I was temporarily diverted from what I was meant to be doing when I came across a news item about the London County Council’s Medical Officer (Education)’s report for 1911.
Doctors had inspected 204,000 children at 9,785 sessions. 62% of parents attended.
Over half the children showed ‘defects’. One third had enlarged tonsils & adenoids. However four-fifths had caries of the teeth, which suggests, because it is so much bigger a proportion than one half, that these were not counted among the ‘defects’.
The OED quotes a legal definition of ‘defective children’ from 1899 as those who are neither imbecile, nor merely dull or backward, but with mental or physical defects which make them incapable of receiving proper benefit from instruction in the ordinary schools – which makes the 50% figure sound even more alarming, & probably not what the doctor meant by ‘defects’.
In addition to these general medical exams, school nurses inspected 251,592 children of whom 14,893 (6%) were reported to be verminous. There were in operation 9 cleansing stations for verminous children.
This sounds much more serious than mere head lice, for which we were still – not very frequently – examined by a school nurse, even at Grammar School. (We just used to call her the nit nurse but later, even less respectful, generations used the nickname Nitty Nora). So I went looking for more information.
The OED has two definitions of verminous as applied to persons.
‘Infested with, full of, vermin, esp. parasitic vermin; foul or offensive on this account’, with, as an illustrative quote from a medical treatise of 1899: - ‘In ‘verminous persons’ the hair is sometimes matted together by pus, nits, scales and scabs’.
‘Of persons: Subject to vermin or intestinal worms’ with an illustrative quote from the Encyclopaedia Britannica of 1860: - ‘Females may be more verminous than males.’
I found a very interesting paper on the development of the London School Medical Service in the British Journal of Nursing for 1924. This tells us that the attempt to provide a health service for schoolchildren in London began as long ago as 1889, was later extended to include eye tests, & the first school nurses were employed in London in 1903, when ringworm was a much more serious problem. All local authorities were granted the power to employ medical officers of health for schools in 1907 & in 1908 were given discretionary powers to clean not only the verminous children, but their homes, including all the bedding & articles of furniture. Parents who, despite this, allowed their children to become verminous for a second time could be taken to court.
With regular medical exams came the recognition that many children needed treatment which their parents could not afford; arrangements were made to set up special child clinics, first with some of the many London hospitals, & later with various voluntary associations, although the council provided the nurses for these voluntary clinics, so by 1924 the number of school nurses had risen to over 300.
Nurses played a major role in improving hygiene, not just by supervising the child cleansing stations but by working – tactfully – with parents to help them implement simple rules of hygiene. For, as the author of the paper in the Nursing Journal points out, it is easy to underestimate the difficulties under which many parents laboured, in London, in maintaining a high standard of cleanliness in the family.
Not surprisingly angry reactions were not uncommon in the early days, especially to the home cleansing schemes, but by 1922 the Medical officer was able to note in his report that
’Riots and assaults became fairly frequent,’ but now ‘It is good to note the disappearance of the acute opposition on the part of the parents which formerly marred the Council’s cleansing scheme.’
The numbers of children who had to be helped to be clean had been dramatically reduced, & of course by 1924 London was on the verge of the revolution which brought electricity to every home
Even so, as late as in the 1960s there were still many families living in accommodation without constant hot water on tap, or a bathroom, or even an inside lavatory, or facilities not shared with other households. And that in the age before proper disposable nappies had been invented. The coin-operated self-service launderette marked the next great advance in the battle to make our children clean.
I do also wonder what those school nurses of a century ago would say if they knew that today they would be expected to work – tactfully –with parents to inculcate simple rules about how not to eat too much
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