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(g) Paediatric Clinic.—The clinic was continued under the
clinical care of Dr. Elchon Hinden, Paediatrician to Whipps Cross
Hospital, who reports as follows:—
"The work of the school consultative clinic has not altered
materially from that in previous years. Perhaps there is rather less
of it. I think there are two causes for this—the big numbers of
children born towards the end of the war (the "bulge" in the
birth-rate) are now entering adolescence, when they are so healthy
they rarely trouble doctors; and the rising standard of health. The
latter throws into strong relief the few chronic ailments of childhood
which still defy our control.
"Asthma is a disease which causes much invaliding in school
life. It often starts much earlier, even in infancy, when it is
frequently labelled bronchitis; but when the child is four or five
the diagnosis is plain. We are not clear as to the causes of asthma.
Basically it appears to be an excessive reaction to the minor irritants
which we are all subject to: house dust, animal dandruff, unusual
foods, trivial infections. Sometimes the trigger is an emotional one
—frustration or even pleasurable excitement. We know that this
tendency to "explode" runs in families, showing itself as infantile
eczema or hay fever, as well as asthma—but we cannot understand
the nature of this excessive sensitivity. The children who suffer
from this disease often lose much time from school, and even when
they are able to attend, their work is not at its best because their
nights are disturbed by asthma. However, the majority of children
recover as they grow up, and most are free by the time of
adolescence. Infantile eczema is of bad omen, and usually babies
with this complaint who contract asthma suffer from it for many
years.
"An intractable variety of asthma is when the exciting cause is
a disturbance of the relationship between the child and the rest
of the household. Treatment is of little avail, for the very air the
child breathes in his own home is vitiated. The diagnosis is often
made by the mother, who has noticed that the child improves out
of all recognition when he goes on holiday. I feel that the best
treatment for such a child, and the only one that can afford him an
undisturbed education, is boarding school. The temporary respite
given by a spell at a convalescent home is usually too short-lived
to be of real benefit.
"I should like to thank the Assistant School Medical Officers
for referring the children to me, and the general practitioners for
granting them permission to do so ; and my colleagues, the
Pathologist and Radiologist at Whipps Cross Hospital for kindly
offering me the facilities of their departments."
Over 5 years Under 5 years
New cases 69 28
Total attendances 108 57