BOROUGH OF FINCHLEY REPORT OF THE School Medical Officer For the Year 1935 BOROUGH OF FINCHLEY REPORT OF THE School Medical Officer For the Year 1935 BOROUGH OF FINCHLEY. MEMBERS OF THE EDUCATION COMMITTEE. Chairman: Councillor F. J. Grocott. Vice-Chairman: Councillor E. Toyne. The Mayor. The Deputy Mayor. Councillor W. L. Brooksbank ,, J. Hugh Jones, LL.B. ,, Major H. W. Steward ,, H. H. Wilmot Co-opted Members: Miss L. Davey, M.A., Mrs. A. S. Miall, B.A., Mr. D. A. A. Merry. Ex-officio Members: County Councillor J. Boggon, J.P. ,, ,, W. Newcome Wright, J.P. The Chairman of the Local Higher Education Committee (Alderman C. S. Syrett, J.P.). Director of Education, T. Frost, B.Sc. 3 BOROUGH OF FINCHLEY. SCHOOL MEDICAL STAFF. School Medical Officer : A. A. Turner, M.C., M.D., D.P.H. Assistant School Medical Officer : C. Russell, M.B., Ch.B., D.P.H. Ophthalmic Surgeon : J. S. Boden, M.B., B.S. Radiologist : [. Rhynland Parry, M.B., Ch.B., D.M.R.E. School Dentist : C. R. Wilshaw, H.D.D. (Edin.), L.D.S. (Eng.). School Nurses and Health Visitors : Miss J. Hull. Miss C. Hemming. Miss F. Hughes. Clinic Nurse : Miss J. R. Sharpe. Dental Attendant : Miss E. G. Sommerfield. Clerk : Miss M. Hidson. 4 FINCHLEY SCHOOLS. ELEMENTARY SCHOOLS. School. Department. Accommodation. Average Attendan 1935. Alder Senior 480 329 Alder Infants 300 119 Northside Senior 320 204 Northside Junior 450 390 Manorside Senior 480 265 Manorside Junior 372 427 Martin Junior 488 382 Summerside Junior 450 443 St. Mary's Junior 484 389 St. John's Junior 304 222 Christ Church Senior 240 194 Holy Trinity Junior 395 253 Our Lady of Lourdes Mixed & Infants 224 217 4987 3834 SECONDARY SCHOOLS. On Roll. County School Boys & Girls 353 Christ's College Boys 482 Woodhouse Boys & Girls 379 1214 5 To the Chairman and Members of the Education Committee of the Borough of Finchley. I have the honour to submit my report on the work of the School Medical Service for the year 1935. The general health of the children has been good throughout the year and the schools have been particularly free from epidemic diseases. The work carried out shows expansion in most directions and there has been increasing evidence that parents realise the value of what is being done for their children. The dental treatment of the elementary school children has suffered a check owing to the fact that the amount of work found necessary for the scholars of the secondary schools turned out to be much greater than was anticipated, but the arrangements which your Committee have made for the next financial year will ensure that no child will go more than twelve months without inspection and the opportunity of receiving treatment. I wish to acknowledge the ever ready co-operation of the Director of Education, the Head Teachers and all members of the staff. I am, Your obedient Servant, A. A. TURNER. School Medical Officer 6 CO-ORDINATION WITH OTHER HEALTH SERVICES. Close co-operation exists between the Public Health Department and the School Medical Service; the Medical Officer of Health is also School Medical Officer, while the Assistant School Medical Officer and the three School Nurses also carry out the Maternity and Child Welfare work in the Borough. The School Nurses know most of the children before they are admitted to school, and they are also acquainted with their home circumstances. Medical Inspection. Routine Medical Inspection is carried out on the elementary school premises and the three age groups laid down by the Board of Education are dealt with, namely:— Five year olds, eight year olds, and twelve year olds. All new admissions to the schools which do not fall into any of these groups are also examined. "Special" children referred by parents, teachers or school nurses are examined in the schools or at the appropriate school clinic, while "re-inspections" are dealt with in the same manner In 1935 the total number of medical inspections was 3,731. Findings of Medical Inspections. The number of defects, apart from dental defects and uncleanliness, found at routine medical inspection in the schools and at other inspections is set out in Table II. Of the 1,540 who were submitted to routine inspection 140 or 9.1% were found to be in need of medical treatment. (a) Malnutrition. The Board's new classification of the nutrition of the children submitted to routine examination was used through- 4 out the year and the following summary of the results clearly shows that very little malnutrition exists. No. of children inspected A (Excellent) B (Normal) C (Slightly sub-normal) D (Bad) 1540 No. % No % No. % No. % 76 4.94 1284 83.38 175 11.36 5 .32 (b) Uncleanliness. A very serious attempt is made to keep the standard of cleanliness as high as possible. New admissions to the schools take place on Mondays only and on these days the school nurses visit all schools and examine these children, who are allowed to remain in school only if they are perfectly clean, while those who are unclean are sent home and not admitted until their condition is satisfactory. All children in the schools are examined by the school nurses at the commencement of each term and the unsatisfactory ones are seen at frequent intervals. Children who have been excluded for uncleanliness are seen in school by the school nurses before they are allowed to return to their classes. The nurses paid an average of 64 visits to each school for uncleanliness inspections during the year; 17,860 inspections were made and 232 individual children were found not to comply with the rigid standard which is enforced. At routine medical inspection the heads of 69 or 4.48% of the children were found not to be entirely satisfactory while 3 or .19% had dirty bodies. (c) Minor Ailments and Skin Diseases. Few cases of minor ailments are found at routine inspection as these are sent to the school clinics by parents, teachers, and school nurses as soon as they are discovered. 8 Two cases of scabies, one case of impetigo and one other skin disease were found at routine inspections, while at special inspections, 2 cases of ringworm of the scalp, 7 cases of ringworm of the body, 28 cases of impetigo, 3 cases of scabies and 54 of other skin diseases were discovered. (d) Visual Defects and External Eye Disease. Eighty-seven or 5.65% of the children at routine inspections were found to be suffering from some fairly serious defect of vision while 31 others were found at special inspections. A considerable number of children who had already been supplied with spectacles were referred to the School Oculist as a result of re-examination. In all 188 children were referred for refraction. Three cases of blepharitis were found at routine inspection and at special inspections 15 cases of blepharitis and 23 of conjunctivitis. (e) Nose and Throat Defects. At routine medical inspection 13 children were found to be in need of surgical treatment for enlargement of the tonsils or adenoids, or both, while 27 were referred for observation. At special inspections 30 were referred for treatment and 15 for observation. (f) Ear Disease and Defective Hearing. As a result of routine and special examinations, 34 cases of discharging ears were referred for treatment. (g) Dental Defects. Six hundred and fifty-three or 42.40% of the children were found to be suffering from dental decay, 10.97% having four or more teeth decayed, and 31.43% having less than four. 9 (h) Orthopedic and Postural Defects. At routine inspection one case of rickets was referred for observation and two cases of other deformities for treatment and one for observation. (i) Heart Disease and Rheumatism. At routine inspection three cases of organic heart disease and one of functional heart disease were found. (j) Tuberculosis. One case of tuberculosis of the knee was found at special inspections. This case was already under treatment and the disease was quiescent. (e) Other Defects and Diseases. These form a very miscellaneous group and in all 282 cases were referred for treatment from routine and special inspections. Following up. There are three Health Visitors and School Nurses who devote approximately two-fifths of their time to school work. There is a whole-time Clinic Nurse who does the minor ailments and supervises the Dental Clinic, and there is also a whole-time Dental Attendant. Home visits are paid by the School Nurses in connection with the treatment of defects; to endeavour to get consents to dental treatment, in connection with uncleanliness cases, and to arrange for children to go to special schools. The following is a summary of the work done by the School Nurses during the year :— Visits to schools 641 Visits to clinics 317 Home visits 691 1,649 Number of examinations of children— heads, bodies, clothing, etc. 17,860 10 Medical Treatment. (a) Minor Ailments. The Clinic at Bourchier House is open every morning from 8.30 a.m. and the clinic at Summerside School on Tuesday afternoons. On occasions the number of patients has been so large as to necessitate a second weekly session which has been held on Friday afternoons. One thousand, three hundred and twenty-seven children received treatment at these clinics during the year, making 8,743 attendances, as compared with 932 children making 6,760 attendances in 1934. (b) Tonsils and Adenoids. Twenty-one children were operated on for tonsils and adenoids at the Finchley Memorial Hospital. The arrangement whereby the children are detained in Hospital for two days following the operation is greatly appreciated by the parents, and it minimises the risk of haemorrhage and sepsis which are apt to occur when children are taken home immediately after operation. (c) Tuberculosis. All cases of tuberculosis occurring among school children are referred to the Tuberculosis Officer of the Middlesex County Council. (d) Skin Disease. The treatment of cases of skin disease is carried out at the Minor Ailments Clinics; 455 children were treated during the year. Ringworm of the Scalp. There were two cases of this disease during 1935, and both were treated by their family doctor. (e) External Eye Disease. Children suffering from external eye disease are treated at the Ophthalmic Clinic and at the Minor Ailments Clinics ; 93 children were treated during the year. 11 (f) Vision. The Ophthalmic Surgeon attends one session per week at the Clinic at the Martin School and examines all children suffering from defects of vision or other eye conditions referred to him. During 1935, 209 children were referred for examination; 183 were submitted to refraction— spectacles were prescribed in 199 cases and 172 actually obtained spectacles. In 29 of these cases the parents were unable to pay the whole cost of the spectacles and the Children's Care Committee subscribed varying sums towards the purchase. (g) Ear Disease and Hearing. Children suffering from ear discharge and defective hearing are dealt with at the Minor Ailments Clinic at Bourchier House. During the year 82 children were treated. (h) Dental Defects. A whole-time Dental Surgeon is employed. Ten sessions per week are devoted to the inspection and treatment of school children, and one session to the inspection and treatment of Maternity and Child Welfare cases. I am indebted to Mr. C. R. Wilshaw, H.D.D. (Edin), L.D.S. (Eng), the School Dental Officer, for the following report on the dental scheme. DENTAL REPORT, 1935. Last year's report on the School Dental Service comprised a description of the procedure taken at school inspections together with an outline of the treatment given at the clinic. This year space must appropriately be given to the new responsibility and service which has been undertaken on behalf and under the auspices of the Middlesex County Council. This refers, of course, to the inclusion of the scholars of the secondary schools in Finchley within the Borough of Finchley's School Dental Service. 12 Because inherent weaknesses in the structure of teeth which predispose to caries so often become manifest within a few years of the eruption of the teeth, it is a matter of great moment to these scholars that defects should be discovered and treated at an early stage while the teeth are still saveable. Many of the pupils attending the secondary schools are there by virtue of scholarships, and it has seemed a little unfortunate that their scholastic achievements should deprive them of a service available to the elementary school children. This new development is therefore the cause of much satisfaction to parents, many of whom are ready to appreciate the value of a facility at a nominal cost to themselves, and others who like to be informed of any dental defect in their children so that they can take them to their family practitioner for early treatment. Inspection revealed that 81% required treatment and of these just over half were treated at the clinic. It was found that the average treatment required for those who attended was 3.31 fillings and .71 extractions as compared with 1.7 fillings and 2.28 extractions in elementary school children. The extractions in young childlren are mainly from the temporary dentitions, while those in older children are permanent teeth. The extra fillings required in older children are due, not alone to the fact that a number of these scholars had not had dental treatment for several years, but to the fact that they have more permanent teeth subject to the vicissitudes of the mouth for a great number of years. As filling teeth is the great time absorber, it may be stated with fair accuracy that it takes twice as long to render sound the dental defects of secondary than of elementary school children. In actual practice the treatment has worked most smoothly. The pupils are excellent at keeping appointments. This dependability makes it practicable to space appointments as required in order to complete two instead of a single item at each attendance, enabling the time at the clinic to be utilised 13 to the utmost as well as reducing the number of visits that each pupil is required to make, which in its turn is an economy of school time. The co-operation of the Headmasters concerned is very stimulating. The time spent in inspecting and treating the children of secondary schools has of course entailed a serious curtailment in similar activities in the elementary schools. This would be a matter of grave apprehension were it not for the fact that your Committee has seen fit to appoint a part-time dental officer to make good this deficiency. Indeed, bv the time this report is in your hands the newly appointed dental officer will be installed and devoting four sessions per week to the inspection and treatment of school children. Then, this temporary lapse over and the leeway recovered, Finchley will again be in the satisfactory position of having a school dental service adequate to its demands, as well as giving the additional advantage of an extended range of service. Grateful acknowledgements are due to the Dental Board for the services of their able demonstrator, Mrs. Turnbull, who attended the elementary schools in Finchley to instruct children on the care of their teeth. The visit cannot be other than beneficial, but unfortunately the visit was too late in the year to enable comparative figures to be made. Anaesthetics. General anaesthetics are administered by a School Medical Officer who attends for that purpose at speciai sessions. No extractions of any kind are performed without the use of either a general or local anaesthetic. The details of the year's work are set out below and on pages 15, 35 and 36. At the routine inspections 1,416 children were inspected, and 1,146, or 80.93% were found to require treatment. Of the 1,146 who required treatment, 677 or 59.8% actually rereceived treatment at the Dental Clinic. In addition to this number 136 routine cases were treated which were held over from the previous year's inspection. As a certain number 14 of treatments are also held over into January of next year the percentage rate of acceptance appears to be lower in the elementary school's tables than it proves to be in practice. The reason for the hold-over of patients is to ensure having cases to treat during the School Christmas Holiday, and as the group held in reserve at the beginning of the year is drawn from a different school to that which should offset it at the end of the year, it is not possible to tabulate under schools the correct percentage of attendance in any arbitrary year. Two children were re-inspected, and both received treatment. 531 Special Cases were seen by the Dentist at the request of parents or teachers and 495 of these were treated. The work carried out for Elementary School Children J by the Dentist during the year is set out in the following table : — 1934 1935 Number of children inspected and re-inspected 3889 1949 Number of children treated 2089 1308 Number of attendances at Dental Clinic 3650 2569 Number of fillings 3331 2256 Number of extractions 3958 2985 Number of other operations I98 147 Number of general anaesthetics 789 626 Parents' Contribution Towards Cost of Treatment The sums recovered from parents in respect of dental and medical treatment are as follows :— 1934 1935 £ s. d. £ s. d. Dental Treatment 100 1 0 60 6 0 Operative Treatment of Tonsils and Adenoids 7 8 0 7 9 0 Treatment of Minor Ailments 4 12 0 4 9 3 £112 1 0 £72 4 3 15 Contributions for dental treatment are collected at the Dental Clinic when the child attends for treatment. The charge is 1/- for each child treated. At the Minor Ailments Clinic an endeavour is made to collect 3d. a week for each child attending, but treatment is never withheld on account of inability to pay. Contributions for the operative treatment of tonsils and adenoids are collected by the School Nurses. Infectious Diseases. The following list gives the number of cases which were brought to the notice of the School Medical Officer for the past three years. 1933 1934 1935 Chicken-pox 1 48 6 Diphtheria 5 17 12 Measles 0 97 3 Mumps 13 36 44 Scarlet Fever 54 76 49 Whooping Cough 7 75 38 80 349 152 16 Exclusion of School Children on Account of Infectious Disease. Disease. PATIENTS. Period of exclusion. CONTACTS. Period of exclusion. SCARLET FEVER: (a) Hospital Cases Until 14 days alter discharge from hospital. All children in the family must be excluded until 10 days after disinfection of [b) Home Cases Until 14 days after disinfection of premises. DIPHTHERIA : (a) Hospital Cases mises. Until 28 days after discharge from hospital. All children in the family must be excluded until 10 days after disinfection of (b) Home Cases Until 28 days after disinfection of premises. SMALL-POX mises. Until Medical Officer of Health certifies that child may attend. All children in the family must be excluded until the Medical Officer of Health certifies that they may attend. MEASLES Until 28 days after commencement of illness. • A A J V** \J V V> * 1 VA • All children in the family who have not had the disease must be excluded until 16 days after the commencement of the Inst case m the house MUMPS Until at least 21 days after commencement of illness. No exclusions. GERMAN MEASLES Until 14 days after commencement of illness. No exclusions. CHICKEN-POX Until at least 14 days after commencement of illness, and longer if scabs have not fallen off head and body. No exclusions. WHOOPING COUGH Until at least 5 weeks after commencement of illness, and so long as characteristic cough continues. No exclusions. N.B.—These periods may be modified by the medical practitioner in attendance or by the Medical Officer of Health, but in such cases a special certificate will be sent to the Head Teacher from the Education Office. 17 Open-Air Education. No organised scheme of open-air education exists in the district. In a few of the schools, classes are conducted in the playgrounds during the summer months, and occasional school journeys are undertaken. No school camps have been held. Four places, two for boys and two for girls, are reserved by the Education Committee at the Russell Cotes School of Recovery, Parkstone. During the year 31 children were sent to Parkstone, and without exception, their health was greatly improved. Two places are also reserved, during the winter months, at the Children's Hostel, Collington Manor, Bexhill-on-sea. Four boys and four girls were sent there for a period of six weeks. Physical Training. No direct control over physical training is exercised by the School Medical Officer, but Head Teachers refer for examination any children who appear to them to be unfit to take part in the games and exercises practised in the various schools. In conjunction with the Boroughs of Hornsey, Tottenham and Wood Green, a male and a female organiser have been appointed, a step which should lead to co-ordination of the scheme of physical training throughout the schools in the Borough. Provision of Meals. No meals are provided by the Education Committee at any of the elementary schools. Provision of Milk in Schools. The scheme of the Milk Marketing Board continued to operate throughout the year. Much time and care has been given by the teachers in working the scheme, often under unfavourable circumstances, and in every case where a child from a poor family has been recommended to have the milk the head teacher has been able to ensure that the supply is forthcoming. 18 19 The record of Alder Infants has invariably been excellent but that of several other departments is distinctly disappointing. School. Department Total number of pupils on the register Number of pupils receiv ling milk % receiving milk Alder Senior 380 136 36 Alder Infants 132 113 85 Northside Senior 243 65 26 Northside Junior 433 246 56 Manorside Senior 302 49 16 Manorside junior 484 239 49 Martin Junior 412 276 67 Summerside Junior 510 320 63 St. Mary's Junior 428 216 50 St. John's Junior 245 160 65 Christ Church Senior 240 60 25 Holy Trinity Junior 274 132 48 Our Lady of Lourdes Mixed 286 145 50 Totals 4,369 2,157 49 There is no room for doubt that milk is an ideal food for the growing child and I firmly believe that with a very few exceptions where it is contra-indicated on medical grounds all school children no matter what their home conditions or the state of their nutrition may be, would derive considerable benefit from this supplement to their ordinary diet. It is therefore a matter of great regret to me that the numbers receiving milk should have declined from the previous year. I am convinced in my own mind that the heads of all departments both senior and junior would be rendering a great service to the children under their care by endeavouring in every possible way to increase the consumption of milk in their schools. The following table shows the numbers of children on the roll in each department and numbers and percentages receiving milk in October 1935. School Baths. The Council's baths in Squires Lane are available for the use of the children of all the elementary schools, and during- the year 16,397 attendances were made by 1,558 children. Co-operation of Parents. Parents are invited to be present when their children are being examined at routine inspections, and the interest that is taken in medical inspection is shown by the following table, which gives the percentage of parents attending during the last six years. Percentage of Parents Attending. 1930 1931 1932 1933 1934 1935 76.2% 72.9% 72.4% 73.2% 69.23% 71.49% Co-operation of Teachers. The closest co-operation exists between the Teachers and the School Medical Service, and in many instances the Teachers have been instrumental in persuading parents to obtain the treatment for their children which has been recommended by the School Medical Officer. Many children are referred by Head Teachers for special examination and children found to be suffering from minor ailments are sent to the school clinics at the earliest opportunity. Co-operation of School Attendance Officers. Weekly lists are prepared by the School Attendance Department of all children absent from school on account of illness, and a weekly list of all children who enter or leave school is submitted to the School Medical Officer. The names of all children excluded from school by the School Medical Officer are notified forthwith to the Attendance Department. The Attendance Officers also inform the School Medical Officer of any children in their districts who are suspected to be physically or mentally defective and thus give valuable assistance in drawing attention to children who might otherwise escape medical supervision. 20 Co-operation of Voluntary Bodies. During the year the Children's Care Committee sent 56 children to Bexhill for a period of one week; and in 29 cases assistance was granted in the purchase of spectacles. Blind, Deaf, Defective and Epileptic Children. Every effort is made to ascertain children suffering from "special" defects and it is very unlikely that any are missed. Physically defective children are few, and so far it has not been found necessary to establish an Orthopaedic Clinic in the Borough, but arrangements have been made whereby the Education Committee assume responsibility for the maintenance in the Royal Orthopaedic Hospital of any cripple child recommended for admission by the School Medical Officer. No difficulty has been experienced in placing blind, deaf and epileptic children in certified special schools. Sixteen mentally defective children were in attendance at the Joint Special School situated within the area at the end of the year, four were at residential schools outside the district. (b) There is one feeble-minded child not in attendance at the Special School, but he is being kept under supervision. (c) The Education Authority has no Special Schools. Nursery Schools. No nursery schools have been established in the district. Secondary Schools. The School Medical Officer conducts the medical inspection in the three Secondary Schools on behalf of the Middlesex County Council. This arrangement has the advantage of co-ordinating the work in the Secondary Schools with that in the Elementary Schools. 683 pupils were examined during the year. 21 Continuation Schools, There are no Continuation Schools in the district. Employment of Children and Young Persons. (1) The children employed in Finchley are mostly engaged in the distribution of milk and newspapers. The conditions of employment have been satisfactory and in no instance has a child been found to have suffered in health owing to such employment. (2) All children are referred to the School Medical Officer for examination prior to their commencing work. 65 children were examined during the year, and all were fit for employment. No young persons have been referred to the School Medical Officer during the year. Special Inquiries. No special inquiries have been conducted during the year. Miscellaneous. All school teachers appointed by the Education Committee are examined by the School Medical Officer before they take up their duties. During the year no candidate has been rejected on medical grounds. 22 STATISTICAL TABLES for the Year 1935 23 24 TABLE 1. Return of Medical Inspections. A.—ROUTINE MEDICAL INSPECTIONS. Number of Code Group Inspections:— Entrants 539 Second Age Group 430 Third Age Group 349 Total 1318 Number of other Routine Inspections 222 B.— OTHER INSPECTIONS. Number of Special Inspections 1478 Number of Re-Inspections 713 Total 2191 C.—CHILDREN FOUND TO REQUIRE TREATMENT Number of individual children found at Routine Medical Inspections to require treatment (excluding uncleanliness and dental diseases). Entrants 27 Second Age Group 47 Third Age Group 44 Total 118 Other Routine Inspection 22 25 TABLE II. A. Return of Defects found by Medical Inspections in the year ended 31st December, 1935. DEFECT OR DISEASE. Routine Inspections. No. of Defects. Special Inspections No. of Defects. Requiring treatment. Requiring to be kept under observation but not requiring treatment. Requiring treatment. Requiring to be kept under observation but not requiring treatment. (" (2) (3) (4) (5) Skin— Ringworm:— Scalp .. .. 2 .. Body .. .. 7 .. Scabies 2 .. 3 .. Impetigo 1 .. 28 .. Other Diseases (Non-Tuberculous) • • 1 52 2 Eye— Blepharitis 3 .. 15 .. Conjunctivitis .. .. 22 1 Keratitis .. .. .. .. Corneal Opacities .. .. .. .. Defective Vision (excluding Squint) 87 29 31 .. Squint 9 3 7 .. Other Conditions 1 1 41 5 Ear— Defective Hearing .. .. 6 3 Otitis Media 7 1 27 .. Other Ear Diseases .. 1 13 1 Nose and Throat— Chronic Tonsillitis only 5 20 17 14 Adenoids only .. 1 1 .. Chronic Tonsillitis and Adenoids 8 6 12 1 Other Conditions 1 .. 22 11 Enlarged Cervical Glands (Non-Tuberculous) .. 1 3 11 Defective Speech .. .. .. .. Heart and Circulation— Heart Disease: Organic 1 2 1 3 Functional .. 1 .. .. Anaemia 1 .. 5 .. Lungs— Bronchitis 1 2 5 .. Other Non-Tuberculous Diseases .. .. 1 1 Tuberculosis— Pulmonary: Definite .. .. .. .. Suspected .. .. .. .. Non-Pulmonary : .. .. .. .. Glands .. .. .. .. Bones and Joints .. .. .. .. Skin .. .. .. .. Other forms .. .. .. 1 Nervous System— Epilepsy .. .. 4 1 Chorea .. .. .. 1 Other Conditions 1 2 9 5 Deformities— Rickets .. 1 .. .. Spinal Curvature .. .. .. .. Other forms 2 1 .. .. Other Defects and Diseases — (Excluding Uncleanliness and Dental Diseases) 13 4 269 41 Tota's 143 77 603 102 26 B. Classification of the Nutrition of Children inspected during the year in the routine age-groups. ROUTINE AGE-GROUP INSPECTIONS AGE-GROUPS Number of Children Inspected. A. [Excellent]. B. [Normal] C. [Slightly subnormal]. D. [Bad]. No. % No. % No. % No. % Entrants 539 15 2.78 455 84.42 65 12.06 4 .74 Second Age group 430 _ 20 4.65 343 79.77 66 15.35 1 .23 Third Agegroup 349 30 8.60 290 83.09 29 8.31 — — Other routine Inspections 222 11 4.95 196 88.29 15 6.76 — — Total 1540 76 4.94 1284 83.38 175 11.36 5 .32 27_30 TABLE III. Return of all Exceptional Children in the Area. Blind Children. At Certified Schools for the Blind. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 1 - - - 1 Partially Sighted Children. At Certified Schools for the Blind. At Certified Schools for the Partially Sighted At Public Elementary 1 Schools. At other Institutions. At no School or Institution. Total. 1 1 - - - 2 Deaf Children. At Certified Schools for the Deaf. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 2 - - - 2 Partially Deaf Children. At Certified Schools for the Deaf. At Certified Schools for the Partially Deaf. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. - 2 2 - - 4 Mentally Defective Children. Feeble Minded Children. At Certified Schools for Mentally Defective Children. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 20 — — 1 21 Epileptic Children. Children suffering from Severe Epilepsy. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 1 2 — 1 4 Physically Defective Children. A. Tuberculous Children. i.—Children suffering from Pulmonary Tuberculosis (including pleura and intra-thoracic glands). At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. - - 1 - 1 ii.—Children suffering from Non-Pulmonary Tuberculosis (this category should include tuberculosis of all sites other than those shown in i. above). At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. - 2 - 1 3 B. Delicate Children. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 6 28 - - 34 C. Crippled Children. At Certified Special Schools. At Public Elementary Schools. At other Institutions. At no School or Institution. Total. 2 4 - - 6 D. Children with Heart Disease. At Certified Special ! Schools. At Public Elementary Schools. At other Institutions. At no school or Institution. Total. 2 - - - 2 Children suffering from Multiple Defects. Combination of defect At Certified Special Schools. At Public Elementary Schools. At other Institutions At no School or Institution Total. Severe epilepsy and mental defect. 1 - - 1 2 31 TABLE IV. Return of Defects treated during the year ended 31st December, 1935. Treatment Table. Group 1. Minor Ailments (excluding uncleanliness, for which see Table VI.). Disease or Defect Number of Defects treated, or under treatment during the year. Under the Authority's Scheme Otherwise Total (1) (2) (3) (4) SKIN Ringworm—Scalp — 2 2 Ringworm—Body 7 — 7 Scabies 5 - 5 Impetigo 388 — 388 Other skin disease 53 1 54 MINOR EYE DEFECTS— (External and other, but excluding cases falling in Group II.) 81 - 81 MINOR EAR DEFECTS- 82 1 83 MISCELLANEOUS (e.g., minor injuries, bruises sores, chilblains, etc.) 586 10 596 TOTAL 1202 14 1216 TABLE IV. (Continued). Group II.—Defective Vision and Squint (excluding Minor Eye Defects treated as Minor Ailments—Group I.). Defect or Disease Number of Defects dealt with. Under the Authority's Scheme Otherwise Total (1) (2) (3) (4) Errors of Refraction (including Squint.) (Operations for squint are recorded separately in the body of the report.) 186 2 188 Other Defect or Disease of the eyes (excluding those recorded in Group I.) ... 41 - 41 Total 227 2 229 Total number of children for whom spectacles were prescribed:— (a) Under the Authority's Scheme 199 (b) Otherwise — Total number who obtained spectacles:— (a) Under the Authority's Scheme 172 (b) Otherwise 2 32 33 GROUP III.—Treatment of defects of Nose and Throat. NUMBER OF DEFECTS. Received Operative Treatment. Received other forms of treatment. (4) Total number treated. (5) Under the Authority's Scheme in Clinic or Hospital. (1) By Private Practitioner or Hospital, apart from the Authority's Scheme. (2) Total. (3) (1) (2) (3) (4 (1) (2) (3) (4) (1) (2) (3) (4) 6 1 14 — 1 - 15 - 7 1 29 — 5 42 (1) Tonsils only. (2) Adenoids only. (3) Tonsils and Adenoids. (4) Other defects of the nose and throat. 34 GROUP IV.—Orthopaedic and Postural Defects. Under the Authority's Scheme. (1) Otherwise. (2i number treated. Residential treatment with education. (1) Residential treatment without education. (2) Nonresidential treatment at an orthopaedic clinic. (3) Residential treatment with education. (1) Residential treatment without education. (2) Nonresidential treatment at an orthopaedic clinic. (3) Number of children treated. 3 - - — - - 3 35 TABLE V—Dental Defects Elementary Schools (1) Number of Children who were: (5) Extractions:— \ / Permanent teeth 313 (1) Inspected by the Dentist:— Aged:— Temporary teeth 2672 Total 2985 Routine Age Groups. 5 41 Total: 1416 (6) Administrations of general anaesthetics for extractions 626 6 175 7 140 8 197 (7) Other operations:— 9 228 Permanent teeth 103 10 220 Temporary teeth 44 11 156 Total 147 12 129 13 62 14 68 (8) Extractions:— Specials 531 On account of overcrowding GRAND TOTAL 1947 (a) Permanent 91 (2) Found to require treatment 1677 On account of advanced decay— (3) Actually treated 1308 (b) Permanent 222 (c) Temporary 2672 (2) Half-days devoted to:— Total 2985 Inspection 20 Treatment 234 Total 254 (9) Other operations:— (a) Dressings Permanent 63 Temporary 2 (3) Attendances made by children for treatment 2569 (b) Application of Silver Nitrate (4) Fillings:— Permanent 4 Temporary 40 Permanent teeth 1962 Total 109 Temporary teeth 294 Total 2256 (c) Scalings 31 (d) Root treatment 7 36 TABLE V—Dental Defects Secondary Schools (1.) Number of Children who were: (5) Extractions:— Permanent teeth 274 (1) Inspected by the Dentist:— Aged:— Temporary teeth 49 Routine Age Groups. 11 49 Total: 1097 Total 323 12 141 13 205 (6) Administrations of general anaesthetics for extractions 50 14 225 15 235 (7) Other operations:— 16 164 Permanent teeth 73 17 65 Temporary teeth - 18 9 Total 73 19 4 Specials 1 (8) Extractions:— GRAND TOTAL 1098 On account of overcrowding (a) Permanent 61 On account of advanced decay (2) Found to require treatment 892 (b) Permanent 213 (c) Temporary 49 (3) Actually treated 455 Total 323 (2) Half-days devoted to:— Inspection 14 Treatment 157 (9) Other operations:— Total 171 (a) Dressings Permanent 55 Temporary - (b) Application of Silver (3) Attendances made by children for treatment 828 Nitrate Permanent - (4) Fillings:— Temporary - Permanent teeth 1504 Total 55 Temporary teeth - Total 1504 (c) Scalings 18 (d) Root treatment - Table VI—Uncleanliness and Verminous Conditions. (1) Average number of visits per school made during the year by the School Nurses 64 (2) Total number of examinations of children in the Schools by the School Nurses 17860 (3) Number of individual children found unclean 232 (4) Number of children cleansed under arrangements made by the Local Education Authority (5) Number of cases in which legal proceedings were taken:— (a) Under the Education Act, 1921 - (b) Under School Attendance Bye-laws - Finchley Press Limited N.2.