View report page

28
CHAPTER XXIV.
REPORT OF THE SCHOOL MEDICAL OFFICER (DR. W. H. HAMER) FOR THE YEAR 1921.
PART II. (EDUCATION).
Introductory Note.
In the Annual Reports, for 1916 and 1920 reference was made to some of the influences which had
determined the notable decline in the general death-rate in the last forty and in infant mortality in the
last twenty years. The general death-rate and the infant mortality per 1,000 births in London, were,
indeed, lower in 1920, than they had ever been before ; moreover, recently available school re-inspection
results showed that the school children originally found defective, whose defects had been or were being
remedied during 1920, yielded the highest percentage attained up to that time. Of the three records,
two, the first and third, were again broken in 1921 ; as regards the second, infant mortality, however,
there was a very slight set-back last year, the rate just exceeding the low rate of 1920, owing mainly to
the higher mortality from epidemic diarrhoea during the phenomenally hot and dry summer season of
1921.
Taking a broad view it will of course be recognised that these satisfactory figures are the outcome
" of no spasmodic or haphazard efforts and influences, but of many years of steady work. " Results "
we have been told, " should not be too voluntarily aimed at or too busily thought of. They are seen
to float up of their own accord, from a long enough daily work at a given matter." The daily work
in this case was commenced more than half a century ago, and " the work as a mere occupation was a
primary interest " with the Victorian builders, who actually builded even better than they knew.
In a review of more recent progress the statement is made by the author of "The Hygiene of
the School Child " that, " The rapid development of health work in the schools during the last two
decades is not to be regarded merely as an educational reform, but rather as the corollary of a widespread
realisation of the importance of preventive measures in the conservation of natural and human
resources . . . The modern crusade for medical and hygienic supervision of schools, began as a
reflection of the popular interest in matters of health ; it will end by becoming the most effective and
convenient instrument for the attainment of a higher national vitality . . . But," he adds, " we cannot
rely altogether upon the progress of medical science and upon reforms of public health administration.
These measures must be supplemented by a never ending campaign for the enlightenment of the young
in matters of personal and social hygiene. The practice of hygiene in the average home follows far in
the rear of medical discoveries." The correctness of this statement is very well illustrated when
careful examination is made of the slow, but fairly steady improvement, now recorded for a number of
years, in the conditions set out in the table on page 30.
Medical
inspection.
During the year 217,333 children in the age groups were examined by the school doctors in elementary
schools, and, of these, 85,687 were found to require treatment for one or more defects; 38,822
boys and 38,397 girls approaching the age of 14 were examined prior to their admission to day continuation
schools. A further 2,255 children in the age groups were inspected in the special schools and 73,572
children not in the age groups were specially examined. In addition the school medical staff inspected
5,646 children for scholarship awards and 17,305 children in connection with their specific defect in
special schools. A detailed analvsis of results by Dr. C. J. Thomas is given on pages 29—34.
Medical
treatment.
The number of children treated was 212,579 as against 197,700 in 1920. During 1921 children
were sent by arrangement with the Metropolitan Asylums Board to Swanley. At the Cyril Henry
centre where child patients are retained for two days after removal of tonsils or adenoids 2,366 operations
were carried out. Moreover, children from certain centres in west and south-west London are
now conveyed home by motor ambulance.
Be-inspections.
The number ot re-inspections was 175,090. the combined results ot nrst and second re-inspections
showed that 78'2 per cent of the cases reviewed had been dealt with, the highest proportion ever
obtained since the Council undertook the inspection and treatment of children.
Personal
hygiene.
The modifications maae in the cleansing scheme, referred to in tne report of 1920, consisted in
arranging for the treatment of slight cases of head infestation at minor ailment centres instead of at the
ordinary cleansing stations ; in the abandonment of the policy of hair cutting which had given rise to
so much difficulty in the past; and in the use of an improved technique, viz. : a newly devised comb
and an improved shampoo soap, which have proved very efficacious in removing nits without making it
necessary to cut the hair. Moreover, ten new stations for the treatment of slight cases were authorised
by the Council and seven of these were established during 1921.
Further, as the outcome of a conference with representatives of the City and metropolitan borough
councils held in February, 1921, it was decided to apply to Parliament in the session of 1922 with a
view to strengthening the Council's Powers relating to infestation with vermin (including fleas, bugs,
lice and itch mites). There has been material improvement as regards prevalence of scabies. The
results obtained at medical inspections show, moreover, that as regards body lice a notable advance has
been made. There is, however, a definite though small increase in the percentage (more particularly of
girls) found to present nits in the hair. The possible causes of this are carefully examined by Dr. Thomas
on p. 31. The main factors which seem to have been responsible are an increased standard of