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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The child stood on the doctor's right, was inspected, and the remaining points in the form
filled in. At the same time, if necessary, the child was referred to the care committee worker
on his left, if milk or convalescence was indicated, for her to take the necessary particulars.
Milk cards were filled in by the care committee worker and signed in a bunch at the end.
Cases for convalescent treatment were referred as specials for the next medical inspection. In
this fashion it was possible to see 240 children in just over two sessions (excluding an hour to an
hour and a half preparing the scheme at the first session), equalling approximately 3J hours
of actual inspection.
In addition to this the headmaster and the care committee had picked out a selection of
particularly unhealthy looking children preparatory to the investigation, who were inspected
by the doctor before the routine examination was made.
The following defects were noted :—
Faces : (i) Pallor—particularly the rather greyish pallor that these children sometimes
suffer from. (Care was taken not to confuse the pallor of anaemia with that of the blond or
red-haired fair-skinned child) ; (ii) A flabby, pasty skin, especially bagginess under the eyes ;
(iii) Expression—note was taken of the two extremes, the dull listless expression on the one
hand, and the rather hectic look on the other ; (iv) Prematurely old and tired faces.
General physique : This was judged by the growth, by the state of the musculature, by
flabbiness, excessive thinness, and/or, stunted growth. Posture was also taken into account.
These descriptions are not very precise, but it is not possible to do more than record a general
impression, which is based on observation of the above points.
For recording purposes some kind of classification was needed. The children were therefore
placed in the following four categories:—
(i) Exceptionally good physique—These cases were boys who were well grown, very
well developed muscularly, had good colour, healthy skins, and an alert bearing. In
popular language they were " A 1."
(ii) Average physique—This comprised children, who, while not as exceptionally well
developed as the others, nevertheless were bright and healthy, and had no obvious defects.
They were quite satisfactory.
(iii) Poor physique—These boys fell short of (ii) in so far as they had one or more of
the defects enumerated above, which made them unsatisfactory.
(iv) Bad physique—These were of such undoubtedly poor physique, that they would
unhesitatingly be recommended for an open-air residential schoool such as Bushy, at a
routine or special inspection.
A record of height and weights was also made, in case some kind of objective record was
needed. Little importance is attached to these findings, which are, however, included for

Table 48.

7 years.8 years.9 years.10 years11 years
Above average weight1041413910141
Below „ „2131516955
Above average height939404615149
Below „ ,,31616171062
Exceptionally good physique1157014
Average physique536313313118
Poor physique6141814860
Bad ,,0535316

Total number of cases showing dental caries, 33 ; anaemia, 46.
N.B. Originally it was only intended to weigh and not to measure. Measuring was
commenced on the second session. Therefore, owing to a certain number of absentees, the
figures for weights and heights do not exactly correspond.
Having classified the physique of the children as shown, an attempt was made to investigate
the underlying factors and to see if anything emerged.
A street analysis was made, but except in one instance, there was no evidence of markedly
uneven distribution of the various groups.