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39
Toddlers Clinic.—The routine medical examination of toddlers is now an
integral part of the Council's Maternity and Child Welfare Scheme. Children are
examined in their birthday month, aged 2 years, 3 years and 4 years. Those requiring
observation are called up for review at intervals of a few months, and those requiring
*treatment are told how to obtain it. All are carefully followed up by the Health
Visitors.
The examinations follow the lines of the school medical examinations and are
recorded in the same way. The record cards, however, are slightly modified in order
to deal with special points of importance to the toddler.
Three sessions are held weekly—one at the Old Town Hall, Woolwich, one at
Plumstead Health Centre and one at Eltham Health Centre. The clinic is under
the medical charge of Dr. Margaret Emslie and she reports below on the year's
working:—
"The finding at routine toddlers' inspections during the year 1934 are summarised
in Table, No. 13, appended.
"These figures and observations include all conditions clinically considered to
show variation from the normal (i.e. from perfect functional utility and health),
but it should be noted that all the conditions recorded were not necessarily considered
to require treatment. In this respect the Table varies from certain other Tables
embodying results of routine examinations, since these in some instances appear to
show only cases or conditions referred for treatment, and are not a summary of
simple observations on the child. In the case of certain defects or pseudo-defects
there is in fact a large difference, in the conditions referred to here, between the
incidence of signs and symptoms patent to the observer, or interesting to him, that
may hold some possible significance on the future or past health of the child, or that
might offer some indication for a different orientation of teaching in preventive health
work at an earlier age, and therefore be worth recording, and that which is held to
be a true abnormality or pathological state requiring treatment. The best instance
of this is the disease of rickets, in regard to which, as will be seen later, there is a
suggestion that a widespread condition of latent or non-disabling rickets may possibly
prevail, but a very low rate (7 per cent. actually) of children was referred to the
orthopaedic clinic for treatment of deformities, of rachitic or other origin. Any
suggestion that the cases recorded (on clinical evidence) as rachitic in this Table
are comparable with the totals of cases of rickets referred for treatment of the acute
condition, or for orthopaedic deformity solely, in the records of other clinics, would
entirely falsify the impression that is intended to be given by these figures, and
falsify the actually prevailing state of affairs. The observations offered in these
annual records are offered as observations only, pending further investigation and