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73
During the year 665 children were seen who were reported sick, and, of these, 85 were sent
to hospital. Most of the accidents were of a minor nature and were treated on the premises;
several, however, of the nature of doubtful fractures, were sent to hospital for confirmation by
X-rays and subsequent treatment. One case of diphtheria occurred of the serious "bull necked"
variety, with a fatal issue after removal to hospital. The remaining cases of diphtheria were
clinically certifiable, but not necessarily positive to bacteriological tests subsequently on further
examination in the isolation hospitals.
Sickness and
casualties.
With regard to the infectious diseases, it was not possible to trace any source of infection
from the premises or from contacts there. In all these cases, systematic daily inspection of all
the contacts was made, and swabs taken where necessary.
Very little active venereal disease was found, most of the cases of vaginal discharge being
due to a simple leucorrhœa, not uncommon in girls about the age of puberty.

The very able and kind co-operation of the superintendent, Mr. M. S. T. Jones, and his
assistants in the work, and his skilled advice on many difficult matters is greatly appreciated by
the medical officers who have worked at the remand home.
Child guidance.
The problem of the maladjusted or "difficult" child has for many years caused
considerable anxiety to teachers, care committees and school doctors. The varying
aspects of the case concern both the educational and medical authorities alike, and
with the establishment of special child guidance clinics some attempt has been made
to tackle the problem on a scientific basis. Speaking generally, the incidence of
neuroses in children is mainly due to either some inherent disability or some undesirable
environmental influence. Different methods of approach have been
attempted by various schools of thought but the difficulty has always been to discover
the hidden factor responsible for the peculiar mental outlook of the child under
observation. The most satisfactory results appear to be obtained through the team
work of the psychiatrist, the psychologist and the social worker, who, after careful
observation of the child's reactions especially during periods of play when the child
exhibits self-expression without hindrance, are able to suggest a mode of treatment
best suited to the individual child and the peculiar problem. The assistance of the
school authorities, medical staff and care committee workers is necessary to the child
guidance authority in aiding the course of treatment recommended, and there is no
doubt that work of very great importance is being carried out. The Council gives
every facility available by way of intercommunication between child guidance clinics
and the various branches of the school educational and medical services. Moreover,
with the consent of the Board of Education five different child guidance clinics in
London have been recognised under section 80 of the Education Act, 1921, in order
that the attendances of school children at the clinics may be regarded as equivalent
to attendance at school for registration purposes. The clinics referred to are (1)
Maudsley hospital clinic, Denmark-hill, S.E.5; (2) London child guidance clinic,
1, Canonbury-place, N.l; (3) East London clinic, Jews' Free school, Whitechapel,
E.l; (4) the Institute of Medical Psychology (Tavistock clinic), Mallet-place, W.C.I,
and (5) the West End hospital for Nervous Diseases, 73, Welbeck-street, W.l. The
subjoined information with regard to the work of the clinics has been submitted by
the authorities of the clinics concerned.
The work at this clinic has proceeded on the usual lines during the year. Cooperation
with head teachers and school care committees has been very helpful, and
useful information and recommendations have been exchanged between them and
Maudsley
hospital
guidance
clinic.