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

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London County Council 1911

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

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Report of the Medical Officer (Education)
This discussion, of the size of the class room with 14 square feet area, and approximately
200 cubic feet per pupil, may appear to set forth an excessive ideal to those whose conceptions have
been based on the acceptance of the 10 square feet per head minimum of the Board of Education
regulations, but the same regulations demand a much higher standard for secondary schools, where
really the sanitary requirements should, if anything, be less than in the elementary school.
A commentary on the whole matter is, however, offered by the School Law of the State of
Minnesota, recently revised (1910), which runs:—
“146. No school room or class room, except an assembly hall, shall have a seating
capacity that shall provide less than eighteen (18) square feet of floor space and two hundred
and sixteen (216) cubic feet of air space per pupil, and no ceiling in buildings hereafter to be
erected shall be less than twelve (12) feet from the floor."
The Swiss regulations require 14 square feet. Our standard of 10 square feet was probably
taken from the Prussian regulations of 1867.
The arrangement of the forty children in the pattern class depends on the furniture used. They
must be placed so that the teacher can see all faces. In the case of small children the teacher can
overlook all, but with children in the standards further devices are necessary. To raise the teacher
on a platform or dais restrains movement and on the part of the children means one of the most fatiguing
of eye movements—that of continued raising of the eyes above the level. The teacher ought, therefore,
not to be on any dais, but the desks should be raised on stepped flooring. The desks must be easy of
access, the child should be able to stand up in its place, and the children in their places should be
accessible to the teacher.
The desks should be simple, solid, easily repaired, and free from mechanisms which can injure
fingers. All headings, footrests, and means of distracting attention by foot play or of making noise
should be avoided. Sloping the gangways instead of using steps serves to diminish noise, dust and
Almost any arrangement of the seats in the room will suit the primary requirement of being
within reach of the teacher's voice and vision, but there is always a tendency if seats and desks are
moveable to crowd them together, and sometimes a class is so crowded that three children are in the
seats intended for two. Overcrowding must be made impossible; therefore the seats should be fixed
to the floor. Difficulties about cleansing may arise, but if footboards are avoided, cleansing is almost
facilitated by the clear floor with merely plain standards screwed to it.
The isolation and ventilation of the individual child is of the greatest sanitary importance,
and the isolated seat for each is the first requirement which must be fulfilled. Isolation is needed to
prevent dissemination of disease, not merely the acute infectious diseases, but grosser forms of sores,
impetigo, scabies or lice, and to dilute the offensiveness of odours from decaying teeth, discharging
ears, dirty clothes, and other kinds of uncleanliness, due to want of washing. Isolation is also required
to effect sufficient ventilation. The condition of fatigue, so wasteful of educational effort, is largely
due to insufficient elimination of heat and aqueous vapour. This ventilation is naturally accomplished
by the continual movement of a thin film of air, rising along the skin surfaces as the result of convection
produced by the body heat. The elimination of heat and moisture is a physiological necessity and most
powerfully affects the metabolism of the body. The “dead alive" feeling even in the chemically pure
air of mechanically ventilated rooms is due to the air being used to carry heat, and therefore perhaps
already as “used up" in this respect as if it had been breathed. There must be a definite free air
space of some inches between each child and its neighbour. This excludes all forms of dual desks as
hygienically unsatisfactory.
As regards isolation, the width of desk allowed to each child is of importance. At present with
the Sheffield system in the schools 18 inches is allowed irrespective of the child's size; 20 inches on
dual desks. For the smallest children 18 inches is a minimum, but the lateral desk width should be
allowed proportional to the size of the children, averaging 20 to 22 inches, and for the biggest children
24 inches. The best sizes have yet to be worked out in the schools.
School habits, due to fatigue from continued muscular efforts as well as from toxic causes and
bad ventilation, are of importance. Myopia and scoliosis are often credited with being the result of
school-acquired habits. Our English experience is against such a doctrine, although there is no
doubt that in those congenitally so disposed school conditions may aggravate either the shortsighted
tendency, or the spinal curvature respectively. The control of the school habits which
contribute to these results, will be much aided by hygienically designed seats and desks, but it is to
the teachers' knowledge and watchfulness that the first place has to be assigned. The habit of a near
working distance is most harmful of all school tricks, bending the head close to the work, cramping the
chest, straining the eyes and twisting the spine. It is a complex attitude developed by the fatigue
and strain of premature fine finger work and eye work in the infant schools. The design of most modern
school furniture has been mainly directed to combat this habit, to make the children sit vertically
when writing, and to keep their eyes far from the work.
The prevention of curvature of the spine should be looked for by promoting good healthy tone
instead of debility in the great muscle masses of the back in the growing child. The greater prevalence
of these conditions among girls than among boys show that all the considerations of playgrounds, exercise
and free space already urged in regard to the catarrhal conditions associated with lymphatic defects
have weight here. In addition, attitudes fixed or maintained by muscular action of any kind are
excessively fatiguing to children, and in the case of unsymmetrical attitudes the element of weight plays
a considerable part in exaggerating tendency to deformity. The attitude which is most important
is that for writing—it should be symmetrical; the child must sit upright. This is obtained bv the