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Report of the County Medical Officer—Education.
117
Classes of Types A and B.—It has been recognised in previous years that a class organised in
the playground of the ordinary school does not prove completely satisfactory for the debilitated and
delicate children for whom special educational provision is required. In consequence, the number of
such classes has been reduced and last year only one class of Type A was reported upon. This class was
organised on Hackney-marshes and had eleven boys from each of the three neighbouring schools at
Berkshire-road, Sidney-road and Gainsboro'-road. The selection was made on account of want of health
and poor ability, and the boys were therefore delicate and dull. Their average age was nine years and
ten months, and they were not equal to Standard I. The fact that the class was held on an open space
in a suitable position and that the proximity of a Council refreshment house made it possible for boys
especially requiring extra nourishment to receive it, probably explains why the results have shown a
striking improvement upon those for Type A classes in former years. Weight and height increased in
the case of all boys except two who were suffering from tuberculosis. Milk was supplied daily to fourteen.
Dr. Cowell sums up his report in the following words: " The Marsh class is adapted to delicate and
dull boys, as it is carried on away from the interruptions of a playground class and can be conducted in
quiet surroundings sheltered from the wind and dust and free from disturbance such as the noise of the
streets or that of other classes."
A class of Type B was held in Greenwich-park. The weakliest boys of the Randall-place School
formed a class of 29 aged from 9 to 13 years. Three boys had catarrhal lung conditions suggestive
of tuberculosis, which cleared up in two cases. It is stated that when they returned to their respective
classes not only had the pupils little difficulty in picking up the routine class instruction, but they
were beyond their old classmates in general intelligence and alert response. There was, however, no
arrangement for the supply of extra nourishment, and the average gain in weight for the six months
was disappointing.
Classes of Type C.—There was one such class in 1909 and there were 73 in 1914. Of the 44
detailed reports furnished by the assistant medical officers, 4 related to classes held on roof playgrounds,
11 to classes in parks or open spaces, 28 to classes in playgrounds, and 1 (at the Wandle) was partly
indoors and partly playground. The temptation to select and include children considered to be specially
suitable for these classes is very great and the children admitted were usually the needy, debilitated
and backward. Thus Eglinton-road, which was a success, is described as " the duffers' class of
the girls' school." Most of the reports speak of the physique on admission as below the average, of
poor clothing, want of cleanliness, and bad sleeping arrangements at home. Anaemic, badly nourished
and mentally dull, were usual descriptions, and the children were often described as neglected, untidy
or dirty. In a few suburban classes (Earlsfield, Gordonbrock, Finlay-street, Hackney Free, Peterborough,
Shillington-street) the children are described as well cared for and from good homes, but even
then are frequently noted as anæmic and delicate. The children at Commercial-street (Jews') Infants'
School where there was an " open air room " are noted as measuring mostly above the average for their
age in London, but this may be in part due to racial precocity.
Results of the classes.—At the Peterborough. " On the whole the class on admission was below
London standards as regards weight and above as regards height; during the summer the deficiency
was rather more than made up." As weight is gained slowly in the spring, when height is being rapidly
added, this is a correct statement of what is observed with normal children examined at the end of
spring when compared with averages derived from the whole annual growth. Thus at Eglinton-road it
is noted " weight actually fell between April and the end of May, remaining the same till July, after
this a great and satisfactory change." Most of the reports note this arrested weight at first and ascribe
it to change of clothing, but as height is rapidly increasing it is more probably a seasonal physiological
fluctuation, as has been pointed out by Dr. Kerr. Some doctors record actual ant of gain in physique
in the six months (Ben Jonson, Gordonbrock, Finlay-street, Hawley-crescent and Stanhope-street,
John Ruskin, Latchmere, Lucas-street, Olga-street, Priory-grove, St. Thomas Colet, Surrey-square,
Wandle, Wilberforce). But against this is to be set the universally noted gain in vitality and muscular
tone, absence of fatigue, gain in colour and development of animal spirits. There also appears to be
a moral gain in comradeship and mental response, even the sullen and morose becoming sociable. " A
more liberal supply of fresh air favours the growth of the virtues as well as the framework of the body,"
writes Dr. Norman.
The absence of illness, complete freedom from colds and disappearance of catarrhal conditions
is most obvious. In many cases it was evident that social conditions prejudicially affected the success
of the classes. Insufficient sleep and out of school work, as well as injudicious or insufficient feeding
at home, were frequently mentioned in the reports.
Sleeping is an integral part of the ordinary open-air school arrangements, and was last year introduced
at the Forster playground class. This year it has been arranged at the Commercial-street infants'
open-air room, whilst at Gordonbrock, hot milk was provided in the morning and the children were
required to take a short rest after the midday meal. At Hackney Free 13 of 37 boys were employed
out of school chiefly delivering newspapers or milk, 6 of these 13 had heart signs, in one fainting attack
ceased on stopping work, but commenced on resuming it. These 6 worked 14, 16, 20, 26, 30 and 34
hours weekly. Only 3 out of the 23 who did not work presented any heart symptoms, and 2 of these
rapidly improved (Dr. Cowell).
Again, more than one-third (11 out of 29) of the boys at Randall-place class got up at 5.30 a.m.
to get stale bread cheaply from a baker's shop in the neighbourhood, which thus cleared out old stock.
The amount of nourishment they got daily was quite inadequate for growing bovs (Dr. Macdonald).
At Canal-road " the majority of the class were under-developed, 12 of 36 had some form of free feeding "
Dr. McVail). At Hackney Free "milk appeared to stimulate growth in several delicate boys"; at