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193
Report of the County Medical Officer—Education.
two cases it was downstairs in the yard. These 18 cases had no means of disposing of waste water in
the house. Every drop had to be carried outside, and in the two worst cases downstairs to the yard.
In the remaining 42 cases there was only a cold water tap in the house, and in some of these homes
also the waste water had to be carried out to be emptied. It is very satisfactory to note that in spite
of these unfavourable conditions the standard of cleanliness at the school was high. The gymnastic
mistress states that whereas some years ago the girls took no advantage of the baths when offered the
use of them, this year the experiment has been very successful.
Dr. Gowdey points out that a considerable amount of time is spent on individual instruction
in such simple matters as the importance of a daily wash, of cleaning the teeth, or of not sleeping in
day garments. She considered that it would avoid repetition and prove to be a saving of time if
health talks of about 15 minutes were given at every medical inspection to the pupils presented for
examination and to as many others as possible. This experiment has been tried in three schools.
Girls of 14 years and over were selected, as many as a classroom would hold, and the subject was
approached from the point of view of discharges or excretions from the body and the importance of
washing these away, whereas if allowed to remain smells, personal discomfort, and unwholesome
conditions could only result. These lectures are wanted as much, if not more, in secondary schools
as in training colleges, in which they are already an established fact. Girls reaching puberty in
secondary schools are just in aplastic condition to receive skilled help in these matters, otherwise they
are only imbued with old nurses' fallacies, which are so difficult to uproot in later life. In all three
schools the head mistress and staff who were present expressed great satisfaction at the way in which
the subject was approached and requested a continuation of these talks on health matters.
At the Shoreditch Technical Institute, in connection with the scheme of instruction in
domestic subjects, the girls in rotation reside a few weeks at a time in a flat and are there taught
housewifery as it should be in small homes, attention to personal cleanliness, and refinement in eating
and table manners generally.
School Dinners.—Cases of malnutrition from actual lack of food are very exceptional in higher
educational institutions. The condition of chronic slight underfeeding produces symptoms difficult to
distinguish from those arising from lack of sleep, fresh air and exercise, or even from overstrain. In
all auspicious cases it is usual to urge that all possible nourishment should be taken at school. Dr.
Gowdey and Dr. Fairfield draw attention to the importance of hot dinners in place of cold lunch.
Many girls do not take sufficient breakfast, and the interval between breakfast and a late dinner is
such as to render them tired and unwilling to eat when the time comes, especially if they have just
assisted in preparing this meal. At one school the girls are encouraged to take a personal interest
in the kitchens, and "old girls" have been allowed to study housekeeping under the housekeeper
in charge of the catering. On wet "games afternoons" the girls make jams, puddings, etc.,
which are consumed at the common dinner. The tables are divided into small sections, each presided
over by an elder girl who acts as "mother" and serves the food.
These devices have succeeded in more than doubling the number of diners. It would be well
if all could partake of the hot mid-day dinner provided at the school. Difficulties have arisen of
a financial character, the parents being unable or unwilling to pay for the school dinners, and in one
instance from the school dining room accommodation being too limited. At this school at the end of
term the doctor noted several pupils with markedly rapid pulses, some as high as 144 and 158 a
minute, and on enquiry learnt that these pupils went home to mid-day dinner, some having as
much as a 20 minutes' walk each way, which left only some 20 minutes to partake of a meal. In
cases where the pupil has been persuaded to remain for the school dinner beneficial results have been
noted in pulse and otherwise. Rapid pulses are often the forerunners of Graves' disease, and it is not
uncommon to find slightly enlarged thyroids and exophthalmos developing in girls of school age under
the strain of hurrv and examination.
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Dr. Gowdey, who noted the chief features in the dinners provided at six secondary schools,
fouud that the price of a meat dinner varied from 5d. to 8d., while 3d. was the usual cost of a
vegetarian dinner. The numbers attending varied from 14.4 per cent. to 30 2 per cent, of the total
number of girls in school. The cost of service varied from 24 per cent. to 64 per cent, of total
takings, the higher wages being at the school where the dinners were the least popular as shown by
the fewer pupils remaining to dinner. In some schools the headmistress and staff dine with the
pupils, which is an obvious advantage, leading to improvement in the manners and hygiene of the
pupils.
The doctors acknowledge the great and valuable aid they receive from the heads of the schools
in securing the treatment of the various defects noted at the medical inspection; nothing goes so
far in this direction as personal influence on the parent. Dental treatment is on the whole more
difficult to secure than medical, and in some areas the quality of the work done by unqualified
dentists to whom many pupils went in spite of advice is of the most careless description. A
particularly flagrant case was that of a fee-paying pupil at a trade school found to have 13
carious teeth, many being septic. She went to an unqualified dentist who offered to give her artificial
teeth for 10s. Her father could ill afford this, for he was an artisan earning under 30s. a week, and
had a hard struggle to keep the girl in a Trade School. However, he agreed, and the "dentist"
extracted the upper incisors, giving the girl four artificial teeth on an ill-fitting plate which he
attached round the septic molars. Nothing was done to the lower jaw. When such a case becomes
the subject of discussion among the girls in an institution it is uphill work to press for dental treatment.
Treatment of
remediable
defects.
Residential Institutions.
During the year there were 8 residential industrial schools and 6 (2 blind, 3 deaf, and 1 mentally
defective) residential special schools with accommodation for about 1,020 children. Since the
1st January, 1914, the Council has taken over full responsibility for the Portslade Industrial School
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