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150
Annual Report of the London County Council, 1910.
prosecution under the cleansing schemes. The homes of children with verminous bodies and clothing
are visited, and, if found to be unclean, the Medical Officer of Health for the district is asked to deal
with them under the London County Council (General Powers) Act, 1904, Part IV. Reports are
made in respect of children found in circumstances which may render it desirable that they should be
dealt with under the Children Act, 1908, with a view to action being taken for their safety and protection
and the punishment of the parent or guardian. The nurse also assists the head teachers generally
with her knowledge and experience by suggesting temporary procedure in cases of suspected outbreaks
of infectious or contagious disease, affections of the skin, ophthalmia, offensive discharge, etc.; by dealing
with parents who attend at the schools to seek advice or to complain of action taken ; by advising in
regard to the many small and doubtful points concerning school hygiene that may be submitted to
her. The nurse also examines children going to the country through the Children's Country Holiday
Fund. The school nurse is thus a most valuable agent for co-ordinating all the influences affecting
the child's health. She is the essential link between the school, the teachers, the doctor and the home
in matters directly affecting health and sanitation.
With the initiation of the cleansing arrangements now being entered into with borough councils
or for Council cleansing stations, additional nurses will be used, one attached to each cleansing centre,
to arrange the supply of children to the centre, to follow up cases in regard to any necessary proceedings
required by statute and to attend police courts, if necessary. With the extension of treatment
"following up" nurses will be required to feed treatment centres. The use of nurses for the
organization of all processes where the individual children and their parents have to be dealt with
is to be recommended because the nurses have all had good experience in dealing with this very
class, their tact and judgments are generally good, their uniform respected, and it may be said
generally that it is scarcely possible to get a higher quality of service for the price paid, than that
of nurses.
Heads.
Personal cleanliness is not merely an educational measure of great importance; it is
the very foundation of any general effort to improve public health. In respect of personal cleanliness
among school children, too, there has been on the one hand great success, and on the other hand
years of retardation from want of administrative foresight in legislation. When I first visited the
London schools nine years ago they presented a very large number, larger than seen elsewhere, of
children with neglected and verminous heads, which often meant prolonged absences. It was
possible in the course of a single afternoon to visit a number of girls' departments in each of which
were several children with masses of scabs and vermin on their heads. At the present time one
would search in vain for a child in a comparable condition.
In the original cleansing scheme the policy of warning the parents and later excluding unclean
children and then prosecuting for non-attendance was adopted. The success of this scheme was
marked, and it must have paid the cost of its working many times over in increased attendance
grants. In working the scheme the school nurse examines all the children at a school, noting the
condition of their heads and using strict precautions against contagion. The head teacher is then
supplied with a white card for each child requiring cleansing. The card is enclosed in a sealed
envelope and sent home by the child. At the end of the first week all cases not treated are separated
from the other children, and a red card with full details is filled up by the nurse for each child still
offensive. This is forwarded to the divisional superintendent who has the card delivered at the home
by the attendance officer. At the end of the second week the assistant to the superintendent of
school nurses visits the school and examines the children proposed for exclusion. After exclusion
the divisional superintendent takes out a summons, but if any child is properly cleansed before the
hearing it is readmitted to school, examined by the nurse, and the summons is not pressed, the
circumstances being explained to the magistrate. About one in four hundred cases seen by the
nurses is fined. This scheme is therefore a simple mechanism which secures cleansing of the heads
by the parents in over 99 per cent, at a comparatively trivial cost and without any unwieldy organisation

Bodies and
Clothing.
The parents of 265 children were prosecuted and fines varying from 1s. to £1 imposed. The
percentages of children found to be verminous to children examined was 22.4 in 1910, as compared
with 20.9 in 1909. The increase may be due to a somewhat stricter standard.
It was pointed out, when the cleansing scheme was first proposed, that it was applicable
to verminous heads which could be cleansed by the parents in a week, but that it would not be
applicable to children whose bodies or clothes were affected and whose homes were also
presumably unclean. These cases were beyond the range of the Education Authority and it was