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161
Report of the County Medical Officer—Education.
The conclusion arrived at is—that for the improvement of the general physical condition the
class is beneficial, the breathing is improved as is also the muscular tone, and thus any deformities due to
"flabbiness" of the muscles are corrected, but for the improvement of any deformity that has become
at all fixed (exclusive of any cases requiring remedial exercises) the class is of very little service.
An instructor who has had special training is necessary to get good results, for he would have a good
knowledge of the defects that occur in drilling and would be better capable of noticing and remedying
faulty positions. Local centres where a class could be taken two or three times a week by a specially
trained teacher would be a great boon, as at present it is necessary to send any child with curvature of
any degree to a hospital or special class in town and most of the parents cannot afford either the time
or money to attend with any regularity.
Hughes Fields, Greenwich (B.)—(Dr. Davies).—The boys selected to form this class were of about
the same age, 10 to 11½ years, and, as near as could be. of the same physical capacity. They were such
as appeared likely to benefit by the physical exercises laid down in the instructions, and in three cases
previous existence of adenoids or throat affection indicated suitability for exercises designed to improve
the respiratory capacity. The exercises occupied from 20 to 30 minutes each morning, and were
conducted, practically always, in the open air. The master in charge of this class has had special
experience in physical drill, and has taken great interest in the progress of the class.
Of the 25 boys selected, three have been omitted from the tabulation: one boy left early in the
summer term: another was away hopping in September, and absent owing to sickness at the final visit
on 9th December: a third was absent unwell during the latter half of the term. Four visits were
made to the school for the purpose of weighing, measuring and examining the boys, viz., on 24th April,
5th June, 11th September and 9th December. The ages of the boys varied between 9 and 12: fourteen
were in their eleventh year. Their weights in 16 instances were below the standard for London children,
15 of these being also below the standard for height. The chest measurements were taken with the
lower edge of the tape above the nipples in front, and its upper edge below the scapular angle behind:
the mean of the measurements in deepest inspiration and expiration has been taken as the chest
measurement. Heights and weights were taken in ordinary clothing without boots. There was an
increase in weight and in chest measurement in 16 boys: in 4 others there was slight increase in weight
without any increase in chest girth: in 2 there was actual, though slight, decrease in weight, the chest
measurement having in one of the boys increased, in the other diminished.
Twelve boys had been noted previously as suffering from some physical defect: five from throat
affection (enlarged tonsils, or adenoids, or both); three from blepharitis; two from defective nutrition;
one from anaemia, and one from discharging ears. None of these defects were actually present during the
period under review, except blepharitis in one boy, and ear discharge in another.
The exercises were carried out according to the syllabus. They consisted chiefly in breathing
exercises (5 minutes), trunk bending, shoulder movements, arm swinging and knee bending and
stretching, but included many others as well. From 20 to 30 minutes each morning were given to this
training, always in the open air. Running, leap frog and other games (also in the open air) formed part
of the exercise. The only actual physical defects made out were in the two boys S. and T. In both
cases there was contraction of the thorax, probably rachitic. S. also suffered from bronchial catarrh
to some extent. This boy 's weight increased by 1.8 kilograms: his chest measurement increased by
3 centimetres, and although his range of expansion was only 3 centimetres, his maximum of 61 in
June became his minimum in December. T. also had a contracted chest and limited expansion:
this hardly improved at all, and his weight remained stationary at 24*4 to 24*5 kilograms, considerably
below the normal. With this exception it may be said that improvement resulted in all the boys in
regard to their general condition.
Prospect Terrace, S. St. Pancras (B.)—(Dr. Norman).—This class was started on June 2nd, 1913,
with 20 selected boys. It was later reduced to 14, four boys having left the school and two being
withdrawn owing to parents' objections. 13 were present at the final inspection. The instructress was
one of the lady teachers in the school, who is well suited for the position, being enthusiastic and thorough.
The boys go through the exercises every morning session, 20 minutes being given to them (9.40 to 10
o'clock). Not one of the boys is on the feeding list, but most of them are of a poor type of physique,
and many are anaemic. 7 out of the 13 were noted as mouth breathers, when the selection was
made at the end of May. After 8 months, only one boy was noted going through the exercises with his
mouth open. The nose breathing drill is well done, the only criticism to be made is that there is an
inclination to conduct the in and out breathing too rapidly. There is a very decided improvement in the
carriage and gait of every member of the class, and no doubt exists as to the utility of the training.
Union Street, Woolwich (B.)—(Dr. Hirsch).—This class commenced in April, 1913, and continued
during term time until December, 1913. 25 children were chosen, mostly those of poor physique due to
lack of tone of muscle. Three had signs of rickets. Ten showed slight lateral scoliosis; in seven of these
the curvature was merely the consequence of faulty carriage and disappeared when they stood correctly to
attention. The remaining three had lateral scoliosis; with the modified Kellett Smith level there was a
difference of about half an inch, the angle of the right scapula being also about lower than the left, and
with the plumb line the curve, mid dorsal in all, was demonstrated. Practically all the boys in the school
were inspected, so as to obtain the most suitable cases.
The ordinary exercises in the syllabus were given ; the teacher's attention being directed to the
need of individual supervision for each child, especially as to correct position from which the respective
exercises should be taken. In addition the following exercises were employed.
(1) Standing against support, head to heels pressed against wall, arms to side, lifting arms
out and up while breathing in, lowering while breathing out.
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