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103
Report of the Medical Officer (Education).
ordinary colds in the head occurred, but there was no loss of attendance. During the late summer,
with a long drought, much sunshine and a shade temperature daily exceeding 80 deg. F, for weeks,
the energy and vitality of the children fell off, exercise had to be curtailed, and there was a slackening
in the weights of the children partly due at Birley House to some attacks of enteritis. The autumn,
on the other hand, was again wet, windy and unsettled, and on several occasions the old time "London
Fog " reappeared. There were, however, no ill effects on the children's health, and the attendance
was steadily maintained.
The Doecker shed at Birley House has had moveable side windows arranged in case of inclement
weather. Clogs have also been provided by charitable donations, and children with defective foot
gear have used the clogs during school hours.
At Birley House the children on admission presented a miserable and uncared-for appearance
and as the weather was cold and windy, and many of them were suffering from common colds, it
would be difficult to imagine a more wretched looking class. They came from very poor districts
and most of them were badly clothed and dirty. They were poorly nourished, had carious and defective
teeth and were anaemic. At an examination of candidates nominated by teachers for admission to
these schools almost every child seen is in a grave condition. A large proportion recommended are
suffering from such lung conditions as fibroid changes, collapse or bronchietasis, all the result of repeated
and neglected attacks of bronchial catarrh in the past. Several had family histories or family environment
of phthisis, and some had previously been under treatment for this disease. It is difficult to
say which of the children are actively suffering from tuberculosis. Two only seemed to be suffering
from phthisis, but this is the final stage of chronic infection. Phthisis nowadays in a school child
almost means that it has never had a fair chance in life. There were several children with
greatly enlarged cervical glands and one case of tubercular elbow joint.
Of the 86 children first admitted 52 required dental treatment, and discharging ears were present
in 6, defective vision 12, and for throat and nose defects 7 were noted as requiring immediate treatment.
The chief difficulty in obtaining treatment was the apathy of the parents, and several children
had to be told again and again before any attention was paid. As the children come from parts
scattered over South London it was not easy for anyone to get actually in touch with the parents,
and still more difficult to get the parents to spend time and money in coming to the school to be interviewed
in regard to the provision of treatment. The conditions requiring medical treatment were all
relieved except one or two cases requiring glasses. The dental cases were taken for treatment in
batches either to the Deptford Clinic or St. George's Dispensary, but here the difficulty of taking the
children came in and 31 remained untreated, some of them having been marked " urgent."

For reasons which will be given presently, it is doubtful whether in the comparisons given the
gain in weight of the standard children is not considerably understated. The nutrition expressed in
grammes weight per centimetre of height was calculated at the opening of the school and at the thirtysixth
week and showed a marked increase all round. It is not set out in tabular form, as the transfer
of several children from one age group to another in such small groups, makes this form of statement
inaccurate. The haemoglobin percentages within the thirty-six weeks rose to be equivalent to those
of 120 normal children taken in November and December at Goodrich-road, Heber-road, St. John's