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8
At the request of the local branch of the Invalid Children's Aid Association an
attempt is being made to see, as special cases, in Southwark, as many children as
possible on their return to infants' departments after absence for measles.
An analysis of the first hundred cases examined shows that the most constant
sequela is enlargement of the glands of the neck (49 per cent.), next in order comes
unhealthy condition of nose and throat (36 per cent.).
Many of the children suffered from bronchitis or broncho-pneumonia during the
attack, and in 20 per cent, there were signs of bronchial trouble still present on return
to school. Anaemia was also recorded in 20 per cent, of the cases. Nine per cent,
had some trouble with their eyes, such as blepharitis or conjunctivitis, and some of
them suffered from squint.
Ten per cent, were found to be undernourished, while 5 per cent, had otorrhcea,
and 5 per cent, had skin affections such as eczema or herpes.
Sixteen per cent, were recommended for convalescent treatment as the result
of the medical examinations, and 45 per cent, for malt and oil or milk in school. It
is evident that a routine examination of infants on return to school after measles
would be a desirable practice. It is, however, hardly a practicable proposition, as
the examination to be useful must be immediately after the return to school, and the
vast numbers of children suffering simultaneously in London during epidemic periods
makes the task an impossible one.
The reorganisation of schools on the lines of the Hadow Report is progressing
apace. The principal organiser of children's care work, in the section on " followingup
" in this report, discusses the repercussion of this reorganisation upon the care
committee system.
The changes being made have brought new problems for solution in regard to
medical inspection. During the actual period of change there is being experienced
some difficulty in arranging beforehand for the visits of the medical officers, owing to
the uncertainty of the amount of work to be performed in each portion of the reorganised
group of schools. A desire has been expressed by the managers and care
committees of reorganised groups that the same school doctor should visit all the
schools in the group, so that members of each family attending the individual
schools shall all be seen by the same officer. This conflicts with a desire sometimes
expressed that older boys' schools should be inspected by a man, and older girls'
schools by a woman doctor.
In secondary, technical and elder children's special schools, where the majority
of the pupils are above thirteen years of age, the latter desideratum is fairly rigidly
observed, but in elementary schools adherence is given to the policy of the same
doctor for the whole group.
The reorganisation of schools has also given further point to a desire that in
London the incidence of the age groups selected for medical examination should be
altered. At present all school children are inspected (i) on entrance to school, (ii) on
reaching the age of 8 years, (iii) on reaching the age of 12 years, (iv) in the term before
that in which they are due to leave, i.e., on approaching 14 years of age.
The two last examinations are rather crowded together and both fall within the
period spent in the senior schools. It is at the age of eleven that children are selected
to pass to senior schools, including scholarship holders to secondary schools, those
winning places in central schools, and those drafted to senior schools within the
reorganised groups. It would be more convenient if the third age group selected were
at age eleven rather than age twelve. There would be some saving of special examinations
of scholarship candidates, all children with defects would be detected, and
opportunities given for treatment before their final school remove.
The age for transference to special school is seven years. In their recent report
the Board of Education's Special Committee on Defects of Vision suggest that it
would be a great advantage if all children had their eyesight tested at seven years of
age.
It appears, therefore, that it would be a logical scheme to bring the ages of
medical inspection into organic relationship with the educational system by arranging
Sequelae of
measles.
Reorganisation
of
schools.