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46
The basement children were examined in their schools in company with a double
set of controls. That is, two children not living in basements were compared with
each basement dweller. These control children were selected by the head teacher for
similarity in age and social circumstances, and they were of the same sex as the basement
child. The identity of the basement dweller was not known to the examining
doctor until the examination in the department was completed : 254 basement
children were examined during the investigation and 508 controls.
The inquiry was divided into three parts : medical history, physical examination,
and school history. The latter included an assessment of the child's progress at
school and the regularity of its attendance.
The medical history was obtained from the medical inspection cards,,
supplemented, on occasion, by information obtained from the head teacher, or, in
the case of the older children, by the child itself. This part of the investigation did
not supply data of much value. Basement dwellers do not seem to be more prone to
infectious disease than other children living in the same neighbourhood. One
exception must be made to this statement: the diphtheria incidence amongst children
living'in basements was twice (5.1 per cent.) that amongst the controls (2.5 per cent.).
Of other conditions bronchitis and pneumonia were 14.6 per cent, as compared with
12.4 per cent. in the controls, rheumatism 1.1 per cent., as compared with 0.2 per
cent., whilst a history of affections of the throat and nose was rather more common
(6.1 per cent.) amongst the controls than amongst the basement dwellers (5.5
per cent.).
The physical examination, was directed rather to certain specific points, e.g.,
debility, defective sight, rheumatism, rickets, than to a complete examination. The
majority of the children were weighed and measured and it will be seen that at most
ages the basement child compared unfavourably with its controls. This was more
marked in the case of the older children.
The medical examination showed that basement dwellers were not far behind
non-basement dwellers in cleanliness, but that they were not so well nourished;
35.7 per cent. of the basement children being definitely under-nourished compared
with 19.1 per cent. of the controls. Pallor of the skin or mucous membranes,
indicative of anaemia, was present in 44.1 per cent. of the children living in basements
and in 38.8 per cent. of the controls. Defective vision (less than 6/9 either eye) was
practically the same for the two classes of children—basement 24.4 per cent., controls
24.8 per cent. Throat and nose affections were found in 7.4 per cent. of the basement
dwellers and in 3.3 per cent. of the controls. Symptoms of rheumatism were found
in 2.2 per cent. of the children living in basements and in 0.8 per cent. of the nonbasement
children. In this connection it should be noted that an analysis of the
figures for the children suffering from rheumatism and admitted to Queen Mary'sHospital,
Carshalton, or to High Wood Hospital, Brentwood, show that out of 600
cases 70 (11.7 per cent.) children lived in houses having basements, and of these
41 (6.8 per cent.) actually lived in the basement. Rickets was evenly distributed
between the two classes—7.1 per cent. basement, 7.3 per cent, controls.
The educational inquiry revealed that there were fewer children living in
basements who were making normal progress at school than amongst the children
selected as their controls. The head teachers returned 43.6 per cent. of basement
children and 24.8 per cent. of the controls as definitely backward; 11.8 per cent,
of the basement dwellers and 5.9 per cent. of the controls were irregular in their
attendance at school.
The more important findings of the investigations are set out in the following
tables. In the tables the children have not been divided into sexes or into half-yearly
periods since the system of controls, of the same sex and within a month or two of
the basement child in age, seemed to render this unnecessary.
The statistical findings of the inquiry although showing clearly the disadvantage
which basement dwelling children suffer do not reflect fully the impression which the
examining doctor received throughout its progress. In some areas, e.g., Southwark,
it was possible to pick out four or five of the basement children from their controls.