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considered necessary. Arrangements for dental treatment at the
Public Health Offices, and for tonsils and adenoids operations at
the Connaught Hospital, have worked smoothly and, on the whole,
without undue delay.
"School Attendance.—It is also a pleasure to record the continued
co-operation of the School Attendance Officers. During the
year it was necessary to exclude 55 children from attending school
for varying periods, and arrangements were made for 5 other children
to attend half-time at school. Six children were recommended to
attend the Physically Defective School, and 5 others the Open Air
School. In this connection it may be pointed out that the Physically
Defective School has recently changed its address and is now part
and parcel of the Open Air School. This means that children
referred to the Physically Defective School are, in fact, going to
attend an Open Air School. That this will be beneficial to the
rheumatic children during the summer months cannot be doubted,
but whether it will be of benefit in the winter remains to be seen.
Some of the children from this clinic attending the school have
severely damaged hearts, and it would be quite impossible for them
to attend an ordinary school; while others have congenitally
deformed hearts and are more than usually prone to feel the cold
and to suffer from chest infection. The sheltered life of a Physically
Defective School is very valuable to them. Whether, in particular
cases, it is going to be beneficial to have a Physically Defective
School run as an Open Air School must be regarded as in the nature
of a scientific investigation.
"Recent facilities for recommending cod liver oil and malt to
children attending school are most welcome.
"Convalescence.—Sixty-three children have been recommended
for convalescence, and 60 have actually been placed in suitable
homes. The value to many of these children of a properly organised
convalescent holiday cannot be doubted, and although a few slip
back into poor health when they return to a home which is inadequate
for their support, the great majority retain permanent benefit from
their change of air.
"Prevention.—During the year the practice of following up
children who have been discharged from the Sanatorium after scarlet
fever and diphtheria has been continued. Twenty-four children
were referred to the clinic in this way, and of these, 14 were judged
to have some cardiac disability. Were this follow up system not
in existence, it is fair to assume that these 14 children would have
run a risk of considerable and permanent cardiac injury, whereas
by getting their trouble dealt with in its early stages, it is probable
that they will be spared from some degree of heart disease.