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there is some evidence that under present day conditions it is
perhaps somewhat wasteful. For example, Table VI shows the
number of defects which were discovered on routine examination
and at special examinations respectively for the ten years 1928—
1937. The table also shows those figures expressed as percentages
of the school population for each year.
This table brings out quite clearly the fact that routine
inspections are becoming less and less fruitful of results as the
years pass, while the number of defects which are discovered as
a result of special examinations is increasing steadily. In fact,
the proportion of defects found at special examinations per 100
of the school population in 1937 was 77.5 percent, greater than
the corresponding figure for 1928. When account is taken of the
fact—as is shown in Table V—that during this period there has
been only a slight increase in the proportion of children who arc
examined as "specials", this increase in the positive findings at
examinations is remarkable. It can hardly be that doctors are
more efficient at spotting defects. The only other alternative
which seems to merit serious consideration is the suggestion that
teachers are becoming more adept in recognising those children
who should have a special examination.
A casual inspection of treatment tables for a series of years
will show that the bulk of the defects which are discovered at
routine examinations is made up of cases of visual defects, squint,
enlarged tonsils and adenoids, otitis media, anaemia, and simple
lung diseases. When these conditions—which, with the possible
exception of diseases of the throat and nose, can often be suspected
by a nurse or a teacher—are excluded, little remains, and the
question arises whether it is economic to ask a doctor to devote
a considerable proportion of his time to the detection of the
residue by routine examination.
The School Medical Officer of Manchester has expressed his
dissatisfaction with the existing procedure, and he has suggested
that the lime of the school doctor would be better employed in
schools if the present system of routine medical inspection were
made less rigid and severe, so that the doctor could, by more
frequent attendance at his schools, pass under review any child
who appeared to merit his attention. A similar scheme has been
tried unofficially with considerable success by the School Medical
Officer of Leicester. The results which have emerged regarding
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