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It will thus now be seen that orthopaedic surgery is both
preventive and curative; hence it will be readily understood that
any scheme for the prevention and curing of cripples must b.
very comprehensive, and should consist of:—
(a) An orthopædic team.
(b) An orthopaedic clinic.
(c) An orthopaedic hospital.
"Where it is possible to combine treatment and education,
a Cripple School and Orthopædic Hospital School, i.e., Brookfield,
should be attended. The value of early consultation with
the orthopædic surgeon cannot be too strongly emphasised, e.g.,
a case of club foot should be treated from the moment of birth,
similarly with a case of wry-neck.
"An orthopaedic Clinic consists in brief of a consultation
room, a treatment room, a gymnasium, and a plaster room added
where necessary.
"The orthopædic team consists of (1) orthopaedic surgeon, (2)
masseuse, (3) school medical officer, (4) local medical practitioners.
(5) infant welfare centre workers, (6) school nurses, (7) voluntary
association, i.e., Invalid Children's Aid Association, etc. All
personnel should be under the direct training and supervision of
the orthopaedic surgeon, and this applies in particular to the masseuse.
Co-operation of local medical practitioners should be
sought and difficult cases brought by them for consultation.
(Signed) B. Whitchurch-Howell, F.R.C.S."
DEFECTIVE AND SUB-NORMAL CHILDREN.—Local
Education Authorities are responsible under the Education Acts
for all educable defectives between the ages of seven and sixteen
years, the School Medical Officer under the M.D. (Notification of
Children) Regulations being the certifying officer. Educable
defectives are feeble minded children, whose mental deficiency
does not amount to imbecility, yet is so pronounced that they are
incapable of receiving proper benefit in an ordinary elementary
school, although not incapable by reason of such defect of being
instructed in a special class or school. Ineducable defectives, on