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101
To ensure the attainment of this ideal, insistence must be laid
on the continuing need for proper medical inspection rooms, where
the doctor can work in privacy, with at least the minimum equipment
for the observance of hygienic technique, and a modicum of
quiet. Thanks are due to many head teachers who make every
endeavour to place the best possible accommodation at the disposal
of the visiting medical officers to facilitate this important work.
SCHOOL HEALTH CLINICS.
The establishment of comprehensive facilities for medical
treatment (other than domiciliary care) has resulted in a considerable
expansion of the School Health Clinic service.
Additional sessions were devoted to the work and the services
of a second medical officer employed to relieve the congestion
and avoid too great a loss of school time on the part of pupils and
" shopping or business time " for parents.
The field of activity in these clinics has widened to include
the diagnosis and treatment of a variety of medical and minor
surgical disabilities. The clinical routine and special examination
of school-children, following trends directed by the problems
of nutrition which arose during the war, have now been
standardised to allow elasticity of interpretation to individual
workers in this field.
Nevertheless certain basic criteria must be observed and are
universally accepted as indicative either of general nutritional
defects or a degree of particular avitaminosis.
The indelible impress of skeletal rickets, early postural
deformities associated with lack of tone in the muscles and bad
habits of breathing and standing, constitute a group for selection
and treatment.
Clinical assessment is notoriously subjective and fallible, but
examination of the skin, hair, mouth and tongue, the teeth for
caries, the gums for gingivitis, pyorrhoea or bleeding, the eyelids
for blepharitis, the eyes for conjunctivitis and corneal vascularisation,
and the limbs and neuro-muscular system for muscle
tenderness, diminution of co-ordination and vibratory sense,
taken in conjunction with other clinical findings, help the school
medical officer to arrive at a true summation of the physical