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undoubtedly raised the standard of cleanliness, as is testified by the observation of school nurses and
teachers. A special point is that the local sanitary authorities act in close co-operation with the
Council in taking steps to deal where necessary with any other members of the family. Thus in
28 per cent. of a series of cases reported to the Hammersmith Metropolitan Borough Council, "other
members of the family" were cleansed; in St. Pancras the figure is given as 20 per cent. ; whilst in
Stepney, Battersea and Kensington importance has been laid upon advising the parents and arranging
for disinfestation of bedding or homes.

Work at
cleansing
stations.
The number of cleansings given at cleansing stations proper during the year was 92,024 as compared
with 123,975 in 1920. This decrease in the number of cleansings, not in the number of children
cleansed, is due to the policy instituted at the beginning of 1921 of thoroughly cleansing each child at
one attendance at the stations. In previous years it had been the practice (owing to the difficulty of
eradicating the nits) to arrange for repeated attendances until the child was certified as clean. With
the introduction of the special comb and the use of new shampoo soap (both referred to in previous
reports) it was found that, by devoting a somewhat longer time than hitherto to each child, it was
possible to effect complete cleansing in most instances at the one attendance. The great majority of
children, therefore, now miss one attendance only at school; some exceptions are necessary in the cases
of children suffering from impetigo, which, of necessity requires more prolonged treatment.
Out of 65,084 children whose verminous condition was brought to the notice of the parents, 24,134
attended voluntarily at the cleansing stations, but in 23,989 cases it was necessary to serve statutory
notices after a further examination. Following upon these statutory notices 7,380 children attended the
stations voluntarily, but of the remainder 11,081 were found verminous after a still further examination
and were compulsorily taken by the nurses for cleansing. Among the children who were compulsorily
cleansed 913 were subsequently found to have relapsed and prosecutions under Sec. 122 of the Children
Act were instituted in 833 cases.
It is, perhaps, necessary here to comment upon the increase from 27,409 to 42,595 in the number
of children cleansed at the stations. It was pointed out in the previous report that the work of dealing
with such children was considerably interfered with during the war by the resort to the cleansing stations
of children suffering from scabies. Additional help was provided to cope with the difficulties arising
and more baths were provided, but from the table it appears that although the action taken has at
length reduced the incidence of scabies, the task of dealing with verminous children apart from those
suffering from scabies has been seriously hampered. With the reduction during 1921 in the numbers
of children suffering from scabies, time and accommodation were available for dealing with a large
number of verminous children who were formerly crowded out.
During the year an agreement was made with the Stepney Metropolitan Borough Council for the
use of their cleansing station, and the new cleansing station opened by the Kensington Borough Council
commenced work in August. Agreements were in force with 17 of the local sanitary authorities for the
use of their stations, and also with one voluntary committee, but the station of this last-mentioned
committee was closed at the end of the year.
A new Council station was opened in the Camberwell district in April and it was reserved entirely
for head cases, body cases in that area being dealt with as hitherto at the borough council station. The
number of cases attending at this new station up to the end of the year was 1,926, a figure which is not
included in the total number of cleansings referred to above.
During the year a noticeable reduction occurred in the number of children treated at the cleansing
stations for scabies : whereas in 1920, 9,675 children were thus treated, in 1921 the number fell to 5,863
a decrease of 3,812. The number dealt with is lower than that of any year since 1916 and the reduction
gives rise to the hope that this minor horror (due no doubt largely to contact with soldiers) is now
definitely on the decline.
Co-operation
with local
sanitary
authorities.
As in previous years the practice was continued of notifying to the borough medical officers particulars
of children dealt with under the Council's cleansing scheme in order that where possible the home
conditions might be remedied under the Act of 1904. During 1921 reports were received in regard to
4,882 homes visited ; out of this number disinfestation or destruction of bedding or disinfestation of
homes was carried out in 1,792 instances. In 1920 the corresponding figures were 3,645 homes visited,
action taken in 1,852 cases; whilst in 1919, 3,421 homes were visited and action was taken in 1,650
instances.
Use of public
washing
baths during
school hours.
The scheme for bathing children at certain public baths was continued throughout the year,
but the extensions of the scheme referred to in the last report were not put into operation. The number
of baths arranged for during 1921, was 5,702 in Camberwell and 6,154 in Kensington.