426 



NA TURE 



[March 5, 1908 



tion of tlie a. panicles with time. For purposes of 

 iiieasureinents, tlie active material, in the form of a thin 

 film covering a small area, is placed in an exhausted 

 lube connected in series with the ionisation cylinder, and 

 at a considerable distance from the hole. The number of 

 a. particles entering the opening per ininute is counted, 

 and from this the total number expelled can be calculated. 

 Preliminary measurements show that the number of 

 a particles expelled from a known weight of radium is of 

 the same order as the calculated value. When the 

 measurements are completed it should be possible to deter- 

 mine the charge carried by each a particle, since the total 

 charge carried by the a particles from i gram of radium 

 is known. In this way it may be possible to settle whether 

 the a particle is a helium atom or not. In any case, it 

 is a matter of some interest to be able to detect by its 

 electrical effect a single atom of matter, and so to deter- 

 mine directly with a minimum of assumption the magni- 

 tude of some of the most important quantities in 

 radio-active phenomena. 



MEDICAL INSPECTION OF SCHOOL 



CHILDREN.' 



'pHE memorandum issued by the English Board of 



Education on the medical inspection of children in 

 public elementary schools is a statesmanlike document. 

 It propounds a policy; it indicates a method, and the 

 method, no less than the policy, takes full account of 

 conditions, difficulties, and obstacles. The memorandum 

 gives body to the provisions of section 3 of the Educa- 

 tion (Administrative Provisions) Act, 1907. This section 

 confers three broad powers on education authorities, first, 

 to provide special environments for special children, e.g. 

 vacation schools, vacation classes, play centres, ' &c. ; 

 second, to establish a medical inspection of the individual 

 children ; thirdly, " to make such arrangements as may 

 be sanctioned by the Board of Education for attending to 

 the health and physical condition of the children educated 

 in public elementary schools." These three powers may 

 be exercised in cooperation with voluntary agencies, of 

 which, it is needless to say, there are niany. But' the 

 point of importance is that the powers may now be 

 exercised by the education authorities, and practically, 

 since grants may be made to depend on their exercise] 

 the education authorities are now placed under obligation 

 to carry them into full effect. The memorandum proceeds 

 on this assumption ; but it aims rather at sketching a 

 process of natural administrative growth than at imposing 

 an imperative system to be immediately realised. Accord- 

 ingly, it starts from what is already being done in several 

 localities to supervise the hygiene of schools and scholars. 

 The sanitary authorities are in possession. This Act does 

 not supersede, it expands and supplements, their work. 

 Here emerges the cardinal principle of the memorandum, 

 namely, the extension of the conception of public health 

 to include, not merely the environmental sanitation con- 

 sidered apart, but the individual child's health as it is 

 affected by his environment in the widest sense — physical, 

 educational, &c. 



The purpose of individual inspection, no less than of the 

 general inspection of the hygienic conditions, is " to secure 

 ultimately for every child, normal or defective, conditions 

 of life compatible with that full and effective development 

 of its organic functions, its special senses and its mental 

 powers which constitute a true education." Unfortu- 

 nately, owing to accidents of administrative convenience or 

 development, there has arisen within the medical pro- 

 fession an acute difference of opinion as to the relative 

 advantages of a special school medical service and an ex- 

 panded public health service. Dr. Newman's appointment 

 unplied that the Board of Education favoured the idea of 

 an expanded public health service, and this memorandum 

 sketches in firm outline what this view implies. Incident- 

 ' (i) Memorandi 



Medical Inspection of Children in Public Ele- 

 mentary Schools, under Section n of the Education (Administrative 

 :ircular, 576). 



ciation on the Circular of the 

 a/, Supplement, December si. 



Pre 



f2) M 

 Board of Ed 

 1907.) 



(3) Schedule of Medical Inspecti 



ns) Act. 1Q07 (Roard of Education ; C 

 ndum by British Medical Assoi 

 cation (British Medical Journ. 



(accompanying Circular 582). 

 NO. 2001, VOL. ']']'] 



ally, it shows that there is no opposition between the two 

 views. On the one hand, it puts upon the medical officer 

 of health the organising of the system of medical inspec- 

 tion, but on the other, it provides that " its actual execu- 

 tion " shall be " deputed wholly or partly to suitable 

 colleagues or assistants (men or women)." The two 

 factions are thus reconciled in the one administrative 

 organisation. 



The memorandum in more than one place emphasises in 

 a way that it is impossible to controvert the primary 

 importance of the home and its hygiene in the school-life 

 of the child, and the absolute necessity for maintaining 

 continuity of inspectorial interest between the home and 

 the school. Medical inspection will thus work backwards 

 to the home and forwards to the after-school life of the 

 child, so covering the entire period between birth and the 

 entry on industrial life. When this conception of con- 

 tinuity is fully grasped, there will be no further theoretical 

 dispute between the medical factions concerned. 



The British Medical Association has issued a memor- 

 andum d|pling in a thoroughly practical spirit with the 

 proposals and suggestions of the Board of Education. It 

 is of immense importance that the medical profession 

 should thus declare itself at the beginning. The differ- 

 ences between the association and the Board are essentially 

 differences of detail. The association is quite frank in its 

 acceptance of the general positions. The association's 

 memoranduin states that " these duties could not, having 

 regard to the nature and extent of the duties already 

 required of Medical Officers of Health, be efficiently dis- 

 charged by them personally." This is not inconsistent 

 with the Board's suggestions on the same point. The 

 association also states that " part-time " medical officers, 

 paid as for work done, could appropriately undertake 

 medical inspection. This comes naturally from the pro- 

 fession, and there is much to say for it ; but again there 

 is nothing here inconsistent with the Board's views. But 

 just as in the earlier, so in these later expansions of pre- 

 ventive medicine, the tendency vi'ill be towards " whole- 

 time " specialists. In England many of the counties have 

 not yet appointed whole-time or even part-time medical 

 officers — so differing from Scotland, where every county 

 is obliged to appoint a medical officer, and all except five 

 have appointed whole-time men. 



The association's memorandum is emphatic on another 

 point, namely, that treatment of disease and visitation of 

 the hoines of the children shall be excluded from the scope 

 of the medical inspector's duties. The full bearing of this 

 suggestion will require very careful consideration. The 

 Education Board's memorandum contains a very judicious 

 discussion of the implications of the Act as to treatment, 

 and it is difficult to reconcile the Act with the letter of 

 the association's decision. The schedule proposed by the 

 association is very well drawn, but it makes no provision 

 for any record as to home conditions or occupation of 

 parents, &c., which are insisted on in the Board's 

 memorandum. 



The Board of Education has followed up its inemorandum 

 by a detailed schedule, with full directions for the medical 

 inspection. In most respects, this schedule meets all the 

 proposals of the British Medical Association. From the 

 tenor of the memorandum on the clear necessity for re- 

 cording the home conditions and the occupational condi- 

 tion of the parents, we naturally expected that these points 

 would be explicitly provided for in the schedule. In this 

 we are somewhat disappointed ; for all that we find is a 

 heading for " Directions to Parent or Teacher." It would 

 have been much simpler to have specified what details 

 are wanted for every child — number of rooms in house, 

 number of persons, occupation of father or mother, pre- 

 and post-school labour of the child. These are all primary 

 factors in the mental state of the child at any one time, 

 and practically all these data are already in possession of 

 the school authority. In other respects, the schedule is 

 very comprehensive. Indeed, this is the one real criticism 

 offered by medical critics. But when it is closely 

 scrutinised, it will be found to contain only the bare 

 essentials of a real inspection. The order of the schedule 

 is simple, and the directive notes are models of lucidity. 

 The anthropologist may regret that his special point of 

 view is not as such provided for, but there is nothing 



