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43
30 cases was the clothing considered sub-standard and only one child was put
down as in a really dirty or neglected condition.
The whole of the results are closely consistent with those in past years—except
the figure for anaemia, which shows a diminution-—that is
somewhat astonishing in view of the remarkably sunless summer last year and
rainy weather generally. Functional heart conditions, however, have not
diminished (20 per cent.) but it should be noted that we include all murmurs
and irregularities amongst our records for purposes of information and observation,
though obviously in the great majority of cases no symptoms whatever
are attached. Figures for school examinations of children have never shown
anything like the percentage of murmurs we have shown each year, but it is
probably useful to know that a murmur of some kind may be expected to be
present in something like one child out of five in the pre-school age period,
without tangible disability, in order that the murmur accidentally discovered
in a single child may not be given undeserved importance. The difficulty of
associating these murmurs with clinical anaemia (i.e. calling the functional murmur,
as it used to be called,' haemic ') is very noticeable this year when anaemia
considered clinically, has so far declined ; but it is not inconsistent with the
findings published in our report of the year 1932, when we examined in detail
that year's records for anaemia, pallor, functional heart conditions and their
mutual bearings on each other, and found that anaemia and heart conditions
did not necessarily go together. Such findings tend to increase, not diminish,
the interest and possible importance of the functional heart murmur as an
" original " sign with, maybe, directional significances of its own that we will
appreciate better at a later date. So far as heart murmurs and rheumatism
are concerned, in only seven of the total children seen were symptoms found
that might be called early rheumatism, as compared with 284 " hearts " and
of these seven, six cases were girls—a, sex distribution which is consistent with
findings in other places.
The figures for tonsil enlargement again reaches 40 per cent. (It was 45
per cent. last year) but of the total, only 4 per cent were recommended for
tonsil or adenoid operation. In view of the possible bearing of unhealthy
tonsils on infections of the respiratory tract, and of the high toll which respiratory
disease takes on young child life (in comparison nowadays with other
illness) it is interesting to find that only 3 per cent. of the 1,385 children examined
showed traces of chest trouble present, of whom four were cases of asthma.
The figure for behaviour symptoms has not dimished this year (23 per cent.
compared with 18 per cent. in 1935), to which might be added G per cent. of cases
of minor retardation and less than 3 per cent. of enuresis cases, excluding cases