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178
Annual Report of the London County Council, 1913.
A few cases of slight bronchitis were found; in two treatment was necessary. Of these latter
one was a slight case which did not interfere with the child's holiday in the least; on the contrary
the open-air walks undoubtedly accelerated the cure. The other case was that of the smallest
boy in the party. This child had not been examined before joining, and on arrival at Shanklin
he was suffering: from a severe cough. Examination revealed numerous rhonchi over both bases and
bubbling rales in the left lower lobe. He improved considerably and was allowed to take part in
the walks, accompanying the juniors, except on one day when his condition was not favourable and
he was left behind to rest at the hotel. This was the only case in which there was a condition which
could in any way be accounted serious. He was much too young a child to have been included in the
party, and it would have been better not to have brought him.
At the final examination one child was found to be suffering from what seemed to be
appendicitis. This boy had been one of the most active on the excursion, and had never complained
of anything. He had, however, had a previous attack of iliac pain and sickness some mouths before.
The first symptoms in his case developed on the day after his return, and were put down to his having
eaten something that disagreed with him. Another child was found to be suffering from slight
bronchitis, and a third from scabies.
Taking everything into consideration it may be concluded that the health of the children was
remarkably good; when the weather conditions are taken into account, the freedom from slight
pulmonary complaints was striking, especially in comparison with children of a similar class and age
who had remained in London and who could, to some extent, be taken as controls.
Nutrition.—One of the most important points in estimating the hygienic and general value of
the school excursion must be the effect of the outing on the nutrition of the children. The degree
of nutritional excellence was expressed by the figures 1,2, 3, or 4—1 being excellent, 2 good,
3 poor, and 4 malnourished. In estimating the nutrition according to this standard the usual
observations were made; the appearance of the skin was noted, changes in its elasticity, and colour
in the shape of pigmentation, were considered, and the texture of the hair and smoothness of the
nails were observed; special attention was paid to oral sepsis, condition of the musculature, presence
of glandular enlargement, hairiness of back, or signs of lymphatic hyperplasia, while the ratio of
weight to height was also taken into consideration. Finally, a brief investigation into the home
conditions of the child, and his or her method of life and general history, was made, the hours of
sleep and work being noted. These observations were made in combination with those taken to
estimate the degree of fatigue present. At the final examination a similar comparison was instituted,
and from the data thus obtained an attempt was made to estimate the improvement, if any, in the
nutrition of the child.
The following is a summary of the results obtained:—
Girls.—At the preliminary examination 7 were noted as "Nutrition 1" at the final
examination these girls were again classed as 1 although their general condition had
improved sensibly. Twelve girls were noted as 2. Of these at the final examination 8
had improved to 1, 3 were still 2, while 1 was not re-examined. Three were noted as 3 at the
preliminary inspection; at the final examination all those had improved, their nutrition
being noted as 2.
Boys.—Eight were noted as 1 at the preliminary inspection; at the re-examination all
these had improved. Fourteen were noted as 2 before leaving. Of these 12 on their
return had improved to 1 ; 1 was still 2, and 1 was not re-examined.
Three were noted as 3 at the preliminary inspection; at the re-examination all 3
had improved so that they could now be considered as 2.
These results show that in the majority of cases there was a decided and striking improvement
in the nutrition of the children directly due to the outing, while in comparatively few there
was little improvement. In only two cases was there any loss of weight unaccompanied by obvious
6igns of physical deterioration in other respects.
Heights and weights.—Taking only the records of those children who were fully re-examined,
since these alone are available for comparison, the following results were obtained:—
Girls.—Average height at first examination, 145.1 cm.; on return, 145.3 cm. Average weight
on first examination, 35 kilograms; on return, 35.4 kilograms.
One girl apparently lost 1 cm. in height. This was the child who had suffered from sore feet,
and in her case there was a slight dropping of the arch of the foot. An increase of 1 cm. in height
was recorded in five children. A loss of weight was recorded in one child, whose weight at the
preliminary examination was 25 kilograms, while at the final examination she registered only
24.6 kilograms. An increase of weight was noted in 10 cases out of 18, the greatest increase being
1 kilogram, while the smallest was 0.2 kilogram.
Boys.—The average height of 24 boys before starting on the excursion was 138.6 cm.; the
average height on return was 139.45. The average weight of the same group of 24 boys before starting
was 30.12 kilograms; on their return the average weight was 30.8. The individual improvements in
height and weight among the boys were, however, much more marked than among the girls. The
greatest increase n height was 2 cm. (two cases); an increase of 1 cm. was noted in nine cases. The
greatest increase Tin weight was 4.G kilograms; other increases were 2.8,2, 1.2, 1.1, 0.9, 0.8 (four
cases), 0.6, 0.5 (two cases), 0.4, and 0.2 respectively. In one case only was there a loss in weight,
from 25 kilograms to 24.6.
Fatigue and mental strain.—At the preliminary examination it was noted that several children
were unduly tired and fatigued, and some attempt was made to estimate the degree of fatigue with a
view to comparing it with the child's condition on the return. Apart from the ordinary signs of
lassitude and physical and mental weariness which are well known to every teacher since they show
themselves in the child's inattention during the class lesson, in mind wandering, in mistakes in
simple matters of arithmetic or other class work, in yawning, listlessness, or actual drowsiness, there