" VERMINOUS CHILDREN "
By A SCHOOL MEDICAL OFFICER
CRITICS of the evacuation arrangements have naturally fastened, as ground for their chief complaints, on the discovery that a certain proportion of the children arriving in reception areas were verminous. Stories to that effect have come from all over England and Scotland. No doubt there is a tendency to emphasise them unduly, but they obviously rest on a certain basis of fact. Universal concern has been created, not by the fact of verminous children appearing in the country, but by the discovery that sub- stantial numbers of town-children are regularly in that condition. It is worth while therefore to attempt some estimate of what the extent of the evil is and what steps are being taken to diminish it. The subject may not be attractive, but its importance is undeniable.
It must be admitted at once that not only in London but in all the great cities of Europe the population in the poorest quarters is fully infested with different varieties of vermin, chief among them the pediculus capitis, or head-louse, and the pediculus vestimentorum, or body-louse, the latter a scourge from which soldiers inevitably suffer in every war. The children are, naturally, not exempt, and in their case it is for the schools to take the evil in hand. That was not seriously begun till the early years of the present century. In 1907 it became compulsory upon all local education authorities to set up a system of school medical inspection. A few more enlightened authorities had not waited for this and in London and Bradford, for instance, the school-boards had in 1901 and 1902 appointed the first school doctors and school nurses.
The first and greatest task they had to tackle was the almost universal infestation of the school children by parasitic conditions. The early reports of these pioneers are horrifying, particularly on the subject of vermin. They were greatly hampered by lack of powers to deal with infested children. Much ignorance prevailed among the population. Infestation by lice was actually regarded as a sign of health and vigour. In 1908, however, Mr. Herbert Samuel's Act, " The Children's Charter," gave the school medical officer or his agents the power to remove and cleanse any child found in school in a verminous condition if not dealt with by the parents after due notice. Education authorities were thus compelled to instal bathing-centres where the verminous conditions could be treated. As the only justification for re- moving the children to the centres was that they were to be returned to their parents in a clean condition, difficulties at once arose. The treatment of body vermin is a simple matter—a bath and a change or sterilisation of clothing and the case is at an end. The body-louse was, in fact, under the measures taken practically exterminated. It is no longer a menace. Whereas in the early days of the school medical service numerous children at every inspection in a poor quarter would be found to be infested, now many of the younger school doctors have never seen this particular species of vermin on a school child. With the head-louse, however, the case is otherwise. The head-louse affixes her ova or nits to the hairs with an in- soluble cement, and no means of removing their resistant bodies was known, even the small-toothed combs then in use failing to dislodge them. With boys the treatment of the head-louse is as easy as that of the body-louse or easier ; the hair has only to be cropped short. At the bathing- stations there was no alternative but to treat the girls in the same way. This caused the greatest resentment and oppo- sition. The school nurses were assaulted in the streets and rioting even took place. The nurses, however, heroically continued their work.
One day, however, what appeared to be a miracle took place. A child who was refused a medical certificate for fitness to take up a scholarship on account of a verminous head returned in two hours quite free from nits. This event caused great excitement, and it became the writer's duty to investigate the phenomenon. It was found that a hairdresser, to whom the child had been taken, possessed combs that had been used by his ancestors for wig-making in the eighteenth century, and by the use of these appliances the nits were readily removed. The properties of these combs were investigated and the bathing-centres were sup- plied with similar instruments. It was now found quite easy to remove the nits as well as to destroy the vermin at one operation. Subsequently the combs were placed upon the market at a cheap rate. Mothers were instructed in their use and supplied with them at the bathing-centres at cost price.
That meant a good deal, but although live vermin are killed with ease, no application was known that could be relied upon to kill the nits. Bacot, the entomologist to the Lister Institute, devoted much time to research on the habits and nature of the louse. The school medical service is greatly indebted to him on this account. It was he who first drew attention to the lethal properties (lethal, of course, to the louse and the nit) of light wood tar oils. These now form the basis of the preparations used officially in the treat- ment of verminous heads. Bacot, a martyr in the service of humanity who is in danger of being forgotten, lost his life while investigating the disease-carrying properties of the louse.
The result of the measures taken by the education authori- ties has been a very great improvement ; the body-louse has been " liquidated," and infestation by the head-louse greatly reduced. Superstitions and ignorance have been dispersed by continuous educational propaganda. Already by 1913 very considerable improvement had been effected. It was in this year that careful statistics of medical inspection in the schools began to be kept. In 1913, 33 per cent. of the older girls in the schools (always the worst cases) were still found infested ; in 1923, 25 per cent. were so found ; in 193o, to per cent. ; in 1935, 5 per cent. ; and in 1938, 3 per cent. That is a not unsatisfactory achievement.
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