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The heating of schools
1928.
PUBLIC HEALTH.
pleurisy and haemoptysis. The former is of the greater importance as one finds in dispensary work that slight haemoptysis is not so readily disregarded as it used to be. Altard and Koster show that of 574 cases of pleurisy with effusion, folloxv;ed up over a number of years, no fewer than 47"7 per cent developed puhnonary tuberculosis. Even after dry pleurisy 42 per cent of cases developed lung disease subsequently. The number was much smaller in childhood than after pleurisy in later life; in patients developing pleurisy between the ages of 31 and 35 no fewer than 60"4 per cent afterwards suffered with phthisis. W i t h regard to hmmoptysis, statistics are sufficiently serious to warrant this condition being notifiable. Cabot found that 50 per cent of his cases were due to tuberculosis, whilst Jex Blake gives the figure as 54"6 per cent, and Stueker 77"6 per cent. If, therefore, we could get hold of all cases of pleurisy and hmmoptysis we should most certainly get a large number of patients with early tuberculosis who now escape. The present scheme does not include the treatment of observation and suspect cases. Anmmic and debilitated c h i t d r e n ~ t h e socalled pre-tuberculous--can in some cases be referred to other agencies who, however, find difficulty in providing convalescent treatment of sut~cient duration to do permanent good. W i t h regard to adults, the position is still more . unsatisfactory, and the tuberculosis officer can only examine them at intervals--if they will come for periodic examinations. W i t h regard to contacts, what proportion develop active tuberculosis, or does propinquity result in a larger degree of immunity ? There must now be an" enormous amount of valuable information on these and similar matters buried in dispensary papers which would repay collection, and an investigation of these points would be a great assistance. I am, Yours faithfully, F. J. c. BLACKMORE,
Tuberculosis Officer. Woolwich. January 14th, 1928. T H E H E A T I N G OF S C H O O L S . T o the Editor of PUBLIC HEaL'tin S I R , ~ I t is an unwritten taw that a presidential address shall not be discussed at the meeting at which it is to be delivered, but I feel that the occasion of its printing produces a different set of conditions. The portion of
15~9
the address which I feel must be criticised is that in which our President deals with the heating of schools, starting from tile sentence in which he states " It is necessary to provide a warm surface close to each child, and this can only be effected by floor heating'." W h i l s t agreeing that radiant heat is the only satisfactory form, recent researches, particularly some which have been carried out by Dr. Vernon from the Industrial Fatigue Research Board, have shown that things have progressed very materially beyond the stage of floor heating. Panel heating, as it is termed, is regarded by most people as an entirely new proposition, but it has so far progressed that there are many well-known public buildings in London which are panel heated, such as Bush Building, Devonshire House Flats, and Cook's new of[ices. The system is spreading, and only recently I have seen that some new shops and offices in Brighton are being panel heated. Panel heating is a modification of the Derbyshire system in that hot water is used in large coils of small dimensions buried in the material of the building. These are used largely in tlie floor and the walls. For instance, one of the large hotels in Liverpool is panel heated in the floor of the corridors. Panel heating in the wall has tile game disadvantage as an open fire, viz., the persons close to it receive more than their share of heat, and are at times definitely uncomfortable. In addition to this there is, owing to the situation, a definite proportion of convected heat. Progress from panel heating in the wall has now gone to the ceiling, and bv far the most sarisfactory results are being obtained, in that practically 100 per cent radiant heat is obtained with an extraordinarily even distribution. If panels are inserted in the floor, a n y t h i n g which is put upon them cuts out the radiation in precisely the same way as the umbrella held over the head protects from the radiant heat of the sun. Floor heating h a s t h e disadvantage that it tends to dry the dust, and the finer particles are of necessity carried upwards by the convected currents. Farther, in order to get the necessary temperature in the room, the floor must be uncomfortably hot to the f e e t . Experience has shown that with a floor temperature of over 70° discomfort is liable to occur to the individual, if standing upon it for any length of time.
le0
PUBLIC HEALTH.
There are, at present, two schools built upon open air lines which are panel heated in the ceiling, and at my instigation in ttle early part of this year, Dr. Vernon carried out a series of researches in one of these in order to show what the results of ceiling panel heating in a school really were. I find in discussing this with lay people and even with some doctors, a difficulty in making it understood that the heat descends from the heated ceiling. I have been almost invariably met by the statement that hot air rises, and it takes some time to grasp the fact that heating from the ceiling is entirely radiant and not convected, and that in the open-air school such methods of heating are constant, whereas if heated by convection, immediately the windows are opened the British Thermal Units disappear into space. The system of installing the panels in large buildings is that the pipes are laid on the shuttering, then concrete on the top of that, so that the pipes appearon the under surfaceof the concrete bedded in. The ceiling is then plastered below so that the pipes are completely embedded. It will be understood, of course, that these pipes have to be tested to a very high pressure to ensure the absence of leakage, and also that it is important to have an ample panel area so that a comparatively low temperature from the ceiling" can be maintained, as otherwise if the panel is small, and the temperature has to be correspondingly raised, the ceiling will crack and the decorations will be spoiled. It is important in buildings to insulate the floor above with Kleine bricks, or some such method. The system of panel heating can be edlually well applied to single storeybuildings, and has been done both at Risedale and Doncaster. Recently an improved form of ceiling panel has been devised which can be super-imposed on an existing ceiling and treated as if it were part of the decorative scheme. I have recently been consulted b y the architect who is building what will be the first open-air school for ordinary use in the South of England, and I have advised him to put in ceiling panels as the best method of heating. R o u g h l y speaking, the cost of installation appears to be 30 to 85 per cent higher than an ordinary convecting system of radiators, but the results obtained over a period of running demonstrate that the saving in fuel consumption is 25 per cent per annum as corn-
FEBRUARY, 19~8.
pared with the convecting system. Those who work in the rooms heated in this manner express the opinion that the air is more comfortable with a temperature some 2---4 ° lower than is usually maintained, and the air much more buoyant. This opinionwhich is definitely expressed b y those who are speaking from day to day experience in the schools is not entirely borne out by the strict physiological experiments carried out by Dr. Vernon in the same schools. The full researches into the panel heating by Dr. Vernon and his colleagues will shortly be published by the Medical Research Council in a complete form where members can refer to the results in detail. The ceiling panel seems to produce the ideal condition seeing that, as Dr. Vernon has pointed out, the temperature of the air at head level is slightly less--although the source of heating is in the ceiling--than at the feet, for the temperature of the floor surface is raised 2 ° to 4 ° by the heat radiated from the ceiling. Although the floor heating system introduced by Mr. Widdows, coupled with hot water pipes below the north window as used in the open-air schools, provides a pleasant form of heating together with absence of down draughts as the result of the pipes below the window, I would strongly urge any of my colleagues who are having anything to do with heating systems in schools or otherwise, not to advise the floor heating without further investigations. Dr. Vernon is undertaking" a specific investigation into the Derbyshire system, so that there will be for the first time accurate scientific data as to th.is system as compared with ceiling panel heating'. I am, Yours faithfully, ELWlN H. T. NASH. Chairman of ~he Ideal Classroom Joint Committee. Council House, Hounslow. January 18th, 1928.
GODSTONE Rural District Council have appointed Dr. W . H. Butcher, Assistant Medical Officer of Health, Willesden, as Medical Officer of Health and School Medical Officer, at a salary of $800, rising to ~1,000 a year.
PUBLIC HEALTH.
pleurisy and haemoptysis. The former is of the greater importance as one finds in dispensary work that slight haemoptysis is not so readily disregarded as it used to be. Altard and Koster show that of 574 cases of pleurisy with effusion, folloxv;ed up over a number of years, no fewer than 47"7 per cent developed puhnonary tuberculosis. Even after dry pleurisy 42 per cent of cases developed lung disease subsequently. The number was much smaller in childhood than after pleurisy in later life; in patients developing pleurisy between the ages of 31 and 35 no fewer than 60"4 per cent afterwards suffered with phthisis. W i t h regard to hmmoptysis, statistics are sufficiently serious to warrant this condition being notifiable. Cabot found that 50 per cent of his cases were due to tuberculosis, whilst Jex Blake gives the figure as 54"6 per cent, and Stueker 77"6 per cent. If, therefore, we could get hold of all cases of pleurisy and hmmoptysis we should most certainly get a large number of patients with early tuberculosis who now escape. The present scheme does not include the treatment of observation and suspect cases. Anmmic and debilitated c h i t d r e n ~ t h e socalled pre-tuberculous--can in some cases be referred to other agencies who, however, find difficulty in providing convalescent treatment of sut~cient duration to do permanent good. W i t h regard to adults, the position is still more . unsatisfactory, and the tuberculosis officer can only examine them at intervals--if they will come for periodic examinations. W i t h regard to contacts, what proportion develop active tuberculosis, or does propinquity result in a larger degree of immunity ? There must now be an" enormous amount of valuable information on these and similar matters buried in dispensary papers which would repay collection, and an investigation of these points would be a great assistance. I am, Yours faithfully, F. J. c. BLACKMORE,
Tuberculosis Officer. Woolwich. January 14th, 1928. T H E H E A T I N G OF S C H O O L S . T o the Editor of PUBLIC HEaL'tin S I R , ~ I t is an unwritten taw that a presidential address shall not be discussed at the meeting at which it is to be delivered, but I feel that the occasion of its printing produces a different set of conditions. The portion of
15~9
the address which I feel must be criticised is that in which our President deals with the heating of schools, starting from tile sentence in which he states " It is necessary to provide a warm surface close to each child, and this can only be effected by floor heating'." W h i l s t agreeing that radiant heat is the only satisfactory form, recent researches, particularly some which have been carried out by Dr. Vernon from the Industrial Fatigue Research Board, have shown that things have progressed very materially beyond the stage of floor heating. Panel heating, as it is termed, is regarded by most people as an entirely new proposition, but it has so far progressed that there are many well-known public buildings in London which are panel heated, such as Bush Building, Devonshire House Flats, and Cook's new of[ices. The system is spreading, and only recently I have seen that some new shops and offices in Brighton are being panel heated. Panel heating is a modification of the Derbyshire system in that hot water is used in large coils of small dimensions buried in the material of the building. These are used largely in tlie floor and the walls. For instance, one of the large hotels in Liverpool is panel heated in the floor of the corridors. Panel heating in the wall has tile game disadvantage as an open fire, viz., the persons close to it receive more than their share of heat, and are at times definitely uncomfortable. In addition to this there is, owing to the situation, a definite proportion of convected heat. Progress from panel heating in the wall has now gone to the ceiling, and bv far the most sarisfactory results are being obtained, in that practically 100 per cent radiant heat is obtained with an extraordinarily even distribution. If panels are inserted in the floor, a n y t h i n g which is put upon them cuts out the radiation in precisely the same way as the umbrella held over the head protects from the radiant heat of the sun. Floor heating h a s t h e disadvantage that it tends to dry the dust, and the finer particles are of necessity carried upwards by the convected currents. Farther, in order to get the necessary temperature in the room, the floor must be uncomfortably hot to the f e e t . Experience has shown that with a floor temperature of over 70° discomfort is liable to occur to the individual, if standing upon it for any length of time.
le0
PUBLIC HEALTH.
There are, at present, two schools built upon open air lines which are panel heated in the ceiling, and at my instigation in ttle early part of this year, Dr. Vernon carried out a series of researches in one of these in order to show what the results of ceiling panel heating in a school really were. I find in discussing this with lay people and even with some doctors, a difficulty in making it understood that the heat descends from the heated ceiling. I have been almost invariably met by the statement that hot air rises, and it takes some time to grasp the fact that heating from the ceiling is entirely radiant and not convected, and that in the open-air school such methods of heating are constant, whereas if heated by convection, immediately the windows are opened the British Thermal Units disappear into space. The system of installing the panels in large buildings is that the pipes are laid on the shuttering, then concrete on the top of that, so that the pipes appearon the under surfaceof the concrete bedded in. The ceiling is then plastered below so that the pipes are completely embedded. It will be understood, of course, that these pipes have to be tested to a very high pressure to ensure the absence of leakage, and also that it is important to have an ample panel area so that a comparatively low temperature from the ceiling" can be maintained, as otherwise if the panel is small, and the temperature has to be correspondingly raised, the ceiling will crack and the decorations will be spoiled. It is important in buildings to insulate the floor above with Kleine bricks, or some such method. The system of panel heating can be edlually well applied to single storeybuildings, and has been done both at Risedale and Doncaster. Recently an improved form of ceiling panel has been devised which can be super-imposed on an existing ceiling and treated as if it were part of the decorative scheme. I have recently been consulted b y the architect who is building what will be the first open-air school for ordinary use in the South of England, and I have advised him to put in ceiling panels as the best method of heating. R o u g h l y speaking, the cost of installation appears to be 30 to 85 per cent higher than an ordinary convecting system of radiators, but the results obtained over a period of running demonstrate that the saving in fuel consumption is 25 per cent per annum as corn-
FEBRUARY, 19~8.
pared with the convecting system. Those who work in the rooms heated in this manner express the opinion that the air is more comfortable with a temperature some 2---4 ° lower than is usually maintained, and the air much more buoyant. This opinionwhich is definitely expressed b y those who are speaking from day to day experience in the schools is not entirely borne out by the strict physiological experiments carried out by Dr. Vernon in the same schools. The full researches into the panel heating by Dr. Vernon and his colleagues will shortly be published by the Medical Research Council in a complete form where members can refer to the results in detail. The ceiling panel seems to produce the ideal condition seeing that, as Dr. Vernon has pointed out, the temperature of the air at head level is slightly less--although the source of heating is in the ceiling--than at the feet, for the temperature of the floor surface is raised 2 ° to 4 ° by the heat radiated from the ceiling. Although the floor heating system introduced by Mr. Widdows, coupled with hot water pipes below the north window as used in the open-air schools, provides a pleasant form of heating together with absence of down draughts as the result of the pipes below the window, I would strongly urge any of my colleagues who are having anything to do with heating systems in schools or otherwise, not to advise the floor heating without further investigations. Dr. Vernon is undertaking" a specific investigation into the Derbyshire system, so that there will be for the first time accurate scientific data as to th.is system as compared with ceiling panel heating'. I am, Yours faithfully, ELWlN H. T. NASH. Chairman of ~he Ideal Classroom Joint Committee. Council House, Hounslow. January 18th, 1928.
GODSTONE Rural District Council have appointed Dr. W . H. Butcher, Assistant Medical Officer of Health, Willesden, as Medical Officer of Health and School Medical Officer, at a salary of $800, rising to ~1,000 a year.