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126
moderate bowing of the legs is a trivial deformity that
will correct itself; this is partially true but there is often
a residual deformity at the ankle that escapes the notice
of the unobservant mother, and in any case it is no argument
against the proper prevention of rickets. We shall
not succeed in abolishing this disease until rickets comes
to be regarded as disgraceful a condition as scabies.
There were four cases of torticollis (wry neck) that
required operation; they occurred in children ranging in
age from 7 to 13 years. This deformity results from a
condition that is apparent shortly after birth and one
that ought to receive the close attention of Child Welfare
Officers. These four cases represent a lack of vigilance
on the part of someone a good many years ago; they do
not indicate any laxity at the present time.
Eight children required treatment for deformities of
the feet. In no single case was the deformity preventable
according to our present knowledge. In none of the remaining
cases (chiefly bone diseases — osteomyelitis,
multiple exostoses, and coxa vara), was there any
possibility of averting the condition that called for treatment
nor was there any delay in referring the patients
to the clinic.
In short, I am confident that the standard of the work
at the Hendon centres is of a very high order, and such
as to make the incidence of crippling deformity a thing
of the past. Unfortunately, preventive work has its
limitations, one of the most serious of which is our lack
of knowledge of the causation of certain diseases. This
is where the value of medical research becomes so
apparent, for prevention, even more than treatment, cannot
be entirely effective where there are gaps in our
scientific knowledge. On the other hand the most complete
academic work is of little value to the community
until it is actively applied by the medical services of the
country."