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55
expects to find the gross illness and neglect of 50 years ago, but
looks for the weakly and ailing child—or the one with some chronic
upset who may be helped by special educational treatment, convalescence
or nutritional supplements, in addition to the normal
medical care.
At one time there was a demand for each child to have a
routine medical examination every year. Such frequent
examinations would bring to light defects not at present discovered,
but when one recalls that 60% of the school population are examined
each year at present, it suggests that the number of defects discovered
would not probably be commensurate with the effort.
The general nutritional state of the children continues to
improve and last year only 71 children, i.e. 1% were classified as
nutritionally poor (97 in 1951).
The number of children found at routine medical inspections
to be requiring treatment rose from 630 in 1951 to 732 in 1952.
However, the following table of defects requiring treatment, found
at special as well as routine examinations, shows a satisfactory
reduction of many types of illness as compared to last year's figures,
i.e., number of skin defects fell from 695 to 600, visual defects
from 433 to 368, squint from 49 to 31, speech defects from 47 to 29.
Another satisfactory figure was that of heart disease of which only
6 new cases were found during the year. This experience of steady
reduction in the number of cases of rheumatic heart disease in
children is one shared by many other authorities over the country ;
whether it is due to a change in the virulence of the responsible
organism, or follows the improved nutritional and housing standards
in recent years is impossible to assess.
There has been a rise in the number of hearing defects from
51 to 73, but this may be ascribed to the work of the audiometric
service which discovers slight degrees of deafness that were
previously unnoticed.
Tuberculin jelly testing of children has been carried out at
schools where there has been some special risk, i.e., infection of
one of the pupils or a teacher. In such cases the class is tested
"en masse," after obtaining the parents consent, and the positive
reactors are sent to the Mass X-ray unit at Central Middlesex
Hospital. Fortunately, our investigations have not led to the
discovery of any active cases among the contacts of the disease.
Dr. Dick's scheme for examination of school leavers with Jelly
tests and B.C.G. vaccination is being continued and much valuable
information is being obtained.
In a number of authorities, schemes of mass jelly testing of
the whole school population have been attempted, but the results
have not been such as to cause me to recommend commencement
of a similar scheme in Ealing at present.