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of a temporary nature following illness, is not usually manifested for the first time
at adolescence. There is a definite clinical syndrome, easily recognised, in those of
a highly strung nature. The prowess of children showing this syndrome seldom
entitles them to represent their class or school in athletic contests. The healthy
adolescent heart is capable of doing everything demanded of it. Evidence of poor
circulation, mottled skin, blue hands and face, etc., is the most important single
clinical sign of inability for effective adaptation to emotional and physical strain.
Competitive games and athletics, including swimming, are as important for girls
as they are for boys to ensure full development of mind and body along the right
lines. Regulation of the time, quantity and quality of a meal prior to any contest
is necessary. Particularly in swimming competitions there should be close supervision
of the temperature of baths and water, and of the time children are undressed
prior to entry into the water.
Dr. F. C. Lewis, the divisional medical officer, reports as regards his division:—
"The school medical staff have attended most of the swimming galas and
preliminary competitions in the north-eastern division during the past season.
As a result of my own observations and the reports of Dr. Raffle and Dr. Porter,
I should like to offer a few points for your consideration.
The strokes taught by the swimming instructors are varied. They
apparently always commence with the ordinary breast stroke. This is undoubtedly
the best and least exhausting for both boys and girls, but is seldom
used by competitors in the races.
The strokes used are (1) the trudgeon stroke, an overarm stroke with a
scissors action of the legs. This is strenuous as, unless the breathing is properly
taught, there is a tendency for the breath to be held during a short race, either
entirely or partially.
The chest crawl, an over-arm stroke with a fast (optimum, 8 leg strokes
to 2 arm strokes) paddle action of the legs from the knees. This is an extremly
exhausting stroke for young children, and the only cases requiring medical
attention at the competitions were for children under 12 and 13 who had used
this stroke. The reason for the collapse, which in one instance was severe
enough to need strenuous restoratives, was in all cases insufficient aeration,
due to the face (nose and mouth) being practically under the water during the
race when the crawl stroke is used. I may mention that practically all winners
in the competitions, at any rate amongst the boys, used this stroke only, so
that it is obviously the fastest.
What would seem to be indicated is that the crawl stroke certainly (and
possibly the over-arm trudgeon also) should not be allowed to be used in races
in which the competitors are under 12 years old. The strain, both cardiac and
muscular, is too severe to be borne safely by young children, and in view of
the danger of collapse, due to partial asphyxia, it should be prohibited in school
organised competitions before the age of 12. The trudgeon, if more care is
devoted to the proper teaching and management of breathing, is far less objectionable,
as the mouth and nose should be well out of the water as each arm is
brought forward. In a fast crawl this is impossible, the body and face lying
practically prone on the water during the whole of the race.
It was the unanimous opinion of all the school doctors in attendance at these
competitions that the crawl stroke should not be allowed in races for children
under the age of 12."
Health classes.—In many schools children, found by the school doctors to have
postural deformities susceptible of improvement by directed physical exercises, are
formed into special classes which are drilled in appropriate exercises for twenty
minutes each day. Such "health classes" have been established in 34 boys' and
50 girls' departments. As the classes are small it is possible for the teacher to
14172 H
Health
classes.