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124
Annual Report of the London County Council, 1910.
suppurative and catarrhal), or 75.8 per cent., a high percentage, but, when the enormous potency
which these hypertrophies possess for causing ear diseases in children is taken into consideration, not
higher than is to be expected.
The medical officer (education) states that during the last three years a very pleasant form
of education extensively used in German-speaking lands, and of a more real kind than the classroom
can give, has been spreading steadily in the form of school journeys, and he is of opinion that
these should be encouraged in every way possible and regarded as most serious and valuable methods
of education. There may be some risks in subjecting ill-nourished or debilitated children to prolonged
physical efforts, and for this reason a large number of journeys has been investigated by Dr.
Clive Riviere, who has endeavoured to assess the conditions of the children before and after their
excursion and to relate his findings to the various conditions of the journey. He finds that the boys
looked the best who had spent a rambling seaside holiday ; they gained in weight.
A review of the past year reveals a striking diminution in the incidence of scarlet fever and
diphtheria, both of which diseases appear to be passing through a stage of inactivity. Measles, on
the contrary, has been unusually prevalent, the figures both for the spring and autumn showing an
abnormal rate of incidence, the latter part of the year especially having been visited by an outbreak
probably unprecedented for the time of year (when measles usually appears to be somewhat quiescent),
which, as subsequent events have proved, was the beginning of an epidemic of almost unparalleled
intensity and prevalence. As regards diphtheria, the number of notifications from teachers was
1,861, as compared with 2,212 in 1909. In all 81 schools were under observation ; 999 cultures were
taken in 17 schools and 35 children excluded as carriers.
Report of the Medical Officer (Education) (Dr. J. Kerr) for the Year 1910.
This series of reports on school hygiene in London, which were commenced voluntarily as an
annual review of the duties of the medical officer to the Education Authority, have now become permanent
in the form of statutory reports of the school medical officer which have to be submitted to the Board
of Education annually. When the work of the year 1910 is surveyed, there is no great forward step
to record nor any considerable addition to knowledge or practice to explain, but there is a sense of solid
and substantial advance beyond the position attained when the year opened.
The increase in extent and cost of medical work in the schools has naturally subjected it to much
examination and criticism, but if it be considered that the changes of the last generation emphasise the
importance of making capable and healthy citizens, it will be realised that the physical side of the
children's life requires a proportional expenditure of thought and money to that spent on the mental
side.
The chief matters dealt with in this report may be briefly enumerated :—
The Council's arrangements made four years ago for carrying out the statutory duties imposed
by the Education (Administrative Provisions) Act, 1907, have now fully developed, and medical inspection
is completely organised in all our schools.
A scheme for the medical treatment of children has been slowly developed on a large scale ;
experience is being obtained, and when the scheme has grown efficient it will be a most valuable service.
Some beginnings have been made with dental provision, but so little have the public realised the
value of this service that its development must be slow.
The services of the nurses have been most valuable, and this branch will probably best repay
extension.
Experiments of recent years in the matter of healthier environment for educational work,
whether in the form of open-air schools, playground classes, school journeys, or special invalid schools,
all appear to have been so much appreciated that they are being continued and in some cases extended.
In several directions the Council's work is incomplete when divorced from that of other authorities.
In the case of children coming from unclean homes and with verminous clothing, it has not been possible
to apply the scheme drawn up some time ago to the whole of London.
The general physique of children and their nutrition is another line of enquiry to which much
attention has been directed. It largely depends on factors which can only be remotely and indirectly
affected by the Education Authority.
Elementary Schools.
The requirements of the Education (Administrative Provisions) Act, 1907, are that provision
shall be made for the medical inspection of children entering and leaving school in each year.
A complete scheme was drawn up early in 1908 for introducing this statutory medical inspection by
arranging an increasing service to provide for gradual compliance with these requirements during three
years. Beginning with 40 quarter time doctors in 1908, increasing them to 56 on September 1st, 1909,
and to 72 on September 1st, 1910, this modified scheme was deemed ample to fulfil ultimately all requirements.
The Board of Education accepted the modified scheme when put forward, but withheld
judgment as to whether it would satisfy the requirements of the Act until they had an opportunity of
observing the working of the scheme. Owing to this mode of gradual compliance, which was fully
represented when the scheme was originally proposed and approved by the Council, the staff was not
sufficient prior to September 1st, 1910, completely to fulfil the Code requirements. The professional