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children failed to detect ringworm, where it had been found microscopically within a week or two previously.
In one case repeatedly examined microscopically the doctor several times refused to accept
this decision, and on a summons being issued went into Court and contradicted the evidence offered
on behalf of the Council. The case was adjourned for the evidence of a specialist, and Dr. Sequeira,
the dermatologist of the London Hospital, examined the boy and certified it to be a case of chronic
small spore ringworm, upon which the defendant agreed to accept the Council's decision, and placed the
boy under treatment.
In another case where ringworm was found, and the case contested owing to the allegation
that a mistake had been made, and the nurse failing to send up stumps when asked, a small sum was
actually paid in compensation for loss of time, etc., and within a week or two there was no doubt
about the correctness of the first decision.
Another case, where the Committee actually saw a deputation of managers later, was where two
children had been suffering since September, 1906, from ringworm, but returned to school in the spring
with a card from Hospital stating that they were suffering from a non-contagious disease. Stumps
sent up by the nurse were shewn to have ringworm, and the children were excluded, but re-admitted a
week later on the written authority of a manager. As permission to take further stumps was refused,
and no medical evidence submitted, the children had to be excluded. Every opportunity was given
to the parents to show that the children were free from disease, and they remained out of school until
after the summer holidays, when they were re-admitted on a medical certificate.
We have had a good many Hospital cards and certificates of freedom from ringworm, but under
the circumstances of the Hospital out-patient room this is quite to be expected. Quite apart from
the serious irritation set up by the exclusion of these children there is just as much trouble to people
who want to get their children cured. Many parents, trying to do their best, have enquired how
a chronic case is to be relieved and cured. They have attended doctors and hospitals till the doctors
are tired of seeing them. Some cases are exceedingly chronic, and for even respectable and better class
people there may be no available means of cure, save attendance at one of the two or three hospitals
where Rontgen-ray apparatus has been installed and where only a few patients have a chance of treatment.
Apart from the duty of the Public Authority, quite apart from charity, to help those whose
means do not allow of their benefiting by such apparatus as recent developments have made available,
and as the only efficient means in many cases, it will be an economic gain merely from the school attendance
point of view.
Twelve schools taken at random in various parts of London lost 26,766 attendances from ringworm
in twelve months. On this basis, which is quite reasonable, the loss of attendance in the whole
of London is 1,179,934. Taking the minimum number of sessions in one year required by the Board
of Education to be 400, the number of lost attendances is equal to 2,950 children in average attendance.
or a loss of grant amounting to £5,654 per annum. Evidently there is a financial profit on the treatment
of ringworm besides the increased time gained in education.
The Metropolitan Asylums Board used to have ringworm schools at Banstead Downs and Witham.
The average stay of the first hundred children was 1 year 7 months ; 28 per cent. stayed over 2 years,
and 15 per cent. over three years. In May, 1905, the X-ray treatment was introduced, and at the following
Easter the Witham school could be closed as there was no further use for it, The average period of
detention of the first hundred children being 5¾ months, or 4½ months from the date of the application
of the rays. In 1906 over 400 children were discharged cured by X-rays only. Dr. Critchley, who is
on our staff, has been applying X-rays to the cases of ringworm at Croydon, and finds that they are cured
in a few weeks ; a child who had been under treatment for two years] was rendered fit to return to
school five weeks after the use of the rays, and numerous cases given a clean bill of health within
the month. At first the number treated was small, because parents were not over-anxious to submit
their children, but latterly their anxiety to be treated has increased beyond his means of satisfying it.
There is no doubt that the installation of this treatment will be one of the duties to be attended to in
the proposed school clinics, and probably the formation of special ringworm classes will not be required.
FAVUS SCHOOL.
First Year's Working.—The method of treatment of the cases of Favus which occur
chiefly among the children of the alien population in the East End has been to exclude such children
from the ordinary school and require their attendance at a school for favus cases only.
The school was opened on July 8th, 1906, with 61 children. Between then and 31st March,
1907, 29 more children were admitted and 9 left. There were, therefore, 81 on the books at that date.
Of those who left 3 were cured, 3 had attained the age limit, 2 had removed from London, and 1 was
taken off the books as the boy was forbidden to attend by the authorities of the hospital where he was
being treated.
Dr. Bertram Abrahams has kept all the cases under close supervision, and has attempted to
follow up the modes of dissemination of the disease. Of the 90 children under his observation 8 had never
previously attended school. Fourteen came from the Jews' Free school, 13 from Myrdle-street
school, 5 from Baker-street school, 4 each from Chicksand-street, Quaker-street, and Old Castle-street
schools, and smaller numbers from 23 other schools in the immediate neighbourhood. The residences
of the cases were noted and analysed, but no local incidence could be detected. There is considerable
difficulty in finding whether other members of the family are affected ; the details given by children
or relatives untrustworthy; even home visits have not given satisfactory results.