London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1910

[Report of the Medical Officer of Health for London County Council]

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146
Annual Report of the London County Council 1910.
Feeding.—Many headmistresses are strongly of opinion that the scholarship holders are often
badly in want of nourishing food, and they suggest that a portion of the maintenance grant allowed
by the Council might, with advantage to the scholars, be diverted towards compulsory school dinners,
thus ensuring at least one hot meal a day during the school term. The food that some of these
children bring to school is often wanting in nutritive quality, especially fat. Where children are provided
with food at the school or institution a marked improvement in general physique, tone and
appetite is obtained after a few weeks' regular dinners.
Games.—No cases of overstrain in the girls' secondary schools and training colleges have been
noted, due no doubt to the precautions taken to regulate the amount and nature of play in cardiac
and anaemic conditions. In these and in every doubtful case medical opinon is asked before the pupil
is allowed to take part. It would be an advantage if the playing ground was always of easy access
from the school; Moorfields Training College is at a great disadvantage in this respect.
Homework and Nerve Strain.—Enquiries have been made into the amount of homework
undertaken. In some cases it appeared as if there were some overpressure, but this seems to be due,
not to the amount of home-work actually set but to additional work unconnected with the school.
At one secondary school the head mistress has arranged the work so that each class has no special
homework given on one evening in the week which necessarily involves slightly more on the other
evenings. There is apparently no overpressure in the lower school. In the upper school the time
taken at homework ranged between averages of 1¼ hours for a class of average age 13 years 11
months, and 3¼ hours for a class of average age 16 years 4 months, four nights weekly. In addition
it appears that more than half these girls practise music for half an hour or more daily and assist in
home duties such as washing up, minding the baby, etc., for more than another half an hour. As
a consequence the girls have not only to do a corresponding amount of homework to the boys but
have, in addition, accessory occupations which, however different from school work, have not the
recreative effect of the boys' play. In many cases girls seem to work harder and more conscientiously
over their homework than boys, and are proportionately fatigued. With regard to music, it is perhaps
only excessive practising, say over half an hour daily, to which exception can be taken. The
amount of outside engagements also formed the subject of enquiry. Of the upper school (Form V.
and upwards) only five girls out of 124 had regular engagements more than once weekly and in some
cases these were music lessons. The pupils do not leave school till 4 o'clock, many do not reach home
till 5 and cannot commence their homework for perhaps another hour. As a result the average bed
hour is late. In a class of 28 girls of average age 15 years 8 months, nine go to bed at 9.30; ten at 9.3010;
four at 10-10.30; one at 10.30-11; four at 11 and later. There is the further difficulty that an
enormous proportion of girls have to do their homework in a room where everyone is talking around
them and where the delay due to distraction must be very considerable. In some schools an arrangement
is made whereby a certain proportion of the preparation can be undertaken at the school and
in many instances this would seem the preferable system.
Certain cases where excessive homework had been complained of by the parents were investigated
at the request of the head mistresses and it appeared that in all there were complicating factors
such as music practice, domestic duties or regular outside engagements, which formed additional causes
of stress. Many parents of the scholars do not look on domestic duties as work and expect the girls to
be useful at home and also to prepare for a scholastic career, while in the case of the boys the need
for play and recreation would be conceded.
Spinal
Curvature in
Secondary
Schools.
Curvatures of the spine occurring during the years of most active growth are undoubtedly common
in school children, and generally of little importance, but some are serious, and all have, therefore, to be
regarded from this possibility. They have recently aroused much interest in connection with their
treatment in school by remedial exercises; it is important, therefore, that their frequence, variety and
importance in after life should be understood, and that the possibilities and limitations of school
treatment should be known.
Boys and girls are, according to previous observers about equally affected. In orthopaedic
clinics the proportion of boys to girls attending for treatment of spinal curvatures is from 1.4 to 1.7.
The variety of curve found is also very different in examinations in school and in orthopaedic clinics.
Scholder found in school:—
Single curves to L., 70.3 per cent. of the whole.
Single curves to R., 21.1 per cent.
Double curves, 8.6 per cent.
Whitman in a New York Orthopaedic Clinic found amongst 180 cases—
Single curves, 39.
Double curves, 117.
Triple curves, 24.
It seems evident that there is a considerable variation in the standard adopted in looking for
spinal curvature and that the common school types of curve are not those usually seen in orthopaedic
clinics. For these reasons it seemed advisable that in any investigation all cases of alleged curvature
should be seen indepently by two observers and that one of these should be an orthopaedic surgeon.
The boys in one secondary school were examined by Dr. Clive Riviere and the girls in two secondary
schools were examined by Dr. Annie Gowdey. Card records were made of all children considered to
have spinal curvature ; these were then examined subsequently by Mr. Elrnslie. The results were as
follows: Total examined Antero-posterior curve only. Lateral curve
Boys 166 2 28
Girls 459 13 49
The percentages with lateral curves are, therefore, Boys, 16.9 per cent., Girls, 10.9 per cent.