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housing conditions improve, and the factors which produce chronic
ill-health in little children become more widely known. The
presence of unhealthy teeth, tonsils and adenoids, with rickets,
and combined with infection of the clothing and hair, which must
occur where many children crowd together, and occurs in spite
of the sustained efforts of the School Nurses, leads to a state of
chronic ill-health before and during school life which does more
harm than the School Medical Service can hope to rectify. Parents,
desiring as they do to co-operate, sometimes find it difficult to
believe this. In some cases we have been able to produce very
surprising improvement by sending the children away to Miss
Hudson's Home at Bushey Park, in others treatment by artificial
sunlight, will, we hope, give good results.
During the year five cases of squint have been referred for
operative treatment, and I have operated upon G cases at the Royal
Northern Hospital at Holloway. The long waiting list, a problem
which the work of this hospital in a crowded area makes it
difficult to solve, is patiently submitted to by parents and children
alike.
I would, lastly, Sir, like to draw attention to a new feature of
my work at East Ham. On June 8th, 1926, I began to see cases
under the age of five years referred to me from the Maternity and
Child Welfare Clinics, and since the commencement have seen
39 cases. The work of this branch falls into three groups:—
(a) Advising on the treatment of cases of incipient squint
(29 cases). Many of these cases if taken at once on
appearance (within a fortnight) can be cured, and much
distress and disfigurement in school life, with perhaps
ultimately an operation for its relief, thereby avoided.
(In 11 cases of incipient squint glasses were prescribed.)
(b) Treating conditions such as acute conjunctivitis, abscess
of the tear duct, or corneal ulcer, which are liable to arise
with surprising suddenness in very young children, doing
irreparable damage before efficient treatment is provided
(8 cases).
(c) Advising on cases of congenital malformation of the eyes
which may or may not be amenable to treatment, but for
which help should be available as early as possible
(2 cases).