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153
children, compiled by Dr. Russell, are reproduced here. Dr. Chaikin also contributes
some notes upon the "Lupus" class in connection with the London Hospital.
The number of canal boat children now upon the report of the barge class is
104, a notable increase during the year. Gentle and tactful handling has increased
the confidence of the parents and no doubt is leading to the establishment of more
civilised conditions. It has even been possible to induce some of the parents to be
present at the medical inspections. This was accomplished by special efforts by
the teaching staff, who visited the wharf in person, printed invitations having proved
quite useless owing to the illiteracy of the people. Whereas in the case of asthma
and bronchitis medical treatment is required for the children over a period of some
months great difficulties arise, as although wbile the boat is moored at Paddington
wharf hospital attendance can be secured, so soon as the boat starts on its voyage
treatment is interrupted and may not be recommenced for from 4 to 6 months.
In February the Council's sanction was received for a daily visitation to the
class by the school nurse to carry out the treatment of minor ailments. 471 dressings
have been carried out by the nurse. The nurse's greatest difficulty was to establish
a sufficient degree of cleanliness of the parts affected in order to see what was wrong
before dressing it. Kettles of hot water and small pails were obtained in which
the children steeped their affected limbs or other parts until clean. Amongst the
conditions mentioned were dog bites and especially septic places behind the knees
due to the friction of the towing rope.
Striving after cleanliness in this way has brought home to the children and
their parents the need for personal hygiene and indeed there is a marked improvement
in this direction. The children have become more humanised and the girls now come
to school in tidy overalls and the boys even try to wear a collar, and all brush
their hair.
Vermin still give trouble, but the nurse has persuaded 12 children to go with
her to the cleansing station and one or two mothers have come to the school and
asked to be allowed to take their children voluntarily to the station, so that is a distinct
advance. After much visiting and persuasion 16 children have attended a dental
centre, and we now have about 20 children cleaning their teeth regularly. This
is really rather wonderful because they had never even heard of such a thing as a
tooth brush before.
Of 31 entrants to the class medically examined 4 were suffering from debility,
one from epilepsy, one from tonsils and adenoids, one from congenital eye defect
and one from otorrhea.
A dental inspection was held during the year with the results already detailed.
The results of the medical work are on the whole very satisfactory; both teachers
and nurse have worked with a will and they have gained the confidence of the parents,
a big step with these somewhat primitive people, who are timid of interference and
would be quick to resent it.
Lupus vulgaris, or what is commonly called "lupus," is an afEection of the
skin, caused by the tubercle bacillus, its usual onset being in childhood, very often
attacking one cheek, although not limiting itself to the face, and sometimes
selecting covered parts, in which case it is liable to spread considerably before
attracting attention. Starting with what looks like a pimple, which does not
disappear but persists with some scarring round it, when pressed with and seen
through transparent glass (diascopy) it reveals the presence of parts having the
colour of "apple-jelly" or "barley-sugar" "apple-jelly" nodules or "barleysugar"
bodies of Sir Jonathan Hutchinson Ulceration and spread follow. It
may extend into the nostrils and destroy the cartilage if near the nose, or may
attack the orbit and eye if situated near.
School Medical Inspection has done and can do a great service by early
recognition of the disease and prompt recommendation for treatment—both
Dr. Russell's
report on
canal boat
children.
Dr. Chaikin's
report on the
"lupus"
class.