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

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London County Council 1937

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

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Table 16.—He.examination of children found "definitely subnormal" or "slightly below normal" at the first test

GroupInterval after which re.examinedDosage of vitamin A administeredCases examinedNumber and percentage
Became normalImprovedNo improvement
Children, Council school, east London.2 weeksHalibut. liver oil 15 drops daily4025 (63)8(20)7(17)
4 „30 (75)9(22.5)1 (2.5)
Negative controls2 „Nil2002(10)18 (90)

Of 92 unselected school children aged 11.14, 20 were found by this method to
be definitely subnormal, and 35 slightly subnormal. After heavy dosage in school
with halibut.liver oil for four weeks, 30 out of 40 subnormal children became normal
and nine improved.
Opportunity was taken by me to correlate the result of Dr. Harris' research
with the administration of milk in school to the children. The results of this correlation
are given below:—
No. of children, 88; No. found normal by Dr. Harris, 38 (43.2 per cent.);
No. slightly subnormal, 30 (34.1 per cent.); No. below normal, 20 (22.7
per cent.).
No. of normal children, 38; No. on doctor's milk, 12 (31.6 per cent.); No.
on voluntary milk (regular), 8 (21 per cent.); No. on voluntary milk
(occasional), 10 (26.4 per cent.); No. not on milk, 8 (21 per cent.).
No. of children slightly subnormal, 30 ; No. on doctor's milk, 3 (10 per cent.);
No. on voluntary milk (regular), 8 (26.6 per cent.); No. on voluntary
milk (occasional), 10 (33.3 per cent.); No. not on milk, 9 (30 per cent.).
No. of children subnormal, 20; No. on doctor's milk, 3 (15 per cent.); No.
on voluntary milk (regular), 5 (25 per cent.); No. on voluntary milk
(occasional), 6 (30 per cent.); No. not on milk, 6 (30 per cent.).
Of those children on doctor's milk, 66.6 per cent. were found by Dr. Leslie
Harris to be normal, while of those not on doctor's milk, only 37.1 per cent. were
found normal.
Children on doctor's milk are those found by the doctor on clinical examination
to be poorly nourished, who receive two bottles (⅔ pint) of milk a day in school.
Children receiving voluntary milk have only one bottle (⅓ pint) a day. Considering
that those upon doctor's milk were clinically found originally to be the least well.
nourished, it may be deduced from these figures that the administration of two.
thirds of a pint of milk in school goes far to protect the children, and the results
justify the practice which the school medical officer has always insisted upon, that
children appearing ill.nourished should have daily two bottles and not one only.
Children's
care
committees
Following.up
The following.up of children found to be in need of treatment or special observation
is carried out by the school care organisation, consisting of upwards of 5,000
voluntary workers aided and supervised by a staff of paid organisers.
The voluntary workers are responsible for acquainting the school doctor with
any particular difficulties with which the family has been contending, such as
unemployment, lack of proper accommodation, or illness, any of which might help
the school doctor in determining the action desirable in any particular case. Such
action may not be confined to medical treatment under the Council's arrangements,
but may require that use be made of other ameliorative channels which are not
always under the Council's supervision.
In this way the Council's school medical service is brought into touch with other
social and medical organisations with undoubted advantages to the children and their
parents.