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"I have never seen a ringworm go on in this way
from the age of three months to eight years, and remaining
localised to the two areas of scalp as indicated by the
mother.
"I have also carefully examined some hairs microscopically,
but I have not been able to find any fungus:
at any rate there is none in the hairs I examined.
"Taking all the points into consideration and
taking the history as correct (I cross-examined), the
case would come in the category of a recurrent herpes.
"I would suggest that the child be sent to school,
the onus probandi lying with the School Medical Officer.
If he finds undoubted fungus in the hairs then the case
had better be X-rayed. Meantime I would recommend
that nothing be applied locally, before she goes to the
School Medical Officer.
"I should like to know the upshot of this line of
procedure."
As a result of this the child was presented for re-admission
to school but on examination I found ample evidence of fungus,
and in order that there should be no doubt whatever on the
matter I made a permanent specimen of the hairs showing the
disease, and communicated with the specialist in question and
forwarded to him the specimen that I had obtained, with the
result that I received a letter from which the following extract
is taken:—
"I have received your letter and specimen. I have
examined the latter, and the fungus is undoubted.
When I saw the child in my consulting room on October
13th, I was not able to find fungus, nor did I discover
any when I had another search that same afternoon."
As a result of these combined opinions the child was
X-rayed and is now back at school quite cured. This case is
quoted at length as it is a very good instance of the difficulties
that beset the School Medical Officer in dealing with some
cases of ringworm. This parent has consulted various practitioners
in different parts of London who have been recommended
to her and has produced certificates that her child was
not suffering from ringworm. It will be seen that one has to
be adamant in pitting one's opinion even against letters from
eminent specialists. The work entails a large amount of
troublesome and careful examination of the heads, but the
decrease in the number of cases shows the wisdom of the
process, and also emphasises the value of the examination of
all children before they enter school, as by this means many
sources of infection are kept out of our schools.
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