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a certain number of centres to which cases could go from the ringworm classes for treatment. It is
quite impossible for the general hospitals to deal with a disorder of this magnitude. To the Educational
Authority the saving in loss of grant will pay the capital expense in a few months.
In the cases of ringworm and favus there seems a clear field for public treatment of all affected
children, and it is quite possible to define the limits of treatment.
There are, however, other diseases where the result of treatment to be obtained at hospitals
is so unsatisfactory that it would be almost advisable that public provision should be made for these
cases, the only difficulty being the restriction of the class of cases to be treated.
The determination of the refraction of school children where ocular defect is suspected, and
the provision of spectacles where necessary, at a reasonable price, would much relieve the work of the
hospitals, and also save many children from the suffering and damage that so often results from the
treatment of the "qualified optician." All cases seen complicated by other than refractive trouble
could be referred for further treatment elsewhere. Powers should be obtained by the Council for this
purpose.
The treatment of discharging ears may be looked upon as practically impossible to be managed
at the hospitals, patients will not attend daily, beds cannot be afforded, and possibly not more than
ten per cent. of the cases get advice or treatment that results in any permanent benefit, and yet it is
a most dangerous condition, The actual risk of neglect here has been compared by one of the most
eminent of our surgeons to that of carrying a dynamite cartridge in the pocket. Every child with
this condition, whether the result of infectious disease or a mere cold, requires treatment following
up until the discharge ceases. An invalid school where regular treatment can be followed out is
required for these cases. Every case should be passed in until cured. Such a school need not be
residential. Here, again, a difficulty arises, as many cases which resist protracted treatment would
have to be passed on elsewhere for operation.
The question of invalid schools of recovery, seaside schools, or country convalescent schools for
scholars in failing health or threatened by early tuberculous disease is one of the greatest economic
importance, as a preventative of disease, which at present is allowed to gradually establish itself in
many children, and render them permanently inefficient.
Children should be taken there and kept till healthy, not merely relieved from the moat urgent
symptoms and sent out again to drag away months till urgent symptoms again supervene, as is the
common history of such cases at present.
Should section 24 of the Education Act now under consideration in Parliament become law it
will probably be advisable to abandon the principle of "no treatment" in connection with the Public
Health Department and by public provision of treatment for certain common conditions such
as those referred to above free the hospital authorities from the crowds of common cases, which
at present they cannot manage even to their own satisfaction
CAUSES OF BACKWARDNESS IN THE STANDARDS.
The children who are backward in their standards form a serious item in the roll of schools in
some districts. The cases, however, where the retardation amounts to as much as 3 years of school
life are not very many.
Dr. Critchley noted in 18 Battersea schools that the number of children over 10 years old in
Standard I. was 57, and he put the cause down roughly to mental defect in 22 cases, merely backward
20, and dull 15.
Particular schools are known where there is a considerable excess of defective or backward
children, and in most of these cases this has come about by a process of selection. A school may be
recently opened in a district, there is some inaccessibility or other feature which has prevented it
being filled as readily as other schools, so that the teachers of other schools are enabled to select
children admitted to their schools, whilst all the others drift to this particular school. This process
of selection should be further developed by the institution of intermediate schools, and with a
curriculum on a lower intellectual plane than the ordinary elementary school.
The educational importance of backwardness and its causes has suggested its investigation in
the schools of Hoxton and Haggerston by Dr. A. H. Hogarth.
The term "bacKwardness" generally connotes a certain lack of intelligence and is often euphemistically
employed for mental dulness. An arbitrary criterion of backwardness was, therefore, taken
by assuming that a normal child who began schooling at 4 or 5 years of age would reach Standard I.
by 7 years of age, and thereafter progress a standard annually, passing out of Standard VII. and the
school at its fourteenth year. All children who fail to pass through the standards in this way are
abnormal in that they do not obtain the full benefit of their education. It is quite possible that a boy
of 14 years of age in Standard V. may be more intelligent than a boy of the same age in Standard VII.;
but the one has not obtained the full benefit of his education, whilst the other has done his best. Even
the boys in a school who are sharpest in other respects may be backward in relation to schoolwork,
especially when they are wage earning for the greater part of their time out of school. In this enquiry,
then, all who failed to pass up to their standard at the regular age were considered backward. Fourteen
schools were visited, with a roll of 9,500 children, 8,450 being present. Of these 2,900 were backward
according to the above definition—1,400 boys and 1,500 girls, approximately one third.
Although these figures may appear very high, the tendency was to keep them as low as possible, and
in every case a child was given 9 or 10 months' grace as far as age was concerned, so that no child was