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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172
Annual Report of the London County Council, 1910.
school was taken. The schools had been so selected that it could be assumed that the conditions were
equal except in the matter of heating and ventilation. The facts regarding each teacher were recorded:—
(i.) not absent; (ii.) absent owing to an illness which might arise from school surroundings; (iii.)
absent owing to causes which cannot in any way be related to school surroundings. The number of
separate attacks of each disease was noted and the number of whole days absent from duty. The
conditions of school life which were particularly concerned and which might deleteriously affect the
health of teachers are:—
(i.) Infection of the respiratory system from impurity of the air, deficiency of moisture
or the presence of dust, and includes such illnesses as common catarrhal colds, influenza, fever,
acute rheumatism, bronchitis, pulmonary catarrh, pneumonia, tonsilitis and various varieties
of ulcerated, relaxed, or sore throat.
(ii.) Conditions arising from deficiency of heat and moisture in the air breathed and
predisposing to chills and the various infections above noted.
(iii.) Conditions associated with overheating of the atmosphere and insufficiency of
humidity. These are chiefly local catarrhal conditions of throat, nose and larynx, and also the
more acute toxic symptoms, from disturbance of metabolism, showing itself in subjective feelings
of languor, exhaustion, or in headaches.
Headache has always been noted unless definitely stated to be due to gastro-intestinal trouble.
All other causes of absence (neuralgia, toothache, accident, heart disease, nervous debility, or breakdown,
operations or family bereavement) have been summarised as showing what an important factor
they form in explaining absence from school.

The following table shows the causes of absence of 521teachers in Schools under various systems of Heating and Ventilation:—

Causes of absence.Nine Plenum schools.Nine heated with radiators.Nine heated by open fires.Culloden-street.
Percentage of teachers absent.Average number of days absent.Percentage absent.Days absent.Percentage absent.Days absent.Percentage absent.Days absent.
(i)(2)(3)(4)(5)(6)(7)(8)(9)
All associated causes392443.5452.7525.2
Simple colds233.6402.3311.9301.8
Influenza1085.912.311.16.52.03.4
Bronchitis3.7127.712.04.014.08.35.5
Tonsilitis6.26.09.15.011.15.512.56.3
Headaches9.11.216.61.011.11.012.51.0

This table shows that in spite of alleged drawbacks the schools with the Plenum system are the
healthiest. The conditions of Culloden-street were, however, very much worse than those at any of
the other schools, and there must, therefore, be some special cause at work. On going into the question
at the school it appeared that the ventilation was not being given a fair trial. The teachers showed
considerable ignorance of the most elementary requirements of ventilation. Windows had been broken,
thereby short-circuiting other parts of the building, and doors were kept open or shut at random.
The only other defect found was that whilst the air was pure and of the right temperature it was too
dry. Further enquiries are to be made as to the ventilation of school rooms.
There is little doubt that, whilst ventilation under the conditions of our English climate can
be maintained tolerable by the so-called natural ventilation, this requires extensive opening of windows,
practically the whole side of a classroom, and also very considerable provision of heat. Mechanical
ventilation gives by far the purest air. The best system of mechanical ventilation would be a combined
system of pull and push, so that the average pressure in the building would equal that of the outer air.
The great evil of the Plenum, and indeed all mechanical systems, is that the air is used for the convection
of heat. Heat should be supplied separately to the classrooms by means of low-pressure pipes or radiators
and the air supplied at a considerably lower temperature than the room (say 50 deg. F.). Only by this
means will the sense of fatigue and headache be kept clear with a supply as low as 1,000 cubic feet
per head per hour.
School Journeys,
During the last three years a very pleasant form of education, extensively used in Germanspeaking
lands, and of a more real kind than the classroom can give, has been spreading steadily in the
form of school journeys. 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. This
year the excursions were less strenuous than on previous occasions, and there was but little dilatation of
the heart of any consequence. It appears that a moderate enlargement of the heart (as measured by a
half or three-quarters inch increase in the breadth of the surface dulness) is common and harmless as
the result of these holidays. The size of the heart is determined by deep percussion over it and by the