The Health of the Child
THE nation may be congratulated on having Sir George Newman as Chief Medical Officer to the Board of Education. His Report for 1926 on the health of children in the State schools is as absorbing as it is masterly in arrangement, narrative and comment. Here is a case of the art that conceals art, for the writing is so simple and domestic that anyone could understand it. And it is extremely important that it should be understood, as it is in substance an appeal for preventing illness in its earlier stages instead of letting matters drift till the State is put to the vast expense of curing disease which need never have occurred. It cannot be too much emphasized that it may be economic to spend large sums on prevention, but that if is certainly uneconomic to spend the vast sums that now disappear in attempts to overtake neglect.
Although Sir George does not dispute that much disease is due to insanitary housing, poor clothing and under-feeding, he is firm in his conviction that the -Worst enemy of all is ignorance. He believes that this ignorance could gradually be abolished. Nothing is more satisfactory in his Report than the bold logic with which he advances to his conclusion that, as instruction in hygiene is one of the most important branches of knowledge, it ought to be made com- pulsory in schools for all children over a certain age. We have seldom read better 'advice. It is not as though lessons in what Sir George calls "a wholesome way Of living" would be a detached subject of no educational value in itself. The study of what disease is, of how it is caused, and of how it can be avoided, is interlocked with countless other fascinating branches of general knowledge. A child who can think intelligently about health—not only of its own health but the health of others—is on the high road to be a good citizen.
Sir George Newman gratefully acknowledges that the health of the children of school age is noticeably better than it was. In the past twenty years the children have become stronger, taller and heavier—particularly in London. They wear better clothes and they are .better fed. This testimony of improvement is all the More agreeable because it covers the period of the War 4and of the coal strike.
Yet how much remains to do ! The system of jrnedical inspection in schools is comparatively recent, and we can see how much it has achieved already ; but by lighting up one area it has shown the darkness '`of others. Sir George points out that one-quarter of he children when they first come to school need medical attention.' Evidently there is a pre-school period in vhieh 'many Children, if they have not been neglected; Fat least have not been carefully watched. The Maternity ind Infant Welfare -clinics have done invaluable work, put there is a gap between infancy and the school ,age. iir George definitely suggests that this gap ought to be covered, and he is stronzly in favour of more Nursery Schools. If we assume that infant welfare work comes to an end, as a rule, when the child is one year old, there is the period from one year to five years, which is a common time for the almost invisible development of disease. It is well known to-day that one of the most frequent causes of wrecked lives is rheumatism in school children. Sir George says that rheumatism causes something like eighty per cent, of the deaths from heart disease under twenty years of age, and not less than forty per cent, of the total cardiac mortality which in 1926 was the principal cause of death at all ages.
From the body Sir George Newman turns to the mind, and shows that the provision of more oppor- tunities for playing games is essential. He conceives of education as a " charming " thing. He is no crank, and he would not sanction the nonsense that the charm should so obliterate the consciousness of being dis- ciplined that the child -would leave school without ever having- discovered that life consists largely of the duty of doing tedious or disagreeable things. All the same, he sees the time of education as the great occasion for "happy days in the sunshine in the wide and winsome fields of Nature." Education, he says, should consist "of the beginnings of music, art and letters, of adventure and heroism, of the vigour of the youthful body and the curiosity of the awakening mind, of tales of romance; Of games." Translating this ideal into practice, he wants not only more playing fields, but more open-air schools. He is no friend of the sterile and snobbish doctrine that the children in State schools should be taught only what is "useful "—as though any child could grow up to real usefulness whose mind was incapable of being engaged by beautiful things and the amenities of human culture. In elaborating his thoughts about' the impulse to play, Sir George takes an analogy from the young of all animals. "Puppies, kittens, chicks and baby elephants and the human infant all manifest this hidden impulse. Is it not something we ought to train and build upon ? " Surely it is.
This Report ought to be widely circulated. It is not only a counterblast to ignorance, but a strong stimulus to new endeavour. The time has almost passed away when one used to read in the evidence at an inquest on a child who had died from eating indigestible food the familiar answer of the ignorant mother. When asked by the Coroner if the child had been "properly fed," she would proudly say : "It always had what we had " ! It will pay the nation to make children healthy from the cradle. We might put the argument on much higher grounds, but these lowest grounds are firm. enough. Ill-health lowers the productivity of the nation more than it has ever been lowered by strikes. And if the average of health among the wage-earners can be bodily raised, we need not wail so much as our eugenists do now about the disparity of the birth-rate between one class and another,