CHIS 15 Chiswick Education Committee. ANNUAL REPORT ON THE MEDICAL INSPECTION OF ELEMENTARY SCHOOL CHILDREN FOR THE Year ended 31st December, 192O. URBAN DISTRICT OF CHISWICK EDUCATION (AIMINISTRATIVE PROVISIONS) ACT„ 1907. REPORT ON THE MEDICAL INSPECTION AND TREATMENT OF ELEMENTARY SCHOOL CHILDREN FOR THE YEAR ENDED DECEMBER 31st, 1920. TO THE CHAIRMAN AND MEMBERS OF THE EDUCATION COMMITTEE, Ladies and Gentlemen,, I have the honour to submit herewith my Annual Report on the Medical Inspection of the school children and on the treatment carried out at the various Clinics and elsewhere The Board of Education has made suggestions as to the scope and arrangement of the Report and I have endeavoured to arrange my statements and tables accordingly. 1. STAFF. The Staff of the School Medical Department is at present as follows s:- (1) School Medical Officer (The Medical Officer of Health)„ (2) Two School Nurses. (3) Clerk (half-time). The remainder of her time is devoted to Maternity and Child Welfare work. (4) Dental Surgeon (whole time). (5) Clerk for Dental Clinic, who also act3 as assistant to Dental Surgeon. During the year 1920, it was decided to appoint a whole time dentist in the place of the two part time dentists then employed. The Committee appointed Miss M.M.Loretz, L.D.S.. to that position and she commenced her duties on September 1st, 1920. Nine half days a week are entirely given to the school Dental Clinic, while the remaining two half days are devoted to Dental work in connection with the Maternity and Child Welfare Centres. 2, CO-ORDINATION, Arrangements have been made whereby there is co-ordination between the Maternity and Child Welfare Centres, and the School Inspection Work. When children attending the Centres reach the school age, their medical history sheets are passed to the School Medical Officer and thereby a continued record of history and treatment is obtained. 1 3. SCHOOL HYGISNE AND ACCOMODATION. During the year a new School for Infants was built on part of the playground of Hogarth Boys' School. This Infant School was designed by, and erected under the supervision of Mr.Willis, the Council's Surveyor and is admirably adapted for it's purpose. It is a one storey building containing a large hall and classrooms which are very light and well ventilated. The school accommodates 240 children and was intended to take that number of infants from the old Glebe Street School, the latter benefiting greatly by it's numbers being reduced. There are therefore ten departments in the schools of the District, Belmont and Strand-on-the-Green being Schools containing Boys', Girls' and Infants' Departments, while Hogarth Boys' (children 7 - 14),Hogarth Girls' (children 7 14), Glebe 3treet (infants'), and Hogarth Infants' are separate schools, serving the same drea. One extra classroom has been built at Strand Girls' School providing much needed accommodation while a large open balcony at Strand Boys' has been turned into a large Science room. The accommodation in the various Departments is as follows :- Hogarth Boys 872 Belmont Boys 354 Hogarth Girls 948 Belmont Girls 354 Hogarth Infants 240 Belmont Infants 396 Glebe Street Infants 410 Strand Boys 420 Strand Girls 396 Strand Infants 392 Belmont, Hogarth Girls, Strand Boys and Hogarth Infants are the most modern schools. They have ample playground space, good lighting and heating, and are hygienic. Glebe Street Infants has been improved by reducing the number of scholars by 240 but it remains an old type of school with cramped playing space and rooms opening one into another„ In all the schools the sanitary arrangements are on the vsater-carriage system and are kept in good order,. 4. MEDICAL INSPECTION. Arrangements are made to carry out the Routine Inspection of the various age groups at the school. The Medical Inspections are usually held in the afternoons and notices are sent to the parents concerned, inviting their attendance. As is to be expected, a greater number of parents attend when the younger children are examined. This is useful as the School Medical Officer is able to point out any defect and give advice on the spot. It is useful sometimes to have an inspection without notice being given. One then sees the children without any special preparation, and cases of uncleanliness and poor clothing are seen which would be missed if a warning notice had been sent. 2 (a) Age groups Inspected. The Board of Education requires Local Authorities to make provision for the Medical Inspection of all children admitted to school during the year ending March 31st, and of all children between 12 and 13 years of age, together with children over 13 years of age, who have not already been inspected after reaching the age of 12. An intermediate group - children between 8 and 9 years of age - has also to be examined. During the year all these children have been inspected and in addition 88 special cases have been examined at the Routine Inspections. The latter were mainly children who owing to the war - had missed an inspection or were specially brought forward by the School Teachers owing to the presence of a supposed defect. In addition to these a very large number of children were seen at the Minor Ailment Clinic, altogether during the year, 1130 such children were seen. In my Report for 1919, I mentioned that during that year it had not been possible to examine as many children as usual, but I stated that more inspections would be made in future years. The figures show that this has occurred during 1920, and - what is more important - more following up of defects has been undertaken. Very little disturbance of school arrangements is involved by the Medical Inspections. There are no special rooms,of course,for this work, but the Head Teacher's room is usually available or a spare class room. At some schools there is no available room for the waiting mothers, and this causes some congestion and discomfort. It is usual to visit one of these schools in the Summer, so that one class can be outside in the playground for lessons while the classroom is being used as a waiting room for mothers and children. 5. FINDINGS OF MEDICAL INSPECTIONS. (a) Unclear-illness. The degree of cleanliness of both head and body is noticed at the Inspections. I again have to report a large number of cases of uncleanliness especially with regard to the hair of the girls. Out of 935 girls examined, 5 had verminous heads while 278 or 29% had nits in the hair. This is an improvement on the previous year's figures but the percentage is still too high. It should be noted that the number given,viz.,278 includes every child showing only one or two nits, and it was only necessary to refer a small proportion of these for treatment by means of special notices. Out of 1065 boys examined, one was found to be verminous and 38 were found to have nits in the hair. All of these boys were found to be wearing their hair too long, and it v/as 3 only necessary to advise that the hair be cut short in order to remedy the trouble. It is difficult to make any headway with regard to these conditions in some families. It is said that nits are dead and therefore they do not trouble to remove them, or the mothers state that in spite of all washing,etc., they are unable to effect a cure, As it has been demonstrated that a head can be cleansed in half an hour, it should not be difficult to realise the ideal of having every scholar with a clean head. Those parents who regularly neglect this care of their children should be brought to book, as they continually keep up the infection in a school. Cleanliness of body. 13 girls were classed as dirty while 111 were only fairly clean. Among the boys 22 were dirty and 118 only fairly clean. Chiswick is fortunate in having a splendid open air bath, but lacks provision for the cleansing of those people who have no baths in their homes„ It is to be hoped that shortly public baths and wash houses may be provided. If this cannot be undertaken at present, a cleansing station in connection with the School Clinics would be a very useful adjunct. During the year periodical visits were made to the Schools by the School Nurses with a view to examination of the general cleanliness. 6512 children, mainly girls, were seen at these visits, and those found in an uncleanly state were either referred to the school clinic for inspection by the School Medical Officer or were given a special notice to the parents re cleanliness. (b) Minor Ailments. During the year 730 children were referred for treatment owing to Minor Ailments. These children were seen either at Routine Inspections or at the Minor Ailment Clinic (sent by teachers or parents). These minor ailments consist chiefly of skin diseases, such as Ringworm, Scabies, and Impetigo, and the methods of dealing with these are referred to later. (c) Enlarged Tonsils and Adenoids.. These conditions of nose and throat may be divided into (1) Enlarged Tonsils only. (2) Adenoids. (3) The combination of the above. During the year 31 cases of Enlarged Tonsils were referred for treatment while 249 children were kept under observation as their Tonsils were only slightly enlarged* 27 cases of Adenoids were noticed and referred for treatment while 37 children were put on the observation list for further examination. In all the latter cases advice was given regarding breathing exercises etc. /with a view to an improvement in the condition. Seventy cases of Enlarged Tonsils and Adenoids were referred for treatment and 24 for further observation. 4 It is interesting to note that a very large number of children examined at the Routine Inspections had alreadiy been operated upon for Bnlarged Tonsils and Adenoids. It is also noteworthy that many parents bring their children to have their throats examined with a view to the operation beinfc done. (d) .Tuberculosis. Three cases of definite Pulmonary Tuberculosis and one suspected case were seen during the year and referred for treatment. Seventeen children whose lungs were doubtful were put under observation and advised to appear regularly at the Clinic until a definite diagnosis can be made. Of non-pulmonary Tuberculosis only one case of Tubercular hip and one case of Lupus were seen. (f) External Bye Diseases. Fifty-five cases of External Eye Diseases were seen during the year and referred for treatment. The most common of these Diseases were Blephariti u, an inflammation of the eyelidSo (s) Vision, including. Squint. No fewer than 223 children were referred for treatment for defective vision. Here again it is a pleasure to note that children are brought to the Clinic or to School with a request that the eyes may be tested at the Routine Inspections A good number of children were noticed to be wearing glasses obtained for the most part at the School Clinic, but in some cases children were not wearing glasses previously prescribed. All these cases were referred to the Eye Clinic for further examination, as the glasses might not be suitable and required changing. (h) Ear Disease, and Defective Hearing. Thirty-six oases were referred for treatment, while twenty-eight were placed under observation. These numbers do not include the cases of slight deafness caused by adenoids. (i) Dental Defects. During the Routine Inspections the teeth are of course examined, but not as a Dental Surgeon examines with a probe and mirror. Only the obvious carious teeth were therefore .seen and generally speaking, when the child has four or more carious teeth, the parents are advised to seek advice. The School Dentist inspects most of the children and therefore it is only in bad and urgent cases that children are referred from the medical inspections. 6- INFECTIOUS DISEASE. The Medical Officer of Health is notified of all Infectious Diseases occurring in school children, either by the Doctors in attendance on the notifiable disease cases, or by the parents or teachers-in the non-notifiable diseases, 5. Instructions are sent to the Head Teachers as to the exclusion of contact children usually with a note as to the period of exclusion. In the case of Diphtheria, contacts are examined by the Nurse or Doctor and swabs taken if necessary. During the latter part of the year under review, there was an epidemic of Diphtheria, which did not attack any particular school but was fairly general all over the District. During this period, schools were visited more frequently, and throats examined and swabbed. Several cases of actual Diphtheria were discovered by these methods and also many cases of Diphtheria carriers. The latter were excluded.from school and treatment given until negative swabs were obtained. No schools were closed on account of Infectious Disease during the year. 7. FOLLOWING UP. During the year special visits have been paid to the schools by the School Medical Officer to re-inspect children previously found to be defective. 551 children were so seen and special notices regarding the defect sent to the parents or a special visit made by one of the School Nurses. Each School Nurse has her own District and schools and is continually visiting the homes where treatment is requiredc 1033 such visits were made during the year and a large number of cases were treated which otherwise would have been neglected. The Nurses urge the parents, in any difficulty, to attend at the Clinic, where the Schoo,l Medical Officer advises or suggests an appropriate line of treatment. 8» MEDICAL TREATMENT. Arrangements have been made for the treatment of »- (a) Minor Ailments (b) Tonsils and Adenoids (c) Defective Vision (d) Dental Defects (e) Ringworm (f) Diseases requiring remedial exercises, (a) Minor iilments. The treatment of these minor ailments is carried out at the School Clinic (12 Heathfield Terrace) which is open every morning of the week except Sunday. The School Medical Officer is present on Monday and Thursday mornings and sees new cases and those referred to him by the School Nurses. During the year the number of children attending the Clinic for all purposes was 11,30, and the number of attendances made by them was 6802. 6 I find that there is a tendency for parents to expect treatment for all kinds of diseases, apart from minor ailment In these cases the parents are advised to call in their own doctor hut at the same time a note is made regarding the child on the school medical card. In practically all the cases attending at the Minor Ailment Clinic, treatment is carried out to a satisfactory conclusion. (b) Tonsil8 and Adenoids. Arrangements have been made with the Chiswick hospital to undertake the treatment of these conditions,, A fee of £2.2.0 for six cases is charged and the children are admitted to the Hospital and kept there for 24 hours or longer after the operation,, The parents are required to pay a fee of 3/towards the cost of the treatment and this fee is remitted in the very few cases where there is inability to pay. During the year 214 cases of defects of nose and throat were referred for treatments 130 were treated under the Local Authorities' Scheme, while 7 were treated elsewhere,, a total of 137 or 64%. (c) Tuberculosis. The treatment of Tuberculosis in this district is carrie out by the County Authority. The branch dispensary is situated next to the School Clinic, and the County Tuberculosis Officer visits once each week. I am thus able to send children suffering from Tuberculosis or suspected cases to the Tuberculosis Officer for examination or treatment and advantage is taken of this in every case. (d) Skin Disease. These cases are classified under Minor Ailments and are for the most part treated at the Clinic or advised as to treatment. Impetigo is the principal skin disease treated at the School Clinic and most of the cases are excluded from school until cured. The slight cases attend at the Clinic from school and receive the necessary treatment Scabies. Fifty-five cases of this disease were observed during the year, five during the routine inspections, while the remainder were special cases sent by parents or teachers to the Clinic. No actual treatment is carried out but advice is given, the parents being asked to attend for the purpose It is found that if the advice is carried out. the cases get well very quickly. The children are excluded from school and must attend for inspection frequently. Ringworm. Two cases of Ringworm of the scalp were seen at the routine inspections while 32 were sent specially to the Clinic by teachers or parents. 7 Arrangements have been made with Chiswick Hospital to have X-Ray treatment for this condition. A fee of £2.2.0 per case is paid by the Education Committee, and no fee is paid by the parents., Of the 34 cases seen, 31 were treated at the Hospital by means of X-Rays while 3 were treated elsewhere,, The cases of Ringworm of the body were treated at the Minor Ailment Clinic. (e) External Eye Disease. Only a few cases of these diseases were seen during the year, principally, Blepharitis, Conjunctivitis, and Corneal Ulcers. All were treated at the Minor Ailment Clinic. (f) Vision. A special Eye Clinic has been established in connection with the Minor Ailment Clinic. Dr.R.Craske Leaning attends generally twice each week for these refraction cases. 223 cases of defective sight were referred for treatment, and 185 or 83% were actually treated, the majority having glasses prescribed and provided. A few parents are still found who absolutely refuse treatment for these conditions. One or two of the cases where the vision was very bad were mentioned to the Inspector for the N.S.P.C.C. with very good results. Parents are expected to pay up to 4/6d towards the cost of the glasses prescribed. The children treated are seen at intervals by the Ophthalmic Surgeon to ensure that the glasses remain suitable and teachers are asked to see that the children wear the glasses regularly at school. (g) Ear Pi aease and Hearing There were 36 children observed during the year suffering from ear disease and defective hearings. Most of these cases were treated at the Minor Ailment Clinic but in some instances it was found necessary to advise that Hospital treatment should be obtained. Letters for Hospital were generally given to the parents and the children kept under supervision. (h) Dental Defects. As before mentioned the treatment of Dental defects was carried out by two part time Dental Surgeons for the first seven months of the year, while a whole time Lady Dentist commenced duties in September. There was therefore a certain amount of overlapping but the figures given below are approximately correct. During the year 2011 children were inspected by the Dental Surgeons. 1613 were referred for treatment and 1221 received treatment,, or 75%. This is a very good percentage and the result is due principally to the visiting by the School Nurses, who advise the parents who do not trouble to obtain treatment when notified that it is required. 8 The School Nurses during the year made 2189 visits to homes in connection with Dental Treatment. Mr. Chas.R.Shattock, M.R.C.S. L.D.S., one of the previous part time Dentists writes 'The Clinics both routine and emergency have been 'well attended and as a consequence, the results achieved 'compare very favourably with those embodied in past 'reports. 'The emergency Clinic in particular has shown 'increasing expansion and bears evidence of it's great 'usefulness in the treatment and relief of those children 'who, by reason of age, are not eligible for the routine 'Clinic. I have had the opportunity recently, especially 'at the second inspections of noting the great improve'ment in the condition of the children's mouths which 'provides ample and very gratifying justification for 'the adoption of the principles of school dental treat'ment. 'I venture to make the following suggestion which I 'think:) would increase the usefulness of the Dental 'Clinic - attention toy and treatment of the teeth as a 'routine measure commencing at the age of 5 years of age 'instead of six as at present.,' Mr.C Hammond Williams, L.D.S., the second part time dentist writes :- 'Comparison with the report for 1919 is favourable,, 'The attendance is better - this is chiefly noticeable 'in the cases of re-inspection. On the whole the Clinic 'is now in very satisfactory working order, the patients 'seem to be more tractable,, The prejudice of ignorant 'parents is still present though not so evident, The 'improvement in this respect I can only ascribe to two 'factors (l) the unfailing tact and experience of the 'Nurses in dealing with the parents and secondly the 'general improvement already noticeable in the children 'treated.' Miss Loretz, L.D.S., the present whole time dentist agrees that the age of 5 years is the best for commencing the routine treatment, and I also agree with this from my observations of the children seen at the Routine Inspections., I am also glad to notice the excellent condition of the mouths of children of 8 to 12 years of age who haye been treated by the dental surgeons at an earlier periods (i) Crippling defects and Orthopaedics. Twelve children were observed with lateral curvature of the spine, while sixty-four were seen with other defects, most of these being due to old Rickets. Most of the cases of lateral curvature wero treated by one of the School Nurses (Nurse Bevis), who is qualified in this remedial treatment. The children attended the Clinic on Saturday mornings and received exercises,massage,etc., and the parents were instructed as to home exercises. Other cases were referred to medical practioners or hospitals for treatment. 9 9. OPEN AIR EDUCATION. There is no open air school in this District, but I am glad to note that practically all classes in the schools receive part of their instructions in the open air. The training of a special class for "backward children at one school consists of open air work in connection with the school garden with very gratifying results. 12. SCHOOL BATHS. Only one school, viz.,Hogarth Infants' School is provided with a bath. At the present time, I do not think it advisable . to increase the Staff of the School Medical Department in order to provide for the cleansing of children "but no doubt when things are more normal the bath will be of great use and probably a small cleansing station at the Clinic might be instituted. 13. CO-OPERATION OF PARENTS. Before every routine medical inspection, notices are sent to the parents of children to be examined, inviting their attendance. This invitation is accepted mainly, as might be expected, by the parents of the younger children, i.e., the children in the Infant Schools. The presence of the parents is useful (l) in reassuring the children and (2) because it gives the School Medical Officer an opportunity of advising the parent as to any defect which may be discovered. I am of opinion that this method of advising parents should be continued in dealing with the infant children, but it might be done away with entirely in the case of older children. A School Nurse is always present at the inspections and the inspecting officer gets a better idea of the general condition of the children when the examination takes place without notice. 14. CO-OPERATION OF TEACHERS. I have to thank all the Head Teachers for their assistance in the school medical work. For the routine inspections they prepare a list of the children at the specified ages, and send round the notices to the parents. They also, as a rule, assist when necessary at the inspections and so are acquainted with any defects found I have also had many children sent to the Clinic direct by the teachers owing to some defect which they have noticed or suspected., 21, (l) During the year the Council have adopted Bye-Laws regarding the employment of children and young persons in the area. 10 All children between 12 and 14 who wish to work out of school hours must receive a certificate from the School Medical Officer. I have examined in all 166 such children, and refused certificates in 3 cases. The employment which is most general is the delivery of newspapers and I am of opinion that children who are in good health will not suffer, but may be benefited by this out door work which they do. It is necessary of course, that the conditions of the Bye-Laws should be observed with regard to clothing, etc. Every child who is licensed to carry out out-door work of this character in all weathers should be provided with rain proof covering and good footwear. Your obedient servant, C.S. BREBNER. 11 TABLE I. - NUMBER OF CHILDREN INSPECTED let JANUARY 1920 to 31st DECEMBER, 1920. A. - Routine Medical Inspection. Age Entrants. 3 4 5 6 Other Ages. Total Boys - - 198 104 84 386 Girls - - 209 106 81 396 Totals - - 407 210 165 782 Age Intermediate Group Leavers Other Ages Total Grand Total 8 12 13 14 Boys 263 198 126 12 - 599 9 35 Girls 244 183 98 6 — 531 927 Totals 507 381 224 18 - 1130 1912 B. - Special Inspections. Special Cases Re-Examinations (i.e., No, of Children Re-examined) Boys 622 261 Girls 596 290 Totals 1218 551 C. - TOTAL NUMBER OF INDIVIDUAL CHILDREN INSPECTED BY THE MEDICAL OFFICER, WHETHER AS ROUTINE OR SPECIAL CASES (no Child being counted more than once in one Year) . No. of Individual Children inspected 3130 12 TABLE II. - RETURN OF DEFECTS FOUND IN THE COURSE OP MEDICAL INSPECTION in 1920. Routine Inspections Specials Number referred for Treatment Number requiring to be kept under observation but not referred for Treatment. Number referred for Treatment. Number requiring to be kept under observation but not referred for Treatment. Malnutrition - 22 11 Uncleanliness: - - - - Head 75 - 82 - Body 18 - 10 - Skin (Ringworm ( Head 2 - 32 - ( Body - - 56 - ( Scabies 5 - 50 - (Impetigo 8 - 151 - (Other Diseases(non-Tubercular) 1 - - - Eye (Blepharitis 2 - 19 - (Conjunctivitis - - 3 - (Keratitis - - - - ( Corneal Ulcer 3 - 6 - ( Corneal Opacities - - - - (Defective Vision 142 - 63 - (Squint 9 5 9 - (Other Conditions 5 3 17 — Ear (Defective Hearing 4 19 4 2 (Otitis Media - - - - (other Ear Diseases 9 5 19 2 Nose and Throat (Enlarged Tonsils 26 235 5 14 (Adenoids 22 29 5 8 (Enlarged Tonsils and Adenoids 61 24 9 - (Other Conditions - - 2 - Enlarged Cervical Glands(Non-Tubercular) - 2 - - Defective Speech - 21 - - Teeth - Dental Diseases 367 - 38 - Heart and Circulation. (Heart Disease: (Organic 1 - - - (Functional - 28 2 12 (Anaemia 3 42 - - Continued Overleaf. 13 14 TABLE II. - Continued. Routine Inspections Specials Number referred for Treatment Number requiring to be kept under observation but not referred for Treatment. Number referred for Treatment. Number requiring to be kept under observation but not referred for Treatment.[/##] Lungs (Bronchitis 2 - - 2 (Other Hon-Tubercular Diseases 3 53 9 2 Tuberculosis. (Pulmonary: ( Definite - - 3 - ( Suspected 1 - — 17 f N on-Pulmonary: ( Glands - - - - ( Spine - - - - Hip ... - - 1 — ( Other Bones and Joints - - — - ( Skin 1 - - - ( Other Forms - - - - Nervous System (Epilepsy — - 3 2 (Chorea 1 - 9 3 (Other Conditions - 12 - Deformities. (Rickets - 43 A 3 f Spinal Curvature 10 — 2 (Other Forms - 14 - 4 Other Defects and Diseases 6 41 102 729 NUMBER OF INDIVIDUAL CHILDREN HAVING DEFECTS WHICH REQUIRED TREATMENT OR TO BE KEPT UNDER OBSERVATION 2046 CHISWICK URBAN DISTRICT. TABLE 111. Numerical Return of all Exceptional Children in the Area in 1920. Boys. Girls. Total. BLIND: (including partially blind) Attending Public Elementary Schools - - - Attending Certified Schools for the Blind 1 1 2 Not at School - - - DEAF and DUMB: (including partially deaf) Attending Public Elementary Schools - - - Attending Certified Schools for the Deaf 3 - 3 Not at School - - - MENTALLY DEFICIENT (Feeble Minded) Attending Public Elementary Schools - - - Imbeciles Attending Certified Schools for Mentally defective Children. - - - notified to the Local (Control) Authority during the year 1 - 1 Not at School - - - At School - • • Idiots Not at School " - - EPILEPTICS Attending Public Elementary Schools - - - Attending Certified Schools for Epileptics - - - Not at School 3 - 3 PHYSICALLY DEFECTIVE; Pulmonary Tuberculosis Attending Public Elementary Schools - - - Attending Certified Schools for Physically Defective Children - - - Not at School 2 6 8 Other forms of Tuberculosis. Attending Public Elementary Schools 4 2 6 Attending Certified Schools for Physically Defective Children - - - Not at School 1 1 2 Cripples others than Tubercular. Attending Public Elementary Schools . 2 2 Attending Certified Schools for Physically Defective Children 1 - 1 Not at School - - - DULL OR BACKWARD* Retarded 2 years 30 42 72 Retarded 3 years 12 15 27 *Judged according to age and standard. .15. TABLE IV - TREATMENT OF DEFECTS OP CHILDREN DURING 1920. A - Treatment of Minor Ailments. Disease or Defect Number of Children Referred for Treatment Treated Under Local Education Authority's Scheme Otherwise Total Skin - Ringworm-Head 34 31 3 34 Ringworm-Body 56 56 - 56 Scabies 55 55 - 55 Impetigo 159 157 2 159 Minor Injuries 4 4 - 4 Other skin disease 426 421 1 422 Ear Disease 36 36 - 36 Eye Disease (external and other) 55 55 - 55 Miscellaneous 163 155 8 163 B - Treatment of Visual Defect. Number of children. Submitted to Refraction. Referr ed for Refrac tion Under Local Education Authority's Scheme Clinic or Hospital. By Private Practitioner or Hospital. Otherwise Total For whom Glasses were prescribed For whom Glasses were provided. Recommended for Treatment other than by Glasses Received other Forms of Treatment. For whom no Treatment was considered necessary. 223 178 7 -i 185 180 176 2 2 3 C - Treatment of Defects of Nose and Throat. Referred for Treatment Number of Children. Received Operative Treatment Received other forms of Treatment. Under Local Education Authority's Scheme-Clinic or Hospital. By Private Practitioner or Hospital Total 214 130 6 136 1 .16. D. - TREATMENT OP DENTAL DEFECTS. 1. number of Children dealt with. Age Groups. 'Specials' Total 5. 6. 7. 8. 9. 100 11. 12. 13. 14. (a) Inspected by dentist 21 l64 465 825 245 87 10 - - - 194 2011 (b) Referred for treatment 21 133 334 673 176 74 8 - - - 194 1613 (c) Actually treated 18 119 290 441 109 47 3 - - - 194 1221 (d) Re-treated* (result of periodical examination ) 6 4 81 184 10 7 3 - - 259 *It is understood that cases under this head are also included under (c) above. 2, Particulars of time given and of Operations undertaken. No, of Half Days devoted to Inspection. No.of Half Days devoted to Treatment. Total No.of Attendances made by the Children at the Clinic. No.of Permanent Teeth. No.of Temporary Teeth Total No. of Fillings, No.of Administra tions of General Anaesthetics included in (4) and (6) No. of ether Operations Extract ed. Filled Extract ed. Filled Perma nent Teeth Temporary Teeth (1) (2) (3) (4) (?) (6) (7) (8) (9) (10) (11) 18 291 1968 314 1063 3534 1110 2173 281 68 8 TABLE V - SUMMARY OF TREATMENT OF DEFECTS AS SHEWN IN TABLE IV. (A, B, C, D and F but excluding E.) Disease or Defect Number of Children Referred for Treatment Treated Under Local Education Authority's Scheme. Otherwise. Total. Minor Ailments 730 700 30 730 Visual Defects 223 178 7 165 Defects of nose and throat 214 130 7 137 Dental Defects 1613 1221 - 1221 Other Defects 254 250 4 254 Total 1826 1517 54 1571 .17. TAELE VI - SUMMARY RELATING TO CHILDREN MEDICALLY INSPECTED AT THE ROUTINE INSPECTIONS DURING THE YEAR 1920. (1) The total number of children medically inspected at the routine inspections. * 2000 (2) The number of children in (l) suffering from Malnutrition 22 Skin Disease 16 Defective Vision (including Squint) 156 Eye Disease 13 Defective Hearing 23 Ear Disease 14 Nose and Throat Disease 397 Enlarged Cervical Glands (non-tubercular) 2 Defective Speech 21 Dental Disease 36 7 Heart Disease Organic 1 Functional 28 Anaemia 45 Lung Disease (non-tubercular) 5e Tuberculosis (definite - Pulmonary suspected 1 Non-pulmonary 1 Disease of the Nervous System 13 Deformities 67 Other defects and diseases 47 (3) The number of children in (1) suffering from defects (other than uncleanliness or defective clothing or footgear) who require to be kept under observation (but not referred for treatment) 598 (4) The number of children in (l) who were referred for treatment (excluding uncleanliness, defective clothing, &c.) 694 (5) The number of children in (4) who received treatment for one or more defects (excluding uncleanliness, defective olothing, &c.) 435 * 'Specials' should not be included in this Table. .18.