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127
are referred to the Tuberculosis Dispensary for the opinion
of the Tuberculosis Officer, and it is largely left to him to
carry out the necessary investigation and supervision of
the confirmed cases.
Glandular tuberculosis is not, however, unusual,
although it occurs with much less fr equency than in years
long past. This is no doubt due to the pasteurisation of
milk which has now for some ten' years been almost the
only type of milk distributed for sale in Bromley. As a
suspected cause of chronic ill-health in children latent
glandular infection is by no means uncommon, many of
these children being tabulated under malnutrition classification
rather than the more fearful diagnosis of latent
tuberculosis.
(k) Other Defects and Diseases
This classification refers mainly to diseases of the
nervous system, deformities, and those diseases which are
seasonal infections.
The incidence of the so-called " nervous child ' is
increasing, and appears to be more noted in the early
entrant to school. Such children, however, rapidly
respond to the school environment.. The damage begins
in the 2-5 years of age period, and the opening of nursery
classes for these children is to be strongly advocated to the
Local Education Authority.
Following-up.
The following-up of cases in their homes is carried
out by the school nurses who co-ordinate their duties with
those of Maternity and Child Welfare. Necessitous cases
requiring extra nourishment, or convalescence, are
referred to the Bromley Childrens Care Committee, whose
Annual Report follows later in this report. 846 special
visits to school children were made by the school nurses
during the year.
The following-up of the leaver is now passed to the
National Health Insurance records under the new arrangement
with the service, and where the medical condition
of the child does not permit certain types of employment,
the recommendation is made to the Juvenile Employment
Bureau. This joining up of the various services is slowly
progressive after many years of its advocation.