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The Board of Education have agreed to provide, under section 44 (2) of the Education Act, 1918, for onehalf
of the expenditure incurred by the Council in connection with these classes, and have requested the
school medical officer to give some account of them in his annual report.
The reports for the whole of the year 1920 show that 275 children were treated, 106 were cured,
61 left before care or were withdrawn for various reasons and 108 were still in attendance at the end
of the year. Of the children discharged as cured 10 boys and 3 girls (12 per cent.) relapsed after a
little time. Stammering commenced at an early age, that is in infancy, in the greater proportion of
cases; while a greater percentage of cure was shown amongst those in whom stammering had more
recently developed. Amongst tie causes to which the habit of stammering was attributed were
imitation 10 cases, shock 56 cases, heredity 36 cases, neuropathic tendencies 47 cases, physical causes
43 cases.
Left handedness was found in 13 cases, a number which does not greatly support those who
consider that this condition is largely responsible for stammering. In 56 cases stammering was
noticed from the early beginnings of speech, so that quite a large proportion of the children never
spoke normally.
The work of the classes is proceeding steadily and satisfactorily, and there is evidence that
they are appreciated by head teachers, parents and children.
Special Investigations.
The year 1920 was one of sheer hard work for the medical staff and the various sections of the
report testify to the exceedingly great amount carried through. The calls upon the time of the school
doctor are innumerable and have increased more rapidly than has the increase in personnel. During
1920, the demands were augmented in a high degree by the necessity for medical investigation in the
schools in consequence of the almost unprecedented prevalence of scarlet fever combined with a high
incidence of diphtheria. There was, therefore, practically no opportunity for special investigations.
Attention may be drawn, however, to Dr. E. J. Boome's observations upon the condition of children
as affected by physical training which will be found in. the section dealing with the latter, to
Dr. Richard Armstrong's investigation upon the occurrence of epidemic sore throat appended to the
section on Infectious Diseases and to the researches into the cause and cure of stammering conducted
by Drs. Margaret Hogarth and.E. J. Boome, upon whose reports the section on the subject of stammering
has been based. In the section on Personal Hygiene, the results of a special enquiry by Dr. Elwin
Nash into the prevalence of scabies are given.
Following-up.
The work of following-up children suffering from minor defects, writes Dr. C. J. Thomas, is essentially
one of education. It is tedious and prolonged or never-ending. However it may be attempted to
tabulate the results in figures—and figures in abundance will be found in the appendices to the report—
the very nature of the work eludes statistical representation. It is impossible to eliminate the human
element. Poetry cannot be weighed with scales nor can the emotions of the heart be measured in
grammes and centimetres. The system of following-up adopted in London differs essentially from that
adopted in many other places; it is a special manifestation of the British spirit, so different in its
essential qualities from that of the Teuton or the Latin, and it is particularly insusceptible to
mathematical treatment. There are those who would deal with the parents of children suffering
from minor defects on a stern bureaucratic basis, they would have each child officially catalogued and
enumerated and would in a very short and prescribed time present a table in which should be shown
each child accounted for either by the certificate of the school doctor that his edict has been complied
with, or by the appearance of the parent as a unit in a statistically represented number of prosecution
cases, some of which had undergone fines and some imprisonment. Such a system as this in London
would inevitably defeat its aim ; the London parent can be taught and, given time, can be persuaded, he
cannot be driven. The fact that medical inspection in school is not compulsory of itself forbids such
a system in dealing with those who voluntarily permit the examination of their children. Any
manifestation of official overbearance would result in wholesale withdrawal of children from the medical
oversight in the schools which they are now enjoying. The choice for the watch-dog, therefore,
appears to lie between creeping into the freedom of Paradise with the Asses of Francis Jammes or
bursting into Limbo with the tin-can of bureaucratic efficiency attached to his tail. The London
Education Authority in its care for children has consistently chosen the former course. The duty
of following-up has been delegated to the school care committees consisting of voluntary workers
attached to every school. Each school care committee is given direct responsibility and the whole of
the school organisation, including teachers, attendance officers, organisers and officials is enjoined
to give every aid to the voluntary workers in their devoted endeavours.
No body of officials could probably vie with the voluntary workers in their conception of duty
or their tenacity in clinging to well-nigh hopeless causes, but no one has yet been found who can induce
voluntary workers to take the credit due to them and to prepare reports giving the numbers, results
and present position of the cases entrusted to their care; they know no "office hours," they will not
submit to official domination and they will not "waste their time "over preparing statistics or
writing reports. Yet who shall say that any other system could produce better results than the figures
which are derived from indirect and independent sources reveal ? Much of the success of the work
depends upon the personality of the worker. Some voluntary workers are more persuasive than
others. A great deal depends upon the doctor. Some school doctors are able to impress upon parents
the importance of attending to minor defects in a way that others who may possess greater professional