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Report of the Medical Officer (Education).
93
From the total 63,752 children re-inspected, there would be proportionately about 74,671 defect
requiring treatment. There would be 31,730 who had received treatment, of whom 19,345 would have
been satisfactorily treated, 4,242 would have been unsatisfactorily treated, and 8,143 would be still
undergoing treatment, or otherwise undecided. These results may be taken as on the whole satisfactory
for the present.
Since 1908, medical inspection has been carried out in all the Council's secondary schools, training
colleges, trade and technical schools. It is just as important in these institutions as in the elementary
schools, and from the economical point of view, probably more important. Each student is examined
once a year, and each institution visited once in six weeks, so that the doctor can be consulted
about pupils presenting any symptoms likely to effect their health or work. Every student has a
medical record card showing at a glance the condition, so that the students are continuously under
observation and are not permitted to continue at the institution, if through illness or other causes they
become unfit. Appendix VIII . shows the defects noted.
Training
Colleges,
Secondary
and Trade
Schools.
A comparison of the lists of defects found in 1910 and 1911 shows a considerable
improvement, the physique of many children previously noted as unsatisfactory having materially
altered. The head masters and mistresses exercise vigilance and show keenness in obtaining
prompt treatment of any ailments noted at the medical examinations, and the-parents have responded
to their efforts. Medical inspection is now looked on as part of the school routine, and opposition or
dislike is not experienced in any quarter. The general physique of the students at the Islington College
is superior to that of the students at the London Day Training College, probably on account of their
less strenuous life.
Dr. Riviere points out that while many of the boys in the trade schools improve remarkably in
physique under the combination of physical and mental training a few fail to benefit. This may be due
to the lack of sufficient food, as many boys at these institutes appear to come from very poor homes.
Good nutrition is essential if the best value is to be obtained from the scholarship. A boy of first-class
ability may learn so easily as to get on in spite of a third-class physique. A boy of first-class physique
will not be harmed by trying to push on his third-class wits, but a boy of rather poor physique and
average intellect suffers from the strain, as do those who get really insufficient comforts and nourishment.
This could be remedied by giving scholarships for a combination of mental and physical qualities,
and not to children who are in the second grade in both respects. Such procedure would involve a
medical examination of more candidates than at present when the examination is confined to those
who have been awarded scholarships as a result of their mental work.
On the 31st October, 1910, it was decided that the Council's scholars in attendance at non-maintained
secondary schools, and all scholars attending aided trade and domestic economy schools, at
which a system of medical inspection had not been adopted, should be periodically examined by the
medical officer. About 3,500 scholars are affected by this resolution. Of the 38 aided secondary and
other schools concerned, the Governors of 15 preferred that the scholars should be examined at the head
office, on the grounds either of lack of accommodation or the undesirableness of differentiating at the
schools between the Council and other scholars.
Non-maintained
Secondary
Schools.
Medical treatment.
In the first medical report to the School Board for London ten years ago it was stated
that—
"The selection of children whose efficiency in school is damaged by dirt, parasites, chronic
diseases of the 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."
Experience in the case of chronic discharging ears has since then shown that it is hopeless to
expect sufficient service from the hospitals. AVhen on the passing of the Administrative Provisions Act
in 1907 the management of the Queen s Jubilee Nurses proposed that the Council should subsidise them
to act in connection with the schools, the aid was declined. Miss Susan Lawrence suggested that the
institution might be useful in connection with discharging ears, for which nothing was being done.
The difference in the cost of education in deaf schools as compared with ordinary schools would alone
make treatment of aural cases a justifiable economy. In the case of children presenting chronic middle
ear suppuration, not only is the deafness of account but the liability of the disease to invasion of the
cranial cavity, and to end by death from meningitis, brain abscess or blood poisoning is considerable.
Simple cleanliness if constantly maintained aids recovery, and by such treatment as an adjunct to
the surgeon's efforts, a considerable proportion of recoveries are obtainable without the risk of serious
and costly operation. If after several weeks of honest and maintained effort recovery is not obtained,
then additional steps should be taken. Probably the child is still suffering from some throat or nose
condition, adenoids or hypertrophic rhinitis or deep recesses of the ear are involved which requiresurgical
relief, without which recovery is almost hopeless. Other cases are seen in such a condition of
angemia, ill-nutrition or debility that a residence for a time in a convalescent school in the country
may be needed to stimulate the natural effort to recovery. The important point is that the nurse's
treatment alone is often insufficient, that efficient syringing twice or thrice daily is but a first selective
step, and that all cases which do not respond should be followed up to recovery. Without this end
being reached, any scheme is incomplete and fails to accomplish its object.
Discharging
ears.