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The nature of the work has not altered. I am deeply Impressed by the wide range of
normality, and the consequent difficulty of defining the abnormal. This is a matter of
supreme importance, for particularly in school health, the commonest question I am asked
is - "is this child normal?" The difficulty arises not only on the physical side; mental,
and temperamental, aspects are equally important. Nor is the question academic, for it
may well be that our answer to it may alter the course of the child's life, and so bring
about the very deviation we diagnose! It follows that every child should be assumed to be
healthy and normal, and should live a normal and healthy life, until the contrary is proved
beyond the shadow of a doubt. I am happy to see that this principle is being more and more
widely adopted, so that the child restricted in his activity because of a heart murmur of
doubtful significance, is no longer seen.
St.Mary's Hospital, Plaistow, continue to afford the clinics the facilities of their
X-ray department, and Whipps Cross Hospital that of their pathological laboratory; to both
of these hospitals I am very grateful for their help, which is of great benefit to the
children. I should like also to acknowledge the co-operation of the assistant school
medical officers and the general practitioners who refer children to me.
TUBERCULOSIS IN CHILDHOOD. The number of children In whom active tuberculosis is
found remains comparatively small but has shown no marked trend of recent years. A summary
of the work of the West Ham Chest Clinic in this respect has kindly been contributed by
Dr.Lawless, the Chest Physician.
Number of school children referred by assistant school medical officers 2
Number of school children referred by general practitioners 92
Number of school children examined as contacts 380
Number of school children found to be suffering from tuberculosis 14
The classification and disposal of the definite cases is set out below:-
Resplratory Non-Respiratory
Pleural Effusion 1 Spine 1
Pulmonary tuberculosis 2 Meningitis 1
(adult type)
Pulmonary tuberculosis 8
Pulmonary tuberculosis
with pleural effusion 1
Twelve of these children were admitted to institutions, and two attended hospital as
out-patients.
B.C.G.VACCINATION. Since 1950 the Medical Research Council has been undertaking
controlled clinical trials of anti-tuberculosis vaccine. The trials are on a large scale.
In September of the same year the Education Committee agreed to co-operate with the Medical
Research Council in the trials, and the trials commenced towards the end of the year. The
trials involve children leaving secondary modern schools at the age of 15 years, and it was
proposed to follow them up by regular examinations for at least three years. Participants
in the trials are volunteers. All children participating in the scheme have a simple skintest
carried out (tuberculin test). In this test a substance, tuberculin, which is quite
harmless, is injected into the skin. A localised red reaction after 2-3 days shows that the
person has already been infected. It is no indication of disease but it means that B.C.G.
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