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This shows that the mothers appreciate what is being done for the toddlers and that they are
being stimulated to care for them along the right lines.
General Physique.—The heights and weights of the children were then considered. It was
found that:—
(1) Of the 7 children between 2 and 3 years of age, 3 were underweight, one of whom
was also undersized.
(2) Of the 8 children between 3 and 4 years of age, 6 were underweight, one of whom
was also below the average height.
(3) Of the 21 children between 4 and 5 years of age, 13 were underweight, but all were
up to, or above, standard height.
(4) Of the 3 children aged 5 years, one was both underweight and undersized. The
other 2 were up to standard.
When weighed and measured some months later, all the children had grown taller and all
had gained in weight except 2 who had lost. One of the latter, a boy of 3 years and 11 months,
suffered from rheumatism. He was referred at the medical inspection for enlarged tonsils and knock
knee. Tonsillectomy was refused by the father, but the boy was treated in the orthopaedic department
of the Health Centre for the knock knee. He has since left the nursery school, the family having
moved out of the district. The other, a girl of 4½ years of age, was found, when examined, to have
bronchitis to which she was subject. Prior to entering the nursery school she had had a tonsillectomy
and mastoidectomy. It is not surprising, then, that neither of these two gained weight.
Defects found at Routine Medical Inspections.
35 of the 39 children were found to be suffering from one or more defects.
(1) Enlarged Tonsils and Adenoids.—28 children were found to have some degree of enlargement
of the tonsils. 14, of a slight degree and without symptoms, were scheduled to be kept under observation
for 6 months, while the remaining 14 were recommended to see an Ear, Nose and Throat Specialist.
4 have since had their tonsils removed, while 5 are waiting for operation. In 2 cases the parents
wished the operation postponed until the children were older, and 3 have refused to consider it.
(2) Defective Teeth.—Defective teeth were noted in 14 of the children. At the time of the
inspections 6 were having dental treatment, while of 2 cases referred one only completed the treatment.
It is a point of some interest, in view of the theory that dental caries may be a factor in causing
septic proliferation of the lymphoid tissue of the nose and throat or adenoids, that of these cases,
8 had enlarged tonsils in addition.
Tooth-brush drill between 9.30 a.m. and 9.45 a.m. forms an important part of the daily programme
of the nursery school. This, apart from establishing a necessary habit, should help greatly
in keeping the mouth healthy and thus increasing the resistance of the pre-school child against infection.
(3) Bony Deformities.—Spinal curvature was noted in one child and genu valgum in another.
Both were subsequently examined by the Orthopaedic Surgeon at the Health Centre, and treatment
prescribed. One unfortunately is unable to attend for home reasons.
A slight tendency to round shoulders, associated with general debility, was noted in 2 cases.
The mothers were accordingly advised, and both children were entered up for re-examination in
three months.
(4) Pulmonary Affections.—1 case was found to be suffering from bronchitis, and 2 were
suffering from bronchial catarrh, all 3 clearing up under treatment.
(5) General Debility.—Debility was noted, as part of the general condition, in a pre-rheumatic
child, in a rheumatic child and in an under-nourished child. Some degree of improvement has since
been noted in all 3.