found with some degree of hardness of
hearing, of these 193 were entrant infants (.25 per cent.). Fewer children were found,
however, with hardness of hearing than in previous years, the number during 1927
on a lower total of inspections being 868.
Defect of
vision.
46.6 per cent, of boys and 48.9 per cent, of girls at age 8 failed to pass the test
for normal vision ; this is again a very considerable improvement, for in 1926 the
figures were 51.9 per cent, and 54.7 per cent, respectively, and in 1927 they were
51.1 per cent, and 52.9 per cent.
The greater incidence of visual defect upon girls is still in evidence, in spite
of the efforts which have been made by improved methods in school to equalize in
the two sexes the conditions of education in regard to strain. At 12 years 41.2
per cent, of boys and 44.9 per cent, of girls failed to pass the tests, an excess of 3.7
per cent, amongst girls as compared with an excess of 2.3 per cent, at age 8. It
appears, therefore, that the conditions unfavourably affecting the visual acuity of
the girls as compared with the boys persist and are active throughout school age,
although the greater incidence of defect among girls is not so marked as it was in
former years. In 1927 among twelve.year.old children 43.2 per cent, of boys and
46.6 per cent, of girls failed to pass tests for normal vision, so that in 1928 the
improvement in visual acuity of children at age 8 was repeated in children at age
12. Children are tested for visual acuity wearing their spectacles, as the aim of
medical inspection is to discover those who require correction. The total amount
of visual defect, therefore, does not find exnression in these figures.
Heart defect
and anaemia.
Heart defect (functional or organic) was reported in 4,634 children; 2.2 per
cent, of those examined compared with 2.4 per cent, in 1927, and 2.6 per cent, in
1926. Older girls continue to present the signs of heart strain in excess (2.8 per
cent, in girls as compared with 2.3 per cent, in boys), but this excess tends to diminish
and is less marked than in the previous year when it was 3.3 per cent, in girls compared
with 2.4 per cent, in boys.
Anaemia was recorded in 3,423 children (1.7 per cent.), a great improvement on
former years, since 2 per cent, were returned as anaemic in 1927, and 2.4 per cent,
was recorded in 1926.
Defects of
the lungs.
5,360 children (2.6 per cent.) were found with lung complaints. Here again
was a great improvement upon former years, there having been 3.4 per cent, in
1926, and 3.3 per cent, in 1927, so recorded. Lung complaints are by far the most
numerous in the entrant infants of whom no less than 4.3 per cent, suffer, compared
with 1.2 per cent, of 12.year.old children. It is extremely common to find entrant
infants with bronchitic rales in the chest, especially amongst those showing minor
degrees of rickety signs.
Tuberculosis
Pulmonary tuberculosis, definite or suspected, was reported in only lz7 children,
and other forms of tuberculosis in only 109, in each case being less than one in 1,000
of those inspected. The drop in cases of surgical tuberculosis from 152 to 109, in
spite of the larger numbers inspected, is noteworthy.