View report page

366
A.—Prevention.
Much work has been done by the Corporation as Public
Health Authority for years past in the prevention of these causes
of crippling: (1) Health visitors by their advice in the homes on
diet, exercise, open-air and general hygiene, and Infant Welfare
Centres, by the similar advice there given to expectant and nursing
mothers and in regardd to their young children, must have had a
marked influence in reducing the risks of crippling through
rickets. (2) The improvement in the milk supply, the systematic
sampling of milk for tuberculosis, associated with the system of
commercial pasteurising, have—whatever the arguments for or
against the advisability of the latter—had an important effect in
reducing the risks of infection by tuberculous milk; while the Corporation's
tuberculosis scheme, with its supervision of patients at
the tuberculosis dispensary and in their homes, and by the treatment
and education in control of infection afforded through treatment
in institutions, must have had a similar influence in decreasing
the chances of infection from person to person. (3) A third
factor in crippling, viz., infantile paralysis, is affected by the compulsory
notification of such cases, by the facilities for consultation
with medical practitioners, and particularly by the expert advice
available through the Orthopedic Clinic. While this does not
prevent the disease, early treatment is the best means of preventing
permanent crippling being produced by it.. (4) The work of
Welfare Centres, of teachers, and of the school medical and
nursing staff tends, by constant watch for the early stages of such
conditions as spinal curvature and flat-foot, to prevent crippling
arising through these defects, while the systematic physical training
in force in the schools must be a great means of prevention of
these defects.
B.—Treatment.
Apart from treatment through the private practitioners and
through hospitals, the following facilities are provided by or in
association with the Corporation:—
(a) Orthopedic Clinic at the Croydon General Hospital, at
which an experienced orthopedic surgeon sees children referred by
the Public Health Department, at a fixed charge by the Hospital
per patient per session. Children under 5 are seen under the Corporation's
maternity and child welfare scheme, those between 5
and 16 under the Education Committee's scheme, while cases of
tuberculous crippling, whatever their age, are seen under the
Corporation's tuberculosis scheme.
121