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the children may do it by marching—four beats or steps to an inbreath, and four to an outbreath—
can be conveniently continued for from two to five minutes. It is better to maintain an easy rhythm
regularly than to attempt records. The object of the exercise is to encourage the habit of filling the
bases of the lungs.
Children need be taught no more. Let them acquire the sense of central expansion, and then
sing gently, sing sweetly, sing always. Greater local control of breathing and fuller voice training can
well be reserved for a later date if the foundation as described above has been truly laid.
Personal hygiene.
Continuous attention has been paid to the problem of improving the condition of the school
children in regard to personal cleanliness. The figures given in the section containing the results of
medical inspection show the steady improvement in this respect which has taken place, and also
demonstrate the need for further effort.
The scheme had been modified in 1917 with a view to speeding up the process of cleansing. The
modifications had the desired effect of bringing pressure to bear in certain cases, but in practice it was
found that the modifications were not sufficiently drastic and that some amendment was necessary.
The following figures show the amount of work done: Number of examinations, 2,031,735;
number found clean, 1,572,339; number found verminous, 459,396; percentage found verminous,
22.6. 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 95,033 in 1918 and 105,639 in 1919. There are now 25
cleansing stations and it is hoped during the present year to complete arrangements for opening an
additional station in the district of Old Ford.
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 seven stations of its own. By these means the Council has made provision for
cleansing children throughout London, but in Fulham, Hammersmith, Lambeth, Lewisham, Paddington,
Deptford, Greenwich, and Hampstead no provision has been made for dealing with adults under the
Cleansing of Persons Act by the borough councils concerned, although the three last-mentioned boroughs
make provision for the cleansing of children. The total number of examinations made by the nurses
under the cleansing scheme proper was 566,178 and 33,222 children were found verminous; of these
15,929 were cleansed by the parents, the remaining children were dealt with at the cleansing stations;
43,752 cleansings were carried out at the Council's stations and 61,887 at stations of the local sanitary
authorities. This number is an increase of 10,606 or 11.2 per cent. when compared with the number
for 1918. The parents of 86 children were prosecuted and fines varying from 2s. 6d. to 10s., with costs,
were imposed. Of the total number of children cleansed 3,468 were conveyed by the Council's motor
ambulance from outlying schools.
The scheme contemplates that at each stage a notice indicating the condition in which the child
is found shall be sent to the local sanitary authority in order that action may be taken with regard
to clothing and bedding in the home, under the London County Council (General Powers) Act, 1904,
Part IV.
In the annual report for 1914 a table was given showing the action taken in the homes by the
local authorities, and it was noted that upwards of 10,000 houses were visited and rooms, or bedding,
or both were disinfected in more than 2,000 cases. Since the outbreak of war, representations were
made that it was impossible to continue to carry out the necessary home visits in a large number of
instances, and the practice of sending out notices in the ' head cases only" was discontinued. Furthermore,
the number of visits has steadily declined, but it is now hoped that the cordial co-operation
obtaining between the Council and the borough councils in 1914 will steadily be re-established, and
even further extended.
Scabies.
Arrangements for bathing children suffering from scabies were continued. The number of
cases dealt with was 8,371, a decrease of 1,253 from the number for 1918. As in the previous year, cases
have come under notice of infection in a family subsequent to a visit from a soldier from overseas. All
cases in school children have been speedilv followed up, and baths were given throughout the summer
holidays. The hospitals and treatment centres closely co-operated with the Council, and the card
referred to in the annual report for 1917 resulted in expediting the arrival of the children at the cleansing
stations and their consequent return to school after the condition had been cured.
Speedingup
of
cleansing
scheme
During the year 1919 the cleansing scheme generally was again under consideration, and the
Children's Care Sub-Committee in January instructed the school medical officer and education officer
to report whether they could suggest any further tightening up of the regulations as to verminous
children. The following is the substance of the report made to the Committee.
Hitherto children who were verminous as regards heads only were in the first place dealt with
under a scheme which served as a preliminary to the main cleansing scheme. Two notices were sent
to the parents and a fortnight's time was allowed for voluntary action before the first notice under the
main scheme was issued. The main scheme was of necessity framed with a view to following in all its
details the procedure as set out under section 122 of the Children Act, 1908. This section empowers
a properly authorised person to convey a child whose person or clothing is infested with vermin or is
in a foul or filthy condition to a cleansing station after 24 hours' notice in writing has been given the
parent or guardian requiring him to effect a thorough cleansing. It should be realised that under this