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110
Report of the County Medical Officer—Education.
if such benches, which might serve other purposes when not in use for remedial exercises, were
provided.
Thus, Dr. Russell reports in connection with the " Chaucer " (Girls) classes " on the whole the
children show improvement in muscular tone and this is also shown by the increase in clearness of the
heart sounds ; practically all show increased chest expansion and better air entry. As far as improvement
in spinal deformities is concerned the results are very disappointing. Round shoulders due to
faulty methods of standing and lack of muscular tone have improved greatly, but on the other hand
more marked cases of curvature (though not fixed) show practically little improvement."
At Garratt Lane Dr. Griffiths reports that in some cases spinal curvatures were entirely cured
and the others had improved. At Johanna Street Dr. Wells found the largest number of improvements
in antero-posterior curves and round shoulders. In the 13 cases that exhibited this defect no fewer than
12 showed improvement. In 10 cases with various lateral curvatures of the spine, 7 showed improvement.
Dr. Ruth Proctor at Winchester Street reports:—The class has been in existence for over 18
months and from the results appears to be most beneficial to the 24 children of whom it consists. The
children chosen for the class were all poorly developed ; some of them suffered also from spinal curvature,
some from mouth breathing and some merely from debility. In this last group, where the debility was
in all cases marked, there is considerable improvement though they are still rather below the average
standard of development. In the case of the children with obstructed breathing the results, which have
in one or two cases to be taken in conjunction with an operation for removal of enlarged tonsils and
adenoids, are very satisfactory, the breathing being now nasal and quite free. Eleven of the children
had at the outset reducible spinal curvatures of various degrees and types. One of these was not present
at the examination. In 8 of the remaining 10 children the deformity had entirely disappeared, while
in the other 2 it is now very slight. One of these cases had also marked genu valgum with 3 inches
separation of the internal malleoli; the legs are now approximately straight with barely f inch
separation of the malleoli.
In all cases the height has increased to some extent (average 1.8 cm.), but the increase in weight
is usually quite out of proportion to the height, in some cases markedly so (average 9.4 kilos). Perhaps
the most marked improvement is seen in the chest expansion which in every case shows a good increase
—the average increase in expansion being 1 11/20, inches.
The results are most encouraging.
Personal hygiene.
The duties of the school nurses, with regard to cleansing were steadily pursued throughout the
year. They consist of a general inspection of the children, and the application of the Council schemes
for dealing with children who are found to be (1) verminous in head only; (2) in body and clothing;
(3) suffering from scabies.
The nurses are required to visit each school according to a rota so arranged as to ensure that,
every department is systematically examined. The head-teachers are given three days' notice of the
nurses' visits in order that arrangements may be made for the attendance of children in regard to
whom advice is desired. At these visits each child in the department mentioned on the rota is
individually examined. The nurse separates the hair with a metal comb, which is disinfected after
the examination of each child; examines the under-clothing of all cases of suspected venninous body
conditions; notes any abnormal conditions as regards throat, suppurating ears and fingers, obvious
neglect, &c. ; and notes and reports every case of scalp ringworm detected, and in doubtful cases sends
stumps to the head office for microscopical examination. Upon the completion of the examination in
one department the nurse visits the other departments, and examines children found unsatisfactory at
previous visits, and children about whom the teachers require advice. If necessary she interviews the
parents. The nurse also assists the teachers generally by suggesting temporary procedure in cases of
suspected outbreak of infectious or contagious disease, affections of the skin, ophthalmia, offensive
discharge, &c. ; by referring to the divisional medical officer cases of minor ailments requiring treatment
; by advising in regard to the many small and doubtful points concerning school hygiene that may
be submitted to her ; and by drawing the attention of the school care committees and managers to cases
in which their help would be valuable. During the last six months of the year, a complete record of the
numbers of examinations and the conditions found was made, and in illustration of the magnitude of
this branch of the nurses' work the following figures may be quoted:—
Number of examinations 1.053,218
Number found clean 766,554
Number found verminous 286,664
Percentage found verminous 27.2
The number found verminous includes all degrees of unsatisfactory condition from the case of a
few nits on the hair to cases of head, body, and clothing infested with pediculi. In all schools one of
the two cleansing schemes (a) verminous heads only (b) verminous persons and clothing, is applied;
the slight cases, forming the great majority, are cleansed as a result of the rota inspections. Figures
are given later showing the numbers of instances in which it was necessarv to take further action under
each of the two schemes.
The scheme for dealing with children suffering from verminous heads involves the exclusion of
such children from school after repeated notice has been given to the parents, and prosecution under the
attendance by-laws ensues. This scheme is only applied in those schools which, owing to their situation
in outlying parts of the county, are not contributory to a cleansing station. The following table shows
Verminous
heds.