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177
Report of the County Medical Officer—Education
ventilation and access of fresh air directly upon the skin. The best costume for boys is a jersey,
shorts not reaching below the knee; strong boots or shoes and woollen socks, the upper edge of which
is just above the edge of the boot uppers; with these should be worn knitted woollen stockings
without feot, but with an elastic band to slip beneath the instep; a simple double of the stocking
above or below the knee keeps it up, thus obviating the use of garters or straps. The underwear worn
by the children varied greatly; some wore flannel, which was quite unsuitable owing to closeness of
texture; some woro linen, which was even less suitable; others wool, which was, on the whole,
admirable; and a few flannelette or mixtures, which appeared to give satisfaction. The most
desirable underwear for such an excursion is of a mixture of linen and wool with open mesh; but
this cellular underwear is expensive.
Accommodation.—The party stayed at a temperance hotel in Shanklin, which had proved
satisfactory on a former excursion. The adult members of the party had rooms either at the hotel or
were accommodated in lodgings. The girls, and some of the boys, were given large double-bedded
rooms in the hotel on the second floor; the majority of the boys were accommodated in a set of rooms
in an outside building. These latter rooms were above a stable, and were not quite statisfactory,
owing to the want of adequate ventilation. Single and double beds were provided, some of the junior
boys sharing a single bed. One of the masters slept in an adjoining room in this outbuilding, and so
exercised supervision.
Diet.—The children were given breakfast, a cold luncheon to take with them on their walks,
and a hot dinner on their return in the evening. Generally speaking, the diet allowed each child was
in excess of the normal caloric requirement, even taking into consideration the extra physical work
done. A rough calculation of one day's diet gave nearly 3,000 calories, the amount of proteid and
carbohydrate being especially large. As a sample menu of one of the dinners the following will
serve:—
Roast veal. Boiled turnips.
Steak pie. Suet pudding.
Greens and potatoes. Custard and fruit.
From this it will be seen that the diet given was a very generous one, and this possibly
accounts for the one or two cases of slight gastric and bilious attacks which occurred. From a
medical point of view the main criticism must be that such a diet could hardly be fully assimilated
after an excursion that involved some amount of fatigue, and that it was too constipating. For a
future occasion the addition of fresh unboiled green vegetables, such as watercress, and of fresh fruit,
such as apples might be suggested. From the children's point of view the catering left nothing to be
desired. Each child had as much to eat as he or she wanted, and all declared themselves perfectly
satisfied with the food.
Sleep.—All the children were generally in bed by nine o'clock, some of the juniors preceding
the others by an hour. Most of them were dressed and outside their rooms by seven o'clock in the
morning. This gives an average of ten hours' sleep, which is perhaps too little. It must be remembered,
however, that the excitement of the outing and the late meal were not conducive to early
sleep, and to have sent the children to bed sooner would scarcely have secured more sleep. Experience,
in junior boys' camps, is that ten hours' sleep is ample when the child is not doing mental
work that involves a strain. The compulsory advancement of the hour for retiring only entails
considerably more supervision on the part of the masters or officers, since the children do not drop
off to sleep but spend the extra hour in talking. On this occasion the younger children were carefully
inspected for signs of fatigue due to insufficient sleep, but such signs were not found. All
turned out in the morning fresh and vigorous and eager for the day's walk.
The mental work done after return from the excursions was comparatively slight. After
dinner there was a short examination by the sectional leaders on the incidents and sights witnessed
during the day. This was more in the nature of an informal talk than of a formal examination, and
certainly could not be held to involve unnecessary mental strain. Children who wished to go to bed
were excused from this examination, and on several days the masters and mistresses held the
marking tests in the train on returning from an excursion, the evening thus being left free for
conversation, singing, or games.
Sickness and accidents.—With a well-selected party the incidence of sickness on a school
excursion should be small. With unselected children, some of whom are in a low state of health, as
in holiday camps, the incidence is relatively high. With regard to accidents, injuries of a serious
nature can nearly always be guarded against by proper supervision; where they occur it is usually
found that there has been some laxity with regard to such supervision. Minor accidents are comparatively
common, and can scarcely be guarded against.
On this excursion the supervision was excellent, and no serious accidents occurred. In one
or two cases sore feet were complained of, largely the result of ill-fitting boots and too thick socks.
The only severe case of this kind was that of one of the girls; proper attention to the footgear and
simple treatment of the blisters were all that was required in this case. The effects of exposure to sun
and wind were seen in a few chapped faces; but beyond slight temporary inconvenience no great
harm results. Anaemic children are not very susceptible to such exposure, and in their case the
subsequent tanning of the skin is much less apparent than in the case of more ruddy children.
The chief condition needing treatment was undoubtedly constipation. The vigorous open-air
exercise, with free action of the skin, a diminished supply of drink, and probably a richer fare than
the children are accustomed to, were responsible for this. Probably an accessory cause is always the
break in home habits for the time being and the neglect to empty the lower bowel with any degree of
regularity. The results of such neglect, leading as they do to habit constipation, are sufficiently
serious, especially in the case of girls, to demand the attention of teachers and others responsible for
the care of the children.
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