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Slight lung symptoms, clearing up and probably due to adenoids 4
Enlarged glands in chest 4
Chorea (St. Vitus dance) 2
Bone diseases—Old cervical caries of spine 1
Old necrosis 2
Lateral curvature 1
Eye diseases—Corneal ulcers and blepharitis 4
Thirteen children showed marked signs of tubercular diathesis, one of hydrocephalus, one of
congenital syphilis, and four evidence of damage through infantile rickets.
Every child benefited physically by attendance at the school; the general improvement was
greater than could have been anticipated, and in some instances was remarkable.
The children admitted were suffering in the main from debilitating conditions which arise from
city life. The commonest ailments were anaemia, enlarged cervical glands, adenoids and hypertrophied
tonsils. Many of the children were said to be " consumptive," but this meant that they suffered from
adenoid growths and enlarged tonsils. The improvement amongst those with active disease who
happened to be admitted was very gratifying, and this experience should remove any hesitation in
dealing with such cases in future if the opportunity arises. The children were drawn from all social
grades usually attending elementary schools. Some trouble was caused by verminous conditions, and a
few children were withdrawn by parents who would not take the necessary steps to free them from this
condition. The clothing, though in some cases poor, was generally sufficient.
This year the same method of selection was adopted. 453 children were submitted by the head
teachers, 417 examined by the doctors, and 234 admitted to the schools. The roll averaged about 80
at each school.
The reasons of a medical nature for the rejection were that the child was not likely to benefit, or
was likely to come to harm from the school. Cases of tubercular knee, epilepsy, corneal ulceration,
chronic heart disease, rheumatism, and mediastinal tumour were amongst those rejected.
The equipment of these schools was in some instances rather primitive, and the sanitary arrangements
of a rather makeshift nature: Whilst at Montpelier House and Birley House there was an
old mansion with spacious rooms, and conveniences of water and drainage, these were lacking at Bostall
Woods, except water, and at Shrewsbury House, which depended on Plum Lane School as its feeding base
and for the supply of water.
The weather was excellent, but in a wet summer, owing to the clay sites, the schools would have
been very bad. During a few days of excessive heat in July, 1908, there was at all the schools a general
loss of weight, over and above weight of clothes. As shelters in the three schools in 1908 Doecker
sheds were used from which one side had been removed. These gave a floor space of about 50 by
15 feet, a portion at the end being separated off as a storeroom where necessary.
The actual school work amounted to about four hours a day, with one and a half hours of organised
play and manual training in the form of gardening, laundry work, basket making, cane weaving, plasticine
work and needlework.
Feeding.—Three meals were given daily : breakfast at 9 a.m. of porridge ad libitum, sugar, and
a half-pint of milk. Dinner at 1 p.m., 4 ounces of meat or 51 ounces of fish, 6 ounces of potatoes and
a quantity of vegetables, followed by G ounces of pudding. On one day a week the meat was replaced
by a large plate of lentil or pea soup and bread. Tea at 5 p.m. was a half-pint of milk, weak tea or
chocolate, with bread and butter or dripping, followed by bread and jam or cake. A few children were
also given milk in the middle of the morning. To avoid monotony in the feeding arrangements, called
for a good deal of care on the part of the school nurse.
Daily rest and sleep.—The rest of from one and a half to two hours daily after dinner was very
essential. Some of the children slept like logs, but the sleepers were in a minority. They rested and
dozed in deck chairs in the sun or shadow as they preferred, but it was evident that these chairs could
be considerably improved. During the summer days many children preferred to wrap themselves in
their rugs and lie on the ground. Even in the autumn the children did not appear to feel cold from
sleeping in the open. Some further enquiries as to the night sleep of these children would be useful;
it was generally stated that they slept better in spite of the afternoon rest. The absence of long hours
of sitting and the constant stimulation of lymphatic circulation by movement soon made itself
evident in improved tone in the children's appearance. They were kept under regular medical
observation. The nurse recorded weights and heights in alternate weeks, and the doctor at his frequent
visits made notes of the physical condition, especial attention being given to anaemia, which was checked
by Tallquist's method of estimating haemoglobin, by testing the colour of a drop of blood taken up in
white blotting paper against standard tints. The state of nutrition, the teeth, cervical glands, tonsils,
presence of adenoids were watched. Careful chest examinations were made as regards heart and lung
conditions, and some of the children were kept under very close observation by repeated examinations.
Medical treatment generally was not undertaken. Dr. Alice Johnson endeavoured to correct some
spinal curvatures at Birley House by special exercises, and the nurses were also directed to syringe
discharging ears, but no medical remedies were administered.
A noteworthy circumstance was the evident systemic depression resulting from the slightest
operations. Several children were taken by their parents to have treatment of teeth or to have operations
for adenoids, and in most cases there was for some days a distinct effect, which in many showed
itself as an arrest in the rate of increase of weight, and in a few as a loss of weight going on for a
week or two.