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children to discard their glasses ! During the last 3 months of the year attendances were back to normal, and
one outstanding and cheering fact was the co-operation of mothers of the ' under two year olds ' in following
out treatment for squint, with the result that many of these toddlers were cured of their squints at that early
age."
Mr. L. Mushin reports as follows :—
" Notes re Willesden Eye Clinic :
(1) The increase in the number of attendances at the Eye Clinic continues, except for a short period
in the summer, during the flying-bomb attacks, when there was some decline.
(2) The very small number of cases of chronic blepharitis and phlyctenular conjunctivitis which are
seen, indicates that the improvement in the general health of the school child is being maintained
in the fifth year of war. These cases show a rapid response to treatment.
(3) In most cases there is marked co-operation of the parents, who see that the children wear their
spectacles regularly, and in the case of squinters, carry out the instructions of the ophthalmic
surgeon as to the wearing of occluders, with consequent improvement in the vision of the amblyopic
eye."
Mental Health.—Dr. Reginald Lightwood, m.d., f.r.c.p., d.p.h., had to give up this work early in the
year and has not yet been replaced.
Orthopaedic Department.—Report by J. A. Cholmeley, f.r.c.s. :—
"Although the number of attendances for examination and treatment at the Orthopaedic Clinic is
still below the 1939 level, nevertheless the number attending is steadily increasing and this has occurred with
only a monthly surgeon's visit, whereas before there was a weekly attendance. Unfortunately, at the present
time, pressure of work is so great that a more frequent surgeon's attendance is impossible.

* Includes Secondary School Children.
Thus the number of cases of Rickets in the age group 0-5 referred to the Orthopaedic Clinic is in 1944—
the fifth year of the war—less than half the number referred in 1939, a great credit to the Medical and Nursing
Staff of the Infant Welfare Centres.
On the other hand, the number of cases of Flat Feet referred has increased considerably, and when
considered as a per cent. of the cases attending for examination by the surgeon, this increase is over 100 per
cent. There is no doubt that this increase is partly due to the poor quality and type of children's shoes which
are generally available to the public. There has also been an increase in the number of children in the age
group 5-14 (16)* referred on account of postural defects of the spine, this group includes the adolescents, on
whom the strain of the war years cannot but leave a mark—a period of rapid growth and development when
our rations may be inadequate, large school classes with overworked teaching staff, some of whom have had
little training in physical culture, damaged schools leading to further overcrowding, at home, tired and
overworked mothers, who expect help from the older members of the family, particularly the girls, and finally
the shelter life with the disturbed nights.
This brief and rough analysis for 1939 and 1944 of these 3 types of orthopaedic cases shows a most
satisfactory fall in the incidence of Rachitic deformities ; in the Flat Foot class an unsatisfactory state of affairs
due in no small part to the poor type of children's shoes, and finally the increase in postural defects of the
spine, largely a social problem, at the present time almost unavoidable."
Ear, Nose and Throat Department.—G. H. Livingstone, f.r.c.s.—Mr. A. L. Pereira, f.r.c.s., has carried
on the work of this department in the absence of Mr. Livingstone.
HOME NURSING SERVICE.
The Home Nurse employed by the Council nursed 222 cases during 1944, and in connection with such cases
paid 1,273 visits.
Of the 222 Cases nursed during 1944, 217 were new cases. 212 of these 217 new cases were referred by the
Health Department for nursing, 2 by private doctors and 3 by hospitals, associations or private persons.
SANITARY SECTION.
During the year the Deputy Chief Sanitary Inspector and 10 District Sanitary Inspectors were on the staff.
The Deputy Chief Sanitary Inspector was appointed Acting Chief Sanitary Inspector in February, and during
the year 4 of the District Sanitary Inspectors resigned on taking up other appointments. 5 District Sanitary Inspectors
were appointed during December, 1944.
The number of premises inspected on complaint was 2,887, and the total inspections and reinspections were
18,084.