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132
Accounts of various special researches made independently by the staff during
the year are given under their appropriate headings. Amongst them are Dr. Nairn
Dobbie's investigation into footrests on school desks (p. 53), Dr. Mabel Russell's
investigation into conditions of sleep of elementary school children (p. 67), an
investigation into the after history of children who have been treated for stammering
by Dr. E. J. Boome and Dr. Nairn Dobbie (p. 80), Dr. Livingston's investigation
into the present condition of children's mouths in regard to oral sepsis and dental
decay (p. 63), an investigation into the progress of myopia under sight-saving
conditions (p. 168), by Dr. Elizabeth McVail, and investigations into the physical
results of attendance at nursery schools also by Dr. McVail (p. 128), and an
analysis of the results of institutional treatment of rheumatic children by
Dr. Nairn Dobbie (p. 81).
Introduction.
Infectious Diseases (Schools).
The school has been so frequently accused of constituting one of the most
important factors in the spread of infectious disorders that it will not be inappropriate
in this report to endeavour to correct a misconception which has for so long
persisted in the public mind. It would be idle to deny that occasionally illnesses
are contracted by children through association with their school fellows, whether in
school or during playtime, or whilst going to and from school, through unrecognised
cases, or thoughtlessness of parents in sending their children to school whilst ailing,
but the risks of infection, induced by the compulsory aggregation of children for the
purpose of school attendance, have been so greatly minimised in recent years by a
well-organised system of medical inspection and supervision, by the increasing
activities of the school nursing service and by a more enlightened understanding
and closer co-operation of the teaching staff in applying modern elements and principles
of preventive control in the schools, that it is now safe to say that the school
child of to-day is more guarded and sheltered from risks of infection whilst actually
in attendance at school than he is in his social and domestic life. The child is compelled
to attend school at the age of 5 years, and many commence their school life
before the compulsory age of attendance, namely at a period when the susceptibility
to many of the infectious ailments is at its highest. This want of immunity is
especially marked during the earlier years of school life, and, ipso facto, it is during
these years that infectious diseases exact their toll; they would do so whether
the children attended school or not, and under modern social conditions of a large
town there is little doubt that the opportunities of infection are far greater out of
school. It must also be borne in mind that children only spend 5 hours of the day
in school, during which time they are under strict supervision.
Teachers are under an obligation to report to the school medical department
every case of exclusion or absence from school on grounds of infection, and these are
reviewed daily by the responsible medical officer, who takes immediate action if
there is the least indication of spread of the more serious infections, such as diphtheria
and scarlet fever, among the children. The classes in the school affected are
medically examined, any suspicious cases are excluded for medical advice and
treatment, the facts are reported to the medical officer of health of the borough for
domiciliary enquiry, and all precautionary measures are taken. The services of
school nurses are utilised in advising the teachers in regard to local outbreaks of the
less important diseases, such as mumps, chickenpox, etc. With regard to measles,
a rigid system of control is exercised whereby, in co-operation with the local sanitary
authorities, every effort is made to prevent the serious complications and mortality
arising during epidemics of the disease, which appear with regularity every two
years. This scheme was fully explained in last year's annual report.
School teachers are provided with handbooks showing the periods for which
children suffering from the various infectious diseases, or living in houses where