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

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London County Council 1912

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

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Report of the County Medical Officer—Education. 165
that great benefit is derived by children spending their time in the open air compared with those who
have lessons indoors; particularly does this apply to children who are normal or slightly sub-normal in
physical development. The specific defects most amenable to cure in the open-air classes appear to be
anaemic and catarrhal conditions of moderate severity. The good results of the classes are shown by
physical measurements, by the increased spontaneity and mental alertness of the children, by
improvement in carriage and muscular tone, and, as is pointed out by several school doctors, by the
general freedom from colds and coughs compared with the children in the indoor classes. The factors
producing these results are the constant breathing of pure air as opposed to the quickly fouled air of
the ordinary classroom, the stimulation of the skin tending to increase muscular tone, and the facility
with which school work can be periodically interrupted by simple physical exercises.
Type "A"
Classes.
Type A Classes.—From the medical records which were kept it is manifest that there is a
certain proportion of debilitated children for whose needs the playground class is insufficient. This
proportion forms a third of those selected on medical grounds. These children made no perceptible
improvement in physical condition, and, on that account, the average results of the classes are disappointing
when compared with the open-air schools or with classes of type "C." For these children
the full open-air school regime is required. A fully developed system of open-air tuition will require
three distinct types of institution, viz., (i.) The playground class; (ii.) The open-air day school; and
(iii.) The residential sanatorium school in the country. A large number of the children suffered from
ailments to which the parents in many cases could not be induced to pay attention, and, in some instances,
wretched home conditions, with lack of proper sleeping arrangements, nullified what was done at school,
particularly in the cases of the Daniel Street and Turin Street classes.
Daniel-street (Bethnal Green, S.W.)—This class consisted of 31 boys. The low standard of personal
cleanliness was especially remarked, and the strenuous efforts of the teachers failed to bring about
much improvement in this respect. At the outset all the children were ill-nourished and in poor health,
with the exception of three, and feeding at school was necessary in most instances. Eleven boys
improved greatly in colour, alertness, muscular tone and general nutrition, but quite a third of the class
made little or no improvement, the explanation given being the existence of bad home conditions and
lack of attention to remediable defects which included septic mouths, otorrhœa, adenoids, etc. : two of
the boys were tuberculous. The increases in height and weight under these circumstances were not
remarkable, the average increase of height being 1.8 cm. and in weight, 1.0 kilogram. It was noted,
however, that children suffering from anaemia were uniformly benefited, and two boys were cured of
their nervous symptoms (twitching and stuttering).
The "Laurrence" (Bethnal Green, (S.W.).—This class was composed of 31 boys. At the outset,
15 were considerably below and 15 others were below the average in nutrition; nearly all
suffered from minor ailments. The average increase in height was 0 9 cm., and in weight 1.3 kilograms.
The majority of the boys improved in physical condition and became brighter and more energetic;
hilt about ft third were not strikingly improved.

The increases in physical measurements noted are shown in the following tables, the figures in brackets being percentage increases on the original measurements:—

Number of children. (1)Increases in
Height. (2)Weight. (3)Chest measurement. (4)
4Age 9, 3.4 cm. (2.8%)1.3 kilos. (5%).75 inch
8„ 10, 2.4 „ (2.1%)2.0 „ (6.5%).58 „
7„ 11, 2.8 „ (2.0%)1.4 „ (5%).20 „
12„ 12, 3.0 „ (2.27%)228 „ (7.6%).50 „

The effect of warm weather upon the weights observed is shown by the following table representing the percentage of boys whose weights rose, fell, or remained stationary for each month. It was stated that the boys wore the same amount of clothing on each occasion when they were weighed:—

Month. (1)Rise. (2)Fall. (3)Stationry (4)a
per cent.per cent.per cent.
April-May82144
June ...30664
July63334
September78.5183.5
October928

Turin-street (Bethnal Green, S.W.).—This class consisted of 32 boys. The scholars came from
poor homes in the larger proportion of which the sleeping accommodation was unsatisfactory; 13 were
given meals at school. Many suffered from minor ailments; in the case of anaemia and enlarged glands,