Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for London County Council]
There is a demand for health instruction on the part of the population over school
age. In the evening schools there are some 250 classes in infant care, health, home
nursing and first aid with over 3,000 pupils. These classes are conducted by selected
There are also 46 courses of lectures provided by the Education Committee
for mothers attending infant welfare centres, with an average attendance of 20 at
Advanced lectures are also given to teachers in the evenings, and the assistant
medical officers who carry out medical inspection of the students in training colleges
assist there with the teaching of hygiene which is a compulsory subject.
Special inquiries and reports.
Certain special inquiries and reports have been included in their appropriate
sections. Reference has been made to Dr. R. H. Simpson's enquiry into the provision
of school dinners (p. 58); Dr. G. Chaikin's enquiry into the effect of milk meals
(p. 55); Dr. E. McVail's joint report with the education inspectors on nursery
schools and classes (p. 78); Dr. A. G. Wells' report on the special aural work
(p. 26) ; and Dr. C. E. Thornton's report on the rheumatism scheme ("p. 33).
Mr. C. Lambrinudi, one of the Council's orthopaedists, has conducted a research
into the incidence and causation of kyphosis in children in London schools. The
schools visited were those in Southwark in close proximity to Guy's hospital. The
results were published in the British Medical Journal of 3rd November, 1934.
Mr. Lambrinudi found that it was common for children in school to possess
short hamstring muscles, that this was more often unilateral than bilateral, and that
in the former there was invariably rotation of the lumbar vertebrae towards the
His conclusions may be quoted in his own words :—
I doubt if any but a few cases of adolescent kyphosis are the effect of congenital causes.
The key to the problem lies in those mysterious fissures in the cartilage plate (of the spinal
vertebrae), which I believe arise from flexion injuries. During the rough and tumble of play
any child might sustain a flexion injury sufficient to produce these fissures, but I believe that
the back of a child whose hamstring muscles are short is more susceptible to traumata of this
nature, particularly if his general musculature is poor on account of previous debility or
overgrowth. I would go even further, and say that not only do short hamstring muscles
predispose to flexion injuries, but that they also give rise to rotation of the vertebrae and
ultimately to scoliosis.
If I have succeeded in convincing you that shortening of the hamstring muscles is an
important factor, then we ought to agree that children with that condition should be watched
with the utmost care and intelligence at school, and that toe-touching exercises in gymnastic
classes should be condemned as a routine practice.
A member of the Education Committee noted that the junior boys in one
Bermondsey school, at which she distributed the prizes, appeared to her to lack
stamina to an exceptional degree which she had not noticed in other schools she had
visited. Dr. Thomas visited the school and agreed with this opinion. The conditions
referred to anaemia and posture rather than to malnutrition. The school
is one that has no playing field within a distance which is within reach of younger
boys. It has been stated in an earlier section of this report (p. 11), that junior
boys are at a critical age, and that many types of defect reach their maximum
Dr. Neustatter, who is the school doctor at the school in question, was asked
to pay special attention to the physique of the boys and he has submitted the
There were four workers—two care committee workers, one nurse and the doctor. The
investigation was carried out in a large room. The doctor sat in the middle with one of the
care committee on his left. The nurse weighed and measured the children, and called out the
weights to the second care committee worker, who sat beside her. She also made a note of the
address of the child and its age.
A class of about thirty was brought up, removed their shoes, but not their clothes, and
were weighed and measured. The children were lined up in such a way that each child
approached the doctor from the front, walking towards him for a distance of about five yards.
This was considered a matter of some importance, as it allowed the doctor to get a good view
of the " tout-ensemble " of the child's bearing, expression, comparative size, etc.