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93
but steady and persistent labours of the school nurses. The photographs of children
reproduced on pp. 91-92 form a record which shows how striking is the improvement
in appearance, in personal neatness, and in carriage, which has taken place.
Quite definite medical conclusions can be drawn from the photographs referred
to. It must strike everyone that the children in the later photographs are brighter
and more intelligent in appearance, infinitely better cared for and happier looking.
As seen by the medical eye, the following differences are observed.
Taking the group of boys on the foremost page, the earlier photograph presents
great inequality in physical condition, the types ranging from robust to very ill
nourished, while the later photograph shows a set of boys of average nutrition without
any of the inequalities of the former group. Carriage and posture are deplorable in
the earlier photograph, slack and loose postures predominating; in the later photograph
the evidence of physical training is very apparent in the improved carriage
and alert appearance. A very striking medical point is the absence of mouth
breathing in the later group, while in the earlier group two of the nine boys are
mouth breathers.
In the groups on page 92 similar observations can be made.
In the 1894 group grave inequalities in nutrition are apparent, while all the
children but one in the 1924 group appear very well nourished. Carriage and
posture are greatly superior in the later group, and while mouth breathing is common
in the earlier group, it is quite absent in the lower group. In these photographs
also the contrast in strain as shown by the facial muscles is very marked. In the
earlier group there are at least eight children who would at once be called out on
cursory inspection for medical examination, while in the lower group there is only
one.
Taken as a whole the photographs show the attainment in the later groups of a
higher cultural level and the response to the influences making for better care
and improved physique is well illustrated.
The first school nurse was appointed in 1901. At that time ringworm was very
prevalent in the area and accounted for such a large proportion of chronic absence
from school that a nurse was appointed for the sole purpose of following up
children suffering from the disease. She was, in fact, called a "ringworm nurse."
Although the work of the school nurses has now been extended over a wide domain,
the following figures relating to ringworm prevalence testify to the results which
attended the nurses' efforts in the restricted sphere in which the school nurses
were originally employed.
Cases
carried Cures
forward effected
Fresh Cured to new by X-ray.
Year. cases. cases. year. %.
1911 6,214 5,872 2,458 30
1912 5,311 5,131 2,204 37
1913 5,573 5,257 2,277 44
1914 4,449 4,904 1,638 50
1915 3,747 3,928 1,334 47
1916 3,115 3,081 1,232 51
1917 2,814 2,964 992 53
1918 2,639 2,555 979 51
Cases
carried Cures
forward effected
Fresh Cured to new by X-ray.
Year. cases. cases. year. %.
1919 3,447 3,103 1,259 57
1920 3,983 3,856 1,332 56
1921 3,473 3,765 999 61
1922 2,766 2,918 818 65
1923 2,322 2,395 705 69
1924 1,724 1,924 482 70
1925 1,518 1,611 373 71
1926 1,029 1,141 228 76
The deplorable condition of many of the children when the nurses were first
appointed can be judged from a quotation from a report by Dr. J. Kerr, formerly
Medical Officer to the School Board for London, who stated: "When I first went
round London schools in 1902, nearly every school had from 4 to 6 children, the back
of whose heads was crusted with a thick mass of scabs, exudation and lice." That
such conditions are now non-existent may fairly be attributed to the nurses' work
in the schools.
School
nurses and
the cleansing
scheme,
etc.