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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212
Annual Report of the London County Council, 1912.
Recent reports and the finding of Parliamentary Committees on employment out of school have
made it exceedingly difficult to recommend extension of school hours for any purpose. If it be admitted
that extension is possible and advantageous, there would appear to be no reason on the one hand for
keeping school hours within the limits at present laid down, or, on the other hand, for debarring
children from engaging in light Wage earning employments out of school.
The maximum educational time which can be used economically without danger of over-pressure
at school ages is represented by the ordinary school hours. These have been fixed both by common
experience and by fatigue experiments. Any encroachment upon school time should, therefore, be
critically watched. It has been represented, however, that swimming cannot be compared with either
school lessons or wage-earning employment, and should be looked upon as a species of recreation. This
contention does not bear examination. The swimming classes as observed fall into two categories.
Firstly, there are learning classes. In these the children have with great pains to learn new
muscular co-ordinations ; it has been demonstrated frequently that learning new physical exercises
causes quite as much nervous fatigue as other mental occupations; added to the fatigue of nerve is the
fatigue of muscle which is particularly great after swimming.
Secondly, there are classes in which the children already swim well. In these, great stress is
laid upon speed, and children are urged to compete with their fellows in speed and distance trials. Great
enthusiasm is shown by both masters and children, and strenuous competitions are arranged with
neighbouring schools. The length of the races is frequently above the average strength of the children ;
only the very strong are able to finish, and even these show signs of distress. Children sometimes
engage in these races when quite unfit physically to do so.
Under these circumstances, it is not possible to maintain that the fatigue caused by swimming
is a negligible quantity. The objections to swimming classes before the day's school work begins are
considerable. To engage in strenuous exercises immediately after breakfast is harmful. The succeeding
school work must suffer and the morning session is extended beyond the three hours, which has been
shown to be the maximum length of time that elementary school children can safely be kept at a stretch
without danger of over pressure. Hardly less objectionable is swimming during the mid-day rest. It
is to be noticed in the above table that four classes of girls had a swimming lesson of the duration of
one hour during the dinner interval. This does not appear to be defensible. It is important that all
children should learn to swim, and a choice between extension of school hours for this purpose, and
deprivation of opportunity to learn is a choice of two evils.
Much difficulty was, therefore, felt in advising the Committee. Not without hesitation, it was
recommended that a swimming lesson not exceeding half an hour might be permitted in the midday
interval in the case of classes of children who are able to swim 100 yards and who present no sign of being
weakly. It was also advised that swimming lessons should not be permitted before morning school;
and, that where absolutely necessary to extend school hours for the purpose, the after school class of not
more than an hour's duration is probably the least objectionable. The Committee decided inter alia—
(a) That instruction in swimming before 9 a.m. to pupils attending the Council's elementary
schools be discontinued.
(b) That the period devoted to instruction in swimming during the midday interval
shall in no case exceed half an hour.
(c) That, as far as possible, only classes of well-nourished children be permitted to take
instruction in swimming after 4.30 p.m.
School
journeys.
The development of the practice of arranging for educational journeys involving the withdrawal
of pupils from their homes for periods extending from seven to 21 days, during which time they are in
the charge of teachers, is likely to add appreciably to the work of the medical department. The responsibility
thrown upon the teachers who accompany the parties is so great that anxiety to obtain a medical
opinion upon the health of each scholar before the commencement of the journey naturally arises. It
is important, for instance, that no child suffering from a contagious disease or in the early stages of an
infectious illness should be included in the party. Then, too, unless the physical capacity of all the
party is Uniform there is considerable danger of Weaklings, who may be suffering from unrecognised heart
trouble or other serious affections, being injured by attempting tasks of too great magnitude. In
previous reports the serious possibilities of the production of heart strain by too sudden an alteration
from a moTe or less sedentary existence to one of intense activity has been pointed out. The advice
of the school doctor upon regime during the holiday, both in general, and in the case of particular
members of the party, is eagerly sought and taken.
The physical benefits or otherwise of such excursions require careful consideration and it has
been the practice wherever possible to arrange for an examination by the school doctor after return
in those cases in which a medical inspection was carried out before the journey commenced. During
the holiday season of 1912 eleven applications were received for the services of a medical assistant in
connection with the examination of scholars who were proceeding upon school journeys. Owing to
insufficient notice or pressure of work it was not possible in every case to render the assistance asked
for. In the case of four schools, however, an examination of the scholars was carried out both before
and after the journey. Special attention in each case was paid to the condition of the heart muscle
and circulatory system. The examinations enabled the school doctors to advise the organisers of the
expeditions in regard to particular scholars where health demanded special care or treatment, and the
results were uniformly good.