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. 167
The figure for chest expansion was taken as ratio of expansion to circumference of emptychest.
In April the average expansion was 8.53 per cent. of the chest; in September it was 10.38 per
cent.
There were three case of defective vision and squint, and one of severe adenoids ; for these treatment
was advised. The improvable defects were:—
Two " adenoids," i.e., large tonsils and mouth breathing; both improved.
Two enlarged glands, marked ; both much diminished.
Two blepharitis ; both quite well.
One heart (hæmic murmr); murmur disappeared.
One impetigo, cured by treatment; no fresh, cases.
Three debility; all markedly improved.
One chronic conjunctivitis; not improved,
Five " nerve signs," e.g., tremors of hands. Four much improved, one a little better.
One severe (old) rickets. General health and chest expansion much improved.
One definite pulmonary tuberculosis. Quiescent. This boy seems to have gained practically
no weight, and seems to have had a fresh " attack," with cough, loss of weight, etc.,
in May. Latterly hot milk was advised, and he now begins to show marked improvement.
One of the cases classed as " debility " showed signs of early tuberculosis.
Nasal respiration was a point to which the school doctor specially directed the attention of the
master in charge of the class. Breathing exercises were especially well carried out and great care was
taken to discourage mouth breathing. With a view to keeping the nose free from mucus, a special effort
was made to secure the use of handkerchiefs, and the school doctor sent three or four dozen cheap handkerchiefs
for distribution among those boys who had regularly brought " substitutes." The idea was
well carried out and the boys who had these handkerchiefs given to them took care of them and washed
them. At the first inspection, only 20 per cent. of the boys had handkerchiefs; at the later inspection,
about three months after any handkerchief had been given, 90 per cent, of the boys had them. Corresponding
to these measures, there was a considerable improvement in spite of the very unfavourable
weather conditions. The changes noted were (1) shrinkage of tonsils; (2) almost complete disappearance
of mouth breathing and on the other hand, improved nasal respiration, even in those cases where symptoms
suggested definite adenoids ; (3) several cases with defective hearing appear to have improved somewhat,
as measured by watch distance. There were scarcely any cases of " colds " contracted in the class,
although up to the last medical visit in October the boys had only spent one day indoors, and this was
on the occasion of a thick fog. Besides the results noted above, there were very marked changes in
other respects which cannot be expressed statistically. There was a marked improvement in the colour
of the boys ; in their postures while sitting, standing, doing exercises and marching ; in their expressions,
which were both more alert and more cheerful; and more especially in their cleanliness and neatness.
It was evident that the boys themselves were interested.
Bolingbroke-road (Battertea) — A boys' class held in a somewhat unsuitably drained part of the
playground. Satisfactory increases in height and weight are noted and most of the children suffered
from catarrhal troubles which were cured by the open-air treatment; it was noted that they remained
free from colds except on the occasions when they were obliged to spend long periods under shelter.
Bow-creek (Poplar).—This class was made up of twenty girls and eighteen boys of Standards V.,
VI. and VII., not selected on medical grounds. The playground is pleasantly situated on the river
bank, and is open. The children showed great improvement in colour, carriage and muscular tone.

The increases in physical measurements are shown in the following tables, the first showing nutrition expressed as grammes per centimetre, and the second the average weights in kilograms.

Beginning of session.Beginning of holidaysEnd of holidays.End of session.
Girls (16)234.5230.7 (—3.8)232.8 (—1.7)242.4 ( + 7.9)
Boys (16)229.7228.1 (—1.6)229.0 (—0.7)232.9 ( + 3.2)
15th April, beginning of session.23rd July, beginning of holidays30th August, end of holidays.22nd October, end of session.
Girls (16) Boys (16)32.53 31.1832.47 (—0.06) 31.28 (+0.1)32.97 ( + 0.44) 31.56 (+0.38)34.68 (+2.15) 32.31 ( + 1.13)
Country holidays (5 girls, 6 boys)32.4132.50 ( + 0.09)33 04 ( + 0.53)34.27 ( + 1.86)
Meals at school (4 girls, 3 boys)31.8531.71 (—0.14)32.75 ( + 0.50)33.42 ( + 1.57)

Canal-road (Haggerston).—Forty-two boys whose ages ranged from 8 to 13½ years. The
class was held in a corner of a large open playground to the south of the school buildings. Although,
in reality one of the ordinary classes drafted into the playground, the general condition of the children
was identical with that of children found in type "A" classes ; several showed old tuberculous lesions.