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108
Annual Report of the London County Council, 1914.
The following table gives, in the case of those children obtaining treatment, the percentages who
obtained it,—A, by private doctor or dentist; B, under the Council's scheme ; and C, at other hospitals
or institutions. A. B. C.
By private Under Council's At other hospitals
doctors. scheme. or institutions.
Refraction.. 3.1 74.3 22.6
Minor ailments 17.6 50.7 31.7
Ear, nose and throat. 7.4 58.9 33.7
Dental defect 21.2 56.1 22.7
Other ailments 27.1 6.2 66.7
Total 13.6 56.2 30.2
The very great percentage, 74.3 per cent, of the whole, who get their refraction done under the
Council's scheme shows what a need has been met by the facilities for treatment of visual defect arranged
by the Council; very few cases needing refraction (3.1 per cent.) or cases of operation for adenoids and
tonsils (7.4 per cent.) are able to arrange for treatment privately.
The percentage of cases treated found on primary re-inspection to have completed treatment
and to have been satisfactorily cured of their defects is shown for each class of disease and mode of
treatment in the appended table. Private Council's Other hospitals
doctor or dentist. scheme. or institutions.
Refraction 65.8 63.4 65.3
Minor ailments 78.8 64.4 66.2
Ear, nose and throat 66.4 85.9 76.0
Teeth 63.5 90.2 70.9
Other ailments 61.9 38.4 46.3
Total 65.9 74.4 63.6
It is seen that the treatment given through the Council's scheme is considerably more expeditious
and satisfactory in the cases of ear, nose and throat disease and of dental defect than through other
channels. It is very largely of course a question of " following up " ; while the parents who can afford
to pay are more likely to see that continuous attendance is maintained, the better results obtained generally
through the Council's scheme (74.4 per cent, satisfactory against 63.6 per cent, at other hospitals and
institutions) are due to the work of the organising staff who attend the centres and inform the Care
Committees in cases where failure to attend or some other obstacle to continuous treatment arises.
Provision of Meals for Necessitous Children.
The work under the Education (Provision of Meals) Act, 1906 is co-ordinated with the school
medical service in the following ways—
1. Supervision of dietary.—The menus from which the meals are prepared by the Alexandra
Trust were drawn up in consultation with the school medical officer, and all questions of alterations and
modifications of the menus are referred to him. A large proportion also of the dietaries supplied by
local associations and local caterers have been submitted to him, and this is invariably done when any
question of suitability or adequacy is raised. In addition to this the assistant medical officers at their
periodical inspections of the dining centres pay regard to the character of the meals supplied. Actual
samples of meals provided are forwarded to the public health department from time to time for analysis,
and the results of analysis are transmitted to the education officer with recommendations as to improvement
of the dietary in cases where this appears to be inadequate. Similar provision exists for the taking
of samples and for analysis of milk supplied to the schools. Out of 29 samples of meals, 27 were found
to be satisfactory, while two were deficient in fats.
The number of samples taken of milk intended for use of children at schools during the year was
214, of which 181 were reported as being either " satisfactory " or " fairly satisfactory." Of the 214
samples, 23 were found to contain added water varying between 3 and 30 per cent.(average 121/2 per cent.)
svhilst 2 samples were reported as being deficient in fat to the extent of 5 per cent, and 20 per cent,
respectively. A few samples were of such quality as to raise suspicion, but in these cases further samples
were obtained and examined. Of two samples of milk supplied to special schools and sent by the
Chief Officer of Stores, for examination, one was found to be unsatisfactory, containing about 18 per
cent, of added water.
Dr. Margaret Macdonald has worked out the protein content of the dinner menus and finds that
with one exception the menus supply 46 per cent, to 60 per cent, of the daily protein requirements
of a child of 10 years.
2. Medical inspection of individual children.—When children are discovered to be undernourished
during the routine inspection of age groups, the assistant medical officers make recommendations
to the care committees with regard to feeding, and, in the small proportion of cases in which the
assessment 4 is placed opposite the nutrition record, a very careful system of following up has been carried
out and the physical measurements of the children have been taken at the subsequent re-inspections.
In one of the Shoreditch schools Dr. Elizabeth McVail undertook an investigation, primarily to
ascertain the effect of feeding upon the children. Out of 73 children examined in September who were
selected for feeding on 7 days a week, only 24 had continued to be fed, or had been sufficiently regular
in attendance for an estimate to be made of the effect of feeding at the end of twelve weeks. These
children were compared with a similar number of children who had been fed at home, and it was found
that 19 boys and infants who had been fed constantly for 12 weeks showed an average weekly increase
in weight of .082 kilograms, while 19 corresponding children who had not been fed at school and who
had been selected as controls, showed during the same time an average weekly increase of 063 kilograms.
The remaining five children were girls and were examined for the second time after a lapse of