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London County Council 1913

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

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Annual Report of the London County Council, 1913.
addition two or three persons occupying the same room, and that the window is not open during the
night. Sometimes it is found that although the child may be going to bed regularly at 8 p.m., the
bedroom is at the same time the sitting and work room, with the result that the first sleep is
necessarily much broken.
Period of nightly sleep obtained.—An enquiry was made among 100 Jewish children between
the ages of seven and eight years with the following result—
16 children were being put to bed at 8 p.m.; 62 between 9 and 10 p.m.; 2 from 9.30 to
11 p.m.; 16 at 11 o'clock; and 4 from 11 until midnight.
One effect of lateness in going to bed is that the children rise late, and hurry to school without
any breakfast other than "a cup of tea."
Unbroken Sleep.—It is a little difficult to find out whether a child's sleep is unbroken,
without actually observing it, but the probability of sleep being disturbed is fairly certain, if several
persons share the same bed, some of them being adults retiring at a different hour.
Of the 167 children (Jewish and Christian) among whom the enquiry was made it was found
that 19 each slept in a bed alone; 57 each in a single bed with one other person; 53 with two other
persons; 32 with three other persons; and 6 each shared a bed with four other persons.

Inquiry into the hygienic condition of the sleeping apartments of 133 children moderately poor gave the following results:—

Number of persons to each room234567
Number of children at each degree of crowding3932441251
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Of these 11 admitted having the window open at night "about an inch" (the inquiry was
made during the warm weather). It is very unusual to find on close enquiry that the vest or shirt,
worn during the day next the skin, is removed at night, and it is no uncommon thing to find among
the poorer Jewish children the night shirt serving during the day as an ordinary shirt.
In order to obtain some means of comparing the effect of unsatisfactory sleeping conditions
upon the health of the children the average total increase in height and weight of the children
in two playground classes was taken. One playground class was situated in Bethnal Green, the other
in Stepney. Both were classes of girls of comparable ages, and the circumstances (of the parents of
the children in the Bethnal Green and Stepney class were similar.

The figures worked out as follows the figures were taken from 52 children):—

Number sleeping in a bed.Total increase in Height [ April—October.]Total increase in Weight [April— October.]
1 or 23.1 c.m.2.3 kilograms
31.7 c.m.1.3 „
41.1 c.m.0.78 „
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glands and
other defects.
It was impossible to eliminate other factors, such as poverty; but on the whole the figures
appear to indicate that the children sleeping under more satisfactory conditions show greater increase
in height and weight than those whose sleep is necessarily more broken owing to overcrowding.
Glands.—Swollen glands other than submaxillary and cervical were noted at medica
inspections in 298 children, 39 cases being referred for treatment. These cases include enlarged
thyroid glands and lymphatic glands in any part of the body. Of these 298 cases 138 were amongst
entrant boys.
Other diseases or defects.—Under this heading are classed digestive disorders, urinary diseases,
injuries, debility (when not associated with anæmia or malnutrition), hernia, abscesses and enuresis,
as well as any other complaints not specially provided for on the record card. 4,757 such cases were
noted, 2,335 being recommended for treatment. In Hampstead, Islington, and Shoreditch there
were 683 cases of "other defects" noted, and of these 107 were cases of enuresis, mostly occurring
amongst younger girls. There were 39 cases of hernia, the largest proportion occurring amongst
entrant boys who had umbilical hernia.
Condition of
teeth of
Condition of teeth.—Particulars as to the condition of the teeth classed as good, fair or bad will
be found in the appendix. The school doctors are instructed to report all children with defective
teeth, but there is considerable variation in practice, some school doctors reporting all cases where
there is the slightest sign of decay in either temporary or permanent teeth, and others reporting only
cases where the decay is more serious. In all cases of oral sepsis, and in general where there are
three or more teeth affected with caries, the case is referred for treatment.

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