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66
Nutritional
condition.
In 1925 of the children in the three age groups 6.3 per cent. were found to be
under-nourished. In 1926 the percentage was 6.2, in the successive years 1927-9 it
was 5.3, 5.1 and 5.2. The nutritional state of the children has for the past three
years therefore remained steady as a whole, although the result in the year 1929 is
better than appears in this comparison owing to the fact that the 12-year-old age
group, which invariably shews a smaller percentage of under-nourished children
than the 8-years-old group, was smaller this year than usual. In each age group
girls continue to be returned as better nourished than boys. The worst age group
in this respect continues to be the 8-years-old group, amongst whom 6.7 per cent. of
the boys and 5.2 per cent. of the girls were under-nourished.
Cleanliness.
The index which has for many years been taken in London for comparison in
regard to the state of personal hygiene, is the condition of the hair of the 12-yearold
girls. In 1913 only 67.2 per cent. of the older girls were completely free from signs
of verminous infestation. In 1916 and 1917 the percentage had risen in the girls to
70, in 1920 to 75, in 1923 it had climbed to 80, in 1926 to 88.1. In 1927 the percentage
was 89.5 and in 1928 for the first time the 90 per cent. mark was passed, the
percentage being actually 91.5. This percentage has been maintained exactly in
1929.
The improvement in this one respect is to be taken, of course, merely as an
index of all-round general improvement in personal hygiene and care. Infestation
with body vermin, which in the early days of medical inspection was found in 3 to
4 per cent. of elementary school children, has now practically disappeared, being
found in 178 children out of 189, 144 examined in 1929, or in less than one in a thousand.
Sir William Hamer, when he was school medical officer, in the course of his
epidemiological researches caused a record to be kept over many years of the ondition
of the bodies of school children in regard to flea-bites. At his request the
results were lately overhauled and provide convincing collateral testimony to the
great improvement which has taken place in the care and cleanliness of the children
since the institution of the school medical service. In the 14 years to 1922 the
proportion of badly flea-bitten children fell from 30 per cent. to 7 per cent., in 1925
to 4.7 per cent., and in 1926 (the last year for which these records were preserved)
to 3.7 per cent.
Dental decay.
The heaviest burden by far upon the school medical service is the condition of
the children's teeth and this is in its sheer bulk the greatest menace that exists to the
national health It is probable that very many remote sequelae of a most serious
nature, not at first sight obviously connected with the teeth, are due primarily to
dental decay with its accompanying oral sepsis.
The condition of the teeth of the entrant infants continues to give cause for great
concern. In 1929, of the entrant infant boys 46.7 per cent. showed obvious dental
decay and of the entrant infant girls 47.7 per cent. compared with 47 and 48 per cent.
in 1928.
Owing to the extended (but not yet completed) provision made for the dental
treatment of children during school life the dental condition of the older children has
greatly improved in recent years. In 1929, of 12 year old boys 27.1 per cent. and
of 12 year old girls 24.4 per cent. were found by the school doctors with obvious dental
caries compared with 28.3 per cent. and 26.6 per cent. in 1928 and 294 per cent. and
27.7 per cent. in 1927. Each year therefore marks a slight but definite progress.
Altogether since 1913 the sum of improvement is very considerable indeed for in
that year 50 per cent. of 12 year old boys and 47.6 per cent. of 12 year old girls had
obvious dental decay. Improvement in the degree of dental caries is still more
striking. 15.8 per cent. of entrant infants are marked with severe dental caries
(four or more teeth decayed). In 12 year old boys, although 27.1 per cent. are
returned with dental caries, in only 2.5 per cent. is the defect severe, and in girls
with 24.4 per cent. of caries only 1.6 per cent. is recorded as severe. Even when