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12
interfering with education, are sometimes the indication for active preventive treatment.
Many of these cases are not detected by the ordinary method of medical
inspection, in which the test is the forced whisper at 20 feet.
Heart
defect
Heart defect (functional or organic) was reported in 1,742 children in the prescribed
groups or 1.4 per cent., being the same proportion as in 1937, compared with
1.5 per cent. in 1936, 1.7 in 1935, 1.9 in 1934 and 2 per cent. in 1930. As usual,
older girls presented a percentage (1.6) in excess of older boys (1.2).
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 this excessive incidence of rheumatism in the
female sex.
The continuous reduction in the percentage of children found with heart disease
of late years corresponds with the increase in preventive measures described in the
account of the rheumatism scheme (p. 28).
Anaemia
Anaemia was recorded in 590 children, or .5 per cent., the same percentage as in
1937, compared with .6 per cent. in 1936, .7 in 1935, 1.0 in 1934, 1.1 in the years
1931 and 1932, and 1.2 per cent. in 1930. In this respect also the children's health
shows steady improvement.
Lung defects
Lung defects were noted in 2,393 children in the prescribed age groups (or 1.9
per cent.), compared with 1.8 per cent. in 1937, an improvement upon 1936 and 1935,
in both of which years the percentage was 2.1.
The bulk of the cases is provided by the entrants (3.0 per cent.). This is due
largely to bronchial catarrh, which is especially prevalent among entrant infants
Tuberculosis
There were 63 children in the three age groups reported to have symptoms
indicative of pulmonary tuberculosis, compared with 56 in the previous year, and 66
in 1936. In addition, 17 children were found with other forms of tuberculosis, compared
with 24 in 1937, and 30 in 1936. The incidence of tuberculosis in any form
found at routine inspections was .6 per thousand. For many years the amount of
tuberculosis among school children has been very small.
Nervous
diseases
Epilepsy was noted in 41 children, compared with 45 in 1937, 30 in 1936, 28 in
1935, 65 in 1931, and 73 in 1929 ; chorea in 90 children, compared with 76 in 1937,
101 in 1936, 104 in 1935, 158 in 1932, and 170 in 1931 ; paralysis in 44 children,
compared with 61 in 1937, 41 in 1936,45 in 1935,55 in 1934, 63 in 1932, and 81 in 1931.
Rickets
Signs of rickets or the effects of early rickets were noted in 551 children in the
prescribed groups. This is .4 per cent., compared with -5 in 1937 and 1936, .4 in
1935, .5 in 1934, .3 in 1932, and .4 per cent. in 1931 and 1930. Infant boys had an
incidence of 1.0 per cent., as in 1937 compared with 1.1 in 1936,1.0 in 1935 and 1934,
.7 in 1933, and .9 per cent. in 1932, and infant girls .4 per cent., compared with .5
per cent., in 1936 and 1935, .3 in 1933, and .4 per cent. in 1932. The stigmata of
early rickets tend to disappear as growth proceeds, and only .2 per cent. of the 11-yearold
group are noted witli remains of the disease.
Deformities
Among deformities, spinal curvature accounted, in the prescribed age groups,
for 377 children, or .3 per cent. as in 1937 and 1936, compared with -4 per cent, in
1935. Of these, 107 were among the 11-year-old girls, and 94 among the 11-year-old
boys. Other deformities, mainly flat foot, were present in 1,321 children (or 1-0 per
cent.), compared with .9 in 1937 and 1936, and 1.0 in 1935 and 1934.
Vaooination.
Records are made of the presence or absence of vaccination marks when children
are stripped for medical examination, but no enquiries are made. The following
are the results of the doctors' observation of the percentage of children having
vaccinal scars: entrants, 43.1; 7-year-olds, 44.5; 11-year-olds, 48.6; and
"leavers" (13£), 50.5; compared with, in 1937, entrants, 45.3; 7-year-olds, 47.2;
11-year-olds, 47.9 ; and "leavers" (13½), 54.6. These figures show that the percentage
of children with obvious vaccination marks is less than last year at all ages except
in the 11-year-old group. A greater percentage of the older children in the schools
at present are vaccinated than of the younger children.