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B. School Medical Service.
The chief objects of Health Visiting under this heading are :—
(1) To aid in the work of School Medical Inspection by " following-up " cases found to
be defective by the School Medical Officer.
(2) To prevent the spread of infection in the schools.
(3) To maintain a high standard of cleanliness in the schools and instil a knowledge of
hygiene and healthful living into the coming generation.
Since Routine Medical Inspections were instituted statistics have shown a considerable improvement
in the health of the school child, but these inspections can only be of benefit if the defects
found are subsequently treated. The " following-up " therefore of the Health Visitor is a very important
part of this work, and by tact and perseverence she may do much towards getting these defects
attended to by the parent.
The prevention of the spread of infectious disease in the schools is always something of a
problem. It is now generally accepted that nothing is gained by the wholesale closure of schools
in time of epidemics, but much more good may be done by the constant supervision of scholars in the
classes affected and the early exclusion of those showing premonitory signs of the disease. This
supervision can best be carried out by the Health Visitor on her visits to the schools.
Since the Health Visitor included cleanliness inspections in the scope of her school work the
standard of cleanliness in the schools has improved very markedly.
In 1914 the percentage of scholars in the Willesden Council Schools found to have unclean heads
was 20 per cent., in 1924 it was 7 per cent., and in 1925 6 per cent.
C. Infectious Diseases.
The chief objects of Health Visiting under this heading are :—
(1) Investigation into Source of Disease.
(2) Prevention of Spread.
(3) Diminution of the Severity of the attack and the prevention of complications in home
nursed cases.
Much help is given to the Medical Officer by the Health Visitor in investigating the source of
an infectious disease. By suitable inquiries and inspection of the home she may be able to trace the
source of the infection, e.g., to a milk supply, defective sanitary arrangements, a possible " carrier,"
etc. By her supervision of isolation in home nursed cases, her dealings with contacts, and arrangements
for disinfection she aids in the prevention of the spread of infection. Most infectious diseases
are liable to be followed by complications, many of which may be fatal or produce chronic disability
or invalidism. The complications following Measles and Whooping Cough, in particular, are responsible
for a large percentage of infant deaths, and it is in these cases, which are generally treated at home,
that the Health Visitor may do much to prevent complications by her supervision of the isolation and
general hygiene and by explaining the necessity for medical advice in severe cases.
Speaking generally the Health Visitor is our chief method of Health Propaganda. She carries
advice on health and hygiene actually into the home, and affecting, as it does for the time being, some
particular member of the family, her words carry far more weight that any newspaper article, lecture
or film could hope to do.
APPENDIX 0.
CANCER.
by
W. D. Champneys, M.A., B.M., B.Ch., D.P.H. (Oxon.), M.R.C.P.
Introduction.
In the following memorandum I have attempted to discuss briefly this extremely difficult, but
most important, subject in the light of our present knowledge, and to indicate what methods of attack
have been employed elsewhere in the fight against this dread disease and what methods might be
employed in Willesden. With such an aim in view it has seemed to me most important to avoid
making any assertions which do not rest on a firm basis of ascertained facts. I have, however, thought
it of use to refer briefly to certain recent attempts to elucidate the nature and cause of Cancer which,
though far from resting at present on the firm foundation referred to above, have excited a good deal
of attention on the part of both the scientific and the lay public.
1. The Nature of Cancer.—The morbid conditions to which the term " Cancer " is applied
differ very widely among themselves in many of their characters, but they all possess in common
certain features which justify their inclusion in one category. These common features may be summarised
as follows :—