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(g). Ear Disease and Hearing.
Amongst children examined at the routine medical inspections, 59 cases of defective
hearing were found, 29 of these being referred for treatment. Twenty-two cases of ear disease
were also discovered, 16 being referred for treatment.
Special examinations at the Clinics account for 25 cases of defective hearing; and 196
cases of ear disease.
(h). Dental Defects.
Nine hundred and ninety-two cases of dental caries were discovered at routine medical
inspection, and a further 119 cases were found by examination at the Special Clinics.
At the routine dental inspections in the schools, a total of 6,254 children were found
requiring treatment. Table IV on page 39 gives further statistics in this connection. See
also Statistical Table on page 26.
(i). Deformities.
One hundred and thirty-five cases of deformity of varying degrees were discovered by
inspections at the schools and at the Special Clinics. The greater number of these were cases
of slight spinal curvature and flat feet.
Malnutrition.
Officially, according to our Returns, there are 10 cases of malnutrition which have been
discovered during Routine Medical Inspection. That this is a true picture of the departure
from normal nutrition which exists amongst our school children as a whole is far from the real
fact. These are only the grosser cases. At the present time there is, in my opinion, a far
too optimistic view of the nutrition amongst the children and even some adults. That there
is gross malnutrition to any extent it is certainly not true to say, but that there is sub-normal
nutrition of varying amounts I am convinced is the true picture. The unfortunate fact, as
I have expressed before, is that the metric systems of assessment lose sight of one of the main
features in the picture of sub-normal nutrition, that is, the protein starved, carbo-hydrate surfeited
child who is bulky and flabby and whose height-weight index does not disclose that
particular fact. Those of us who, for a quarter of a century, have had to deal with school
children and who in the early days learnt the syndrome which sub-normal nutrition produces,
have a knowledge which the medical officer of later date has never had the chance of acquiring.
The picture has been modified in various ways, but to those of us who have learnt the
syndrome it remains even after modifying.
I want again to point out how accurate that can be. I have used these figures before,
but they are worth repeating. At a tea given to the children at one of the Isleworth Schools
some time ago I picked out 13 children who to my mind were obviously suffering from malnutrition.
In 12 of the 13 cases either the father was dead, or had been out of work for six
months or more. Surely, one out of 13 is not a big margin of error.
I am convinced that this sub-normal nutrition is due to two causes:—
(1) High Rent. As I pointed out last year in my Report as Medical Officer of Health,
some of the families pay as much as 46 per cent, of their income in rent.
(2) Mismanagement of the family income due to two causes.
(а) The inability to buy properly.
(b) The inability to prepare the food which has been bought. There is, as I have
seen as a result of some of the budgets which have been kept for me by some
of the mothers, a very definite protein shortage in dietary in a number of these
humble people. I am convinced that one of the great needs at the present time
is education in the homes of these people as to how to prepare, within the means
at their disposal, meals which will provide not only a balanced diet, adequate
in calories, but adequate in vitamin content.
6 INFECTIOUS DISEASE.
The rules as to exclusion of infected children and contacts as laid down by the Ministry
of Health and Board of Education in the joint Memorandum of 1927, have been carefully
followed.
The following table shows the infectious disease which occurred among children attending
public elementary schools during 1932, and the three previous years.
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