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hospital, and another pupil suffered in August from an attack of appendicitis, from
which she died. It is to be noted that in neither case was the class open when the
girls were taken ill. Dr. Raffle reports it to be an excellently conducted class
on an admirable site, and every effort should be made to retain the class.
The St. James'-park open-air class (girls'), type A. Dr. Danvers-Atkinson has
sent in a very detailed and careful report upon all the children attending this class.
There are medical records of 47 children; in spite of certain difficulties, such as the
distance away of lavatory accommodation, the results were very remarkable.
The gain in health to the children who stayed in the class for the whole period
was manifest. The disappearance of cough and night sweats in pulmonary cases
formed an outstanding feature. The parents who attended the examinations were
unanimous in considering that their children were much benefited by their sojourn
in the class, particularly pointing out how much more bright and alert they were.
Although many children received milk in the class, Dr. Danvers-Atkinson suggests
that each child should automatically be placed on milk, except in cases where it
actively disagrees, and thinks the provision of an oil stove for heating the milk
in cold weather would be an added advantage.
Eleven of the children were simultaneously under observation at the tuberculosis
dispensary; all these improved greatly, and in many the symptoms entirely disappeared.
There is no doubt at all that the results of the open-air classes during the past
year have been exceptionally good, and they have been the means of restoring to
health a number of children of that anæmic and debilitated type which is sometimes
referred to as pre-tubercular.
School
journeys.
No less than 372 school journeys required the services of a medical officer to
inspect the children before leaving. This made necessary the examination of no
less than 12,832 children, of whom 74 or 0.58 per cent. were rejected. The complaints
which caused rejection were mainly minor infectious or contagious conditions,
but there were in addition 4 rejections for heart trouble, 7 for otorrhoea, 2 for
enuresis, 1 for epilepsy and 1 for rheumatism.
The necessity for medical inspection is very pressing in the case of children going
upon school journeys, as the danger of a party being upset by the outbreak of
infectious disease in a strange place is always to be borne in mind. Several
children with tonsilitis and other preliminary symptoms of infectious disease were
detected by the medical officers.
In the case of a party from a "hard of hearing" school, one child fell ill upon
the journey and unfortunately died. It is noteworthy that this child escaped
medical inspection and was included in the party without a medical certificate.
Not only may the excursions be spoilt by the illness of one or two children,
but the expenses of such an illness are rather heavy, and the Government Auditor
during the past year drew attention to certain cases. The conclusion was arrived at
that the authority should only pay the expenses in those illnesses which the medical
officer certified were due to the school journey. This decision is one peculiarly hard
to make, but the moral of the experience gained is that it is better to avoid any
risk, even at the expense of upsetting the parents, than to take the responsibility
of including children in a school journey party who are not in good and
able physical health.
Day open-air
schools.
An additional open-air school for non-tuberculous children was opened in the
autumn at Aspen House, Brixton Hill, and preparations are being made for a further
school of this type overlooking Hampstead Heath.
With Aspen House, the open-air schools in London for non-tuberculous children
number five at present, the others being Stowey House on Clapham Common, Birley
House at Forest Hill, Shrewsbury House at Shooters Hill and Bow Road in the
East End.