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56
CHAPTER XXIV.
REPORT OF THE SCHOOL MEDICAL OFFICER (SIR WILLIAM HAMER)
FOR THE YEAR 1922.
Introductory Note.
During the year under review, 1922, many quite exceptional though in some
instances opposing factors were operative in determining on the one hand retardation,
or on the other acceleration, of progress in respect of health conditions in
the London schools. The year opened with a considerable prevalence of infectious
disease in London. In the second week of January the deaths from influenza were
551, and were thus higher than those recorded in any single week for nearly two
years previously. Moreover, prevalence of throat maladies, scarlet fever, and
diphtheria, followed in 1921 at the usual interval of seven years upon the preceding
waves, which had culminated in 1907 and 1914. After attaining the 1921 maximum,
the numbers suffering from these diseases, and particularly from diphtheria, remained
at an unwontedly high level throughout the early months of 1922. The time too,
in the spring of 1922, was ripe for the appearance of the usual periodical measles
wave, and the maximum mortality from this disease (115 deaths) was attained in
the 14th week of the year. Whooping cough was also during the early months of
1922, unwontedly prevalent.
Certain social conditions were unfavourable in 1922. The rise in unemployment,
which had followed upon the coal strike of April-June, 1921, and other trade
disputes later in that year, raised the proportion of unemployed persons to a quite
exceptionally high level in October, 1921 ; and then, after a slight fall in November,
and December, the curve showing unemployment was once more very notably
raised by the engineering lock-out of March to June, 1922, and it remained unprecedentedly
high throughout the year.
Administrative difficulties were, furthermore, accentuated by the fact that,
following upon the report of the Government Committee appointed in 1921 on
national expenditure, detailed consideration was devoted to the possibility of
retrenchment. The main change affecting medical work in the schools was that
consequent on the discontinuance of compulsory day continuation schools to which
reference is made on p. 58. Again, in the first six months of the year there was a
falling off in attendances at the treatment centres, partly due to unemployment,
and partly to other causes referred to later (see p. 69).
Three particularly satisfactory influences remain to be mentioned, which may
clearly be regarded as redeeming the time. Thus, there was notable activity with
regard to " following up " in 1922, in continuation of the progress in this respect
already apparent during immediately preceding years ; in particular, the cumulative
effect of the work at the treatment centres relating to tonsils and adenoids and to
the care of the teeth, was at length becoming unmistakably apparent. As regards
throat operations, the precedent of establishing a hospital as a war memorial was
inaugurated by Lady Henry two years ago in South-East London; and this was
followed by the building by Mr. and Mrs. Kohnstamm of a new hospital in NorthWest
London, which was almost completed at the end of 1922. In the sccond place,
there was decided increase in the rate of progress made in respect to the personal
hygiene of the children ; this was much facilitated by use of the new head cleansing
stations sanctioned in 1921 by the Council, by an improved technique in the cleansing
operation itself, by the abandonment of the objectionable practice of hair cutting,
and by the acquirement of new legislative powers, obtained under the General Powers
Act of last session, which remove difficulties formerly experienced in the work of
cleansing homes and bedding, etc., carried out by borough councils. Finally, during