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REPORT OF THE SCHOOL MEDICAL OFFICER (Dr. W. H. HAMER) FOR THE
YEAR 1917.
PART II.—EDUCATION.
Introductory Note.
In last year's Report it was possible to cite the continued improvement in the results obtained
at medical inspections, during the years 1913-16, as a proof that the war " had not been allowed to
interfere with the growth of that solicitous care for the welfare of the children which has distinguished
recent years." It will be seen immediately that this improvement has been maintained; moreover,
an indication of the favourable economic conditions prevailing during 1917 is afforded by the fact that
the number of necessitous children receiving free meals continued to decline below the already very
remarkable figures of the preceding year. These are exceedingly satisfactory results after three years of
war ; on the other hand, there have not been wanting indications that certain possible sources of trouble
should now be considered. Thus, during 1917 the suspicion was aroused in the minds of a few observers
that particular symptoms of illness were attributable to eating war-bread ; this view has not so far
been supported by any conclusive published evidence. A more serious difficulty has been that of
checking fraudulent adulteration. This practice has become so common in the case of milk that comment
was recently made by the writer of London "Charivaria" on a statement that in South Wales "samples
of water examined had been found to contain 45 per cent. of milk." The Education Committee has
had under its consideration the poor quality of much of the milk supplied to necessitous school children
in London. The results of analysis were at certain times of the year unpreccdentedly unsatisfactory
inasmuch as more than half the samples taken were found to contain added water. The question
is being further investigated.
In spite of difficulties of this sort, an enquiry made by Dr. C. J. Thomas into the number of
malnourished children found at medical examinations, shows improvement and not deterioration.
Over and above the food difficulties there remains to be mentioned the mischief of quite another kind
which was undoubtedly caused in the autumn by nervous excitability associated with air raids, and
there was even a suspicion that spread of infection was caused by the undue crowding which took
place late in the year in some of the places of shelter (see p. 37).
Broadly speaking, setting aside certain small and localised outbreaks of dysentery in North
and North-west London—and apart from the comparatively speaking minor difficulties mentioned
above, there were only two serious interferences with the children's health during 1917 directly attributable
to war conditions ; in the first place there was notable increase in the prevalence of scabies,
doubtless largely introduced by soldiers returning from abroad ; and seoondly, less satisfactory results
as regards treatment of the ailments of school children were obtained, owing partly to a marked falling
off in the facilities afforded at certain hospitals, and partly to a further increase in the difficulty ex.
perienced in " following-up," due in some degree to mothers going out to work, but mainly to
diminution in the number of voluntary care committee workers. In the latter part of the year
arrangements were made for nurses to render further assistanco in home visiting, and in a few selected
schools, in which the need was most urgent, nurses were made responsible for the medical following-up
work (see p. 29).
Medical
inspection.
In last year s Annual Report it was shown that the scheme, approved by the Council in November,
1915, under which the detailed examination of entrants was replaced by a preliminary inspection
followed by a detailed inspection of those apparently ailing, had led to the detection of fewer ailments
than in previous years. As a result the Council, on the 31st July, 1917, decided to revert to the former
method of examining all the entrants in detail. During the year 228,124 children in the age groups
were examined by the school doctors in elementary schools, and of this number 89,171 were found to
require treatment for one or more defects. A further 1,727 children in the age groups were inspected
in special schools, and 53,334 elementary school children not in the age groups were specially examined,
giving a total of 283,185. In addition, the school medical staff inspected 4,458 children for scholarship
awards, 8,800 students in secondary schools and training colleges, and 13,904 children in connection
with their specific defect in special schools. A detailed analysis of the results of the examination of
elementary school children has been made by Dr. C. J. Thomas and is given on pages 22—27.
Medical
treatment.
The facilities provided by the Council for the medical and dental treatment of school children
have been considerably increased during the year, five new centres being opened and the provision at
many of the existing centres being extended. The number of children who received treatment under
the Council's arrangements was 122,765, as compared with 111,456 in 1916. Details as to the number
of children treated under each class of ailment and of the results of treatment are given on page 27.
Under the arrangements approved for the year commencing 1st April, 1918, authority has been given
for schemes which will provide treatment for some 164,500 children annually.
Re-inepection.
The number of defects noted at primary inspections for treatment or observation coming under
review was 177,742. It was found that in the case of defects requiring treatment 36 9 per cent. of the
cases had received treatment within six months, a falling-off compared with 1916, when the figure was
41.7. 15.2 per cent. of the cases were deemed to be no longer in need of treatment, and in 47.9 per cent,