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The health of the school child
t)Ut1LIC HEALTH THE JOURNAL OF
T H E SOCIETY OF M E D I C A L O F F I C E R S OF H E A L T H . No. 4.
Vol. XLV. JANUARY, 1932.
PUBLIC H E A L T H , the Official Organ o/ the Society o/ Medical Officers o] Health, is prepared receive a certain number o] approved advertisements. Application should be made to the Executive Secretary oJ the Society, at 1, Upper Montague Street, Russell Square, London, W.C.1. Subscription price 31s. 6d. per annum, post ]ree in advance. Single Copies, 2s. 6d. post ]tee. to
Contents. EDITORIAL--
pAGE
SOCIETY O F M E D I C A L
The Health of the School Child
......
97
Council
The British Social Hygiene
......
98
Ordinary
The
Council
London School of Hygiene and Tropical Medicine .. . . . . . . . . . . . . .
Dietic
Investigations
in
AfriCa
......
The 99 100
Meeting Meeting
Yorkshire
The Home The
Welsh
Fever H o s p i t a l P o l i c y a n d M o d e r n T r e a t m e n t .
The
Maternity
The
Maternity (Birmingham
By H . STANLEY BANKS, M.A., M.D., D.P.H., M e d i c a l Superintendent, City of Leicester Isolation Hospital and Sanatorium ; and DUNSTAN BREVCER, M.R.C.S., L.R.C.P.y D.P.H., Medical Officer of H e a l t h , S w i n d o n .........
Ut Ita Dicam. (Being Comments, apropos otherwise, on Sundry Matters) ......... A
122
. . . . . . . . . . . .
Branch
Branch and
Branch
122
.........
125
.........
125
.........
126
. . . . . . . . . . . . Child Welfare
Group
127 ...
127
and Child Welfare Group and Midland Sub-GroupS
127
101
THE LITERATURE OF PREVENTIVE MEDICINE--
and 112
C o u n t y H e a l t h Officer a n d t h e M i l k P r o b l e m . By H. LESLIE CRONK, M.A., M.D., D.P.H., C o u r i t y M e d i c a l Officer of H e a l t h , H a m p s h i r e ...
120
o.f E n g l a n d
The
HEALTH--
. . . . . . . . . . . . . . .
Counties Branch
SPECIAL ARTICLES--
OF
. . . . . . . . . . . . . . . Branch
North-Western
The West
OFFICERS
Cremation in G r e a t B r i t a i n
.........
Your Vision and How to Keep It 114
The
Modern
Treatment
of N a s a l
128 ......
Catarrh
128 ...
128
Editorial. The Health of the School Child. ' T is some twenty-four years since school
I .medical work was begun, and in his annual
report as Chief Medical Officer of tile Board of Education for the year 1930---" T h e Health of the School Child " * - - S i r Geo,rge Newman permits himself to look back now and then and to contrast the conditions and trends of the present with things as they were when the service was first established. Generally he finds evidences of real advance and every reason for congratulation o.n what has been done and for optimism as to the future. Even the school doctor he finds he can encourage, prone as that individual may have been to. despondency and to regard the routine inspection of endless children as monotonous and even so,ul-destro.ying and his job as a blind alley and leading ~'H.M. • S t a t i o n e r y Office.
P r i c e 2s. n e t .
nowhere. T o such as talk thus, Sir George in effect commands a study of his report, bid-. ding them note how " monoto,ny disappears when the wider sco.pe appears; and the hope of a future lies in the expansion of the opportunity, the increased ramifications, and association with a more and more unified public health service." T h r o u g h o u t the repo.rt there appears over and over again a reminder as to. what the doctor is do.ing in the school; what. he is aiming at, and what the whole aim of school inspection is. True, it is terribly gratifying to think of the number of children who have been picked out as suffering from this, that or the o.ther : of some .defect detected that had been overlooked, or might have been overlooked, but for the inspection. Fine, too, to note the number of sick, defective o.r .diseased children cured or remedied. In the earlier days of medical inspection, and in some
98
PUBLIC HEALTH.
quarters even now, such things as these are counted the chief benefits secured by the work and as constituting its triumphs. The worker who can go on regarding them as such and be satisfied with them and with making inspection with, as the ordinary object of his inspections, the collection of masses of figures and facts and the detection of an occasional abnormality as a reward, has failed almost entirely to recognise the vast possibilities of the scheme. As Sir George himself puts it : " The sick child is an individual met with on the journey; we must do all that is practicable for him. But it is the whole body o.f children we are concerned with, well or sick, normal or abno.rmal, every citizen's child." How much is being done for the sick children the report shows. In 1930, for example, when 2,739,297 children were examined, the total number o.f cases of minor ailments, defective vision and other eye defects, enlarged tonsils and adenoids, treated reached 1,197,34 ° . The fact that the numbers are in excess of those for the previous y e a r - - b y 106,798--may be ,due to more careful and complete search for defective children. Or it may be due, as Sir Geo.rge Newman suggests, to the fact that the occurrence of defects is not prevented in the days before school attendance begins. If this is the explanation it is rather distressing, having regard to the vast amount of maternity and child welfare work that is done, the numbers o.f clinics and centres and the multitudes of children who attend them and who. have been weighed and measured and discussed and fed and clothed ' a t cost price or below it. Probably if there had not been the centres the number of defects detected by the school doctors Would have been larger, but the possibility that must be borne in mind is that perhaps the mesh of the maternity and child welfare net, being the first set for the detection .o.f co.nditions that call for prevention, may be too. wide, and that even after all these years of experience there is need for reconsideration and overhauling of the methods. Even though the school medical service has had to devote so much time to dealing with what might be regarded as the failures, of the pre-school scheme, it has found sufficient to do a great deal of good for the children once they passed into. its hands. T h a t all the good has not been the result of medical effort is admitted in the report. To the " non-medical " health services for the child, Sir George Newman is prepared to
JANUARY,
give the fullest credit. Amongst these he includes the parents, for whom he claims that in the twenty-four years, of the school medical service they have shown a remarkable growth in interest and sense of responsibility. Another of the no.n-medical agencies in which there has b e e n i m p r o v e m e n t has been in relalion to nutrition, partly by means of supplementary school feeding and partly by general care of the well-being o.f the child at home and at school. Further, physical exercise and hygiene have helped in the working o.f some of the wonders to which attention is directed in the report. T o physical exercise, on which Sir George has always been very keen, a special section is devoted and, like all that is said with regard to the importance and necessity for teaching of h y g i e n e - - a subject to which Sir George appears to find it necessary, in spite o.f all he has said and do.ne, to return again and again--calls fo.r and will repay close attention. As a fact, there should have been no need for the placing of emphasis on these sections: all of the report calls for and will repay close attention on the part especially, of course, of all education authorities and members of the service, those who are aware of the widening outlook of school medical work as well as those who are still complaining that medical inspection is monotonous and soul-destroying. By others than these the report will be found more than interesting, definitely fascinating indeed, and to justify the use of a title--" The Health o.f the School Child " - - t h a t suggests that it is a dissertation on a specific subject rather than a mere report dealing with work done in a particular period: *
,-R-
*
-R-
.x-
The British Social Hygiene Council. E report o.f the British Social Hygiene T HCouncil for 1930-31 is prefaced by a presidential address by Sir Basil Blackett which sets out very ably the present position with regard to social hygiene, and enumerates those defects in administration which prevent full achievement of the aims and obiects of the Council. It is unfortunate, though true, that m a n y local authorities are still apathetic to the need for public enlightenment in matters relating to sex. Venereal diseases are, after all, but one symptom o.f emotional disharmony, and very early in its career the Council realised that, in order to combat disease, the .deeper underlying causes must be dealt with.
T H E SOCIETY OF M E D I C A L O F F I C E R S OF H E A L T H . No. 4.
Vol. XLV. JANUARY, 1932.
PUBLIC H E A L T H , the Official Organ o/ the Society o/ Medical Officers o] Health, is prepared receive a certain number o] approved advertisements. Application should be made to the Executive Secretary oJ the Society, at 1, Upper Montague Street, Russell Square, London, W.C.1. Subscription price 31s. 6d. per annum, post ]ree in advance. Single Copies, 2s. 6d. post ]tee. to
Contents. EDITORIAL--
pAGE
SOCIETY O F M E D I C A L
The Health of the School Child
......
97
Council
The British Social Hygiene
......
98
Ordinary
The
Council
London School of Hygiene and Tropical Medicine .. . . . . . . . . . . . . .
Dietic
Investigations
in
AfriCa
......
The 99 100
Meeting Meeting
Yorkshire
The Home The
Welsh
Fever H o s p i t a l P o l i c y a n d M o d e r n T r e a t m e n t .
The
Maternity
The
Maternity (Birmingham
By H . STANLEY BANKS, M.A., M.D., D.P.H., M e d i c a l Superintendent, City of Leicester Isolation Hospital and Sanatorium ; and DUNSTAN BREVCER, M.R.C.S., L.R.C.P.y D.P.H., Medical Officer of H e a l t h , S w i n d o n .........
Ut Ita Dicam. (Being Comments, apropos otherwise, on Sundry Matters) ......... A
122
. . . . . . . . . . . .
Branch
Branch and
Branch
122
.........
125
.........
125
.........
126
. . . . . . . . . . . . Child Welfare
Group
127 ...
127
and Child Welfare Group and Midland Sub-GroupS
127
101
THE LITERATURE OF PREVENTIVE MEDICINE--
and 112
C o u n t y H e a l t h Officer a n d t h e M i l k P r o b l e m . By H. LESLIE CRONK, M.A., M.D., D.P.H., C o u r i t y M e d i c a l Officer of H e a l t h , H a m p s h i r e ...
120
o.f E n g l a n d
The
HEALTH--
. . . . . . . . . . . . . . .
Counties Branch
SPECIAL ARTICLES--
OF
. . . . . . . . . . . . . . . Branch
North-Western
The West
OFFICERS
Cremation in G r e a t B r i t a i n
.........
Your Vision and How to Keep It 114
The
Modern
Treatment
of N a s a l
128 ......
Catarrh
128 ...
128
Editorial. The Health of the School Child. ' T is some twenty-four years since school
I .medical work was begun, and in his annual
report as Chief Medical Officer of tile Board of Education for the year 1930---" T h e Health of the School Child " * - - S i r Geo,rge Newman permits himself to look back now and then and to contrast the conditions and trends of the present with things as they were when the service was first established. Generally he finds evidences of real advance and every reason for congratulation o.n what has been done and for optimism as to the future. Even the school doctor he finds he can encourage, prone as that individual may have been to. despondency and to regard the routine inspection of endless children as monotonous and even so,ul-destro.ying and his job as a blind alley and leading ~'H.M. • S t a t i o n e r y Office.
P r i c e 2s. n e t .
nowhere. T o such as talk thus, Sir George in effect commands a study of his report, bid-. ding them note how " monoto,ny disappears when the wider sco.pe appears; and the hope of a future lies in the expansion of the opportunity, the increased ramifications, and association with a more and more unified public health service." T h r o u g h o u t the repo.rt there appears over and over again a reminder as to. what the doctor is do.ing in the school; what. he is aiming at, and what the whole aim of school inspection is. True, it is terribly gratifying to think of the number of children who have been picked out as suffering from this, that or the o.ther : of some .defect detected that had been overlooked, or might have been overlooked, but for the inspection. Fine, too, to note the number of sick, defective o.r .diseased children cured or remedied. In the earlier days of medical inspection, and in some
98
PUBLIC HEALTH.
quarters even now, such things as these are counted the chief benefits secured by the work and as constituting its triumphs. The worker who can go on regarding them as such and be satisfied with them and with making inspection with, as the ordinary object of his inspections, the collection of masses of figures and facts and the detection of an occasional abnormality as a reward, has failed almost entirely to recognise the vast possibilities of the scheme. As Sir George himself puts it : " The sick child is an individual met with on the journey; we must do all that is practicable for him. But it is the whole body o.f children we are concerned with, well or sick, normal or abno.rmal, every citizen's child." How much is being done for the sick children the report shows. In 1930, for example, when 2,739,297 children were examined, the total number o.f cases of minor ailments, defective vision and other eye defects, enlarged tonsils and adenoids, treated reached 1,197,34 ° . The fact that the numbers are in excess of those for the previous y e a r - - b y 106,798--may be ,due to more careful and complete search for defective children. Or it may be due, as Sir Geo.rge Newman suggests, to the fact that the occurrence of defects is not prevented in the days before school attendance begins. If this is the explanation it is rather distressing, having regard to the vast amount of maternity and child welfare work that is done, the numbers o.f clinics and centres and the multitudes of children who attend them and who. have been weighed and measured and discussed and fed and clothed ' a t cost price or below it. Probably if there had not been the centres the number of defects detected by the school doctors Would have been larger, but the possibility that must be borne in mind is that perhaps the mesh of the maternity and child welfare net, being the first set for the detection .o.f co.nditions that call for prevention, may be too. wide, and that even after all these years of experience there is need for reconsideration and overhauling of the methods. Even though the school medical service has had to devote so much time to dealing with what might be regarded as the failures, of the pre-school scheme, it has found sufficient to do a great deal of good for the children once they passed into. its hands. T h a t all the good has not been the result of medical effort is admitted in the report. To the " non-medical " health services for the child, Sir George Newman is prepared to
JANUARY,
give the fullest credit. Amongst these he includes the parents, for whom he claims that in the twenty-four years, of the school medical service they have shown a remarkable growth in interest and sense of responsibility. Another of the no.n-medical agencies in which there has b e e n i m p r o v e m e n t has been in relalion to nutrition, partly by means of supplementary school feeding and partly by general care of the well-being o.f the child at home and at school. Further, physical exercise and hygiene have helped in the working o.f some of the wonders to which attention is directed in the report. T o physical exercise, on which Sir George has always been very keen, a special section is devoted and, like all that is said with regard to the importance and necessity for teaching of h y g i e n e - - a subject to which Sir George appears to find it necessary, in spite o.f all he has said and do.ne, to return again and again--calls fo.r and will repay close attention. As a fact, there should have been no need for the placing of emphasis on these sections: all of the report calls for and will repay close attention on the part especially, of course, of all education authorities and members of the service, those who are aware of the widening outlook of school medical work as well as those who are still complaining that medical inspection is monotonous and soul-destroying. By others than these the report will be found more than interesting, definitely fascinating indeed, and to justify the use of a title--" The Health o.f the School Child " - - t h a t suggests that it is a dissertation on a specific subject rather than a mere report dealing with work done in a particular period: *
,-R-
*
-R-
.x-
The British Social Hygiene Council. E report o.f the British Social Hygiene T HCouncil for 1930-31 is prefaced by a presidential address by Sir Basil Blackett which sets out very ably the present position with regard to social hygiene, and enumerates those defects in administration which prevent full achievement of the aims and obiects of the Council. It is unfortunate, though true, that m a n y local authorities are still apathetic to the need for public enlightenment in matters relating to sex. Venereal diseases are, after all, but one symptom o.f emotional disharmony, and very early in its career the Council realised that, in order to combat disease, the .deeper underlying causes must be dealt with.