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16
their progress at school. It is clear that middle ear disease
must still be regarded as a serious condition and that the
School Health Service must be vigilant for possible long term
sequelae.
Defects of the heart and circulation
The significance of cardiac murmurs in symptomless children
is a matter for dispute even amongst leading specialists in the
field, so that the discovery of an increased number of defects
in this category last year must be viewed with some caution.
When a previously unsuspected cardiac condition is found to be
amenable to surgery, the Service may be forgiven for selfcongratulation.
Unfortunately, the price which must be paid for
such satisfying discoveries is a large number of children and
parents who must experience some anxiety whilst lengthy investigation
and observation confirm that other heart murmurs are not
associated with any apparent abnormality.
Twenty-one children were thought to be clinically anaemic
and the subsequent requests for blood examination revealed, in
almost every case, results well below the range of accepted
normal values. Anaemia is an unexpected condition in a population
of healthy schoolchildren and it would be helpful to know
whether low haemoglobin values are common in the absence of
clinical anaemia. A detailed survey of a whole secondary school
using a simple screening test would be a valuable contribution
to our existing knowledge.
Defects of the Lungs
There was no significant change in the pattern of lung
defects during the year.
Number of cases of Notified Tuberculosis in children of
school age:-
Pulmonary 9
Non-Pulmonary Nil
The school population was 50,000 (approx.) so that the
incidence rate of pulmonary tuberculosis per 100,000 was 18, and
there were no deaths from tuberculosis.
Developmental Defects
The school medical inspection procedure continues to make
a useful contribution to the detection of undescended testicles.
This condition is readily amenable to surgery and most authorities
seem to be agreed that treatment is desirable not later