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107
Report of the Medical Officer (Education).
At the "Lawrence" the 20 children who got no school feeding were comparable with five who
had meals and cod liver oil. The 20 "non-fed showed an average weekly increase of .245 per cent,
whilst the children on meals and oil showed .252 per cent., a positive gain if their otherwise poor condition
is remembered, but otherwise a difference of no significance.

The increase in weight in these playground classes is probably below the average rate except
at Rochelle-street and Turin-street, where the children were specially selected by the doctor as being
ill-nourished or diseased. At Turin-street the boys of 13 scarcely gained weight at all. As it was thought
that possibly the fresh air and greater movement might have altered metabolism so that growth was
accelerated, the weekly average percentage of growth in height was also taken out. On the measurements
of 1906 the annual rates for normal children give a weekly height percentage at 9 of .077, at 10
of .077, at 11 of .065, but the open-air boys who did not gain weight so rapidly as the normal boys,
at Cator-street, gave -094, whilst the indoor boys (normal conditions) gave .073.

There is no obvious relation between the rates of growth in height and increase of weight in
these various groups of children.
Turning to other evidence of improved metabolism, there is the increase in haemoglobin content
of the blood. The figures are difficult to set out statistically and yet give a just impression. It is
best to say that nine out of ten children in the open-air schools or playground classes show a considerable
gain in this respect. How much of this is due to seasonal variation it is also impossible to say,
but enquiry on the subject is desirable. During the time in these classes there is a steady gain in
vitality, as shown by the healing of ulcers and cure of eye and ear conditions.
The first enthusiasm with which both the open-air schools and playground classes were received,
amounted to an indirect condemnation of the school buildings and classrooms. Undoubtedly the
cubic capacity of all elementary schools, and the amount of ventilation, is short of healthy requirements.
The quantitative effects of the out-of-door schooling must, however, be somewhat discounted
by the effects not hitherto noted of the seasonal variation in nutrition and growth which I have
endeavoured to describe. At the same time the effects of bad ventilation in diminished metabolism
show in the anaemia noticed in the spring. The effects of bad ventilation and gas lighting or stoves in
giving off carbon monoxide, for which even in the minutest traces the blood has a powerful selective
affinity, no doubt causes this to be a contributing cause of anaemia during the winter months.
The increased brightness, the alertness and absence of fatigue poisoning referred to by all
observers who handle these children, are conditions which must be reproduced in the classrooms.
Actual space can be converted into potential space by greatly increased window opening. In future
schools, practically the whole outer wall should disappear for the greater part of the year; this is
the only choice between nearly doubling the school capacity and a costly system of mechanical ventilation
separate from the scheme of heating.
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