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215
Report of the County Medical Officer—Education.
enter or any glimpse of the sky be seen. Such rooms are, of course, unhealthy. Noisy surroundings
have a prejudicial effect upon the work of the school, and in particular upon the health of the teachers.
There are schools whose walls abut on main roads. The windows cannot be opened, as the noise
totally prevents the continuance of school work. The result is considerable suffering to both teachers
and scholars, especially on account of the deplorable conditions of ventilation which closed windows
entail. Dust from roads is worse than mere playground dust, especially in summer, for the younger
children.
A properly situated school building, therefore, should have the protection from shadow, foul and
stagnant air, noise and dust which an adequate playground can alone give. These are points which have
not received sufficient attention at the hands of authorities in the past, and are not affected by the
provision of neighbouring parks or playing fields or bv the use of roof playgrounds.
School
gardens.
Some 170 school gardens exist in London in connection with schools maintained by the Council.
No doubt the advantages of school gardens outweigh the disadvantages of the consequent reduction of
space open to free play ; but it should be pointed out that more than the actual space taken up by the
garden is involved, as there is a considerable neutral zone adjoining the garden in which anything like
free play is impossible without danger to the usefulness of the garden itself. It would, therefore, be
advantageous if all school gardens adjoining playgrounds were protected by railings.

The above returns are admittedly incomplete, and it is doubtful how much reliance can be placed
upon them statistically. So far as they go they indicate (a) an absolute increase in the average number
of days per teacher absent on account of illness; (b) an increase in 1912 in the absences ascribed to
nervous complaints ; (c) an increase in both 1911 and 1912 in the number of women teachers referred to
the medical officer on account of absences ascribed to nervous complaints.
It is probable that there has been an alteration of procedure in the office whereby a larger
proportion of the cases absent on fortnightly certificates from private practitioners has been referred
for advice. This would tend to an increase in the number of days absences on account of illness,
inasmuch as it is the practice in cases of nervous breakdown to insist upon a sufficient period of rest
from school duties to ensure a thorough restoration to health before resumption.
A careful analysis of the cases of nervous breakdown during 1912, shows that they were
distributed throughout all the branches of the Council's teaching service, and that there are more cases
proportionally amongst secondary mistresses than amongst elementary school teachers, while there
appears to be an undue preponderance in domestic economy and special school teachers.

It further appears that an undue incidence of cases of nervous breakdown occurred in women
teachers at the age period 55-65; more than 3 per cent, of the elementary teachers in this decads in
Council schools have suffered from breakdown during 1912, while less than 1 per cent, of the cases
have occurred in teachers of any other age decade during the year. There was also a greater relative
incidence upon spinsters than upon married women. The total number of the cases in question is insufficient
to base any definite conclusion upon. If, however, any increase in the number of cases of nervous
breakdown has taken place, it is confined to women teachers and the explanation might be sought in
a natural tendency to nervous breakdown in women teachers at certain periods.