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2ii
Report of the County Medical Officer—Education.

It is remarkable that the rheumatic group of diseases, 23 per cent. of the total, forms the highest
proportion among the causes which produce long absences from school. This is a fact of the utmost
importance and was not known until the present mode of procedure was adopted. That rheumatism
in childhood is of more consequence than is generally assigned to it has been frequently pointed out
during recent years, but hitherto little has been done from the public health point of view towards the
study of its aetiology and distribution amongst the population. A beginning has been made this year
towards the study of the distribution of rheumatism in the London area and the information obtained
from the certificates of absence will be of assistance in completing the knowledge of the distribution of
rheumatic diseases amongst school children. This is of very great importance inasmuch as these
diseases are not only very fatal but are very painful, causing great suffering in their early stages and
producing in their later stages much crippling and incapacity for continued exertion.
Most of the cases of phthisis are out of school on certificates from tuberculosis dispensaries but
in spite of the attention that has been paid during the past six months to tuberculosis in school children,
and of the increase in the number of children excluded from school from this cause, the total number
(15 per cent.) is considerably lower than that due to rheumatic illness.
Ringworm accounts for 9 per cent. of the absences. Much is being done towards speedy and
efficient treatment of this complaint and the information obtained from the certificates has given an
opportunity for bringing into the scheme several children who were not on any school books and who
therefore had escaped the following up machinery.
The advantages of interchange of information between the medical and attendance departments
in cases ot children who are out of school on account ot ill-health are so great and the completion of the
knowledge of the distribution of illness among school children so important that the continuance of the
practice of submitting to the medical officer medical certificates upon which children are out of school
should be continued.
Instruction
in Swimming
Extension of
School hours

18820
DD 2