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corneal ulcer, tuberculosis, epilepsy and chorea, found amongst special cases greatly
outnumber in each case those suffering from the same diseases in all the routine age
groups combined.
There were 401 cases of scabies, 522 cases of impetigo, 929 cases of otorrhcea,
327 cases of tuberculosis in its various forms, 239 cases of epilepsy, 460 cases of
chorea, and 353 cases of paralysis, etc., amongst children specially examined. Considerable
numbers of children too, with defective vision (4,090), hardness of hearing
(421), anaemia (1,367), and enlarged tonsils and adenoids (4,729), whose condition
had attracted the attention of the teachers were also thus brought specially to the
school doctor's notice. The provision for special examinations is, therefore, most
valuable and indeed essential to the well.being of the schools.
Medical
inspection
at secondar
schools.
All pupils at secondary schools are examined in detail at the ages of 12 and 15,
while the record of each pupil is reviewed at other ages and the pupil is medically
examined if this is considered advisable. 4,815 male pupils and 5,577 female pupils
were inspected in detail, 2,254 male pupils and 2,006 female pupils were specially
seen and 2,400 pupils were reinspected.
Dental defect was found in 19.9 per cent. Defective vision in 16.8 per cent.,
nose and throat defects in 5.9 per cent., defects of heart and circulation in 3.4 per
cent., anæmia in 2.3 per cent., spinal deformity in 10.8 per cent., and flat foot in
11 per cent. The large proportion of deformities found is due to the careful recording
of every minor departure from the normal, but it is noticeable that many of those
living the lives of students still give scant attention to physical culture, paying the
penalty in the development of narrow chests, stooping shoulders and ungainly gait.
Comparisons made of the results of inspection of children at different ages, whether
between these ages themselves or between the results of the present and those of
past years, show how far the school medical service is playing its part in the improving
of health and physique. The detailed figures show a great mass of disability and
suffering mainly caused by environmental and nurtural conditions. It is seen that
already on arrival at school the infants are, in large numbers, suffering from unhealthy
conditions. During school life, however, they are under constant and intelligent
supervision ; the teacher, the attendance officer, the school nurse, the school dentist,
the school doctor and the organisers and workers of the school care committees
combine to do all in their power with the resources at command to amelioriate their
condition.
In this period of supervision there is a steady improvement which from year
to year is more and more marked, and when, over the whole term of years since
school medical work began, the gradual improvements of the separate years are
added together, the total benefit is seen to be great. Indeed, those things have been
achieved which, at the outset, no one, however hopeful, would have believed possible.
The year 1928 has been an especially good one as substantial advances are noted
all along the line. Particularly gratifying is the continued improvement in standards
of personal hygiene.
It may be asked whether, with greater facilities for treatment and more intensive
effort, the improvement could not be made still more rapid and thorough. There
are three great influences which determine the health of the children. The first
is heredity, the second the environment, and the third the knowledge possessed and
the care exercised by the mother. The school medical service is unable to alter the
first, it can deal only slightly and indirectly with the second ; it is, however, greatly
concerned with the third. Its work is essentially that of education, and this is of its
nature a slow process. Extension of provision for treatment, advantage of which
was not taken by the parents, would be useless. Parents have to be educated up
to a higher standard of care, and this takes time. Each year more and more they
are learning the value of solicitude for personal hygiene and bodily culture, and
the results of this are reflected in the improving condition of the children. Just as
Summary
of results.