MEDICAL INSPECTION OF SCHOOLS 



Reference has been made to the three types of records which 

 must be kept: the first is the card of notification to the parents, 

 the second is the individual physical record, the third is the blank 

 on which the school physician periodically records the numbers and 

 results of the physical examinations made by him. This third 

 form is in nature a recapitulation of the individual records and 

 must be designed so that the results of large numbers of individual 

 records may be combined on it and presented in report form. 



RECORDS OF COMBINATIONS OF DEFECTS 



Reference to the tables which have been presented, giving 

 the results of physical examinations,* shows that the total number 

 of defects reported is considerably in excess of the number of 

 defective children found. This is because one child frequently 

 suffers from several sorts of defects. 



For example, the child who has seriously hypertrophied 

 tonsils commonly suffers from adenoids, and when he has both of 

 these defects to a marked degree, he almost certainly has in addi- 

 tion seriously defective teeth. Plainly, the value of the records 

 would be greatly enhanced if there were some method for recording j 

 not only the existence of separate defects, but the combinations 

 in which they are found. Only through making and studying such 

 records can trustworthy conclusions be formed as to the degree to 

 which different defects are to be rated as both causes and effects 

 of one another. 



The first requisite of a plan for recording combinations is j 

 that it be simple; and this means that it must be restricted to a few ! 

 of the more important defects. The reason for this is that the 

 number of possible combinations increases with enormous rapidity 

 with each increase in the number of defects considered. Thus, if 

 we are considering two defects, A and B, there are four possible 

 combinations. First, the child may have neither defect; second, 

 he may have A; third, he may have B; and in the fourth place, he 

 may have both A and B. When we consider three defects, there 

 are eight possible combinations; and when the number is increased 

 to four, the combinations increase to 16. Proceeding at the same 

 * See Tables 1 1 and 12, p. 38. 



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