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6
Heart and
anaemia.
Lungs.
Tuberculosis.
Nervous
diseases.
Rickets.
Deformities.
Vaccination.
20.6, in 1927 it was 20.9, in 1929 this percentage was 19.3, and in 1931 it was only
18.5. The improvement is most marked among the 12-year old girls, and there is
little doubt that the importance of the early correction of visual defect is becoming
more widely recognised among the parents. Teachers dealing with the younger
children asked some time ago that consideration should be given to the nature of
the Snellen's types used for testing, which presented several difficulties to the modern
child in recognising, as distinct from seeing, the letters. At the beginning of the
year therefore a new series of test types was introduced in which seriphs to the letters
were abolished, and a plentiful use made of letters which have the same form in
capital and small type, such as 0, C, X, S and V.
Heart defect (functional or organic) was reported in 3,212 children or 1.8 per
cent., compared with 2 per cent, in 1930. As usual, older girls presented a percentage
(2.2) in excess of older boys (1.8), but the drop from the previous year was greater
in the girls (from 2.8 to 2.2 per cent.) than in the boys (from 2 to 1.8). In studies of
rheumatism in the metropolis it is found that girls suffer to a greater extent than
boys in the proportion of about 3 to 2. It is reasonable to deduce that the figures
for heart defect reflect not only this excessive incidence of rheumatism but suggest
that the improvement shown may be due to the greater care exercised over rheumatic
conditions during recent years, and the more extended provision of hospital beds for
this condition. Anaemia was found in 1,918 cases, or 1.1 per cent., compared with
1.2 per cent, in 1930. This is less than half the proportion found in 1926 and
corresponds with the general improvement in nutrition.
Lung defects were noted in 4,160 children (2.3 per cent.). This is the same
percentage as last year.
The bulk of the cases are provided by the entrants (3.9 per cent.). These
cases are largely bronchial catarrh, especially prevalent amongst entrant infants
who present rickety manifestations, although the preponderance of incidence upon
infant boys compared with girls does not hold to the same extent as in rickets.
There were 66 children in the three age-groups reported to have symptoms
indicative of pulmonary tuberculosis, but only 13 of these were not already under
treatment. In addition, 64 children had other forms of tuberculosis non-active. The
incidence of tuberculosis in any form found at routine inspections is about 1 child
per thousand.
Epilepsy was noted in 65 cases, compared with 60 in 1930 and 73 in 1929;
chorea in 170 cases, compared with 186 in 1930 and 178 in 1929; paralysis in 81
children, compared with 76 in 1930 and 122 in 1929.
Symptoms of rickets or the effects of early rickets were noted in 758 children.
This is .4 per cent.—the same proportion as in 1930. Infant boys had an incidence
of .9 per cent., and infant girls .5 per cent. The stigmata of early rickets tend to
disappear as growth proceeds and amongst older children signs were recorded in the
8-year old group of boys in .3 per cent., and in girls .2 per cent., and in the 12-year
old group of boys in .2 per cent, and in girls .1 per cent.
Spinal curvature accounted for 665 cases (-4 per cent.). Of these, 225 (.8 per
cent, of those examined) were among the 12-year old girls, while the 12-year old
boys showed .4 per cent. Other deformities were present in 1,594 children (.9 per
cent.). This is practically the same figure as in 1930.
Records are made of the presence or absence of vaccination marks when children
are stripped for medical examination, but no inquiries are made. The following
are the results of the doctor's observation of the percentage of children having
vaccinal scars: entrants, 48.9; 8-year olds, 55.2; 12-year olds, 54.9; and "leavers"
(131) 57.5. These figures show that the percentage of children with obvious vaccination
marks is slightly less than last year. In Poplar, Bethnal Green and Shoreditch,
where the percentage of entrants noted as vaccinated was very low (22.5, 26.0 and
32.8 per cent. respectively), the "leaver" group showed the percentage vaccinated as
44.1, 40.7 and 49.0 respectively. As was suggested last year, it would seem that
in some districts where infant vaccination is low the recent prevalence of smallpox
has led to a considerable amount of primary vaccination at school ages.