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158
Annual Report of the London County Council, 1913.
suitably placed hulks could be adapted lor the purpose, accommodation of this kind should be taken
into consideration, particularly for children living in central London or within easy reach of the
river. Disused naval ships might be considered in this connection. For cases suitable for such
open-air schools some 1,000 places should as a commencement be provided in addition to the accommodation
provided at Birley House (100) and Shooter's-hill 75 and at Kensal-rise (120).
(b) Pulmonary cases requiring residential accommodation are those spoken of as cases of open
tuberculosis, in which there is cough and expectoration. It has already been stated that rest of
the affected parts is the principal feature of treatment. For the more definite tuberculous cases
requiring residential accommodation provision will have to be made for some of the children to lie in
bed all day, when they will be unable to receive any considerable education. These institutions will
be more medical than educational. They will probably require a larger site than the day open-air
school, and the rooms and wards should be so arranged as to enable cots to be wheeled into and for
beds to be provided permanently in the open air. A larger nursing staff will be required than at the
day school, and it will be necessary to provide them with night quarters apart from the children.
Daily supervision by a medical officer of special experience will be necessary. As an initial provision
it was estimated that 125 beds would be sufficient for these cases and for children who, after careful
observation in the open-air school, are found not to improve or to lose ground.
(3) Children suffering from tuberculosis of the skin, glands, or other organs.—A small number
of these cases will require a relatively short stay in the country to accelerate cure. It would probably
be sufficient if 25 beds are provided for these cases, the bulk of which can be dealt with in open-air
schools and the tuberculosis dispensaries. With regard to accommodation, the schools for physically
defective children generally meet the needs of surgical cases who are able to reside in their homes
and are not suffering from chronic abscesses and other septic conditions, but the difficulty in London
in securing suitable sites for open-air day schools has already been referred to.
Attention has been directed largely to securing, in the first instance, suitable residential
accommodation. It is considered that provision should be made for the education of children capable
of receiving it and, for this purpose, the Education Committee are of opinion that any institution
recognised by the Board of Education under the Elementary Education (Defective and Epileptic
Children) Act 1899 can be regarded as satisfactory from an educational point of view.
It is desired that any expenditure which may be incurred by the Council shall be used for the
purpose of enabling existing institutions to bring into use beds at present unoccupied through lack of
funds or to carry out enlargements. In other words, the intention is to avoid the displacement of
patients who would be dealt with without the intervention of the Council. With this object
enquiries have recently been addressed to a number of sanatoria and visits paid to a number of institutions,
from which favourable replies had been received. It was considered that, in the beginning,
about 150 beds would be sufficient, further accommodation being provided as may be found necessary.
Payment not exceeding 20s. per bed per week, including education, was regarded as a reasonable sum
for the maintenance of the children. The Council were able early in 1914 to obtain 50 beds for
pulmonary cases at Nayland Sanatorium, near Colchester. Negotiations were then still in progress
with regard to the additional beds required for surgical cases.
Exercises for children suffering from physical defects in elementary schools.
In 1912 certain experimental remedial exercise classes held in the elementary schools, for
children selected on account of physical defect by one of the medical officers were favourably reported
upon. It was decided to continue the experiment and in the year 1913 it was intended that special
classes in remedial physical exercises should be held at the undermentioned schools:—
Boys.
The Chaucer.
Garratt Lane.
Hughes Fields.
Johanna Street.
Prospect Terrace.
Rosebery Avenue.
Union Street.
Winchester Street.
Junior Mixed Departments.
Frankham Street.
Sellincourt Road.
Girls.
The Chaucer.
Camden Street.
Catherine Street.
Deal Street.
Eltringham Street.
The Highway.
Hungerford Road.
Latimer Road.
Moreland Street.
Snowsfields.
Weston Street.
Betts Street.
Middle Row.
Pritchard's Road.
Church Street, Kennington.
Kennington Road.,
White Lion Street.
Cooks Ground.
Owing to various circumstances the class at Kennington Road was not started, and those at
White Lion Street, Sellincourt Road and Eltringham Street were discontinued. (A report was,
however, made on the class at Eltringham Street.) A special chart was prepared for the use of the
school doctor and a supply sent to each school. It should be noted that the numbers in the special
classes did not generally exceed 20, and the children were selected in the first instance by the school
doctors for such defects as might be expected to be remedied by graduated exercises which could be
given by class teachers possessing the necessary training. The medical reports upon the classes show
that extremely good work was accomplished and that considerable benefit to the children was obtained.
The results were not altogether uniform. The lack of suitable clothing and footgear for exercises
in certain of the classes was noted by the school doctor as militating against success; in one case at Weston
Street, Dr. Williams found the child's movements greatly impeded by 9 layers of clothing on the chest.
In many classes, however, suitable drill garments have been provided and in these classes the results were
exceedingly good. The great benefit to cases of spinal curvature accruing from crawling exercises and