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36
Reverse.
DIRECTIONS FOR CLEANSING
A small-tooth comb should be used daily.
All nits should be removed from the hair.
The use of sassafras oil is strongly recommended.
"When the pupil returns she is re-examined and if the condition has not been remedied she is
again excluded and a copy of one of the following circular letters is sent to the parent:—
(A.)
Secondary School.
When the nurse visited the above School on the inst.,
your daughter's ( ) head was found to be in
an unsatisfactory state. Although a notice was forwarded on the
inst., calling your attention to this matter, the condition has been allowed to persist.
I have now to inform you that unless the condition complained of is remedied and the
child returns to school free from the signs of infection on
I shall have no alternative but to recommend her exclusion from school.
(B.)
Secondary School.
When the nurse visited the above school on the inst.,
your daughter's ( ) head was found to be in
an unsatisfactory state. Although a notice was forwarded on the
inst., calling your attention to this matter, the condition has been allowed to persist.
I have now to inform you that unless the condition complained of is remedied and the
child returns to school free from the signs of infection on I shall
have no alternative but to recommend the termination of the scholarship.
If the pupil does not return to school on the date given, or returns in an unsatisfactory condition,
the case is reported to Committee with a view to permanent exclusion in the case of fee-paying
students and to the withdrawal of the scholarship in the case of scholarship holders.
RINGWORM.
In the first report to the School Board for London which I made in 1903, it was stated that :
"The selection of children whose efficiency in school is damaged by dirt, parasites, chronic
diseases of ears, or impaired visual acuity, is just beginning. The treatment of all these
matters is tedious, has to be thorough, but is a routine of the most monotonous and uninteresting
description. The burden at present falls on the hospitals, and they have not yet adapted
themselves to it. Whether even with time they can ever efficiently discharge this public
duty is at least doubtful."
Ringworm was one of the diseases considered by the Special Sub-Committee on the treatment
of children, and their recommendations will be found on page 23. It is the chief trouble the
nurses have to deal with as considerable numbers of children are out of school for long periods.
It is one of the diseases for which the hospitals fail, and the provision of medical treatment is
required, a disease soon to become comparatively rare when public remedy is provided. Troubles
constantly arise on medical certificates, some of which are given even in face of the knowledge communicated
by letter that ringworm has been found microscopically.

In 151 cases, medical certificates had been given that the children were free from disease or fit
to attend school, but in 144 cases ringworm was found, in 3 cases favus was found, and only in 4 cases
was the distinctive organism not found. In the second period, April to December, 1908, medical certificates
were given in 127 cases where specimens were submitted, and in 119 cases ringworm was found ;
and only in 8 was no fungus found. There were also medical certificates furnished in 5 cases stating
that the children were suffering, but on examination these were found to be free and re-admitted to
school. In one case where ringworm was found no appearance of the disease could be seen when
the child was examined shortly after at the head office. In some of the cases the clinical appearances
were such that we had grave doubts as to the bona fide nature of the certificate.
It was pointed out in a previous report that the loss of grant from ringworm ran into many thousands