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36
Warm baths.
With a view to further control, Dr. Francklyn suggests that greater efforts
should be made at early detection; special attention should be paid to "black"
area schools by the school nurses; an educational leaflet to parents might be drawn
up and distributed at the bathing centres; finally, greater and better facilities should
be provided for the treatment of adult workers.
Dr. W. A. Scott, in a survey of scabies in the northern division, draws attention
to the lateness with which many children come under adequate treatment. Such
late cases are attended with severe sores and dermatitis and prove difficult to cure,
whereas early uncomplicated cases are easy to cure. He finds that many cases have
attended voluntary agencies for treatment, which has been quite inadequate, and
has failed because simultaneous disinfection in the homes and sterilisation of clothes
has not been carried out.
Ultimately such children arrive at the bathing stations in a debilitated condition,
with a combination of corrosive burns, scabies, sulphur dermatitis and
pyogenic infection.
Dr. Scott advises that the voluntary hospitals be asked to refer all cases of
scabies immediately upon diagnosis to the Council's |?athing centres. Regular
visiting of all scabies children at the homes by the school nurses is urged, and the
attention of teachers should be drawn to the necessity of referring immediately to
the school nurse or doctor every case where rashes or broken skin are noticed on
the children's hands or other exposed parts.
A scheme by which children attend certain public baths of the Borough Councils
for warm baths has existed for several years. Parties are formed with the consent
of the parents and are accompanied by the school nurse, who excludes any suffering
from contagious disease.
The number of children attending for warm baths during school hours in 1936
was 30,263, compared with 32,007 in 1935.
Chronic invalidity
The school attendance department reports each month the names of children
who have been absent from school for three months or more on account of illness.
Each year the cases on the list for the month of November are analysed, and the result
gives the only index available of the causes of chronic invalidity in childhood.
The subjoined table shows the number of children reported to have been out of
school for more than three months in November, 1936, and comparative figures for
the four preceding years. The reduction in the numbers between 1933 and 1934 is
due to the fact that the majority of the children who are ill for long periods are dealt
with at the Council's special children's hospitals. In 1933 these were recognised by
the Board of Education as hospital schools. The children who are at these hospitals
are therefore no longer accounted " out of school," and no longer appear as in
former years in the returns. This has special reference to tuberculosis and rheumatism.
The number of children (153) absent on account of rheumatism, chorea and
heart disease still forms a very high proportion of the total, and proves how largely
this group of diseases is responsible for ill-health in childhood, especially among girls,
who account for half as many cases again compared with boys. These include
children who are being nursed at home, are in voluntary hospitals or institutions,
and in the Council's general hospitals. Since July, 1935, steps have been taken to
expedite the removal of such children as were in the Council's general hospitals,
where education is not provided, into the hospital schools.
The effect of this is seen both in the reduction of the numbers of rheumatic
children who are not under instruction and the continued decline in the percentage
of chronic invalids suffering from rheumatism, compared with other diseases.
The very considerable decline in the last two years cannot, however, be wholly
ascribed to the larger numbers brought under instruction in hospital schools, but is
due to an appreciable extent to the preventive measures now undertaken to limit
the ravages of acute rheumatism in the elementary school population.