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With the exception of a slight increase in spinal deformity in girls (1.6 per cent.
as compared with 1.4 per cent. at 12) and a slight increase in hard-of-hearing boys
(0.8 per cent. compared with 0.7 per cent. at 12) the health of the leaving children
is superior at all points to that at any other age. There is much less disease of ear,
nose and throat, less skin disease, less eye disease, and less disease of heart, lungs
and nervous system.
The improved condition of the leaving child is a great tribute to the total effect of
care and training given during the period of school life.
Although much has been done to improve the condition of the children's teeth
and provision has been made through the Council's scheme alone, leaving out the
increase in facilities generally, for the treatment of 120,000 children annually, or about
one in five of all children in average attendance, it is the great prevalence of dental
decay which still, remains the unsolved difficulty. It is doubtful whether provision
of dental treatment, however full and wide it may become, will or can ever solve
this problem. It is the causes and the conditions which produce this almost universal
defect which require to be discovered. Prevention and not dentistry is the sovereign
remedy. The investigation in residential schools organised by the Government
Dental Decay Committee in the hope of solving the riddle will be watched with close
attention, but results can hardly be expected until a generation of school life has
been lived through. Meanwhile the best course to adopt is to prosecute a constant
struggle by the means of modern dentistry in order to confine the ravages of dental
decay within limits.
The control of infectious diseases among school children.
The experience of the school medical service in London has demonstrated
that the control of infectious diseases occurring among children attending school
is best secured by a system of immediate exclusion from school of individual scholars,
who are themselves suffering or suspected to be suffering from illness of an infectious
or contagious character, and of children living in infected houses; the prompt
notification by head teachers of such exclusions to the School Medical Officer and
the Medical Officer of Health of the Borough concerned ; and the investigation
by medical officers of school outbreaks as they arise. As a guide to immediate
action in the matter of excluding individual children from school, head teachers
are provided with a comprehensive handbook setting out the periods of exclusion
required and the general principles or rules to be observed when cases of infectious
disease occur in the school.
School closure as a means of preventing the spread of infection has for long
been abandoned in London, on the ground that such action deprives the school
authority of the essential knowledge of fresh cases as they arise, and of the facilities
for examining other children with a view to ascertaining the existence of suspected or
unrecognised cases which play so important a role in the spread of disease : further, it
is held that in large urban communities school attendance is one of the less important
factors in the dissemination of infection, and that the promiscuous intercourse and
scramble of play in the homes and streets, as well as the presence of unrecognised
cases at crowded assemblies, such as cinemas and other places of amusement, etc.,
provide the chief opportunities for infection. Consequently, no schools have been
closed in London in connection with infectious illness for many years past; on the
other hand, every year large numbers of schools and many thousands of pupils are
specially inspected during local outbreaks affecting school children, with a view to
discovering the sources of infection and excluding children whose attendance might
be a danger to others. The number of special medical inspections and visits to
schools in connection with the prevention of infectious illness during 1925 is set out
in the following pages. Other contributory means of prevention are general attention
to the hygiene and sanitary conditions of the schools. Occasionally, it may become
desirable to disinfect a school during an extensive outbreak, but, generally speaking,