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52
REPORT OF TEE SCHOOL MEDICAL OFFICER (Dr. W. H. HAMER) FOR THE
YEAR 1919.
Introductory Note.
The year 1919 was in certain respects a record year. The hand of war, famine, and epidemic
disease was still outstretched over Central and Eastern Europe, though it is very difficult to assess
with any degree of accuracy the amount of misery and privation prevailing there; on the other hand,
in the two largest aggregations of population—New York and London—the year was one of phenomenally
low mortality. Conditions arising out of the war continued, in large measure, to dominate the
situation throughout the world, though their effect upon death.rates in 1919, was so dissimilar in
the places above referred to.
The experience of the last 70 years, the period, that is to say, in which hygiene and preventive
medicine have made so much progress, shows that following upon a time of conflict and strife there almost
inevitably succeeds what is described as a pacific, but is really a very hypercritical era; at such a
moment, weeping philosophers flourish; and it is agreed, as, for example, was the case after the South
African War, 17 or 18 years ago, that modern civilisation is productive of "physical deterioration";
or, as was the case last year, a cry arises concerning "C 3 populations." At the moment of writing,
Volume I. of the Report of the Ministry of National Service has just appeared, and students of this
lugubrious report, and of the comments made upon it, cannot fail to be impressed with the fact that,
as one of them has recently remarked: "We are apt to find contiguous paragraphs, in which two
statements are set forth: first, that this is the only survey of the physical fitness of the male population
of military age that has ever been made in the history of the country, and next to it, a sentence which
implies that the unsatisfactory state of things which this unique survey reveals is to be attributed to
the effects of modern civilisation." Thus exhibited, the fallacy is sufficiently apparent; none the
less, when objections are pressed, and this or that shortcoming or failure—whether it be obesity, flat.
foot, knock.knee, or hammer.toe—is insisted upon with painful iteration, there is apt to arise in
abnormally impressionable minds a feeling of misgiving. Hence doubtless the strictures of the critic
just quoted, who exclaims, "Imagine a Princess who scolded St. George, and told him in acid tones,
that far finer heroes than he had been treated as the merest hors d'ceuvre by the dragon,"—and, again,
"We need (not less but) more civilisation. The evils that beset us are still the evils that beset the cave
man—dirt, overcrowding, and hunger."
The demand for more civilisation is, at any rate, justifiable, if the question be studied from the
children's point of view; and here, pessimism must stand aside, for steady, although slow, progress
has been made—even during years of war. Thus, taking dirt first, the percentage of children in the
London schools showing freedom from vermin, fairly steadily increased by about 1 per cent. per annum
during the period 1913.17, and it rose in the year 1918.19 at a somewhat accelerated rate, so that in
1919 there was improvement on the pre.war record of about seven per cent. in the case of both boys and
girls; the table given on p. 4, however, makes it clear that much more remains to be accomplished
in this connection. The second test suggested is overcrowding; here, the records are far less reliable
and the statistics relate to adults and children taken together, but, paradoxical as it may seem, in the
face of a serious housing problem and of acute transport difficulties, the available figures show fairly
steady diminution in conditions of overcrowding remediable by law, so far, at any rate, as the great
mass of the population of the County of London is concerned. Turning to the third test, the results
are the most satisfactory of all, for, judging by the number of necessitous children fed, the average for
1919 is only about a quarter of that for the pre.war period. So far, then, as these three criteria are
concerned, the results are good beyond expectation; and there is special justification for laying stress
upon dirt, overcrowding, and hunger, for these conditions are particularly liable to undergo aggravation
during and directly after a war.
But, beyond this, it will be seen that the progress made is far more strikingly apparent when,
taking a longer view, comparison is made between the present time and 50 years ago. Sir Robert Blair,
eight years ago (Annual Report of the Council, 1912, Volume IV:, Education, Chapter XXXIX.), gave
the impressions of a few representative head.masters and head mistresses of the changes that had taken
place within their knowledge in the physical condition of London children. Of the composite photograph,
presented in that report, of London children in the early years after the passing of the Act of
1870, the following glimpses may be given: Mr. E. G. Hardy says: "It was a fairly common sight to
see boys so flea.bitten that one could not place the round end of a lead pencil on any part of the body
without covering marks of punctures." Mr. T. P. Shovelier notes that " The cleansing scheme which
was at first exceedingly unpopular among the parents has had most beneficial results. It required
much patient and tactful handling on the part of both teachers and nurses, as well as the strong backing
of the Council, before the bitter opposition could be overcome." Miss G. E. Brent bears witness to
"The changed attitude of the parents towards these matters. Every teacher in a poor school knows
that only a few years ago we were commonly told by the parents 'to mind our own business' . . .
now both child and parent recognise that it is out first business." Mrs. L. E. White quotes Mr. G. Ricks
as saying as early as 1880, "Taking a survey of the schools as a whole, I have no hesitation in stating
that there is much reason for satisfaction at the general improvement manifested"; and then, speaking for