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110
tinned, actually nothing was done. The suggestion offered was
that those who have already established orthopaedic centres should
make the premises available for these adult cripples, the cost ot
in-patient and other treatment possibly being met from poor law
or other sources. By way of stressing the need and the existing
neglect, Dr. Adamson pointed out that the tuberculous cripple was
actually the only one who was adequately cared for in later life.
Another need emphasised was that of making provision for the
vocational training of cripples, the example of Shropshire being
cited and a hint given that a comprehensive scheme might at no
distant date come into force in the County of Middlesex."
Mr. Seddon is to be congratulated on the able manner in
which this course was conducted and his careful selection of
material which was of such a nature as to be of the greatest
interest to all those engaged in the work of the School Medical
Services.
HEART DISEASE AND RHEUMATISM.
During the year there were found in the course of routine
special inspections 15 children suffering from organic heart disease
and 81 from functional conditions of the heart. In the great
majority of cases of organic disease of the heart, there is a history
of previous attacks of rheumatism. These children are dealt with
according to the degree of severity of the heart condition. Acute
and sub-acute cases in which there is obvious damage to the heart
still being done, are sent to a heart home where adequate treatment
and supervision can be provided. By this means the ultimate
damage to the heart can be minimised.
With regard to the others they are all kept under periodical
observation at the centres and the necessary modifications made
in the school curriculum to suit the individual case.
TUBERCULOSIS.
A Routine Medical Inspection revealed one case of Pulmonary
Tuberculosis and one case of Tuberculosis of the Glands. These
two cases were referred to the Tuberculosis Officer at the Middlesex
County Council Dispensary, it being the usual procedure to refer
children who require to be kept under observation or receive
treatment.