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for the year was 98. As noted in previous reports there was a marked variation in the average attendance
from month to month, the lowest being 65 in October, when there was an epidemic of influenza, and
the highest 84 in September. During the year 28 children left the school, of these 9 were returned to
ordinary elementary schools, 8 were excused from attendance after attaining the age of 14 years, (3 left
the district, 2 went to a sanatorium and 3, two of whom were sent to hospital, were excluded by the
medical officer on medical grounds. Careful measurements were taken and the children who attended
throughout, the whole year gained considerably in weight.
Playground
classes.
During the year two classes of type " A, 36 of type "C, and 20 of type "D,' were conducted.
Particulars in regard to these different types have been set out in previous reports. Of the 58 classes,
10 were held in parks or open spaces and the remainder in school playgrounds. Detailed reports have
been received from assistant medical officers upon 21 of the classes. As in former years, it was found
that the children placed in classes of type "C" generally contained a larger percentage of those who are
delicate or dull or backward than is to be found in the remaining classes of the school. This has to be
home in mind when comparisons are made between the progress physically and mentally of the children
in the playground classes and those remaining in the ordinary classrooms. The unanimity of the doctors
in reporting general improvement ir colour and nutrition is complete evidence of the value of the arrangements
made, and clearly shows that the open-air life is a deciding factor in producing physical and
mental alertness in these particular children. Reference to the happier, brighter and more ready response
to stimuli are found in all the reports. The times have been very trying and the progress of the children
has been affected thereby. Particularly disturbing were the waves of influenza prevalence, although
it appears that in the June outbreak the children in the open air classes suffered to a less extent than
those in the ordinary classes. It was again noted that the children from the same school who attended
classes in parks and open spaces did better than those who merely used the playground, the radiant
colouring of the former children when seen at the height of the summer, in spite of the influenza wave,
being quite remarkable. Physical measurements of a similar number of children from the same school
doing their lessons in the park, in the playground and in the school itself, showed a regular gradation in
the weekly increase in weight, the girls attending the class in the park doing best and those meeting
in the school doing worst.
Unfortunately, although making children blighter and healthier, there are limits to the degree
of improvement to be achieved by an open air life. Living in the open air does not itself remove hypertrophied
adenoid growths and tonsils, cure discharging ears or turn a mentally deficient into a normal
child. It is clear from the reports that hopes that even these miracles might be performed, seem to have
been entertained, for some classes were largely composed of children who should properly have been submitted
for statutory medical inspection for entrance to schools for the mentally deficient. Such an
instance is seen in the case of one school where the criterion of selection for the open air class appeared
to consist entirely in backwardness. So many of the children were in reality mentally defective, that
Dr. Morrish, while commenting on the excellent physical results, reports that no corresponding mental
improvement was noticeable and he was obliged to recommend 15 members of the class for statutory
examination. At another playground class it was reported that many defects were present, including
squint, defective vision and enlarged tonsils and adenoids, but unfortunately owing to war conditions,
there had been a cessation of care committee visiting and these defects were not attended to.
Personal Hygiene.
The general inspection of children by the school nurses and the application of the Council's
schemes for dealing with those found in an unclean or verminous condition or suffering from scabies
were continued in 1918. The scheme had been modified in 1917 with a view to speeding up the
process of cleansing. The modifications have had the desired effect of bringing pressure to bear in certain
cases, but in practice it has been found that the modifications are not sufficiently drastic and further
amendments are under consideration.
The following figures show the amount of work done: Number of examinations, 1,921,762;
number found clean, 1,456,154; number found verminous, 465,608; percentage found verminous,
24.2. The number found verminous includes all degrees of unsatisfactory conditions from the case of a
few nits on the hair to cases of head, body and clothing infested with pediculi.
The continuance of war conditions accentuated the need for cleansing work. This is evidenced by
the increase in the number of children brought to the cleansing stations, the average for the years 1913
to 1916 being 45,711 as compared with 80,755 in 1917 and 95,033 in 1918. There are now 25 cleansing
stations and it is hoped during the present year to complete arrangements for opening additional
stations in the districts of Old Ford and Shoreditch.
The Council has entered into agreements with 16 of the 29 local authorities, including the
Cities of London and Westminster, and with two committees for the use of their cleansing stations.
In addition the Council has 7 stations of its own. By these means the Council has made provision
for cleansing children throughout London, but in Fulham, Hammersmith, Lambeth, Lewisham and
Shoreditch, no provision has been made for dealing with adults under the Cleansing of Persons Act by
the borough councils concerned. The total number of examinations made by the nurses under the
cleansing scheme proper was 516,566 and 13,237 children were found verminous ; of these 4,912 were
cleansed by the parents, the remaining children were dealt with at the cleansing stations ; 34,030
cleansings were carried out at the Council's stations and 61,003 at stations of the local sanitary authorities.
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