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174
Annual Report of the London County Council, 1913.
as to the type of child which improves most readily under the open-air conditions. Children
suffering from tuberculosis did not, as a rule, do well. This was especially noted in the poorer classes
where such cases were more numerous. In one or two of the better classes, however, the school doctors
reported improvement in children suffering from this disease. In many cases the growth of the children
in the playground classes was compared with that of the children in the ordinary classrooms. An
unpremeditated opportunity for comparison of the condition of the children of the playground
classes with the rest of their fellows in the school was afforded upon Empire Day, when Dr. C. J.
Thomas, assistant medical officer, visited several schools in the East End in company with two of
H.M. Inspectors. In three of the schools visited the playground classes were massed in the hall
with the other classes, and there was no indication in attire which would serve to identify them; it
was, nevertheless, in each case perfectly easy to distinguish the playground classes solely by their
bright and healthy appearance compared with the other children.
Type "A" Classes.—The four classes of this type were all held in the playgrounds of schools
situated in the more densely populated districts of the East-end, and the children selected for attendance
were generally of a low type mentally, very badly nourished, exceedingly dirty, poorly clad,
and, in many cases, apparently neglected. A large proportion of them suffered from physical
defects of a more or less serious nature, but it proved exceedingly difficult to persuade the parents
to obtain treatment. A few cases of phthisis were discovered amongst the children upon medical
examination, and none of these showed any improvement during their stay in the class. It has been
pointed out in previous years that only a proportion of the children admitted to this type of class show
improvement, there being invariably a number of children for whom the full regime of an open-air
school with its careful attention to feeding and periods of rest is necessary to effect any improvement.
Thus, at the Daniel-street (Bethnal Green, S.W.), class, while 17 boys showed great
improvement in general physical condition, in 10 others no improvement in health could be detected,
and of these 2 were cases of suspected pulmonary tuberculosis and 2 had tuberculous glands. At
the "Lawrence " (Bethnal Green, S.W.), class 7 made satisfactory progress, 3 fairly satisfactory, 10
were unsatisfactory and 4 very unsatisfactory. At the Turin-street (Bethnal Green, S. W.), class
Dr. Peters reports that at one end of the list were a number of children whose inherent vital powers
were manifested in considerable and steady improvement under the open-air conditions, while at the
other end was a group of children who showed practically no inherent re-active powers. Dr.
Russell (Daniel-street) points out that cases of functional heart trouble, of catarrhal conditions
generally, of moderate degrees of anaemia, and especially those with unstable nervous systems did
well in playground classes, while children with organic heart disease, rheumatic cases generally, and
children suffering from phthisis did not improve. The justice of these observations is borne out by
independent reports upon individual children received from many other school doctors.
Type "B" classes.—The "Forster" (Islington, N.), class was the only one of type B. Considerable
improvements had taken place in the conditions under which the class was carried on, the
canvas awning erected in the playground being of great assistance. Dr. Tosswill reports that of
31 girls examined, 17 received considerable benefit, 9 others showed improvement, and 5 children
made no progress. The last included one child with heart disease, one with profound anaemia, and
one who had been away for a considerable time "hopping." Dr. Tosswill further reports favourably
as to the good effects ot the regular time for sleep afforded at the beginning of the afternoon session.
This appears to be the only playground class where such an arrangement was introduced. It is
unfortunate that the conditions under which the playground classes are generally held do not admit
of this regular sleeping hour, which is found to be such an important factor in the improvement of
the health of the children in the open-air schools at Birley House and Shooters-hill.
Type "C" classes.—The open-air classes of type C were kept under supervision by the school
doctors, who submitted detailed reports upon 59 of them. Forty-six of these classes are said to have
been attended with satisfactory results to the health of the children, while in 13 the results were inconclusive
or unsatisfactory. Eleven of the unsatisfactory classes were composed chiefly of children
coming from poor and neglected homes and difficulties in regard to out-of-school supervision, together
with the unsatisfactory environment of the classes, accounted for want of improvement. Although
nominally of type C many of the classes were really of type B, the children being selected by the
teachers on account of physical defect or mental dulness.
The school doctors, in many instances, point out that, the subnormal children in classes situated
in good surroundings and in schools where co-operation on the part of the care committees was effective
improved under the open-air conditions to a greater extent than did the normal children. Many
instances are quoted of individual children who steadily lost weight in the open-air until put on milk
ineals, when they began to improve. Thus a necessitous child at Bow-creek (Poplar), is reported by
Dr. Burrows to have lost no less than 3.5 kilograms in the first three months; the doctor then
recommended milk meals, and from the time they were given she gradually put on weight. At
Essex-street (Mile-end), and St. Paul's-road (Mile-end), where the care committee co-operation was
obtained, and the poorer children were given milk meals, the general result was good, while in other
similar cases in the East-end, where co-operation with the care committee was not effective, the results
were unsatisfactory from the point of improvement in physique.
Many of the classes were this year held in open spaces and parks, and on the whole the results
of these were better than in the case of classes held in the playgrounds, which were sometimes hot
and dusty, and where the shelters were often inconvenient and unsuitable. At Olga-street (Bethnal
Green, N.E.), school, one class of girls was held in Victoria Park, and another in the school playground.
Dr. Parson, who inspected them, used one of the classes held in the school as a control, and the results
of physical measurements show a regular gradation, the class in the park showing greatest improvement
in physique during the six months, while the children in the ordinary classroom showed least.
In several other instances children in the ordinary classrooms of similar age were measured by the
school doctors in order to form a basis of comparison, and where the playground class met under