AC439(1)COTTENHAM Cottenham Education committee. Annual Report OF THE MEDICAL INSPECTION DEPARTMENT for the year 1912. TOT2 Tottenham Education Committee. ANNUAL REPORT OF THE MEDICAL INSPECTION DEPARTMENT for the year 1912. SCHOOL MEDICAL OFFICER : J. F.Butler-Hogan,M.D., LL.D., Etc. (Died May 28th, 1912). ASSISTANT (later Acting), MEDICAL OFFICER: SOPHIA SEEKINGS, M.D., B.S., D.P.H, Ophthalmic Surgeon: T. W. Letch worth, F.RC.S. School Nurses: A. Inchcoe. B. Wallace. E. Allen. INTRODUCTION. Medical Officer's Department, Municipal Buildings, Tottenham, January, 1913. To the Members of the Tottenham Education Committee. Madam and Gentlemen, Owing to the death of Dr. Butler-Hogan, who had acted as your School Medical Officer for 8½ years, the duty of writing this year's Report has devolved upon me. The keen interest which Dr. Butler-Hogan took in the welfare of teachers and scholars will make his loss long-felt in Tottenham. For myself, I have lost an always courteous, considerate, and kindly Chief, under whom, for these past four years, it has been a pleasure to work. Since the death of Dr. Butler-Hogan in May, 1912, I have acted as School Medical Officer, Miss Hanson, M.D., D.P.H, and Miss King, M.D., D.P.H., having given me assistance in the work of routine medical inspection. Dr. D. C. Kirkhope took up his duties as Medical Officer of Health and School Medical Officer on the 1st January, 1913. 4 I have to acknowledge with much pleasure the help which I have always received from your Teaching Staff, Attendance Officers and School Nurses, and have only to regret that in a year of extra strain and stress it has been impossible to visit in the Schools as much as has been my usual custom. It is pleasant to be able to record the great improvements which the Committee have made in the Schools, improvements which are greatly to the benefit of teachers and children. Some of the objectionable conditions still remaining are structural and impossible of remedy, but a comparison of the list of unsatisfactory conditions given in the Annual Report three years ago with that of 1912, will show what a great deal has been accomplished. I am, faithfully yours, S. SEEKINGS. 5 PART I. General Facts in connection with the District of the Tottenham Education Authority. The Urban District of Tottenham is bounded on the East by Walthamstow in Essex, from which it is separated by the River Lea, on the West by Hornsey and Wood Green, on the North by Edmonton, and on the South by Hackney and Stoke Newington, and has an area of 3033 acres, while its estimated population, at the end of November, 1912, amounted to 141,367. The great majority of the inhabitants belong to the working classes, most of whom are employed in the Metropolis, and journey to and fro daily. The Education Rate for the half-year ending March, 1913, is 1s. 2.53d., which is an increase of 2.08 of a penny upon the corresponding rate last year. A penny rate (for Poor Law purposes) yields £2,165. Water is provided for all the Schools from the Metropolitan Water Board's Mains, and is uniformly of good quality. PART II. SCHOOLS. (A.) Report on School Premises. (B.) Improvements in School Premises effected in 1912. (C.) Arrangements regarding the Provision of Additional Accommodation. 6 (A.) REPORT ON SCHOOL PREMISES. HARRINGAY WARD. WEST GREEN SCHOOL—Boys' Department. Natural Lighting.—In four of the nine classrooms the natural lighting is still unsatisfactory, since the maximum light should come from the left of the scholar and a smaller amount from behind. Seating—The desks are non-adjustable. Cloakrooms.—Insufficient accommodation, both with regard to space and the number of pegs provided. Sanitary Conveniences.—The slate slabs of urinals are corroded and dirty. Girls' Department. Classrooms.—Two classes are held in room No. 8, without screens or partitions. Natural Lighting.—The natural lighting in rooms 1,2,3 and 7 has already been reported as unsatisfactory, since the main illumination is not from the left of the scholar. Heating.—I am glad to note that the heating of rooms 5 and 8, which was reported as insufficient in last year's Report, has been attended to, to the greatly increased comfort of scholars and teachers. Seating.—The desks are of an old type. Cloakrooms.—The cloakrooms are without heating: apparatus. 7 Infants' Department. Classrooms.—Two classes are held in one classroom, without partitions. Natural Lighting.—The natural lighting in Room 1 is still very unsatisfactory, the light coming from behind the scholars. Seating.—The desks in three rooms are non-adjustable. Cloakrooms.—One cloakroom is not provided with heating apparatus. Sanitary Conveniences.—The urinal slabs and cement require scraping and cleaning. WOODLANDS PARK SCHOOL—Boys' Department. Classrooms.—Two classes, separated by movable screens, are held in the hall of this School. Artificial Lighting.—The artificial lighting is unsatisfactory in rooms 2, 3, 5, 6, 7, and 8. I would suggest that two extra gas brackets be fixed in each room. Sanitary Conveniences.—The flushing apparatus is inadequate. Girls' Department. Classrooms.—Movable screens have been provided for the four classes held in the hall of this School. Infants' Department. Sanitary Conveniences.—The paving of the w.c.'s and urinals requires repairing. 8 WEST GREEN WARD. BELMONT ROAD SCHOOL -Senior Mixed Department. Artificial Lighting.—The lights are fixed at too great a height, and the Head Master complains of insufficient gas pressure which renders the general lighting unsatisfactory. infants' Department. Artificial Lighting.—The lighting would be improved if the gas pendants were fixed lower. Cloakrooms.—A clothes peg is not provided for each child. DOWNHILLS SCHOOL—Boys' Department. Classrooms.—Two classes are held in one classroom, without partitions. Ventilation.—The ventilation of two of the large rooms would be improved by the addition of ventilators. Seating.—The desks are not adjustable. Girls' Department. Seating.—The desks are not adjustable. Cloakrooms.—The cloakrooms are crowded, and there is not a clothes peg for each child. Infants' Department. Lavatories.—The lavatory accommodation is not satisfactory, there being only one door for entrance and exit. 9 Junior Mixed Department. As the new building will soon be ready, it is unnecessary to comment on the old. ST. ANN'S WARD. SEVEN SISTERS SCHOOL-Boys' Department. Lighting.—The position of the desks has been altered and the lighting is now satisfactory. Seating.—The desks are not adjustable. Playground.—I wish once more to direct attention to the playground shed; it is inadequate in size and situated in too close proximity to the lavatories and urinals. Sanitary Conveniences.—The urinal flush is not satisfactory. Girls' Department. Classrooms.—Two divisions of a class are held in one classroom, without any partition. Heating.—The heating is by hot water pipes, with the exception of two rooms, where a fire is lighted as well, the heat from the pipes being insufficient. Seating.—The desks have back rests, but are not adjustable, except in Standard 7 room. Cloakrooms.—A clothes peg is not provided for each child. Infants' Department. Seating.—The desks are non-adjustable. 10 Cloakrooms.—There is insufficient accommodation, the children of four classes having to dress in the classrooms. The provision of wire netting prevents the children from throwing materials into the cloakrooms, thus enabling the windows to be opened, and improved ventilation allowed for. STAMFORD HILL SCHOOL—Boys' Department. Classrooms.—Two classes are held in each of three rooms, without partitions. Natural Lighting.—I understand that plans for improving the lighting of rooms 3 and 4, which in our last report was noted as unsatisfactory, are being considered. Ventilation.—The ventilation of rooms 8 (a) and 11 is still unsatisfactory. Seating.—The desks are non-adjustable, and only a small number have back rests. Girls' Department. Seating.—New desks have been supplied to this department. Infants' Department. Ventilation.—The ventilation has on several occasions been found very defective owing to the neglect of proper precautions regarding the opening of the windows and ventilators. ST. ANN'S SCHOOL (Non-Provided)—Boys' Department. Classrooms.—A partition is about to be provided to separate the two classes held in the largest room. 11 Seating.—When the partition is erected in the large room, new desks will be provided. Girls' Department. Classrooms.—A partition has been erected in the large classroom. Classrooms.—The cloakrooms are used as passages. Playground.—The playground is very muddy in wet weather, and should be asphalted ; no covered shed is provided. Infants' Department. Cloakroom.—This is used as a passage for one class. Playground.—The playground is very muddy in wet weather and should be asphalted; there is 110 covered shed. HIGH CROSS WARD. PAGE GREEN SCHOOL—Boys' Department. N atural Lighting.—The desks have been rearranged so that the light fells on the left of the scholars. Seating—The desks are non-adjustable, and the majority of them are without back rests. Girls' Department. Natural Lighting.—Thelighting is quite inadequate, and is from the back instead of from the left; several classes get only borrowed light. To change the position of the desks would improve matters considerably. 12 Artificial Lighting.—In three rooms this is very unsatisfactory ; owing to the gas brackets being placed in wrong positions the light does not reach certain parts of the classrooms. Junior Department. Seating.—The desks are non-adjustable, but most of them have back rests. Playground.—There is a covered shed for the girls, but none for the boys. Infants' Department. Classrooms.—Two classes, without partitions, are held in each of two rooms. Seating.—The desks are adjustable except in two classes, and back rests are provided in all classes except one. EARLSMEAD SCHOOL. -Boys' Department. Classrooms.—Five rooms have two classes in each, and two have movable partitions, and these are low. Natural Lighting.—The natural lighting of most of the classrooms is satisfactory ; in two rooms, however, there is a window directly facing the teacher, and in another a window faces the class. Artificial Lighting.—The artificial lighting is fairly satisfactory, except that the chandeliers are rather too far apart, and the centre of each room is not well lighted. Seating.—A few only of the desks are adjustable. 13 Girl's Department. Seating.—The majority of the desks are not adjustable. Cloakrooms.—A clothes peg should be provided for each child. Infants' Department. Seating.—A small proportion of the desks only are adjustable, but all have back rests. Cloakrooms.—The number of clothes pegs is now sufficient. CROWLAND ROAD SCHOOL. This school consists of three departments, and is thoroughly up-to-date in its construction and equipment. There are cookery and manual training rooms, and a large hall for school meals, with a small room leading out of it for medical inspection. The hall is used for parents and children to wait in when medical inspection takes place, and the children are weighed and measured there. St. IGNATIUS SCHOOL (Non-Provided). This school, which originally accommodated 305 scholars (mixed and infants), has been altered and enlarged by the Managers in accordance with plans approved by the Board of Education. The school now accommodates 465 scholars. The enlargement was completed in August last. HOLY TRINITY SCHOOL (Non-Provided). Cloakrooms.—Two classes are taught in the main room, which is unprovided with a partition. The removal of the galleries is a great improvement. 14 Seating.—The desks are not adjustable. Cloakroom.—The cloakroom is often used as a passage. Playground.—There is no covered shed. Sanitary Conveniences.—These are not satisfactory. MIDDLE WARD. BRUCE GROVE SCHOOL—Boys' Department. Seating.—Some of the desks are non-adjustable, and some are without back rests. Girls' Department Classrooms.—One large classroom is to be divided by a permanent partition. Infants' Department. Playground. —There is no covered shed. COLERAINE PARK SCHOOL—Boys' Department. Classrooms.—Two classes are held in each of two rooms; one room is divided by movable screens, but the other has no division whatever. Artificial Lighting.—The lighting of the hall is most unsatisfactory, as reported last year. Seating.—The desks, with the exception of twenty-five, are fixed and have no back rests. Girls' Department. Seating.—New desks are shortly to be provided. 15 Infants' Department. Heating.—One classroom is insufficiently heated in cold weather. Seating.—The desks in room 1 are not adjustable. PARKHURST ROAD SCHOOL Boys' Department. Classrooms.—Two classes are held in one classroom ; there is no partition. Artificial Lighting—The artificiallighting is still defective in rooms B and G, owing, apparently, to low pressure; the four burners are not sufficient under the circumstances, and the lights are badly placed. Seating.—The desks are not adjustable, but the majority have back rests. Infants' Department. Seating.—The desks are non-adjustable. DOWN LANE SCHOOL. This school was opened in October, 1912, and consists of four departments, manual training and cookery rooms, all under one roof. It is to be regretted that it was not possible to provide either a hall for meals, or a medical inspection room, otherwise the building is constructed and equipped on the most modern lines. THE GREEN SCHOOL (Girls)—(Non-Provided). Classrooms.—Four classes are taught in the principal room without any partitions. 16 MIDDLE CLASS SCHOOL (Girls)—(Non-Provided). Playground.—The playground is much too small and contains no covered shed. LANCASTER1AN SCHOOL—Boys' Department. Natural Lighting.—This is unsatisfactory in room 9 as the light is at the back of the scholars. Heating.—The heating of room 9, which is by a gas stove, is not satisfactory as the gas often blows out. Seating.—The majority of the desks are not adjustable. Girls' Department. Heating.—Room H is heated by gas radiators, which are not satisfactory, as they often blow out and the gas escapes into the room. Seating.—The desks are not adjustable. Sanitary Conveniences.—The flush is not satisfactory. Infants' Department. Natural Lighting.—The close proximity of the Senior School causes the lighting of room 9 to be rather poor. Seating.—The desks are of a very old type. Sanitary Conveniences.—The flush is not satisfactory. ALL HALLOWS' BOYS' SCHOOL—(Non-Provided). Classrooms.—Partitions have been provided in the classrooms. Lavatories.—The location and condition of the wash basins is now satisfactory. 17 ST. PAUL'S SCHOOL (Non=Provided)—Girls' Department. Classrooms.—One classroom has two, and another three classes, screens dividing them. Natural Lighting.—The eight panes of ground glass in the window of the main room should be replaced by clear glass. Heating.—The heating of the large room is insufficient, as reported last year. Playground.—There is no covered shed. Sanitary Conveniences.—The water fittings are defective. Infants' Department. Classrooms.—Two classes, divided by partitions, are held in each of two classrooms. Natural Lighting.—In the main room the light is entirely behind the scholars. Playground.—The plavground is very muddy in wet weather, and should be asphalted ; there is no covered shed. Sanitary Conveniences,—The water fittings are defective. ST. KATHARINE'S SCHOOL (Non-Provided)—Girls' Department. Classrooms.—The largest room is now divided by a wooden partition, which is a great improvement. Classrooms.—One cloakroom is used as a passage. 18 Playground.—The playground, which is shared with the Infants' Department, has no covered shed. ST. FRANCIS DE SALES (Non-Provided)—Mixed Department. Lighting.—The artificial lighting is insufficient in the largest classroom. Cloakrooms.—Additional clothes pegs are needed in the boys' cloakroom. Playground.—The boys' portion of the play ground is very muddy in wet weather, and should be asphalted; there is no covered shed. Infants' Department. Classrooms.—The large room has been divided into two by a wooden screen. Playground.—The playground is very muddy in wet weather and should be asphalted; there is no covered shed. Towels—In most departments the children are encouraged to wash at home rather than at school, but a more frequent supply of clean towels is required in some schools. Cloakrooms.—In most of the old schools the cloakroom accommodation is inadequate, and the lighting and ventilation very bad. In all the new schools hot water pipes are provided. General Cleansing of Schools.—The classrooms are only scrubbed six times a year; it is desirable that this should be done more frequently. 19 Ventilation—The defective ventilation noticed in some of the schools is practically always due to the windows and ventilators being insufficiently opened. The omission to open all windows, ventilators and doors, whilst the children are out at play, so that the rooms may be thoroughly flushed with fresh air, is often noticeable. In some schools the Caretakers are in the habit of closing all the windows directly the children leave, and not opening them until the school re-assembles next day. Sweeping and dusting are carried on with the windows closed, and the consequence is that the atmosphere of the place is anything but fresh the following morning. A great difference is noted where thorough ventilation of the school premises out of school hours is effected. Heating.—I am glad to note that the unsatisfactory conditions as to heating in some of the schools in the very cold weather, reported on last year, are receiving attention. Artificial Lighting.—The artificial lighting in several schools has been improved, but there are others where it is still not very satisfactory. (B.) IMPROVEMENTS IN SCHOOL PREMISES CARRIED OUT DURING 1912. The following works have been carried out in connection with the improvement of School premises :— 20 PAGE GREEN SCHOOL. New sectional heating boiler provided for Senior School. Removal and re-building of a length of wall to Infants playground. SEVEN SISTERS SCHOOL. The whole of the lighting has been re-arranged, and the latest fittings fixed. The old lavatory basins in the Infants' department have been removed, and replaced by eight white glazed basins LANCASTERIAN SCHOOL. Tobin tubes constructed, and two special gas radiators fixed in one of the classrooms in the Girls' department. STAMFORD HILL SCHOOL. Re-building of a long length of the wall to Boys' playground. Gas lanterns fixed on emergency staircase for use of Evening Classes. Panels of one partition in Infants' department taken out and glazed to improve the light. WEST GREEN SCHOOL. Two hot water radiators fixed in one of the classrooms in the Girls' department, and pipes extended in another to give improved heating. CROWLAND ROAD SCHOOL. Removal of a chimney jamb, and fixing of a second gas cooker for free meals. 21 COLERAINE PARK SCHOOL. Removal of old basins,and fixing of eight white glazed ones in two cloakrooms in the Infants' department. Division of room 7 of the Infants' department, by the erection of a glazed partition Conversion of a portion of cookery room into a private room, for use of the Teachers in the Infants' department. WOODLANDS PARK SCHOOL. Additional gas meter fixed to increase pressure of gas in the Senior School. BRUCE GROVE SCHOOL. Erection of a glazed partition in No. 1 room in the Girls' department, dividing the room into two. EARLSMEAD SCHOOL. Erection of glazed partitions in one room in both Infants and Boys' departments, thus making two rooms into four. DOWNHILLS SCHOOL. Laying new lead water service where the old was found to be defective in the Girls' playground. St. FRANCIS de SALES SCHOOL. New connection and drain to sewer in road. Construction of a gully with grease traps for waste from free meals kitchen. 22 DEAF SCHOOL. Internal alterations and decorations to Ashley and Linden Houses, to connect them and adapt them for use of Deaf School. The playshed, new latrines and fence were erected at rear, and the playground was laid out. CLEANSING AND RE-DECORATING SCHOOLS. The following Schools were re-decorated externally and internally during the Midsummer holidays:— Lancasterian Boys' and Girls' School. Coleraine Park School, and St. Francis de Sales School (internally only). The usual annual repairs were done to the playgrounds and heating arrangements. The gutters, gullies, drains and manholes were cleansed and flushed at all the provided Schools. The whole of the glazed brick walls were washed down at Parkhurst Road School. Water taps for fire purposes were fixed in all heating chambers of the provided Schools. During the Christmas holidays, the following Schools were re-decorated internally :— St. Ignatius' School. St. Ann's Infants' School. Woodlands Park Infants' School, and The Private Rooms at Bruce Grove School. 23 (C.) ADDITIONAL SCHOOL PROVISION. The following are particulars of the additional School Accommodation provided :— School. Boys. Girls. Mixed. Infants. Down Lane 400 400 400 436 Coombes Croft Temp'y 96 — — — Culvert Road 500 500 — 520 Risley Avenue 470 470 470 484 Allison Road — — — 200 Amhurst Pk. Temp'y 250 — — — Woodberry Dwn „ — 200 — — Nearing Completion :— Downhills Junior 400 400 — — 24 STATISTICS OF ATTENDANCE. For the 4 weeks ended, Jan. 10th, 1913. PROVIDED SCHOOLS. School. Accommodation. a. On Rolls. Average Attendance. Per Centage. No. of New Scholars Admitted. Left. Refused Page Green BOYS 327 321 309 95.3 6 11 . West Green ,, 436 494 469 94.6 19 20 5 Crowland Road ,, 460 *39 411 93.4 9 21 - Parkhurst Road „ 400 398 375 93.2 4 12 - Stamford Hill ,, 700 726 660 92.5 5 21 10 Coleraine Park ,, 382 353 331 92.4 3 20 - Earlsniead ,, 430 369 352 92 3 8 27 - Bruce Grove „ 560 566 534 91.7 4 13 Seven Sisters ,, 476 497 451 90 2 6 11 Lancasterian ,, 570 587 530 901 9 22 - Woodlands Park ,, 450 555 502 89.9 1 9 18 Downhills ,, 520 576 523 89.4 7 26 - Belmont Junr. „ 400 489 429 86 9 2 9 0 Down Lane „ 400 280 256 85.1 6 14 - Stamford Hill GIRLS 499 620 574 92.7 21 32 - Page Green ,, 358 309 285 92.2 8 15 - West Green ,, 389 459 423 91.9 - 5 - Bruce Grove ,, 484 517 428 913 10 27 3 Crowland Road ,, 460 427 394 91.2 4 17 - Lancasterian ,, 576 594 549 90.8 9 18 - Parkhurst Road „ 400 367 329 90 6 11 10 1 Seven Sisters „ 476 520 469 901 15 18 1 Earlsniead ,, 365 363 335 89.4 1 19 - Downhills „ 420 474 432 89.0 7 19 - Down Lane ,, 400 221 194 88.9 7 6 - Coleraine Park 354 340 306 88.7 4 17 - Woodlands Park ,, 450 568 501 86.2 7 29 3 Belmont Junr. „ 400 430 367 84.7 1 2 - Page Green INFTS. 371 353 311 89 3 18 9 - Down Lane „ 436 363 329 89.1 2 13 5 Crowland Road ,, 500 454 395 88.5 23 14 — Seven Sisters ,, 556 637 559 87.2 4 15 39 Stamford Hill ,, 456 484 423 86.8 4 12 24 Parkhurst Road ,, 460 388 329 86.2 18 9 - Lancasterian ,, 600 605 512 85.9 24 8 - West Green ,, 401 472 377 80 3 20 16 21 Bruce Grove ,, 564 526 408 77.8 19 19 - Earlsniead ,, 298 310 237 77.4 17 10 - Downhills „ 553 596 446 74.4 1 8 - Coleraine Park „ 356 350 248 71.8 14 10 - Woodlands Park ,, 557 682 472 69 6 33 76 39 Belmont Road ,, 436 515 356 69.2 13 16 9 Page Green Jr. MIXED 409 242 226 93.7 4 2 - Belmont Senr. „ 400 329 314 91.8 3 23 - Deaf ,, 40 69 63 88.7 1 4 - Down Lane Junr. ,, 400 373 313 86.4 22 13 2 Downhills Junr. „ 200 241 211 85.9 2 4 8 Coombes Croft ,, 96 117 102 80.8 6 5 - Boys 6511 6650 6132 91 0 99 236 35 Girls 6031 6209 5586 90.5 105 234 8 Infants 6544 6735 5402 80.0 210 235 117 Mixed 1545 1371 1228 89 0 38 51 10 Total 20631 20965 18348 87 4 452 756 170 25 NON-PROVIDED SCHOOLS. School. Accommodation. On Rolls. Average Attendance. Per Centage. No. of New Scholars Admitted. Left. Refused St. Ann's BOYS 175 200 185 92-9 5 1 — All Hallows 238 251 230 92-3 5 5 — St. Paul's GIRLS 147 175 163 931 4 3 — Green „ 182 197 180 92-3 7 2 — Middle Class ,, 147 146 136 91 0 3 6 — St. Katharine's ,, 126 141 129 89-6 — 6 2 St. Ann's ,, 115 136 118 88-7 6 3 5 Holy Trinity INFANTS 92 109 100 91-6 2 2 2 St. Paul's ,, 117 134 123 90 4 — 4 1 St. Francis de Sales,, 113 121 105 89 0 8 47 — St. Katharine's ,, 139 176 148 86 -0 13 3 — St. Ann's ,, 114 146 115 78-7 1 1 19 St. Francis de Sales MIXED 252 257 223 87-1 5 14 — St. Ignatius ,, 450 407 348 83 5 7 17 Boys 413 451 415 92-6 10 6 Girls 717 795 726 91-2 20 20 7 Infants 575 686 591 87-0 24 57 22 Mixed 702 664 571 84-9 12 31 — Total 2407 2596 2303 88-7 66 114 29 TOTALS- Provided Schools 20631 20965 18348 87-4 452 756 176 Non-Provided Schools . 2407 2596 2303 88-7 66 114 29 Total 23038 23561 20651 87'6 518 870 205 Attendance Officers. Mr. H. J. Lewis ,, Cleversly ,, Hurren ,, Goddard ,, Harris ,, Heley ,, Jarvis „ Lyden ,, Nunn ,, Robertson ,, Randall ,, Green ,, Fisher ,. Hardwick Superintendent. Earlsniead, St. Ignatius. West Green and St. Ann's Boys. Coleraine Park, St. Paul's and part of Parkhurst Road. Seven Sisters and Holy Trinity; Downhills and St. Ann's. (Infants). Bruce Grove and Middle Class. Woodland's Park, St. Ann's Girls, and Tottenham Children in Hornsey School. Stamford Hill. Lancasterian, St. Katharine's, Park Lane Boys, and St. Francis de Sales. Belmont Road and St. Francis de Sales. Page Green and Green. Crowland Road, and Tottenham Children attending Craven Park School. Down Lane and Part of Parkhurst Road. 26 PART III. SCHOLARS. GENERAL ARRANGEMENTS FOR MEDICAL INSPECTION OF SCHOOL CHILDREN UNDER SECTION 13 OF THE EDUCATION (ADMINISTRATIVE PROVISIONS) ACT, 1907:— During this year the work of routine medical inspection of entering and leaving scholars has been done by your Acting School Medical Officer, with the assistance of Dr. Hanson, and later of Dr. Kins'. The School Nurses weigh all the o o children who are medically inspected, and fill in on the cards particulars as to age, previous illnesses, and cleanliness. Some 25—30 children are usually inspected in one School session. In some Schools, the accommodation makes it impossible for the examinations to be done on the premises; this is generally to be regretted, as one's visit to the School often affords an opportunity for the examination of other children for various defects. In cases where the examination has to be carried on at some centre, a list of the defects found in the children examined is sent to the Head Teacher, if he or she does not accompany the children. Co-ordination between Public Health and Education Departments :—The following cases were notified to me under the provisions of the Infectious Disease Notification Acts, 1889—1899 :— Scarlet Fever 199 Diphtheria and Membranous Croup 27 Polio-Myelitis 2 Erysipelas 3 27 The following cases were voluntarily notified by Teachers and Attendance Officers during the year:- Measles (and Contacts) 774 St. Vitus Dance 40 Chicken Pox 632 Discharging Ears 10 Whooping Cough 285 Various Skin Diseases 269 Scarlet Fever (and Contacts) 169 Rheumatic Fever 4 Diphtheria (and Contacts) 101 Heart Disease 2 Mumps 137 Tuberculosis. 4 Typhoid Fever 7 Eye Diseases 43 " Sore Throats " 143 "Fits" 3 " Colds " and Bronchitis 73 Pneumonia 5 Influenza 77 "Sickness" 24 " Rash " 16 Various Diseases 60 Ringworm (both varieties) 341 Children excluded owing to Verminous conditions 45 Disease in house 211 Such notifications are of great value, as all cases of Measles, Ringworm, and doubtful cases of Infectious Disease, are visited by the School Nurses, with the help in times of' pressure of the Lady Sanitary Inspectors. Such cases, unless so notified, would not come within the purview of Public Health work, and the timely advice so given, must be fruitful in saving life and preventing spread of infection. I should like to express my appreciation of the way in which all the members of the Public Health Staff have cooperated in every way to promote the sanitation of the Schools and the health of the scholars. 28 220 children have had their bodies bathed and their clothes disinfected at the Council's Disinfecting Station, Markfield Road, and disinfection of the homes from which they came was carried out in 41 cases. The way in which the Teachers have sought for information on matters pertaining to the health of their pupils is exceedingly gratifying, and there is no doubt that the intelligent appreciation on the part of many of them of such points, has been the means of greatly preventing the spread of disease. School Doctors are able to visit the same School at intervals only, and it is therefore for the Teacher who meets the children daily, to realize that he or she cannot be too alert to detect anything physically wrong with them. Children selected for Medical Inspection during 1912: — In accordance with the requirements of the Board of Education, all children entering School for the first time, and all those about to leave School, have undergone routine medical inspection. A total of 4,199 children have been thus dealt with. Some 1,982 children, who were sent by Teachers or Attendance Officers to see whether or not they were fit for School, have been examined at Bruce Castle or at the Town Hall. 1,019 of these children were unfit to attend for longer or shorter periods, and 963 were sent back to School. Many of these children were seen more than once, some, especially those 29 suffering with Ringworm of the Scalp, were seen at frequent intervals, the number of these further examinations amounting to 388. 1,915 other children were examined in the Schools with reference to defects noticed by Teachers, such as defective vision, enlarged tonsils,adenoids, etc., etc. The examination of such children forms a large portion of the general work of Medical Inspection, and, of course, a very large percentage of those thus presented have defects requiring treatment. The total number of children examined amounts to 8,096, and the number of re-examinations to 700. The chief reasons for exclusion were:- Tinea Tonsurans 210 Pertussis 14 Tinea Circinata 36 Varicella 6 Impetigo Contagiosa 40 Bronchitis 10 Eczema 14 Phthisis 18 Scabies 30 Tuberculosis:— Chorea 36 Cervical Glands 8 Rheumatism 18 Skin 2 Morbus Cordis 24 Ankle 2 Eye Diseases 70 Hip 2 Ear Diseases 12 Thigh 1 Epilepsy 13 Dorsal Caries 2 Imbecile 4 Peritonitis 1 Tonsillitis 34 Crippled 4 Empyema 1 Headache 7 Scarlet Fever Peeling 3 Miscellaneous Causes 91 Mumps 6 30 Time occupied by Inspection'. — The average time amounted to 7 minutes. Particulars of the facts disclosed by medical inspection will be found in the appended tables. 31 TABLE A. NUMBER OF CHILDREN EXAMINED CLASSIFIED ACCORDING TO AGE AND SEX. BOYS. No. examined. Years 13-14 Years 14-15 Woodlands Park 77 75 2 Belmont Road (Senior) 66 55 11 do. (J unior) 8 7 1 Earlsniead 46 45 1 Bruce Grove 82 70 12 West Green 65 63 2 Lancasterian 116 107 9 Coleraine Park 66 62 4 Page Green 55 51 4 Parkhurst Road 23 20 3 Downhills 110 101 9 Seven Sisters 60 57 3 Stamford Hill 91 88 3 Down Lane 44 44 — Crowland Road 56 51 5 Coombes Croft 1 1 — St. Ann's 43 37 6 All Hallows - 35 21 14 St. Ignatius (Mixed) 21 19 2 St. Francis 13 13 — Deaf 2 - 2 1080 987 93 GIRLS. Woodlands Park 91 89 2 Belmont Road (Senior) 74 72 2 do. (Junior) 4 4 - Earlsmead 57 55 2 Bruce Grove 83 82 1 West Green 35 33 2 Lancasterian 79 76 3 Coleraine Park 51 50 1 Page Green 60 59 1 Parkhurst Road 58 58 - Downhills 67 64 3 Seven Sisters 78 75 3 Stamford Hill 68 66 2 Crowland Road 55 55 - Down Lane 4 4 — Middle Class 11 7 4 Green 27 27 — St. Ann's 19 18 1 St. Paul's 22 22 — St. Katharine's 10 9 1 St. Francis de Sales 10 9 1 St. Ignatius 12 10 2 975 944 31 32 TABLE A-(continued). No. examined. Years 5-6. Years 6-7. Years 7 and ove INFANTS (Male). Woodlands Park 211 159 29 23 Belmont Road 65 57 7 ] Earlsniead 24 23 1 - Bruce Grove 68 51 15 2 West Green 96 76 17 3 Lancasterian 41 38 3 - Coleraine Park 34 25 7 2 Page Green 77 61 13 3 Parkhurst Road 53 39 11 3 Downhills 83 55 17 11 Seven Sisters 94 68 16 10 Stamford Hill 86 71 14 1 Crowland Road 38 31 6 1 Down Lane 26 18 7 1 St. Katharine's 25 21 3 1 St. Paul's - 23 17 4 2 St. Ann's - 13 4 7 2 Holy Trinity 14 6 8 - St. Francis de Sales 16 8 7 1 St. Ignatius 16 10 5 1 1103 838 197 68 INFANTS (Female). Woodlands Park 188 120 48 20 Belmont Road 73 57 14 2 Earlsmead 22 21 1 - Bruce Grove 46 37 7 2 West Green 108 75 27 6 Lancasterian 46 38 8 - Coleraine Park 49 41 5 3 Page Green 47 32 14 1 Parkhurst Road 50 41 7 2 Downhills 86 57 22 7 Seven Sisters 83 60 16 7 Stamford Hill 63 43 18 2 Crowland Road 26 21 3 2 Down Lane 28 28 - - St. Katharine's 22 10 10 2 St. Paul's 32 24 8 - St. Ann's 18 8 7 3 Holy Trinity 13 8 4 1 St. Francis de Sales 18 12 5 1 St. Ignatius 23 22 1 - .1041 755 225 61 Note. - Where, in proportion to the accommodation at any School, the number of children examined appears small, it must be remembered that the disproportion is accounted for by previous examination held at that school shortly before the beginning of the year under review. 33 TABLE B. CLOTHING AND FOOTGEAR. BOYS. Number examined. Good. Average. Bad. Woodlands Park 77 66 8 3 Belmont Road (Senior) 66 59 6 1 Do. (Junior) 8 4 4 - Earlsmead 46 38 8 - Bruce Grove 82 80 2 - West Green 65 60 5 - Lancasterian 116 101 10 5 Coleraine Park 66 56 7 3 Page Green 55 47 5 3 Parkhurst Road - 23 23 - - Downhills 110 81 23 6 Seven Sisters 60 56 3 1 Stamford Hill 91 69 20 2 Down Lane 44 10 17 17 Crowland Road - 56 50 6 . - Coombes Croft 1 - 1 - St. Ann's 43 40 3 - All Hallows 35 35 - - St. Ignatius 21 12 3 6 St. Francis 13 3 6 4 Deaf School 2 2 - - GIRLS. Woodlands Park 91 88 3 - Belmont Road (Senior) 74 69 4 1 Do. (Junior) 4 4 - - Earlsmead 57 55 1 1 Bruce Grove 83 81 2 - West Green 35 34 1 - Lancasterian 79 69 9 ] Coleraine Park 51 36 10 - Page Green 60 49 6 - Parkhurst Road • 58 38 20 - Downhills 67 52 13 2 Seven Sisters 78 71 4 3 Stamford Hill 68 41 24 3 Crowland Road - 55 37 14 4 Down Lane 4 - 3 1 St. Ann's 19 19 - - St. Ignatius 12 4 6 2 St. Francis 10 4 5 1 The Green 27 23 4 - St. Paul's 22 19 3 - St. Katharine's 10 7 3 - Middle Class 11 10 1 - 34 TABLE B.-(continued). CLOTHING AND FOOTGEAR. INFANT BOYS. Number examined. Good. Average. Bad. AYoodlands Park 211 173 30 8 Belmont Road 65 61 2 2 Earlsmead 24 20 4 - Bruce Grove 68 56 11 I West Green 96 72 22 2 Lancasterian 41 25 9 7 Coleraine Park 34 22 8 4 Page Green 77 31 35 11 Parkhurst Road 53 26 25 2 Downhills 83 59 18 6 Seven Sisters 94 52 35 7 Stamford Hill 86 36 34 16 Crowland Road 38 25 13 - Down Lane 26 9 14 3 St. Ann's 13 8 4 1 St. Ignatius 16 12 4 - St. Francis 16 3 7 6 Holy Trinity 14 14 - - St. Katharine's 25 19 4 2 St. Paul's 23 22 1 INFANT GIRLS. AVoodlands Park 188 166 18 4 Belmont Road 73 70 2 1 Earlsmead 22 20 2 - Bruce Grove 46 38 8 - West Green 108 73 31 4 Lacasterian 46 33 12 1 Coleraine Park 49 25 19 5 Page Green 47 12 23 12 Parkhurst Road 50 25 21 4 Downhills 86 62 20 4 Seven Sisters 83 41 36 6 Stamford Hill 63 42 15 6 Crowland Road 26 18 8 - Down Lane 28 7 15 6 St. Ann's 18 10 7 1 St. Ignatius 23 20 3 - St.. Francis 18 3 7 8 St. Katharine's 22 19 2 1 Holy Trinity _3 9 4 - St. Paul's 32 29 3 - Table C.—AVERAGE HEIGHT (WITHOUT SHOES) AND AVERAGE WEIGHT (WITH CLOTHES). (Anthropometric Committee, 1883). Males. Females. Age last Birthday. Height in inches. Weight in lbs. Height in inches. Weight in lbs. 3 35 312 35 30 4 38 35 38 34 5 41 41.2 40.5 392 6 44 44.4 42.8 41.7 7 46 49.7 455 47.5 8 47 549 46.6 52T 9 49.7 604 48.7 55.4 10 51.8 67.5 51 62 11 535 72 531 . 68 12 . 55 76.7 556 76.4 13 . 57 82.6 57.7 87.2 14 59.3 92 59.8 96.7 15 62.2 . 102.7 60.9 106 35 Table D. HEIGHTS AND WEIGHTS AT DIFFERENT AGES. Boys. Total No. Examined. 13 - 14 14 - 15 No. Examined. Height. Weight. No. Examined. Height. Weight. Inches. Centini. lbs. Kilog. Inches. Centini. Its. Kilog. Woodlands Park 77 75 56.6 143.8 78.3 35 .5 2 55.7 1414 70.7 32 .0 Belmont Road (Senior) 66 55 57.2 145 4 80.3 36.4 11 57.5 146 0 82.4 37 .4 ,, (Junior) 8 7 55.3 140 5 73 4 33 3 1 56 .5 143 5 76.0 34 .5 Earlsmead 46 45 56 .9 144 5 81.5 37 0 1 60.5 153 6 89.5 40 .6 Bruce Grove 82 70 56.8 144.2 80.0 36.3 12 57.6 146 3 82.8 37 .6 West Green 65 63 56.5 143 5 81.6 37.0 2 55.7 141.4 79.7 36.1 Lancasterian 116 107 56.4 143.2 78.4 35 5 9 57.8 146.8 83 6 37.9 Coleraine Park 66 62 56.8 144 2 80.9 36.7 4 56 0 1424 73.7 33. 4 Page Green 55 51 55.7 1414 79.3 36 0 4 56.8 144 3 80.2 36 .4 Parkhurst Road 23 20 57.7 146.5 80.0 363 3 58.1 147.5 83.8 38.0 Downhills 110 101 56.4 143 2 si.i 36 8 9 57.1 145.0 77.6 35. 2 Seven Sisters . 60 57 561 1424 78.5 35.5 3 54.8 1391 75.0 34. 0 Stamford Hill 91 88 54 9 139 4 74.0 33 5 3 60.3. 1531 90.3 41. 0 Crowland Road 56 51 56.7 144.1 80.0 36 3 5 56 3 143 0 76.2 34. 5 Down Lane 44 44 54 6 138.6 76 2 34 .5 - - - - - Coombes Croft 1 1 54.5 138 4 66 .5 301 - - - - - St. Ann.s Boys 43 37 57.4 145.8 82.1 37.2 6 59.7 1515 89 3 40 .5 All Hallows . . 35 21 58.0 147 4 79.3 35"9 14 59 4 150.9 910 41.3 St. Ignatius 21 19 56.4 143 2 79.6 361 - - - - - St. Francis 13 13 54.0 1371 76 3 34 6 - - - - - Deaf School 2 - - - - - 2 58 .5 148.6 89.5 40.6 Table D.-(Continued). Girls. Total No. Examined. 13 - 14 No. Examined. 14 - 15 No. Examined. Height. Weight. Height. Weight. I nches. Centini. lbs. Kilog. Inches. Centini. * lbs. Kilog. Woodlands Park 91 89 57.7 146 .5 84.3 38.2 2 58.0 147 .4 86.2 39.1 Belmont Road (Senior) 74 72 58.4 148.3 86.3 39.1 2 61.2 155 .4 92.2 41.8 ,, (Junior) 4 4 57 2 145 4 79 .0 35 8 - - - - Earlsmead 57 55 57.4 145.8 81.9 37 .1 2 56.7 144.1 78.5 35 . Bruce Grove S3 82 57.4 145 8 82.7 37 .5 1 60 .0 152 .4 84.0 38.1 West Green 35 33 58 2 147.8 83.5 37 .9 2 60. 7 154 .1 93 2 42 3 Lancasterian 79 76 56.7 144 1 80.5 36 .5 3 61.3 155 .7 100.3 45. Coleraine Park 51 50 56.4 143 .2 77.0 34 .9 1 60 .0 152 .4 90. 411 Page Green 60 59 56.1 142 .4 79 .3 36 .0 1 61.5 156 .2 91. 41.6 Parkhurst Road 58 58 57 .0 144 8 80.8 36 .6 - - - - - Downhills 67 64 57.7 146.5 82.0 37.2 3 54.8 139.1 87.0 39 . Seven Sisters . 78 75 57 .4 145 .8 83 .5 37 .9 3 55.6 141.0 70 . 31. Stamford Hill . 68 66 58.1 147 .5 81.7 37 .0 2 61.7 156.7 108. 49 . Crowland Road 55 55 56 5 143 .5 80.2 36 .3 - - - - - Down Lane 4 4 55.1 139 .9 74 2 33 .6 - - _ - - Middle Class . 11 7 56.5 143 .5 78 .3 35 .5 4 59 4 150. 9 88.5 40. Green .... 27 27 57.8 146 .8 84.0 38 1 - - - - - St. Katharine.s 10 9 56.4 143.2 84.2 38 .2 1 58.5 148. 6 83. 37.9 St. Ann.s 19 18 57.6 146.8 80.8 36 .6 1 60 0 152 .4 85 .0 38. St. Paul.s 22 22 59.5 151.1 85.2 38.6 - .- - - St. Francis de Sales 10 9 57 .1 145 .0 87.5 397 1 60 0 152 .4 92 .5 42. St. Ignatius 12 10 56 .3 143. 0 78.2 35 .5 2 59 7 151.6 93. 0 42. Table D.-(continued). Infants-Boys Total No. Examined No. Examined 5 - 6 No. Examined 6 - 7 No. Kx.i mined 7 and over Height Weight Height Weight Height Weight Inches Centini. lbs. Kilog. Inches Centim. lbs. Kilog. Inches Centim. lbs. Kilog. Woodlands Park 211 159 40.6 103.1 38.2 17. 3 29 42. 6 108. 2 42. 0 19.0 23 44.2 112.2 44.2 20.0 Belmont Road 65 57 41 .5 105.4 39 .8 18.0 7 42.8 108.7 41.3 18.7 1 47.0 1193 44.5 20.2 Earlsmead 24 23 41 .4 105.1 40.5 18.3 1 44 .0 1117 40.5 18.3 -. - - - - Bruce Grove 68 51 41 .4 105 .1 39.8 18.0 15 43 .0 109.2 43 4 19.7 2 44 .5 113 0 42 .5 19.2 West Green 96 76 39 .9 103 .3 38 3 17.3 17 41.9 106.4 40 .0 18.1 3 42.3 107.4 42.8 19.4 Lancasterian 41 38 40.7 103 .4 39 7 18.0 3 42 .6 108 2 44 .3 22.0 -- - - - - Coleraine Park . 34 25 40.2 102.1 37 0 167 7 41.6 105.6 41.1 18.6 2 43.7 1109 431 19 .5 Page Green 77 61 40.2 102 .1 37.9 17.1 13 41.8 106.2 40.8 18.5 3 45.4 115.3 48.3 21.9 Parkhurst Road . 53 39 40.9 103 .9 39. 1 17.7 11 42 .6 108.2 42 .1 19.1 3 43.1 108 9 43 3 19 .6 Downhills 83 55 40. 9 103 .9 38.6 17.5 17 43 .4 110.2 41.8 18.9 11 44 .3 112.5 45.0 20 .4 Seven Sisters 94 68 40. 2 102.1 37. 7 17.1 16 42.8 108.7 41.8 18.9 10 42 .0 106.6 43.0 19 .5 Stamford Hill 8(5 71 39. 5 100.3 33 .9 167 14 41.6 105 .6 39.7 18.0 1 42.5 107.9 40.0 18.0 Crowland Road . 38 31 39.3 99.8 38 .1 17 2 6 43 .0 109 .2 41.1 18.6 1 41.5 1054 41 .0 18 6 Down Lane 26 18 39.8 101.1 39 .3 17.8 7 41.3 104 .9 40.8 18.5 1 44 .0 1117 46.0 20.9 St. Katharine.s . 25 21 40. 0 101.6 36.8 16.6 3 41.6 105 .6 39.1 17.7 1 46 .5 1181 45 .5 20.6 St. Paul.s 23 17 40 .3 102 .3 38.6 17.5 4 39 .6 100.6 40.1 18.2 2 48.0. 122.3 56 .2 25 .5 St. Ann.s 13 4 41.4 105.1 38.1 17.2 7 43.8 111 .2 42.6 19.3 2 45 .0 114 3 5l.5 23.3 Holy Trinity 14 6 42 .3 107 .4 42.5 192 8 42.8 108.7 41.9 18.9 - - - - - St. Francis 16 8 40 .1 101.8 39.5 17.9 7 42 .0 107.9 42 .4 19.2 1 44 .0 1117 46 .0 20.9 St. Ignatius 15 10 39 .4 100. 1 37.8 17.1 5 41.7 105.8 39.8 18.1 1 46 .0 116.8 55 .0 25 .0 Table D.—(continued). Infants—Girls Total No. Examined 5 — 6 No. Examined 6 — 7 No. Examined 7 and over No. Examined Height Weight Height Weight Height Weight Inches Centim. lbs. Kilog. Inches Centim. lbs. Kilog. Inches Centim. lbs. Kilog. Woodlands Park 188 120 40.7 103 .4 37.9 17.2 48 42.6 108.2 41.2 18.7 20 45 4 115.2 45.6 20.7 Belmont Road 73 57 41 .2 104 .6 38.4 17.4 14 42 .1 106 9 39.4 17.9 2 447 1135 437 19.8 Earlsmead 22 21 40 0 101.6 39 5 17.9 1 45 .0 1143 46.0 20.9 - — — — Bruce Grove 4li 37 41.5 105.4 39.8 18.0 7 44 .0 111.7 45.8 20.8 2 44 2 112.2 45.5 20.6 West Green 108 75 39.6 100.5 37 .2 16.9 27 41.8 106.2 39.9 18.1 6 42 4 107.7 43.5 19.7 Lancasterian 4(5 38 40.2 102.1 37. 5 17.0 8 42.0 106.6 41.4 18.7 - — Coleraine Park . 49 41 39 .9 101 .3 35 .3 16.0 5 41.8 106.2 36 .4 16.5 3 42 0 106 .6 44 3 20. 0 Page Green 47 32 40.1 101 .8 37 .1 16.8 14 42 .0 106 .6 40 .4 18.3 1 42 0 106 .6 40 0 18.1 Parkhurst Road . 50 41 40.0 101.6 37.7 17.1 7 40 .3 102 .3 38 .3 17.3 2 47.0 119.3 51 5 23 .4 Downhills 86 57 40.8 103 .6 37.8 17.1 22 43.6 110.7 42.7 19.3 7 44.5 113.0 43 2 196 Seven Sisters 83 60 40 .3 102.3 37 6 17.0 16 41.7 105.9 39 .0 17.7 7 45.8 116 .3 46.2 20.9 Stamford Hill 63 43 40 .2 102.1 37.1 16.8 18 41.4 105 .1 38 .6 17. 5 2 44 2 112.2 42.2 19.1 Crowland Road . 26 21 40 .0 101.6 36 1 16 .3 3 41.5 105.4 37 .0 16.7 2 44.5 113.0 47 0 21 .3 Down Lane 28 28 39 .4 100.1 38.9 17 .6 - - - - . St. Katharine.s . 22 10 41 .2 104.6 37 .3 16.9 10 4.2.2 107 .2 40.2 18.2 2 437 111.0 40.5 18.3 St. Paul.s 32 24 40.8 103 .6 36 .5 16.5 8 42.2 107.2 37 .5 17.0 — — — - - St. Ann.s 18 8 41.7 105.9 40 .5 18.4 7 43.7 111.0 43.1 19 5 3 45 6 115.8 46 3 210 Holy Trinity 13 8 40.7 103 4 40.3 18 .3 4 41.7 105.9 42.8 19.4 1 36 5 92.7 39.5 17.9 St. Francis 18 12 39 .9 101.3 39 .1 17.7 5 41.4 105.1 38.9 17.6 1 42 "5 107 .9 42. 0 19.0 St. Ignatius 23 22 40 .3 102.3 37 .9 17. 2 1 44. 0 111.7 43 .0 19.5 — —.. — — — TABLE E. SHOWING THE CONDITIONS FOUND ON EXAMINATION OF THE CHILDREN ATTENDING THE VARIOUS SCHOOLS. Boys. No. Children Examined. Mai-Nutrition. Verminous. Want of Cleanliness. Carious Teeth. Tonsils & Adenoids requiring Treatment. Defective Speech. Enlarged Glands. External Eye Disease. Defective Vision. Ear Disease. Defective Hearing. Morbus Cordis. Lung Disease. Tuberculosis. Infectious Diseases. Other Diseases. Total No. of Children with Defects other than Carious Teeth. Head. Body. Woodlands Park 77 1 - - - 27 2 1 - 1 9 1 2 1 - - - 5 15 Belmont Rd. (Senior) 66 - - - 31 2 - 2 3 9 2 - i - - - 3 12 Do. (Junior) 8 1 - - - 4 - - - - 2 1 - - - - - .- 3 Earlsmead 46 - - - - 19 - - - - 7 - 1 - - - - 4 11 Bruce Grove 82 2 - - - 25 2 1 - 2 13 - - o 1 - - 7 21 AVest Green 65 2 - - - 28 2 - - 2 6 1 1 - - - - 4 10 Lancasterian 16 2 1 - 1 43 3 - - - 17 - - 1 1 1 - 2 26 Coleraine Park 166 1 - - - 22 3 1 2 1 8 - - - - - 1 2 14 Page Green 55 2 - - - 22 2 1 1 1 9 - - - - - - 3 14 Parkhurst Road 23 - - - - 11 1 1 2 - - - - - - - - - 3 Downhills 10 2 - - 1 38 3 3 - 1 14 3 2 2 - - - 9 23 Seven Sisters 160 2 - - - 30 1 3 - 2 9 - - 2 1 - - 2 12 Stamford Hill 91 3 1 1 8 39 2 3 1 4 8 - - 1 2 - - 10 20 Down Lane 44 4 - - 3 16 1 - 1 - 9 1 1 - - - - 2 12 Crowland Road 56 - - - - 19 1 1 - 2 12 - - 1 - 1 - 3 16 Coombes Croft 1 - - - - - - - - - - - - - - - - - - St. Ann's 43 - - - - 16 1 1 - 1 7 2 - 2 - - - 4 13 All Hallows 35 - - - - 18 1 - 1 1 7 1 1 - - - - 2 10 St. Ignatius 21 1 - - 2 13 1 - 3 - 2 - 3 - - - - 3 4 St. Francis de Sales 13 2 - 1 - 8 1 - 2 - 2 - - - - - - 1 4 Deaf 2 - - - - 1 - 2 - - 1 1 2 - - - - - 2 Totals 1080 25 2 2 15 430 29 18 15 21 152 13 13 13 5 3 1 66 245 Percentages 2. 3 .2 .2 1.4 39.8 2.7 1.6 1.4 1.9 14.0 1.2 1.2 1.2 .4 .2 .09 6.1 22.6 Table E.-(continued). Girls. No. Cliildren Examined. Mai-Nutrition. Verminous. Want of Cleanliness. Carious Teeth. Tonsils & Adenoids requiring Treatment. Defective Speech. Enlarged Glands. External Eye Disease. Defective Vision. Ear Disease. Defective Hearing. Morbus Cordis. Lung Disease. Tuberculosis. Infectious Diseases. Other Diseases. Total No. of C'hildren with Defects other than Carious Teeth. Head. Body. Woodlands Park 91 - - - - 34 2 1 2 - 20 - 1 2 - - - 4 23 Belmont Rd. (Senior) 74 - — - — 26 5 2 - 4 12 2 2 1 — — - 10 24 Do. (Junior) 4 - — - — 3 - - 1 - - - 1 - — — - 1 2 Earlsmead 57 5 — - — 26 3 1 2 3 12 — - 2 1 — - 3 16 Bruce Grove 83 2 — - — 41 1 - 1 2 14 - - 3 — 1 - 3 18 West Green 35 2 — - — 14 1 - — 1 7 — — — — — 1 9 Lancasterian - 79 3 3 - 1 33 6 2 - 1 12 - - 2 2 — - 4 19 Coleraine Park 51 7 - - 1 13 1 - 1 2 3 2 - 1 - 1 - 3 9 Page Green 60 7 2 - 4 27 2 - 3 3 14 1 - 2 - — - 4 15 Parkhurst Road 58 5 - - - 19 4 2 1 3 10 - - 2 — — - 2 13 Downhills 67 1 - - - 29 2 - - 11 2 - 2 - — — 2 15 Seven Sisters - 78 2 - - 1 32 4 1 1 2 7 - 1 - - — — 3 17 Stamford Hill 68 1 - - 1 20 1 - 2 1 10 1 - 1 1 2 — 4 15 Crowland Road 55 6 - - - 18 2 - 2 2 8 - - - - - — 4 12 Down Lane 4 — — — — 2 — — — — — — — — — — — — 2 Middle Class - 11 - - - - 5 1 - 1 - - 1 1 1 - - - - 3 The Green 27 1 - - - 7 1 1 - - 5 - - 1 - - 3 8 St. Ann's 19 - - - 9 1 - 1 - 5 - - 1 - - 3 9 St. Paul's 22 - - - - 7 2 - 1 1 2 - 1 - 1 2 7 St. Katharine's 10 - - - - 2 1 - - 2 5 - - - 1 - - 2 6 St. Francis de Sales 10 - - - - 4 1 - - - 3 - 1 - - - - 1 3 St. Ignatius 12 2 2 7 2 1 3 Totals Percentages - 975 44 4 5 5 '5 - 10 l'O 378 387 43 4'4 10 10 19 1-9 27 2'7 163 16'7 0 *9 8 '8 21 21 5 *5 5 '5 - 59 6 0 248 25'4 Table E.-(continued). Infants. No. Children Examined Mai-Nutrition Verminous Want of Cleanliness Carious Teeth Tonsils & Adenoids Requiring Treatment Enlarged Glands External Eve Disease Defective Vision Ear Disease Defective Hearing- Speech Morbus Cordis j Lung Disease Tuberculosis Infectious Diseases Other Diseases Total No. of Children with Defects other than Carious Teeth Head Body Woodlands Park (Hoys) 211 8 - - 3 80 12 11 6 8 4 2 4 3 6 1 1 7 41 „ „ (Girls) 188 5 2 - 1 72 9 11 3 3 3 3 1 2 3 1 - 3 30 Belmont Road (Boys) 65 - - - - 15 3 3 3 2 1 - - 3 2 - 1 4 12 „ „ (Girls) 73 - - - - 17 3 8 3 1 - - - 1 1 - - 4 11 Earlsmead (Boys) 24 - - - 5 1 - 2 2 - - - - 2 - 2 3 7 „ „ (Girls) 22 1 - - 5 2 4 2 2 - - - 1 - 2 3 7 Bruce Grove (Boys) 68 - - - •26 7 6 - - 2 2 1 2 3 4 1 4 18 „ „ ((iirls) 46 - - 21 - 4 - 1 1 2 1 - 1 - - 1 4 11 West Green (Boys) 96 2 2 - 6 31 11 9 3 3 2 1 2 5 1 - 7 22 „ „ (Girls) 108 4 2 - •2 24 4 6 9 6 3 - 1 2 2 - - 5 •23 Lancasterian (Boys) 41 3 - - 1 13 3 8 1 _ 1 1 - - 3 - - 2 5 „ „ ((iirls) 46 1 - - 14 1 -- -- 1 - 1 - - 2 6 Coleraine Park (Boys) 34 2 - - I 14 2 •2 - - 1 . 1 - 2 1 1 '2 : 7 „ „ ((iirls) 49 6 - - 1 13 3 2 1 - 1 - 1 2 _ - ' 1 .7 Page Green (Boys) 77 3 2 - 4 27 5 5 3 1 1 - - 1 2 - - ' 4 11 „ „ (Girls) 47 3 3 - 3 9 3 4 - - 1 -. - - 2 1 - 1 3 8 Parkhurst Road (Boys) 53 2 1 - - 15 3 2 1 1 1 - 1 2 1 - 2 10 „ „ ((iirls) 50 4 1 1 1 12 4 - 3 1 2 1 - 3 1 4 10 Downhills (Boys) 83 6 - - 43 4 6 1 - 1 4 1 2 4 2 5 16 „ „ ((iirls) 86 10 - - _ 29 3 6 1 1 1 1 - 4 3 - 1 4 14 Seven Sisters (Boys) 94 5 1 1 2 •28 7 5 5 3 3 1 1 •2 5 1 6 24 „ „ ((iirls) 83 9 1 1 4 31 5 2 5 4 1 2 1 - 4 • 4 16 Stamford Hill (Boys) 86 2 2 - 1 20 5 6 4 •2 1 1 - 1 4 2 1 6 19 „ „ ((iirls) 63 1 2 - 3 •20 2 10 1 1 1 - 1 2 - - 3 10 Crowland Road (Boys) 38 1 1 - 2 11 2 1 2 1 1 2 - 2 2 2 6 „ „ ((iirls) •26 3 - - 1 10 ,2 - 1 1 - i _ _ 1 1 - - - 2 6 Down Lane (Boys) 26 '2 - 3 3 2 - 1 - - - - 2 1 4 „ „ ((iirls) 28 - . 2 - 4 2 2 2 1 •2 4 St. Katharine's (Boys) 25 2 - - - 7 1 2 1 1 1 -. 1 - - - - .- 5 „ „ ((iirls) 22 1 - -- - 2 1 2 1 1 •2 5 St. Paul's (Boys) 23 1 - .- - 5 4 4 1 1 - - - 1 - - 2 7 „ „ ((iirls) 32 1 - - - 4 4 3 - - - - - - - - :- 4 St. Ann's (Boys) 13 1 - - - . 8 1 2 1 1 1 1 - 1 - 1 1 4 „ „ ((iirls) 18 2 - - 1 10 1 1 2 2 Holy Trinity (Boys) 14 7 2 2 „ „ ((iirls) 13 - - - .- 7 1 - j 3 St. Francis de Sales (Boys) ((iirls) 16 18 - 1 2 2 2 7 6 8 2 1 1 - - - - - - 2 2 3 •2 St. Ignatius (Boys) 16 1 - - 3 8 1 2 3 „ „ (Girls) 23 - 1 - 1 8 2 1 - - - - - 1 2 - - 2 5 Totals 2144 92 26 8 57 689 129 136 67 49 33 26 11 35 73 15 14 115 410 Percentages - 4-2 1*2 •3 2'6 32 1 6 0 6'3 31 2\3 1'5 1'2 1'6 3 3 "7 '6 5'3 191 43 FEEDING OF NECESSITOUS SCHOOL CHILDREN. The following table shows the number of children in the different departments of the various schools, provided with meals during tlie last week of the year 1912, which may fairly be taken as an average week :- School. Boys. Girls. Infants. Mixed. Total. Belmont Road 1 4 4 2 11 Bruce Grove 10 10 ... 29 Co'.eraine Park 22 14 16 ... 52 Coonibes Croft 16 ... 16 Crowland Road 11 14 14 ... 39 Downhills 17. 5 27 8 57 Down Lane 34 32 35 46 147 Earlsmead. 16 19 12 ... 47 Lancasterian .->1 52 38 ... 141 Page Green •24 23 22 27 96 Parkhurst Road 26 11 11 ... 48 Seven Sisters 23 25 26 ... 74 Stamford Hill 54 17 21 ... 92 West Green 10 5 10 ... 25 Woodlands Park 21 24 27 ... 72 Green ... 5 ... 5 Holy Trinity .. 1 ... 1 M iddle Class .. ... All Hallows 5 ... 5 St. Ann's ... 4 4 ... 8 St. Francis de Sales ... ... 37 75 112 St. Ignatius ... ... 14 32 46 St. Katharine's ... 1 1 ... 2 St. Paul's ... 7 4 ... 11 Totals 341 272 333 190 1136 44 School Dinners.—Some re-arrangements with regard to the feeding centres have been made this winter ; the children from St. Ignatius School now go to the Crowland Road dining hall, and feed there after the Crowland Road children have finished. At the new School at Down Lane the children are fed in their own departments. I have again to report that the food provided is excellent in quality and quantity; it is well cooked and thoroughly appetising and nourishing. At some centres two courses are provided, at others, suet dumplings served along with stew and vegetables, or meat and suet puddings, provide all that is requisite for a dinner dietary. Cocoa and bread and jam are provided occasionally at the other centres and are very popular with the children, being probably the sort of food to which many are most accustomed at home, but it cannot be considered so suitable as the above mentioned dietary, and to educate the palates of the children to take more suitable and nourishing food is, I think, an important point in school feeding. Sitting down to a properly devised and well served meal has great value, I believe, not only from the dietetic, but from the educational standpoint. Records of the weights of the children being fed were kept last winter at the Lancasterian, Page Green, and Crowland Road centres. The weights were taken in November, when the meals were started, and again at Easter, when they were discontinued. 45 At Crowland Road, out of 22 children weighed, 3 lost weight, and 2 remained stationary, whilst the remainder increased in weight from 1 to 9 pounds. At Page Green, records were kept of 47 children. All but 5 showed satisfactory increase in weight. At Lancasterian School, 94 children were weighed in November, and at the end of March 79 showed more or less increase in weight. Mal-nutrition.—In comparing the statistics of malnutrition with those of many other districts we consider that our Tottenham children, on the whole, show a very good average. Dr. King has told me that she has been struck with the really few cases of marked mal-nutrition found amongst the children examined by her. I consider that improper feeding is a more frequent cause of mal-nutrition than actual shortage of food, and that our school meals do much to help to remedy both these factors. Irregular times for meals, a vitiated atmosphere in the home at night, which makes any appetite for breakfast impossible, and lack of sleep are amongst the other conditions conducing to mal-nutrition. Intestinal parasites we find a very frequent cause of malnutrition in the infants, and, of course, latent tuberculosis and general delicacy may account for it even in the most suitable home conditions. When cases of marked mal-nutrition are found on medical inspection, inquiry is made into the home conditions, and, if these are unsatisfactory, the children are recommended by the Medical Officer for free meals. 46 SKIN DISEASES. Ringworm of the Scalp is the cause of long absences from school. Even in favourable cases, where the parents persist vigorously with treatment, absence from school is practically never less than 4 months, while absences of 8 to 18 months in other cases are only too common. Careful watch has been kept for suspicious patches of baldness on children's heads, and the plan of the School Nurses—to examine all the children's heads in a school, especially in classes where cases have arisen—has been effectual in tracking down cases un-noticed or un-recognised by parents, and which would undoubtedly have caused spread of infection. 210 fresh cases of Ringworm have been examined by your Medical Officer during the year, a very considerable decrease on the figures for last year. 270 re-examinations have been made, and when the cases did not appear to be having proper treatment, they were visited at home by the School Nurses. The rule made two years ago that no cases of Ringworm of the Scalp must return to school without the certificate of one of the Medical Officers, has been strictly followed, and has worked satisfactorily. Previous to this rule, cases often returned to school before they were cured, the mother frequently stating that they had been passed by a doctor, when no one but a chemist or neighbour had been consulted. The stage at which a cure has been effected is often difficult to detect, even by a doctor, and resort to microscopical examination has to be made in doubtful cases. 47 With the exception of Impetigo Contagiosa and Scabies, Skin Diseases amongst the children are comparatively rare. Several cases of Scabies proved very obstinate in resisting treatment, and some were only finally freed by having all garments disinfected at the Council's Disinfecting Station. Three cases of Psoriasis were found amongst the children examined at the routine inspections, and 2 cases of Tubercle of the Skin were met with amongst other children. PEDICULOSIS. Steady work has been done in combating this evil amongst school children, and the Nurses and Teachers are often cheered by gratifying results ; but, of course, relapses often occur in children whom it has been possible to get cleansed up to quite a satisfactory standard, and great perseverance is needed in the work. Registers are kept of children with "unsatisfactory" head or body conditions, and such children are seen, whenever the School Nurse visits the school, until the names can be crossed off as having become satisfactory. Several of the Head Teachers have adopted the excellent plan of refusing admission to children when found to have dirty heads until they are properly cleansed. On the opening of the new schools the Nurses have been present and examined every child entering the school. By such methods parents are beginning to realize that they cannot send children to school in a condition which is highly objectionable to all others who have to come in contact with them. Sore 48 heads, due to infection through scratching caused by irritation of head lice, are certainly decreasing in number amongst our scholars. In bad cases with neglectful parents such conditions are often most tiresome, and much school attendance is un-necessarily lost. The Superintendent of the Attendance Officers informs me that 88 parents have been prosecuted during the year for the non-attendance of their children on account of verminous conditions. The School Nurses occasionally attend at Court when such cases are heard, so that they may give their evidence if required. I wish to acknowledge with gratitude the cordial co-operation of the Attendance Officers in this part of the work, for in obstinate cases it has often been the only way to get unsatisfactory conditions remedied. Other neglectful parents too, often take to heart such warnings. CONDITION OF TEETH. On routine inspection, 32'1 per cent, of infants, 38'7 per cent, of older girls, and 39*8 per cent, of older boys were found to have two or more carious teeth. An inspection of teeth by a dentist, with the aid of a mirror and probe, would reveal a far higher percentage than this. Few people realize the importance to health in keeping decay from teeth. We have known children suffering from chronic poisoning from continually swallowing the decayed matter from teeth. I was requested to see one small boy who had a most offensive breath, and found it was due to a mouthful of horribly decaying milk teeth. Not only does 49 much harm result to the system by swallowing the decaying matter from teeth, but through the cavities thus exposed, it is possible that harmful disease germs may gain entrance to the blood. The importance of treating the first teeth of children cannot be over-estimated. If the permanent teeth are erupted into a mouth in which are already many carious teeth it is extremely likely that the caries will spread to the permanent ones as they come through the gums. The first permanent teeth require to be Avatched, and should be stopped as soon as the first signs of decay show themselves. In advocating the establishment of a School Clinic I am recommending: that treatment should be started with the children between 5 and 7 years of age, so that preventive work may be begun in time. It would be manifestly impossible to treat all the children with carious teeth in our schools, and many of them would be found to have too many unsavable teeth to make any conservative treatment possible. Of course, older children than the group I suggest for treatment would have badly carious unsavable teeth extracted whenever necessary. I cannot impress too strongly upon the Teachers the importance of inculcating the habit of regular teeth cleaning among their scholars. When food is allowed to cling round the teeth, fermentation ensues, and the decay germs have their best opportunity for making their deadly onslaughts on the tooth's integrity. Teeth should be cleaned at least once a day, and the most important time is before going to bed, so that the food may not remain undisturbed in contact with them during the long hours of night. 50 Tooth brushes can be bought for a penny or twopence, and the importance of having a separate tooth brush for each person is a point which inquiries show must not be forgotten. NOSE AND THROAT. Tonsils and Adenoids requiring treatment were found in 2.7 per cent. of the older boys, in 4.4 per cent. of the older girls, and in 6.0 per cent. of the infants who underwent routine inspection. In the children presented to us by Teachers as mouth breathers many bad cases of enlarged tonsils and adenoidswere found, whilst in others, the mouth breathing was not due to any blocking of the posterior nasal passages by adenoid growths, but to habit, or blocking caused by lack of the use of a handkerchief. It has been gratifying to find in many cases where mouth breathing was due to habit that careful attention by teachers and parents has resulted in the proper function of the nose being re-established, and any tendency to adenoid formation prevented. Deafness is a defect the importance of which it is hard to get parents to realize; so many of them are "hard of hearing" themselves and accept such conditions in their children as a matter of "heredity," when an operation tor the removal of large tonsils and adenoids may entirely remedy the condition. DEFECTIVE SPEECH. The figures for this year again show that stammering or stuttering is far more prevalent among boys than girls. 51 6 cases were found in 1080 older boys examined, only 2 in the older girls, 1 amongst the infant boys, and 1 amongst the infant girls. The case of a boy, not in the routine age groups, presented to me by the Head Teacher, was one of the worst I have ever seen, the facial and bodily contortions accompanying the attempt at speech being painful to watch. Such children require to be dealt with very patiently. I have noted with pleasure the improvement made in several cases where the teachers have made the children do the special deep breathing exercises which I have advised, for many of the cases are cured when they have learnt to expand the chest fully before attempting to speak. In 12 children the speech was nasal owing to the presence of large tonsils and adenoids. Cleft palate accounted for 4 cases of defective speech, and deafness was the responsible cause in others. A child who only hears very indistinctly will only reproduce his words indistinctly, consonants being more badly produced than the vowels, vowel deafness being a degree worse than consonant deafness. MORBUS CORDIS. Heart disease was found in 1.2 per cent, of the older boys, in 2.1 per cent. of the older girls, and in 1.6 per cent. of the infants. Most of the cases were due to rheumatism, a few only being congenital in origin. Cases undoubtedly functional in nature are not included in the above figures. In all cases general advice was given as to avoidance of damp and cold, the necessity for the 52 child leading as quiet a life as possible, swimming and drilling being forbidden. We find parents very glad of advice as to what trade or calling boys and girls are fitted for on leaving school when examination reveals any heart weakness. Only 2 or 3 cases were so severe as to need exclusion from school at the time of inspection, whilst in some of the children no other evidence of trouble was found beyond that revealed by the physical examination. Two extreme cases of congenital morbus cordis known to me died during the year. One was an infant of 7 years who weighed only 28lbs., and whom I had excluded as entirely unfit for school: the other was a boy, 10 years of age, who, in spite of a very imperfect and huge heart, grew and flourished exceedingly during the 3 years he was under my observation; he died suddenly at play, his death in all likelihood having been hastened by his activity. TUBERCULOSIS In the routine medical inspections the following cases of tuberculosis were met with:— Boys, 3 cases 1 Phthisis. 2 Tuberculous bone (femur) disease. Girls, 5 cases 1 Phthisis. . 4 Tubercular cervical glands. Infants, 15 cases 1 Phthisis. 1 Tubercular ankle. 13 Tubercular cervical glands. 53 Amongst the children specially examined at Bruce Castle there were the following:— Phthisis 12 Tuberculous peritonitis 1 „ cervical glandS 7 ,, disease of bones (hip, ankle, etc.) 7 ,, disease of skin 2 Old dorsal caries 3 In 18 further cases a diagnosis of probable tuberculosis was made. Most of the cases of Tuberculosis coming to our notice have been sent to the Invalid Children's Aid Association for help in getting special treatment. The Association has sent 7 of our phthisical children to Sanatoria, and several cases of incipient phthisis have been sent to Convalescent Homes Some of the children are still away, and those who have returned have greatly benefited, and in most cases were fit to return to school. One boy with a tuberculous ankle is undergoing treatment at the Treloar Cripples' Home at Alton. On making the routine examinations I have been struck with the comparatively few cases in which a positive diagnosis of tuberculosis can be made at once. Children who are really ill are for the greater number withdrawn from school and put under medical treatment, and so do not get included in the routine examinations of children of the two age groups, viz., five and thirteen years. Enlarged cervical glands are not entered on our schedules as tuberculous when carious teeth or pathological throat conditions are found which may account for them, though, doubtless, some of these may also be infected with tubercle. Again, it is not always possible, 54 in my opinion, to diagnose as pulmonary tuberculosis the prolonged or slightly prolonged expiration that is sometimes met with at the right apex, though possibly tuberculosis of the bronchial glands may be suspected The careful observations of Dr. King (who has assisted me during the last 4 months) give corroboration to these opinions. That many of the children whom we examine have a tuberculous focus somewhere, and which may be suspected from various signs, e.g., mal-nutrition, anaemia, etc , or may give no indication at all, is undoubted, but the positive signs are few, and a definite diagnosis by the ordinary clinical examination is in most cases impossible. Hence these cases cannot be definitely entered on our schedules as cases of tuberculosis. Again, we may suspect some of the cases of otorrhoea to be tuberculous in nature, but, in the absence of means of proof at our disposal in school work, we do not diagnose them as such. Under the various Public Health (Tuberculosis) Regulations, which require the notification of all cases of pulmonary tuberculosis, 26 children of school age, i.e., between 5 and 14 years, were so notified to the Medical Officer of Health in 1912. Under the new Tuberculosis Regulations of December 20th, 1912, all cases of tuberculosis, pulmonary or otherwise, have to be notified to the Medical Officer of Health. This will mean a greatly increased number of notifications of children of school age, since tubercle more often affects the glands and bones in children than the lungs. We are looking forward to the day when open-air schools for delicate children and for those pre-disposed to 55 tuberculosis will be but a part in the great national campaign against "consumption.'' Advice as to the necessity for plenty of fresh air, good food, etc., is given to the parents of all tuberculously inclined children, and in not a few cases we have been gratified to note the improvement wrought by the carrying out of our advice. DEFORMITIES. The following deformities were met with in our routine examinations (exclusive of those due to rickets) :— Cleft Palate 4 Hare lip 3 Congenital shortening of 4 Congenital dislocation of hips 1 Talipes equino-varus 2 Amputations of leg 2 Old Infantile paralysis 7 Hemiplegia 1 Stiff knee 1 Facial paralysis (congenital) 2 Scoliosis 11 Rickets accounted for marked deformity in 36 children, genu varum and valgum were found often in conjunction with deformity of the chest. One family showed three members with very marked deformities, affecting chiefly the bones of the legs, due to late rickets. The youngest, aged 8 years, is only able to walk a little with difficulty, and has to be taken to school in a push-cart. They had all been brought up on a strictly vegetarian diet and sterilized milk. 56 I have again to express a hope that the day may not be far distant when a special school will be provided for our cripple children; for the best of them the ordinary schools are not suited, and for many others such schools are entirely out of the question. The special consideration shewn to the crippled children who do attend school by their teachers and classmates is much to be commended, and is good for all concerned. Five children were found to be too crippled to attend school at all. MENTALLY DEFECTIVE CHILDREN. We are looking forward to the special school, for this class of children, which is to be built on the site of Ashley and Linden Houses, The Green. I hope that a strong "After Care" Committee will be formed in connection with the school, so that suitable occupations may be found for the children on leaving, and their welfare continue to be looked after. The State is realizing the necessity for doing something for this class of the community so little able to look after their own affairs, and, doubtless, special schools will be but a part in a general scheme of legislation. Five children were found to be unfit for school at all on account of pronounced mental defect. EPILEPSY. Twelve children had to be excluded from school on account of severe epilepsy. Two children suffering very badly from this disease have been sent by the Education Committee to Institutions for epileptics during the year. 57 One of them, a small sharp boy of eleven years of age, begged hard to be allowed to attend school, "I does want to learn to read, lidy," he said. The Committee, by sending him to an Institution, have given him a chance to fulfil his heart's desire, and, as he had to be almost entirely confined to the two rooms of his home owing to the severity and frequency of his fits, life will doubtless now be much happier for him. CONTAGIOUS DISEASES. Contagious diseases were found chiefly amongst the infants examined, and consisted of 2 cases of whooping cough, 5 of chicken pox, 5 of ringworm of the scalp, one of impetigo, and one of diphtheria. MEASLES. Measles has again been prevalent in the district this Autumn, and affected chiefly the schools which came off more lightly in last year's heavy epidemic The following schools have had to be closed, in consequence, for a period of two weeks. Holy Trinity Infants. Belmont Road Infants. Downhills Infants. Woodlands Park Infants. SCARLET FEVER There was a small outbreak of Scarlet Fever in St. Ann's Ward during the August holidays, and 10 out of 11 children affected were found to have attended the same Sunday School. Closing of this school stopped a further spread, and no more cases occurred afteR the Elementary Schools re-opened. 58 In the autumn, Scarlet Fever was prevalent to some slight extent throughout the district, and particularlyaffected the West Green Ward. Frequent examinations were made by your Medical Officer for signs of recent disease amongst the children; all cases of doubtful nature away from school were visited by the School Nurses, and a daily inspection of hands was made by the teachers throughout the departments of the school chiefly affected. These inspections resulted in bringing to light 3 cases of "missed" Scarlet Fever, i.e., cases in which the disease had been so mild that its true nature had not been recognised ; one boy, indeed, had only been away from school two days with a mild sore throat. The cases were, for the greater part, of such a mild nature that 3 or 4 children were actually at school when the rash began to appear. Indeed, the very mildness of the epidemic was a factor which made it all the more difficult to combat, and I think it probable that some of the cases were due to those others which were not recognised until peeling of the skin of the hands shewed itself. Another feature of the outbreak was the lateness at which "peeling" took place; in several of the cases, the "missed" ones included, it did not take place until the third or fourth week after the initial sore throat. Disinfection of the school premises was thoroughly carried out by the Public Health Department, all modelling clay was thrown away, and the spread of infection stopped by all possible means. CHICKEN POX. Chicken Pox was prevalent in many infants' schools in the Autumn. It was of a very mild nature, and checking 59 its spread seemed impossible, for the children were not ill, and in many cases the eruption was but slight and affected chiefly the trunk. SCHOOL CLINIC. The Eye Clinic was opened on January 17th, 1912, and since that date 664 children have been dealt with, and some 1900 attendances have been made. The small room at Bruce Castle has been fitted up as a dark room, and the two other rooms used as waiting and consulting rooms. To T. W. Letchworth, Esq., F.R.C.S., our Ophthalmic Surgeon, I am indebted for the following report on the year's work :— Children who complain of defective sight or headache, or who are noticed by the teachers to have difficulties with their sight or other ocular symptoms, are examined in the schools by your Medical Officer, and told whether they should attend the eve clinic or not. Moreover, a routine examination of the eyes and sight of all the children in their last school year has been made. To the parents of all the children requiring treatment notices are sent, stating that the children have been found suffering from ocular defect or disease and that they are requested to attend Bruce Castle for further examination and treatment at a certain date and time. Defective vision, that is visual acuity less than 6/9 of the normal, has been found in 14.0 per cent. of the boys; 16.7 per cent. of the girls; and 2.3 per cent. of the infants. 60 These figures vary considerably from year to year, as the numbers are insufficient to get a thoroughly concordant result. When the children are seen at Bruce Castle, those suffering from external diseases are treated and supplied with suitable remedies, of which a small stock is kept, and are, of course, excluded from school if the affection is contagious. Those requiring operation or in-patient treatment are referred to an eye hospital. In cases of error of refraction, which forms over three quarters of the whole, a mydriatic is used, scopolamine for the myopes and some of the older children, and atropine for the others. In the case of the former the error of refraction is estimated the same day, in the latter on the following week, and glasses ordered if required. The following is a list of the cases other than refractions:— Conjunctivitis and blepharitis 54 Trachoma 1 Night blindness due to xerosis conjunctivitis 6 Retinitis Pigmentosa 1 Lamellar cataract 1 Injury to trochlea from operation for dermoid 1 Phlyctenules 14 Congenital syphilitic disease 2 Disturbance of pigment at macula from watching eclipse 1 Primary nystagmus 1 Traumatic cataract 1 61 The trachoma case was excluded and is under treatment at the Royal Westminster Ophthalmic Hospital, as is also the case of lamellar cataract. In the cases of night blindness, which occurred in the Summer, the children were practically unable to find their way about after dark, there was slight conjunctivitis and in four a patch of xerosis upon the ocular conjunctiva. The bacillus was grown. The child whose sight was damaged by looking at the eclipse, which took place on the 17th April, was seen in September. The vision was 5/30 and 5/20 in the right and left eyes respectively. At both maculae there was some atrophy of the retinal pigment. I fear some of the damage will be permanent. Refractions performed 542 Old glasses found to be correct 9 Monocular defect. Glasses not required 8 Nebulous cornae. Not improved by glasses 22 Small errors. Glasses not advised 40 Vision normal 8 Referred to hospital 3 Parents refused treatment 10 Unfinished to date 18 443 pairs of spectacles were ordered, of which the following is a summary:— + Spheres 75 + Sphero-cylinders 112 + Cylinders 28 Mixed sphero-cylinders 73 —Spheres 75 —Sphero-cylinders 69 — Cylinders 13 62 Glasses supplied through Messrs. Ledsham & Co.—438. Three children got glasses elsewhere, two refused to get them, and in three cases they were paid for by the Poor Law Guardians. In 223 cases the parents paid in full, in 127 they paid in part, and in 82 they paid nothing at all. The fee for the examination of refraction cases was paid by the parents in full, or in part, in ten cases. The total cost of the glasses from Messrs. Ledsham and Co. was £50 15s. 9d., of which the Committee paid £18 8s. 11d., and the parents £32 3s. 10d. HYP ERMETROPIA. Age. Number. Boys. Girls. Squints. ? 1 0 1 0 5 9 5 4 8 6 19 11 8 15 7 21 11 10 12 8 16 9 7 5 9 20 11 9 3 10 39 24 15 7 11 21 9 16 1 12 32 10 22 2 13 52 18 34 5 14 6 1 5 1 ... 236 109 131 58 63 Thus at all ages there were 131 girls to 109 boys; but from 5 to 10 inclusively there were 71 boys and 51 girls; whereas from 11 to 14 there were only 38 boys to 77 girls. This is probably due to needlework making the defect more noticeable among the older girls. The large proportion of squints among the younger children is due to the fact that a routine examination of their sight is not made, but they are referred for treatment only when some ocular defect is apparent, and the most common defect noticed is squint. SQUINTS. Age. Number. Age. Number. 5 9 10 8 6 16 11 4 7 13 12 3 8 8 13 9 9 4 14 1 Total 75 (boys, 46; girls, 29). Right eye affected, 24; left, 31; alternating or unascertained, 20. The 61 pairs of spectacles ordered were made up as follows + Spheres 33 + Sphero-cylinders 22 + Cylinders 2 — Sphero-cylinders 2 — Cylinders 2 Small error, too old for fusion, glasses not ordered, 10. Refused treatment, 2. One of these was a child of 10, for whom glasses, though advisable, were not absolutely necessary. The other was quite a young child, who would probably have been cured by treatment. 64 Of these 75 cases, in 12 I am practically certain that the power of fusion and binocular vision will be recovered. 21 I consider hopeless as far as prospect of the use of the two eyes together is concerned. In most of these I have advised the parents to wait till the children are about 1 6 years old and then take them to an Ophthalmic Hospital, with a view of having a cosmetic operation performed to put the squinting eye straight and remove the deformity. I hope that we will be able, by glasses, and other means when necessary, to effect a cure in a large proportion of the remaining 40 cases. These cases will require careful watching and treatment prolonged over many months The fact that we get so many of these cases during the first year of school life is very gratifying, and shows that the teachers appreciate the necessity of wasting no time before starting treatment, yet it is unfortunate that we cannot get many earlier. A child usually starts squinting about two or three, and therefore much valuable time is lost between that and the first school attendance. The proportion of cures would be much greater if one got hold of the children as soon as the squint is noticed. I believe that it would be quite the exception to fail to effect a cure if treatment were applied at that early date. Ignorance is here the great evil. The opinion is prevalent, not only among the lower classes, but some of the medical profession, that a child may grow out of a squint. The consequence of this is disastrous. 65 MYOPIA. Age Number. Boys. Girls. 7 3 3 0 8 13 6 7 9 15 7 8 10 15 8 7 11 23 12 11 12 26 13 13 13 70 35 35 14 2 1 1 15 1 1 0 ... 168 86 82 All the high myopes seen during the earlier part of the year, and those in whom the myopia appeared as if it might be increasing rapidly, were seen at intervals. One boy was excluded from school on this account. The numbers of boys and girls who are found to be myopic are about equal at all ages. The average amount of myopia found was about constant up to 12 years of age, when it rose slightly. At 13 the average amount was less because every child of that age in the schools had had the vision tested in the routine medical examination, and so a larger number with small errors were detected, and included in the total numbers. The average amount of myopia under scopolamine was 2723 and 2-462 diopters in the right and left eyes respectively. 66 The total number of myopes shews a progressive increasethrough the years of school life, but the great increase in numbers at 13 is due to all the children at this age having: undergone routine medical inspection as stated above. MIXED ASTIGMATISM. Age. Numbers Boys. Girls. 6 1 1 0 7 1 0 1 8 4 1 3 9 8 6 2 10 14 8 6 11 11 5 6 12 13 7 6 13 20 8 12 14 1 1 0 ... 73 37 36 I am informed that the teachers have expressed their general appreciation of the results of the work at the Eye Clinic. TREATMENT AND "FOLLOWING UP." The parents of children who are found to have anything the matter with them are always notified at once if they are present when the trouble is found; or, if not present, either by letter, by the teacher or by a visit from the School Nurses. Acute urgent cases are always closely followed up, and as a last resource the help of the Inspector of the Society for the 67 Prevention of Cruelty to Children is invoked or, on occasion, threatened. Some of the children sent up by the Attendance Officers to Bruce Castle for special examination, or with regard to fitness to attend school, are children found to be suffering badly from the need of medical attention and treatment. One small boy who was sent to me by an Attendance Officer, as he had not been to school for 4 or 5 weeks, had had no medical treatment, and appeared to be still ill. On examination I found he had a huge abscess (empyema) filling up one side of his chest to such an extent that the heart was found to be beating: as far over to the right side as it should have been to the left. Prompt removal to hospital and operation undoubtedly saved the child's life. One is often struck with the apathy of parents, their failure to observe that the child is really ill, whilst their fatalistic attitude toward disease is often hard to combat. "It's here-dit-ary" is a conclusion which, if formed by parents, requires much argument to convince them that treatment may still be desirable. But after four years of medical inspection work in Tottenham I think parents are beginning to realize more fully that when treatment is advised for a child, it is not advised as a mere pious opinion, but because it is necessary for the welfare of the child, and must be carried out. With a good General Hospital in the District, to say nothing of the Poor Law, there should be no excuse on the ground of expense for obtaining the necessary treatment. But when the parents are out at work all day, or the mother is ill, the difficulties in the way of getting children treated sometimes seem well nigh insuperable, and it is only at the expense of much energy and planning on the part of the officers or teachers that they can 68 be overcome. We can safely say that no acute or urgent case has ever failed to be put in the way of obtaining treatment however adverse the home circumstances may have been. One of our greatest difficulties used to be to obtain treatment for children with defective sight. By the establishment of our clinic this has been removed, and when a dental clinic is working, as we hope it may be before very long, another great difficulty, viz., to get treatment for decayed teeth will also be tackled. The Invalid Children's Aid Society have again rendered great service to many of our school children. Over 40 children were recommended to the Society during the year by your Medical Officer, and for many of them Sanatorium or Convalescent Home treatment has been provided, and for others, necessary instruments or other treatment. Our cordial thanks are due for the invaluable help thus rendered. Co-operation between the officers of the agencies which have as their object the welfare of the children, viz., the Public Health Department, Poor Law Officers, District Nurses, etc., and the School Medical Inspection Department has been fostered and encouraged with benefit to the work of all. DISTURBANCE OF SCHOOL ARRANGEMENTS. At the following Schools, Medical Inspection was carried on under difficulties, owing to the lack of a proper hall in which the parents could wait, or to the small, dark or otherwise unsuitable rooms which had to be used for the inspections Coleraine Park. West Green. Parkhurst Road (Boys). Bruce Grove (Infants). 69 HYGIENE TEACHING. There is nothing to add this year to the account of the subject given in last year's Annual Report. The lessons on Infant Care and Hygiene are very popular, and many parents have expressed their pleasure and gratitude for the teaching given to their older girls on this important subject. The teachers have, for the most part, taken much care in developing these lessons and making them as thoroughly practical as possible. OBJECTIONS TO MEDICAL INSPECTION. The number of objections to medical inspection during the year amounted to 13 only, whilst numerous parents expressed a desire that their children, who were not of the entering or leaving classes, should be also inspected, showing that they appreciate the value of such examinations, and that they recognise the work as an integral part of the child's school life. The influence which the Head Teachers have had in explaining the aims and methods of school medical inspection to parents who did not understand its purpose, has largely helped to bring about this satisfactory state of affairs. PRESENCE OF PARENTS AT MEDICAL INSPECTION. In the routine examination of infants some 80 per cent, of the parents attended. A fewer number attended with the older children. We are glad to record again the keen interest 70 which the, parents take in the work, whilst the welcome given to them by the Head Teachers does much to promote an allround friendly spirit. DEAF SCHOOL. At the special school for Deaf and Aphasic children there are 72 in attendance. Of the 70 deaf children some have been totally deaf from birth or early childhood, and were, consequently, totally dumb till placed under instruction. Others are deaf in varying degrees and their instruction has to be carried on by such methods and under such conditions as will develop their natural but imperfect speech and scanty knowledge of spoken and written language. A few had, on admittance, normal speech, but are too deaf to benefit by the instruction given in large rooms in ordinary schools, and must supplement their hearing power by lip reading. All the children in the school have been examined by me twice during the year. I found that the hearing power of 3 of them had sufficiently improved to enable them to be sent back to the ordinary schools. One boy had to be dismissed as mentally deficient. 48 children were reported to me by the Head Teachers as suffering from deafness, and on examination I found that 17 of them were so hard of hearing that it was desirable to transfer them to the Deaf School, as they were not able to benefit by instruction in the ordinary schools. The are two aphasic children in the school. One, a case of congenital word blindness, upon whom we reported last year, continues to make steady progress. The other is a boy of eight years, who has been totally dumb since he was 71 knocked down by a bicycle at the age of two years. He hears, but does not understand the significance of speech. After five weeks in the school he has learnt to articulate and know the meaning of 20 nouns (names of objects), and this newly acquired power of expressing himself has had a marked effect upon his whole demeanour. The reading and writing of such words as he can articulate accompanies his progress in speech, and the result is most gratifying. WORK OF THE SCHOOL NURSES. Mrs. Wallace took up her duties as School Nurse in February, 1912, in the Western portion of the district, Mrs. Inchcoe continuing her work in the Eastern. Excellent work has been done by both Nurses, and gratifying results have rewarded their efforts to obtain a better condition of things for many dirty and neglected children. Parents are beginning to realize that they cannot send their children to school in a filthy,verminous condition with impunity,and to know that children so found by the School Nurses will be re-examined repeatedly until a better state of things results. Failure to make an effort to rid the children of dirt and vermin means exclusion from school, and will bring the parents to the Magistrates' Courts, where the School Nurses are often present as witnesses. The heavy fines generally imposed have a salutary effect, not only on the offenders who suffer, but also on those who escape punishment. During 1912 the Nurses paid 617 visits to school departments, and made 18,512 examinations and re-examinations of children's heads. 1706 were found to be actually verminous on one or more occasions, and 3,543 had "nits" and were regarded as "unsatisfactory." 72 365 children with body vermin were found; 220 of these were bathed by their mothers or sisters at the Council's Disinfecting Station, under the supervision of the Nurses, and their clothing disinfected at the same time. 41 houses were reported as dirty to the Public Health Department and disinfected accordingly. Much valuable work is done by the Nurses in home visiting; 1376 such visits were paid during the year, some of them to follow up children found dirty and neglected, others to see that treatment advised by the Medical Officers had been carried out. All cases of Measles and Whooping Cough notified by the teachers to the Public Health Department were also visited, and advice given as to the need for care and medical attention in these diseases. This need is not always recognised, as is evidenced by the mother who was indignant at the Nurse's visit when her child had Measles, as she had "buried four children with it and so ought to know all about it." But, on the whole, the Nurses are well received in the homes, and their advice is frequently sought by the mothers, whilst they have often been able to advise where help was to be got in many a dire extremity, either from the District Nurses, Poor Law, or some charitable agency, with all of which agencies the officers connected with the work of school medical inspection are in close touch. In addition to the work described above, the Nurses assist the Medical Officers at the routine inspections by weighing and measuring the children, filling up the names and other particulars on the schedules, and helping to get the children's garments fastened and unfastened. 73 Nurse Inchcoe has undertaken the syringing, etc., of discharging ears at the Deaf School, when such treatment has been recommended by the child's Medical Attendant. There is a considerable number of children with discharging ears at the Deaf School. Nurse Wallace has assisted Dr. Letchworth and your Medical Officer with the work at the Eye Clinic. The Education Committee has appreciated the value of the work done by the School Nurses and, by the appointment of Nurse Allen, who took up her duties in January, 1913, has extended the scope of their operations. THE EMPLOYMENT OF CHILDREN ACT, 1903. The Special Officer who was appointed to carry out the duties under the Employment of Children Act reports directly to the Education Committee. SCHOOL VISITS. 347 departmental visits have been made by the Medical Officers during the year. TOTTENHAM CHILDREN AT SPECIAL SCHOOLS IN OTHER DISTRICTS. 1 mentally defective child, 1 crippled child, and 2 blind children are under instruction at schools or centres in other districts TRUANT AND SHORT-TERM INDUSTRIAL SCHOOL. The Truant School, which is shared by the Tottenham, Wood Green, Edmonton, Hornseyand Middlesex Education Authori- 74 ties, has accommodation for 20 children. On the 31st December, 21 Tottenham children were inmates of the school, and 20 children were out on license. There were 7 children in Industrial Schools under the Children Act. The cost per head of children dealt with under the Elementary Education Act, 1870, was 7s. per week, and in the case of those under the Children Act, 1908 (Sec. 58), 4s. per week. OPEN-AIR SCHOOLS, SCHOOL CAMPS, Etc. No arrangements have so far been made to provide for scholars requiring special treatment of this kind. EXAMINATIONS BY THE MEDICAL OFFICER. 53 Teachers and 2 Attendance Officers were examined during the course of the year; 1 of the Teachers was referred for subsequent examination, and ultimately passed. The following table shows the number of teachers in the various departments of the Tottenham Schools :— (a) PROVIDED SCHOOLS. Boys. Girls. Infants. Mixed. Deaf. 192 188 177 45 9 (b) NON-PROVIDED SCHOOLS. Boys. Girls. Infants. Mixed. 12 27 21 19 There are also 11 Student Teachers. 75 * HINTS TO TEACHERS REGARDING THE EARLY SYMPTOMS OF INFECTIOUS DISEASES. The following information is included in this Report for the convenience of Teachers and others having the care of school children :— (1) Measles, etc. :—Any scholars suffering from a severe cold, sneezing, redness of the eyes, and running at the nose, should be sent home; such symptoms may mean an influenza cold, or the commencement of measles, and both are infectious; the recommendation is particularly important when measles is prevalent in the district. The incubation period is from 4 to 14 days, and attendance at School should not be resumed until fully 4 weeks from the beginning: of the rash; if at the end of 4 weeks any cough or desquamation be present, the child should be excluded for a still longer period, indeed, until all traces of both have disappeared. (2) Whooping Cough :—A child with a violent cough, especially if it be severe enough to cause vomiting or nose bleeding, should be suspected of whooping cough, and sent home, even if the characteristic "whoop" is not heard, and it should be remembered that this "whoop" may not occur until 7 to 14 days * Confidential information from teachers, pupils, neighbours, etc., regarding the existence of doubtful cases of infectious disease in any house will at all times be gratefully received by the Medical Officer of Health. 76 after the cough has begun. The incubation period is from 7 to 21 days, and the duration of infection is about six weeks from the beginning of whooping, or until the cough has quite ceased, which is frequently a much longer period. Both measles and whooping cough are most fatal to children under 5 years of age. The complication that most frequently causes death is broncho-pneumonia, which is often set up by exposure to cold. (3) Mumps:—The incubation period is from 14 to 25 days, and the duration of infection from 3 to 4 weeks; if any doubt exists in the mind of a Teacher regarding a child with a swelling in the neighbourhood of the ear, the case should be promptly referred to one of the Medical Officers. (4) Scarlet Fever (or Scarlatina) The incubation period is from 2 to 8 days, and the duration of infection from 5 to 8 weeks, and occasionally much longer; indeed, it only ceases when peeling has been completed, and when the child is free from discharge from the nose or ear, or from sore places. The initial symptoms of the disease are vomiting, sore throat, shiverings, headache, and a hot dry skin; those are followed in 24 hours, or thereabouts, by the appearance of a fine scarlet rash on the neck and chest, often spreading over other parts of the body and limbs. The tongue is furred with a red 77 tip at first, the papillœ being large and red, and the throat is red and usually sore; some cases present little or no rash or sore throat. (5) Diphtheria:—The incubation period varies from a few hours to 7 days, and infection lasts a month or more, and always until the throat becomes normal, and there is no discharge from the nose. The disease begins with sore throat, generally accompanied by feverishness and swelling of the glands beneath the lower jaw. Greyish white patches form on the tonsils or throat, and apparently mild sore throat may prove to be diphtheria, contrary to the popular belief upon the subject which associates the commencement of the disease with alarming symptoms. (6) Small Pox:—The incubation period is variously stated as being from 12 to 14 or from 9 to 15 days. The duration of infection is about 5 weeks, or until every scab has disappeared. The initial symptoms are headache, backache, feverishness, and vomiting. In children it frequently begins with marked drowsiness. When the child has been ill 3 days, pimples appear on the face (especially about the forehead) and limbs (especially about the wrists and ankles). The pimples later on become vesicular, and afterwards pustular; scabs form about the tenth day. It is worthy of note that when the rash first appears, the temperature falls, and the patient feels better. 78 Small Pox is rare and mild amongst vaccinated children, but a considerable number of unvaccinated children now attend our schools who, in addition to the risk they personally run, are a distinct source of danger to the other children. (7) Chicken Pox:—The incubation period is from 10 to 16 days, and the duration of infection about 3 weeks, or until every scab has fallen off. The rash in this disease occurs about 24 hours after the child has been taken ill, and consists of watery pimples, chiefly on the chest and body, but often also on the face; it comes out in successive crops; scabs form from the third to the fifth day. INDEX. A. Adenoids 50 Ages of Children 31 Average Time of Inspection 30 Attendance Officers 25 Additional School Provision 23 Arrangements for Medical Inspection 26 Area 5 All Hallows' School 16 B. Blind Children 73 Belmont Road School 8 Bruce Grove School 14 C. Chicken Pox 58 Crippled Children 56, 73 Crowland Road School 13 Contagious Diseases 57 Clothing 33 Cleansing and Redecorating Schools 22 Conditions found on Examination 40 Cloakrooms 18 Children selected for Medical Inspection 28 Coleraine Park School 14 D. Deformities 55 Disturbance of School Arrangements 68 Disinfection 58 Downhills School 8 Down Lane School 15 Deaf School 70 E. Eye Diseases 59 Epilepsy 56 Extent of Medical Inspection 28, 31 Excluded Children 29 Employment of Children Act 73 Examination of Teachers, etc. 74 Earlsmead School 12 F. Footgear 33 Feeding of Necessitous Children 43 G. General Examinations 28 General Cleansing of Schools 18 Green School 15 H. Height 36 Heating 19 Hygiene Teaching 69 Hints to Teachers regarding Infectious Diseases 75 Holy Trinity School 13 I. Introduction 3 Infectious Diseases 57 Improvements in School Premises 19 L. Lighting, Artificial 19 Lancasterian School 16 M. Measles 57 Morbus Cordis 51 Mentally Defective Children 56, 73 Mal-nutrition 45 Middle Class School 16 N. Nose 50 Notification of Diseases 26, 27 O. Objections to Medical Inspections 69 Open-air Schools, School Camps, etc. 74 P. Pediculosis 47 Population 5 Parents at Medical Inspection 69 Parkhurst Road School 15 Page Green School 11 R. Ringworm 46 Rickets 55 Re-examinations, Numbers of 29 Rate, Education 5 S. Scarlet Fever 57 Skin Diseases 46 Speech 50 Special Schools in other Districts 73 Statistics of Attendance 24, 25 School Clinic 59 School Nurses, Work of 71 School Closures 57 Seven Sisters School 9 Stamford Hill School 10 St. Ann's School 10 St. Katharine's School 17 St. Paul's School 17 St. Francis School 18 St. Ignatius' School 13 T. Teeth 48 Throat 50 Tonsils 50 Tuberculosis 52 Treatment 66 Towels 18 Truant and Short Term Industrial School 73 Teachers, Number of 74 Time occupied by Inspection 30 V. Vision 59 Visits to Schools 73 Ventilation of Schools 19 W. Weight 36 Water Supply 5 Woodlands Park School 6 West Green School 7