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124
Annual Report of the London County Council, 1914.
extent, a corrective of the reading habit, and with the inculcation of proper habits of work and a limitation
of hours of study, education can be continued. When the short sight is more serious there can be
no question that to grant a scholarship for further education of the ordinary type is to do a very real
injury to the child. Most of these cases of myopia are progressive, and the rate of progression is at
its highest during the years just preceding puberty, the very time when scholarships are awarded. The
strain involved in study for competitive examinations can be held accountable in not a few cases for
a sudden increase of the degree of myopia, and, if additional work necessary for advanced study be
embarked upon, real injury to the eyes is to be feared, apart from the additional general strain involved
by continuous close work when vision is defective.
In these cases there is a balance of hardship, on the one hand, deprivation of a scholarship won
by diligence and capability, on the other danger to the eyes and health. Of the two the latter is the
greater hardship.
The greatest difficulty is met with in judging the best course to pursue with those children whose
degree of myopia at the time at which they are examined for scholarships is what may be termed borderline.
They are just so short-s;ghted that an increase of one or two dioptres would without doubt rule
out a scholarship of the usual type as being undesirable for them. But at the actual time of examination
it is possible that the degree is not so high as to warrant the recommendation that further study would not
be advisable. In these cases the examining surgeon has to take the future into consideration. A junior
scholarship may lead to a senior, and so on to other spheres of work. It has to be considered whether the
additional work involved by the first step is likely to cause such a progression of the myopia as will lead
to a worse disappointment when the child is brought up for examination for a senior scholarship, or it may
be, after much labour and many years have been spent in training for teaching work. The failure to
pass the medical examination at the second or later stages of a career involves more disturbance, and causes
a greater feeling of soreness than a stoppage at the initial stage.
So far myopia of an uncomplicated type has been referred to, but many of the cases are complicated
by astigmatism of greater or less degree, and in these the conditions of strain produced by the
continued eye work are all aggravated. Eyes suffering from astigmatism of any degree even when
"corrected" by the best and most accurately fitting glasses cannot vie with the natural eye for correctness
of focus, and therefore of ease of vision.
Many short-sighted children show considerable capacity and more than ordinary intelligence
so that the deprivation of advanced study seems, and often is, a particular hardship. It is desirable
therefore that some means of dealing with their cases otherwise than by exclusion should be found.
Both for the border-line cases, and for those whose short-sight is of such degree that there is no
question of their being admitted to the ordinary form of scholarship, some special scheme of scholarship
work might be evolved. Trade scholarships are not generally admissible, as fine work is almost
always entailed. But cookery and domestic work for girls are admissible. Too much stress, however,
should not be laid on the precocity shown by these children. In many cases their standing in the schools
to which they belong is not wholly warranted. Their academic attainments are forced. The time
that should be given to healthy play, and which is thus occupied by their normal comrades, is spent by
them in additional school work. The class advantage thus obtained is in some sense unfair to the
normal children, who in later years are likely by reason of their more robust physical equipment and
better staying powers to out-distance the myopes. The question, however, is a thomy one. In all cases
of doubt the circumstances should be explained to the parents who should assume the responsibility,
and periodical re-examinations of the condition of the eyes should be made, so that the scholarship
awards may be terminated in the event of deterioration of vision making itself apparent.
Urine
examinations
Examinations of urine have been made during the year. Out ot 4,712 such examinations, albumin
was found present in 644, sugar in 4, oxalate crystals in 231, blood cells in 27 and pus cells in 44.
In the great majority of cases the presence of albumin was not of serious import; 357 second specimens
were examined in 250 cases with a negative result; in 28 cases a third specimen was thought
desirable, and of these 15 which had been positive on the two former occasions proved negative.
Cases
specially
referred.
In addition to the first examination, 1,012 referred cases were dealt with. These referred cases
relate to leave granted to employees absent owing to personal illness; to cases in which questions
have arisen in regard to students in institutions for higher education whose health is considered such
as to render exceptional attention advisable; to teachers returning to duty after extended leave of
absence (a) owing to personal illness (b) for educational purposes, (c) to married women urder No. 31
of the regulations in regard to the education service, and to teachers about to be superannuated. The
number of references under review, compared with those for the preceding year, shows an increase of
214, or 26.8 per cent.
In addition, 250 cases (an increase of 23.1 per cent.) were medically investigated in which claims
were received from teachers and others in the permanent service for exceptional treatment as regards
sick pay and re-imbursement of medical and other expenses in respect of illnesses alleged to be due to
conditions under which thev were required to carry out their duties.
L.C.C. Training
Colleges
Secondary
and Trade
Sellouts
Medical inspection in training colleges, secondary and trade schools.
Since 1908 medical inspection has been carried out in all the Council's training colleges,
secondary schools, trade ai.d technical schools. Each student is examined once a year, and each
institution visited once in six weeks, so that the doctor can be consulted concerning pupils presenting
any symptoms likely to affect their health or work. Every student bus a medical record curd showing
at a glance the condition, so that the students are continually under observation and are not permitted
to continue at the institution if through illness or other causes they become unfit. Appendix
VII (A) shows the delects noted.