London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1904

[Report of the Medical Officer of Health for London County Council]

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12
of short lessons in the Infant school broken up by a few quick movements, or, if feasible, a very
few seconds run, are all points which have been borne out by the syllabus of Physical Exercises for
Schools. No formal syllabus has been set forth for use in Infant schools; but what has been
attained in London schools is wholly good, and, with trifling modification in some of the commands
will fit in as introductory to the syllabus devised for the Standards. These exercises, for the sake
of uniformity, will be required as a minimum in all the Standards, and will be adopted in London
from the beginning of the autumn session of this year.
The most common danger seems to be the case of children with chorea (St. Vitus' Dance). In
some districts of London this disease appears more prevalent than elsewhere, and the teachers
should be able to recognise the meaning of the facial twitches and jerky finger or shoulder movements.
Such children should not only not be exercised, but the teacher would be exercising a wise
discretion who refused to allow them to continue school attendance. It would be as well also that
a special squad should be formed in large schools of children who present defects or deformities,
often comparatively slight in nature, which interfere with their being properly looked after if
exercised in large classes. Such children should be presented to the Medical Officer on his school
visits for his opinion and advice as to exercise.
In pupils above the Standards the need for exercise is just as urgent and imperative as in
younger children. Candidate pupil teachers frequently, more especially in the case of the girls,
give evidence of being much in want of exercise. The heart muscles being out of tone and flabby,
and acting sometimes in such a way as to give rise to suspicions of actual disease. Reserve powers
are at a low ebb. Liability to diseases, particularly of the catarrhal type, is increased, and mental
receptivity is diminished, and liability to show signs of comparative over-pressure, exhaustion, or
even neurasthenia is almost to be expected.
THE FEEDING OF SCHOOL CHILDREN.
This is a matter in which it is quite impossible to attain an opinion of any real scientific value
without the expenditure of time and money on observations of the physique of sufficient children
to establish standards.
The following report was made to a Sub-Committee considering the matter:—
"The following are general impressions; definite statements could only be made on exact facts being ascertained
for the purpose.
"The question should be stated, not as 'underfeeding,' but as' ill-nutrition.
"Ill-nutrition is most obvious in the youngest children at school and in 'slum' districts. Among the older
children it is not so common, and is expressed chiefly by anæmia, and by development being less than would be
expected for age.
"The most typical children who present 'simple ill-nutrition' are of a fine textured constitution, frequently
with long delicate hair and thin smooth skins, and often present a mentally sharp appearance even when dull. In
better social position they form the class of ' delicate' children.
"The majority of 'ill-nourished' children are so from a complexity of causes, of which want of food during
school life is a comparatively trivial one.
"Frequently they seem the offspring of people who from inherent want of efficiency, mental or otherwise, have
gone to the wall. These most often present evidences of mental slackness, and with this is associated in great
measure alcoholism and its associates, want of regular employment, and poor housing. Insufficient rest for the
young children is a frequent contributory cause due to housing.
"The married women also have to work, and infants are artificially fed; a want of cheap milk supply leading
to the use of tinned milks deficient in fat, and also of preparations of various foods.
'The children are frequently fed on foods which are savoury from containing stimulating extractive matters
their debilitated condition leading to their passing over wholesome food which is not tasty. The want of a sufficiency
of fat and perhaps sugar is the chief defect noticeable in children's diets.
"Ill-nutrition associated with heredity and home conditions is due to deeper causes than any school feeding yet
attempted is likely to materially relieve.
"In addition, when the child comes into school several new factors come into play, the chief being the foul
atmosphere of most schoolrooms—the importance of this can scarcely be over-estimated; the deprivation of free
spontaneous muscular movements; the contagions of infant life which in large towns play a considerable part in
depressing vitality; the unnecessary strain on immature structures of much of the work in infant schools. The
exclusion of children under 5 would only relieve the last of these causes.