Arthur Newsholme.

School hygiene: or, The laws of health in relation to school life online

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engine without fuel. The more brain-work a child does,
the more food he uses up. It is a great fallacy to suppose that
food is less necessary for the brain-worker than for the navvy.
Each metabolises (roughly speaking^oxidises) a large amount
of combustible material, which must be supplied by food.
The navvy, however,commonly acquires his combustible material
with greater ease than the brain-worker, owing to his better
digestion.

Hence the importance of not allowing half-starved children
to be unduly burdened with mental work is evident. Even
though they may with an effort succeed in their studies, it is at
the expense of a diminutive stature and feeble muscles. It is
to be hoped that the practice of j^iving penny dinners to chil-
dren of Board Scho ols in poorer districts may extend. A still
better plan would be to give them a mug of milk and slice of
bread before the morning's work begins.

It is unhappily the case that the children even of wealthy
people are frequently underfed. A certain amount is appor-
tioned at each meal, and a lecture on the evils of greediness
follows a request for more. We hold that a healthy child "s
appetite is the best guide as to the amount of food required, if
only the food is plain and wholesome. He might surfeit him-



CHILDREN S DIET 97

self with rich pastry, or cakes, but hardly with porridge and
milk.

The danger of under-feeding is especially great among girls,
a good ajjpetite being not uncommonly regarded by them as
something to be ashamed of. Girls between the ages of 14 and
20 often suffer from a species of chronic starvation, having got in-
to the habit of relying on bread and butter and puddings, to ihe
almost complete exclusion of meat, or other nitrogenous (\ ••'>d.'
Much weakness and ill-health in after life are ascribable to
this cause.

According to Dr. De Chaumont (Conference on School
Hygiene at Health Exhibition), for a child weighing looiOs.
(who would probably be 15 years old, see chart, page 79),
about 3 ozs. of albuminate (flesh-producing) food, 2h ozs. ot
fat, 1 2 ozs. of carbohydrates (starch and sugar) and about | oz.
of mineral matter are required per diem. In order to obtain
the above amount of albuminate material, 6 ozs. of meat would
be required, unless cheese, legumens (beans, peas, &c.), or milk
are freely taken. It may be convenient to remember that
bread contains about 8 per cent, albuminates (and 50 per cent,
starch), meat 15 per cent, albuminates, cheese over 30 per cent,
and peas and beans generally 22 per cent. Most dietaries con-
tain abundance of starch and sugar, but are deficient in fat. This
deficiency is a most important matter. If children will not eat the
fat of meat, then dripping, butter, and suet puddings are useful.

Children's diet should be varied and palatable. The inter v'als
between mea's should be regular and not too long. The food
should not be allowed to be bolted, but carefully chewed.
Milk should form an important part of all children's diet.
Alcohol should not be given in any form, unless under medical
responsibility. The teeth should be carefully supervised ; over-
crowding of the permanent teeth should be prevented by the
dentist's aid, and cavities should receive early attention.

H



98 SCHOOL HYGIENE.

The water supplied at school should be pure, and absolutely
above suspicion. Impurities may be due to its being derived
from an impure source, as a shallow well, or to impurities
acquired in transit through the pipes, or to the cistern allowing
contamination of the water, either through its being uncovered,
or having its waste-pipe connected with some part of the
drainage system. The filter should be frequently cleansed,
or It may do more harm than good.



CHAPTER XV.

Children's Dress.

Amount of Clotliiitg required. — Relation of Clothing to Food. — The
Hardening Process.- Distribution of Clothing. — Rjiles respecting
Clothitig.

A. CERTAIN temperature of the surface of the body (about
q8'5 Fahr.) is necessary for the maintenance of health, and
from this it never varies more than i8. This temperature is
the result of the chemical processes going on in the body,
the fuel for which is supplied by the food taken. Food being
deficient, the body-temperature would necessarily fall, if there
were no reserve of combustible material stored up in the
tissues.

It is evident that heat may be economised, and thus within
certain limits the amount of food required may be diminished
by preventing some of the loss of heat from the body. About
•jo to 90 per cent, of this loss being by the skin, clothing plays
an important part in preventing loss of heat.

Clothing should prevent as far as possible radiation and con
duction of heat, but not evaporation of the perspiration. The
cnaterial which is in these respects best, both for summer and
winter wear is wool, which should always be worn next tlie
jkin ; the thickness, and not the material, being altered accord-
ing to the external temperature.

99 Ha



lOO SCHOOL HYGIENE.

The amount of clothing for cliildren should be sufficient to
prevent any sensation of cold. Excessive clothing may make
children tender by increasing the tendency to catch cold,
owing to its exciting perspiration, and to the fact that the extra
clothing is often thrown off at irregular intervals. The effect
of wearing a thick scarf round the neck is a well-known
instance of this.

A deficient amount of clothing is even more dangerous.
The attempt is commonly made to " harden " children to bear
exposure to cold with bare arms and legs. The consequences
of this hardening theory are most calamitous ; not a few
children are hardened out of the world, and those who survive
suffer permanently, either in growth or constitution. The
dwarfishness of La|)landers and Esquimaux is an illustration of
this principle. Children produce heat less freely, and lose it
more quickly, than adults, hence the great mortality of children
in cold climates during the winter months.

Liebig first clearly explained the importance of clothing, say-
ing : " Our clothing is, in reference to the temperature of the
body, merely an equivalent for a certain amount of food." It
vvill be easily understood, therefore, how deficient clothing, like
deficient food, may produce stunted growth, or lay the founda-
tion for disease, or bring latent disease into activity.

Children's clothing should be of such a character that the
warmth is miiformly distributed. No extra amount of chest
protection will prevent bronchitis or pneumonia, if the legs and
feet are cold. The adoption of leggings and >leeves for young
children should always be insisted on. Thin hoots are espe-
cially objectionable. There is a great sympathy between the
feet and the respiratory tract. Chest affections are frequently
due to cold and damp feet. The boots should be thick enough
to keep the feet dry and warm. It is advisable, in some case.s,
especially, for girls to bring a dry pair of stockings to school



children's dress. lOl

Damp garments should be laid aside at once on reaching
home, and the teacher should never allow a scholar to remain
in school with wet clothes.

The practice of wearing thicker outside garments while in
the warm school-room is very objectionable. The skin becomes
relaxed and perspiration occurs, and it only requires the sub-
sequent exposure on the journey home to ensure a severe
catarrh.

The clothing should not be changed according to the
calendar, but according to the state of the weather.

The wearing of summer-clothing late into autumn, and the
assuming of light outer-garments and under-clothing as soon as
a fine day in spring appears, are very dangerous for children.

Moist cold is a good conductor of heat, and the damp chilli-
ness of an early November requires as warm and thick clothing
as the dry, clear cold of January.

Tight clothing of any kind should be avoided. It interferes
with free movement and so prevents proper exercise.

Tight corsets are particularly objectionable, and belts round
the waist. Tight sleeves and skirts prevent free movements of
the hmbs. Stockings should be supported by suspenders and
not by garters. Tight boots destroy the natural elasticity of
the movements, besides interfering with the circulation and
thus causing cold feet. High-heeled boots produce an uncer-
tain and ungraceful gait in girls ; they throw the weight of the
body on the front part of the feet, disturbing its balance, and
tending to produce spinal curvature. The soles of shoes
should be broader than the feet, the heels low and broad, and
the soles should be thick enough to keep out all damp.



CHAPTER XVT.

Baths and Bathing.

Necessity for Cleanliness. — School BatJts and Swimming.

In previous chapters, the use of food and clothing in pre-
venting loss of heat and maintaining a uniform temperature
has been briefly discussed. In this chapter we wish briefly to
impress the fact that the skin, by the proper use of water, may
be brought into such a robust condition that the sudden alter-
nations of temperature to which children are necessarily ex
posed, become comparatively free from danger.

No school education is complete which does not teach chil-
dren the necessity for a clean skin. A dirty condition of the
person strongly favours the incidence of infectious disease, as
well as helps to produce that unpleasant odour which com-
monly belongs to the air of a school-room full of scholars.

The disuse of soap and cold water to the skin renders the
cutaneous blood-vessels deficient in tone, and thus favours the
production of chills. Where morning cold baths are not
well borne by children, sponging with a wet towel, followed
by friction with a dry rough towel, forms a good substitute.

It is impossible, even if it were desirable, always to keep
children in warm rooms. They play about in cold corridors,
or other places exposed to cold currents of air, and if their

I02



BATHS AND BATHING. I03

skin is lacking in tone, a sore throat or bronchitis may be the
result.

School bathing is very desirable, though arrangements are
seldom made for it. Schools containing several hundred boys
can hardly be regarded as complete unless they possess a
swimming-bath of their own, or one in some way open to
them. Many unfortunate accidents would be prevented, and
much gain to the health and happiness of children would
result, if they were taught to swim. A boy accustomed to
plunge into cold water {i.e. at 50" to 60^*, not 32°), is much
less likely to suffer from alternations of temperature than other
children, and, if by chance he should get wet through, is less
liable to be chilled or laid up by fever.

Swimming combines the advantages of bathing and exercise.
A plunge into running water is more liable to produce cramp,
or dangerous chilling of vital organs, than into the water of a
swimming bath, as, in the former case, the water around the
swimmer is constantly being changed, and so a greater abstrac-
tion of heat from the body occurs.

School bathing should always be under strict supervision.
Children should not be allowed to loiter in undressing ; they
should never be allowed to remain in the water until chattering
of teeth, or blueness of lips or nails is produced ; and tne bath
should not be taken within two hours of a meal.



CHAPTER XVII.

Eyesight in Relation to School Life.



Siruc/ure of the Eye.—Cmisaiion of Long and Short Sight.— Use of
Eyes for near Objects. Inadequate Light.^Badly-printed Books.
—Fine Needlework.— Influence of General Health on Eyesight.



In order to understand the influence of school-life on eyesight
the following facts relating to the structure of the eye are
important.

The eye is enveloped throughout the greater part of its
circumference by a dense white coat (the sclerotic), the trans-
parent and more convex cornea enveloping the smaller moiety
in front. (Fig. 20;. Inside the sclerotic is a black vascular layer
(the choroid), which serves to absorb excessive rays of light, and
within this is spread out the delicate meshwork of the retina,
which receives impressions of light and conveys them to the
biain. The interior of the eyeball is occupied by a transparent
gelatinous material in its posterior part, and a watery material
in front, between which lies the delicate lens of the eye,
which is capable of being altered in shape by the action of
minute ciliary muscles. (3, Fig. 20}.
X04



EYESIGHT IN RELATION TO SCHOOL LIFE.



^05



In the normal eye, rays of light coming from a distance {i.e.,
practically parallel rays) are refracted by the passive lens and
media of the eye, and brought to a focus at the most sensitive
part of the retina, without any muscular effort. Thus, vision of
distant objects represents rest for the eyes, and exertion of its
muscles comes into play only for near vision.




Fig. 20 — Vertical section of the eyeball.

I, Sclerotic ; 2, choroid ; 3, ciliary muscle ; 4, cornea ; 5, iris ; 6, aqueous
humour ; 7, lens ; 8, vitreous humour ; 9, retina ; 10. optic nerve.

The divergent rays of light from a near object are brought
to a focus on the retina by the action of the ciliary muscle,*
which renders the lens more convex, and thus capable of
refracting the light more powerfully. The effect of an increased
convexity of lens in bringing divergent rays of light sooner to
a focus is shown in Fig. 21. If for any distance under 20ft.
the eye were not able thus to accommodate its condition, a
blurred and incomplete image would be formed oa the retina.



io6



SCHOOL HYGIKNE.



A child with normal eyes ought to be able to read this page,
in a good light at the distance of 40 inches, and at all inter-
vening distances down to 4 inches. Any child who cannot




Fig. 21. — Diagram showing effect of a biconvex lens on rays of light.

I, Focus of parallel rays ; 2, focus of divergent rays ; 3, focus of divergent

rays brought nearer by more conve.x lens.

read it as far as 15 inches off should have his eyes examined
by a competent eye-surgeon. A rough test may be also made
by means of the following letters : — The Z should be distin-
guishable at a distance of 50 feet, D at a distance of 40 feet, Y
at 25 feet, H at 20 feet, and L at 10 feet.




Y H



so feet- 40 feet. 25 feet. 20 feet. 10 feet.

Three chief defects of vision occur in children ; in the first,
he rays of light are brought to a focus behind the retina



EYESIGHT IN RELATION TO SCHOOL LIFE. I07

(hypermetropia) ; in the second, the rays of light are brought
to a focus in front of the retina (myopia) ; and in the third,
the different axes of the eyes do not bring rays of hght to
a focus at the same point (astigmatism).

Hypermetropia or Lofig-sight, in which the eye is shorter from
behind forwards than usual, is really in a moderate degree a
normal condition in childhood, but if present in a high degree
represents an arrest of development. Parallel rays of light
{i.e., those from a distance) are brought to a focus behind the
retma. (Fig. 22.) Thus, when the eye is at rest there is not



Fig 22.- -Sec ion of hypermetropic eye.
R, the origin of divergent rays of light ; F, the focus beyond the eyeball ;
LL, convex glasses to be worn by hypermetrope ; F' the focus of rays of
light on retina, showing influence of L.

distinct vision even of distant objects for the long-sighted.
The ciliary muscles must always act and accommodate the eye,
and in moderate degrees they succeed in concealing the con-
dition. It is evident, however, that this constant strain on the
muscles, during the waking hours, must be injurious ; and during
the use of the eye for near vision, as in reading or needlework,
the strain on the ciliary muscles becomes still greater. Conse-
quently, congestion and redness, with watering of the eyes,
result.

The lids tend to stick together in the morning, owing to
increased secretion. If close work is insisted on, in severe
cases ^^ziness and total inability to distinguish letters are pro-



108 SCHOOL HYGIENE.

duced, and, in some cases, nausea, or even vomiting. The
child is worse in the morning than the evening, as his ciHary
muscles have to adjust themselves to the strain imposed on
them. Mistakes are frequently made, and the child is often
thought to be idle. In this, as in other abnormal conditions of
the eye, it is very common for the child to have been repeatedly
punished by his teachers for supposed obstinacy or stupidity.

Long-sight is often confused with short-sight, because, in the
former, as in the latter, the child gradually holds his book
nearer and nearer to his eyes. This is because spasm of the
ciliary muscle (causing accommodation beyond the necessities
of the case) is produced by the efforts to see small objects at
moderate distances, and because the large size of the image of
the print obtained by holding the book nearer partially com-
pensates for its imperfect definition.

In the effort at accommodating long-sighted eyes for near
and small objects, those external muscles of the eyeballs
which turn them in towards the nose, are brought into exces-
sive action. A convergent squint may be thus produced, at
first occasional, afterwards becoming constant, and one eye
being usually worse than the other. The squint is worse when
the child is tired or ill, but any squint in a child 4 to 7 yef rs
old should receive immediate attention.

Myopia or Short-sight is the exact opposite of the last con-
dition, the eye from before backwards being too long, so that
rays of light from a distance are brought to a focus in front of
the retina. In order that they may be focussed on the retina,
the affected child finds it necessary to hold objects near his
eye, thus making the rays of light more divergent.

Myopia is distinguished from hypermetropia by the
fact that distant vision is improved by a concave lens,
and by the fact that the smallest type can be read
easily, provided it be held closely to the eyes.



EYESIGHT IN RELATION TO SCHOOL LIFE. I09

The fact of a person seeing equally as well, at a distance,
through a convex lens, as without, certainly indicates
hypermetropia.



Fig. 23. — Section of myopic eye.
R, the origin of divergent rays of liglit ; F, the focus of these in front of retina ;
LL, concave lens to be worn by myope ; F', focus of rays of light on retina,
showing influence ot L.

Myopia is essentially due to the soft and yielding character
of the tunic of some children's eyes, enabling the pressure of
the muscles during accommodation to elongate the globe. The
condition when started may remain stationary, but in some cases
the continuanceof thecauseincreasesthe elongationof the globe.
This may be followed by stretching and atrophy of the choroid,
or even detachment of the retina, and other evil consequences,
resulting in pardal or complete destruction of vision.

The tendency to short-sight is generally strongly hereditary,
but it may be acquired, and it is chiefly during school-life that
this occurs. Jager, in 186 1, first called attention to the
remarkable development of myopia during school-life. Dr.
Cohn, of Breslau, in 1865, took up the subject. Havin


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Online LibraryArthur NewsholmeSchool hygiene: or, The laws of health in relation to school life → online text (page 7 of 10)