H.—3l.

Though the total incidence of ringworm noted throughout the Dominion last year was 0-17 per cent., as against 0-18 per cent, the previous year, considerable difficulty has been caused in certain centres by minor epidemics of the disease, especially ringworm of the head. Complication is added by the fact that bacteriological examination for doubtful cases is not always available or utilized when available. A notice was published in the Education Gazette as follows : — " The attention of teachers is drawn to the prevalence in many parts of the Dominion of ringworm, affecting either the scalp or the body. "In view of the prejudice to the child's health and the disorganization of his school career which may result from infection, it is necessary that every precaution be taken to prevent spread of the disease. (For information see the Health Department's (School Hygiene Division) leaflets: H. Sch. 6 and H. Sch. 10; also H.I.D. 33 —Regulations governing exclusion from school of children suffering from infectious disease.) Where it is not practicable to insist upon a certificate from a private medical practitioner in order to determine whether a sufferer should be readmitted to school, teachers are advised to refer the question for decision to the Medical Officer of Health or the School Medical Officer for the district." Special attention has been given by School Medical Officers and school nurses to schools from which cases of ringworm have been reported. It is to be emphasized that there are other avenues of infection than the school, as the condition is spread by such agencies as domestic pets, careless methods of hair-cutting, &c. It is often very difficult to arrange satisfactory treatment for ringworm of the head, especially for obstinate cases where special methods are indicated. Dr. Turbott reports that a ringworm clinic was continued through the year at the local Health Office, Gisborne, on Saturday mornings for children of poor people, through lotions and ointments, X-rays being unavailable. He states, " The most successful treatment this year was Whittield's ointment thoroughly applied after a spirit wash, but three months' application is needed to attain the desired cure. Twenty-seven cases were treated in 1933." The incidence of scabies or hakihaki among Natives is much greater than among European children —19-79 per cent, as against 1-23 per cent. Dr. Turbott continues to report very favourably of the effect of the Danish treatment with hydrogen sulphide ointment. Further information with regard to this is being published in the Education Gazette. Goitre. The amount of all degrees of goitre found in routine examination this year was 17-55 per cent., indicating little variation in incidence from the previous year. Some School Medical Officers have made observations to determine the influence of the use of iodized salt in regard to goitre, but the evidence obtained is, on the whole, inconclusive. Dr. Stevenson has forwarded returns with reference to 1,766 children classified as to whether the salt is used " not at all," " irregularly," and " regularly." She concludes that " though prophylactic measures have a value, there is some more complex factor complicating the incidence suggesting hereditary influences." In Canterbury Dr. Phillips, in a school of 452 pupils, found that there was a definite lower incidence of goitre in pupils using iodized salt. His returns and Dr. Stevenson's both indicate that though the total incidence of goitre in the group using iodized salt is less, the advantage is mainly in the " incipient " class, the percentage of " small " and " medium " goitre found being as great in the group using iodized salt. The following is an extract from Dr. Champtaloup's report : — " Knowing that my predecessor, Dr. Mecredy, had conducted an investigation into the incidence of goitre, I have kept a careful record throughout the year. It is interesting to find that in the main my observations confirm his findings. " Enlargement of the thyroid has been classified as— " * Palpable but not visible. This corresponds to Shore's Class A and Mecredy's incipient. " f Palpable and also visible. Slight, and confirmed on deglutition. " J Larger. Includes the medium and large groups of the school medical classification. " I examined 2,738 children and found — Per Cent. "528 Normal .. 22-2 " 853 * .. .. 35-8 Palpable .. " 95 ° " ! " '• '• 39 ' ner cent visible T ° ta1 ' 77-8 P ercent " 49 J 2*05 C ptJL L/tillb. Viol Die j

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