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57
In a number of cases investigated, inadequate rest and unsuitable
or inadequate nutrition appear to be among the predisposing
causes. Many of these girls after completing a hard day's work
return home to begin work of another kind by having to assist
in the domestic needs of the home. Others indulge in social amusements,
e.g., dancing to excess to a late hour, and are thereby
prevented from obtaining adequate rest. It cannot be too strongly
emphasised that adequate rest and a highly nutritious and wellbalanced
diet are essential to the maintenance of good health and
resistance, particularly at the adolescent period of life.
Pulmonary Tuberculosis in Children.
This condition is comparatively rare in children, although of
course it can and does occur.
The diagnosis of this condition is often made on slender or
insufficient evidence. This is bound to result in disadvantage to
these children in later life. Poor physique associated with malnutrition
of course requires treatment, and this is obtainable
through the School Medical Service.
Particular attention has to be paid to contact cases of a positive
sputum, but Tuberculous infection has to be carefully differentiated
from clinically active disease, the latter demanding notification.
X-ray examinations and positive or negative skin reactions to
tuberculin may be of considerable help in diagnosis and are always
fully utilised. The use of the Mantoux test was fully described in
the 1932 report. There have been 50 Mantoux tests made in connection
with the work of the Clinic during the year 1933.
These tests were carried out at the East Ham Memorial
Hospital.
Prevention.
The greatest danger for children is the patient with tubercle
bacilli in the sputum living in the same household, particularly if
overcrowding exists, and separation of the child from such sources
of infection is urged on every possible occasion.
The utilisation of the Grancher System, whereby healthy
children of tuberculous patients are boarded out in the country, is
made whenever possible.