London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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fact undoubtedly increases the appetite and gusto for food; indeed, the astonishingly large
helpings that the older children will put away, should be seen to be believed. Of the many
benefits this open-air school regime confers on these young developing souls, the sum total of
which is of incalculable value to them, it seems to me that the most important single physical
factor—the sine qua non—is the wholesome and adequate feeding which these hungry
youngsters get.
House open
air sohool.
Dr. J. L. Newman has reported as follows upon Upton House open-air school:—
The number of children on the roll of the school has stood fairly consistently throughout
the year 1934 at about 130. Room could actually be found for some 20 more, but it is fortunate
that the maximum number has not been maintained, since with a margin to spare, there is no
risk of urgent cases being kept waiting.

The defects from which the 130 are suffering are made up as follows—

Infections (styes, boils, otorrhœa)4
Adenitis, cervical7
Lung diseases—
Recurrent coughs, simple15
„ „ with signs of bronchitis16
„ „ with signs of more gross lung damage10
Mediastinal adenitis2
Skeletal defects—
Old tuberculous18
Nervous disorders—
Tuberculosis contacts20
Miscellaneous (anaemia, debility, delicate)33

The 66 children who make up the first four and a half groups in this classification are all
suffering from some defect which is either interfering with their school work and attendance, or
may be expected to do so if curative measures are not undertaken. All have done well, and
even of the ten who show signs of fibrosis of the lung with or without bronchiectasis, none has
given any evidence of that progressive deterioration, and sometimes rapid decline, which is
only too often seen in the out-patient departments of our hospitals.
The group of tuberculosis contacts consists of those who have recently been in an unsatisfactory
state of health, or who are living under bad home conditions from which it is desirable
to remove them as far as possible. None of them has shown any signs of active tuberculosis.
There remains the large group of children, 44 in number, who are suffering from functional
nervous disorders or have been labelled anaemic, debilitated or delicate. These are fundamentally
healthy children, who may be considered under two headings. First there are those whose
home conditions are so prejudicial as to interfere with their education, and, of these, the following
are typical cases:—
P.Q. was nervous, tearful and could not concentrate. No physical abnormality.
Father, suffering from "war neurasthenia," worries her and assaults her mother.
X.Y. was always ailing" and often away from school. No physical abnormality. She
is one of 15 living in a basement flat.
Under the second heading comes a large group of children who are pale, thin or dark under
the eyes, and, although they show no evidence of disease, they are a source of anxiety to parents,
teachers and sometimes even to nurses and physicians. They are easily, often too easily,
labelled anaemic, debilitated and delicate ; and, from their being often spoken of in this way,
the confidence of all concerned in their physical welfare is undermined, and the foundations of
a neurosis are laid. For such children as these, a course at an open-air school is of great value,
since a period of close physical supervision combined with a graph showing a satisfactory gain
in weight is much the best way of demonstrating a real freedom from disease, and at the same
time, it does occasionally allow the diagnosis of debility to be amended to one of organic disease.
Moreover, there is always the educative value of life at such a school as this, for even in these
days of intensive health propaganda, the beneficial and not unpleasant effects of currents of
fresh air, no less than the other items in the regime, have often to be experienced to be believed.
Of the 35 children returned to elementary schools during the year, 32 were of this latter kind,
and the other discharges were made up as follows:—at age of 14, 33 : at parents request, 3;
left district, 4; while 17 were transferred to other special schools, convalescent homes, etc.