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Most of these cases, even when known, are neglected. Their hospital treatment is often a serious
tax on the parents. A few are attended to at hospital, but generally this is unsatisfactory, and of late very
many cases have been refused treatment. If individual medical inspection becomes general then probably
for eyes and ears, as has been indicated for teeth, all the hospitals in London would not provide for
one.tenth of the children who should be treated. The question of school clinics ought therefore to shortly
become a subject of careful enquiry. It is essentially an educational matter, and should not be complicated
by any other considerations whatever than the health of the children in relation to education.
Such clinics, if established, would also be useful for the further examination of many cases referre d
from the preliminary examinations in school.
MEDICAL INSPECTION OF SECONDARY SCHOOLS AND TRAINING
COLLEGES.
In April, 190G, it was decided that arrangements should be made for periodical medical examination
of pupils in the Council's secondary schools. The medical superintendence of the schools, hygiene
of buildings and general matters, is done by the permanent office staff. As the majority of the
pupils are girls in their 'teens, the individual handling of these girls is done by medical women,
except in special cases where they desire further consultation. Each pupil is separately examined
on entering the school, and a regular medical report form filled up. This is kept at the school in
a " Doctor's Book," but it will be preferable later to have a card system. It adds considerably to
the working capacity of the pupils, especially in the case of girls, and prevents illness, if they can
have access to lay any matters which they desire before the medical officer. A regular consultation
day is therefore arranged about once in six weeks, when any pupil may see the doctor in regard to
any trouble affecting their work such as headaches, neuralgia, sore throat, sleeplessness, or overfatigue,
which would otherwise generally be allowed to run on unrelieved. The parents were present in
many cases, and appreciated the doctor's examination of their children. Head Teachers are quite
unanimous in regard to the fundamental importance of this work in these schools where the physical
condition of the children is considerably below the type of high school girl, to which most of them
have been accustomed. They feel the great help of medical examinations. They have altered time
tables, arranged special classes, and made individual arrangements to suit particular pupils according
to the doctor's advice.
Pupil teachers have to be certified for the Board of Education, and they must be passed
only if it can reasonably be expected that they will eventually qualify as teachers in accord with
the Teachers' Superannuation Rules, which last urgently require overhauling and exactly defining.
The Council;has eight pupil Teacher Centres with 1,700 students and the system of medical supervision
for secondary schools is also applied to these centres.
For Training College students the Board of Education requires an entrance certificate of fitness
and at the beginning of each year of study a certificate that the student is in such health as to be
able to continue their course of study. But quite apart from these legal requirements, the
experience already gained has demonstrated the value of medical superintendence.
Dr. Brincker, who has been inspecting the boys during February and March, examined those at
PaddingtonTechnical School, and some of those at Hackney Downs Secondary School. The schools themselves
were quite sanitary. The general physique of the boys much better than those of the elementary
schools. One or two poorly.clad children were found, showing signs of ill.nutrition, and in one case
it appeared as if the education was too great a stress on the boy, that he was not able to benefit
by it, and was suffering in health.
The following are notes of special points concerning these boys :—
Vision.—28 per cent, were defective, 10 per cent. already had glasses, but in nearly half these
appeared unsuitable. The other boys had never had glasses. Many apart from failing to pass vision
tests, showed signs of eyestrain, e.g., headaches, conjunctivitis, blinking or smarting of the eyes, or
swollen eyelids.
Hearing.—One or both ears were found defective in 7 per cent. boys and in nearly half of these
there was aural discharge present.
Cardiac and Pulmonary Signs.—Heart symptoms were present in 9 boys (7 per cent.), three
of these having a rheumatic history, and four others showing rapid pulse and cardiac dilatation with
hypertrophy of muscle, associated with irregular and rapid growth. Chronic bronchitis was present
in three cases, and one case was apparently old and arrested phthisis without active symptoms.
At the Day Training College at Offord Road, the premises at present are somewhat overcrowded.
The men there are the three.year students under Dr. T. P. Nunn, and the two.year students
under Mr. Dexter. The three.year students will remove this autumn to the new college at Southampton
Row, which will relieve any overcrowding. The cases here are picked men and practically without
defects of serious nature. A general ignorance of how to expand the thorax by deep inspiration was
noticed in making measurements of the basal girth of the chest. The anthropometric records will
become of value when comparisons can be made between different years and a greater number have
been collected, when they will be published.