H.—3l.

holiday homes, health camps, &c. Under present conditions much energy is expended in raising funds for this purpose. A great economy of effort and wider benefit would result if it were possible to place on a more permanent financial basis these means of affording timely care for debilitated children. Goitre : New Zealand School-children. The following is an outline of observations made by School Medical Officers, and in no way professes to be a comprehensive statement of the goitre problem among New Zealand school-children. A systematic classification of goitre in school-children was initiated in 1921. The classification adopted was that suggested by Drs. Hercus and Baker-McLaglan as a result of their work on the schoolchildren of Canterbury. It was as follows : Incipient—Slight bulging of the skin over the trachea, just discernable on inspection, particularly during deglutition, and indicating on palpation a slight thickening or widening of the isthmus or palpable lateral lobes which communicate a sense of fullness. Slight —Definite bulging of the neck and corresponding enlargement on palpation. Medium —Marked deformity, bulging ; palpation unnecessary. Large—With excessive deformity. From this classification it is evident that'a very strict standard is observed, and that a large number of goitres classified as "incipient " would by a slightly less rigid standard be not classified as goitres at all. Incidence. —Figures showing incidence are given below. Those quoted are the findings of Dr. Baker - McLaglan, who made a tour throughout the Dominion for the purpose of acquiring a uniform standard of classification and record. The " incipient " group bulk from one-third to one-half in the returns of School Medical Officers, so that if small, medium, and large groups alone be considered to be goitre New Zealand's percentage incidence will be markedly decreased. It does not appear certain as yet that we have arrived at an answer to the question, What is a normal thyroid ? Dr. Baker-McLaglan's findings showed that at five years old some enlargement of the thyroid is as frequent in boys as in girls, but drops in boys at adolescence. In girls, on the other hand, as is well known, frequency rises rapidly till adolescence, decreasing a little among University girls. With the rise in frequency the general severity of the cases rises also. Goitre is found among Maoris, but in what extent is not yet defined. Dr. Baker-McLaglan's returns were utilized by Dr. Hercus for the purpose of his report, " Endemic Goitre in New Zealand and its Relation to Soil lodine " ; Dr. Hercus, working in conjunction with Dr. Benson and Mr. Carter, of the Otago University, finding a definite relationship between goitre incidence and low iodine content of soil.

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Number of Medical n ... - , T -a -\t tx. i • i rr, • ,. £ Recognition of Percentage Incidence JNo. District. ii/xammations or n & A -,. ChildrGn Oondition. ox Ooitre. 1 Steward Island 2 Bluff .. .. .. .. 280 59 21 3 Inverca gill and Southland .. .. 2,960 1,049 35 4 Waimea Plains .. .. .. 1,025 324 32 5 Clutha Valley .. .. .. 2,947 1,197 41 6 Taieri Valley and Milton .. .. 1,366 406 30 7 Dunedin .. .. .. .. 8,413 1,573 19 8 North Otago .. .. .. 895 155 17 Southland and Otago .. .. 17,886 4,763 27 9 South Canterbury .. .. .. 5,206 3,228 62 10 Christchurch .. .. .. 5,548 3,548 64 11 Banks Peninsula .. .. 1,293 397 31 12 North Canterbury .. .. .. 2,782 1,608 59 13 Marlborough .. .. . . 700 263 38 14 Nelson . . .. .. .. 929 273 29 15 West Coast .. .. .. 1,675 889 53 Canterbury, Marlborough, and Nelson .. 18,133 10,206 56 16 Wellington .. .. .. 2,633 657 25 17 Hutt Valley .. .. 2,343 968 41 18 Wairarapa and Dannevirke .. .. 5,684 1,596 28 19 Hawke's Bay .. .. .. 2,513 912 36 20 Gisborne .. .. .. 1,257 427 34 21 Horowhenua .. .. .. 1,111 137 12 22 Palmerston .. .. .. 8,829 2,910 33 23 Wanganui.. .. .. .. 5,397 2,422 45 24 Taranaki .. .. .. .. 5,493 381 7 25 Main Trunk .. .. .. 2,570 611 24 26 Taumarunui .. .. .. 359 132 34 27 West Coast and Te Kuiti .. .. 574 65 11 28 Waikato and Piako Valleys .. .. 2,973 896 30 29 Taupo and Rotorua .. .. 280 78 28 30 Bay of Plenty .. . . .. 2,000 625 31 31 Cape Colville Peninsula .. .. 220 33 15 32 Auckland .. .. .. .. 7,598 821 11 33 North Auckland .. .. .. 4,950 247 5