Sterilisation of the Unfit
- Type:
Book Reviews & Abstracts
- Author:
Walter M.
Gallichan. Werner Laurie. 7/6 net. 1929.
It is difficult to see for whom this book is written; it is obviously unscientific; it is too dull to be popular.
It is so discursive and ranges over such an immense field that it is necessarily simply a series of rather disconnected jottings. It con- sists of 192 pages of good print, of which 44 are entirely blank and in its course it touches on the following subjects:?the incidence of defect; the physiology of reproduction; various types of insanity (apparently picked at ran- dom); the menace of the feeble minded; crim- inal insanity; sterilisation, voluntary and com- pulsory; birth control, and a Chapter entitled “Terrible Families,” giving an account of the Kallikak and the Jukes family. Very highly debatable propositions are set down as indis- putable facts. For instance, it is repeated frequently throughout the book that heredity is the main cause of Mental Deficiency. It is also stated again and again that the effect of sterilisation is entirely beneficial, bringing about an ” improvement in health, sometimes amounting to revitalization in the case of ailing persons who are operated upon voluntarily.” In a chapter dealing with the objections to sterilisation the only objections considered are sentimental and not those which are urged by informed opinion.
No part of the book shows first hand know- ledge and the author would appear to have gathered together from various very uneven sources a collection of facts and opinions which he has failed to assimilate. There are mistakes in the text which, though probably due to im- perfect proof reading, are none the less an- noying to the reader.
M. T. The Hygiene of the School Child. By Lewis M. Terman and John C. Almack. (Revised Edition, pp. 505). George Iiarrap & Co., Ltd. 8/6 net.
For many years Professors Terman’s and Almack’s ” Hygiene of the School Child,” has occupied a foremost place in the literature of school medicine on both sides of the Atlantic. The revised edition has been undertaken be- cause of changes and increased knowledge in all that relates to the mental and physical health of the school child.
The authors outline the indisputable need for health work in the schools. Education is passing from the narrow definition of ” learn- ing ” to the wider and truer meaning of the art of how to live; and it is in the school that much can be done to rid humanity of the bur- den, the torment and the incalculable cost of disease.
In the preliminary chapters the growth and development of the child and the many factors concerned therewith are discussed together with a comparison of the main differences in child and adult physiology. Reviewing the various skeletal and muscular defects so com- mon in all schools, the writers stress the need for full attention to the medical and education- al needs of the crippled child. It is only in recent years that our educational systems have attempted to recognise and to deal with this important obligation, and the establish- ment of day and residential schools for the physically defective children is a bounden duty of education authorities.
The lean years of the post-war decade have raised the problem of malnutrition in school- children in almost all of our depressed areas. Not one but many causes are seen to lie at the root of this condition, and attention to gen- eral physical health and to the instruction of parents in correct methods of feeding are as important as the provision of school meals. Although the death-rate in the school popula- tion has decreased to a considerable extent, the common infectious diseases still account for much mortality and morbidity. The fact that diphtheria is still one of the leading causes of death amongst children of school- age, and that it is now to be regarded as a preventable disease reveals the need for great- er application of immunisation. Where this has been carried out on a large scale in certain American cities gratifying results have been obtained. The ever increasing ” toll of the road ” calls for serious consideration, for many thousands of deaths are due to motor and other accidents. ” Safety First ” is a slogan which should have a foremost place in the schools if we are to reduce the number of fatalities and permanent crippling conditions which result from street accidents.
Tuberculosis is much less frequent amongst children than hitherto. While this may be clue to improved conditions of living the factor of improved methods of diagnosis must not be forgotten. As initial infections occur most frequently in childhood it is to adequate med- ical care during this period that preventive measures against the ravages of this disease can be best applied.
Dental disease is a widespread condition common to practically every school. The need for increased dental staffs is obvious, but the solution of this problem lies in the early incul- cation of health habits, frequent dental in- spections and the immediate treatment of defects. Closely associated with this question is the hygiene of the nose, throat and eai. ^ere also very thorough medical supervision is essential, and the authors point out the use- fulness and necessity of school clinics which alone can supply the constant and frequently Prolonged treatment required by many con- ditions within this province.
. The human eye has had comparatively little time to become accustomed to ” the tyrrany ?f Print.” While it is now held that the school ls not so responsible for defective vision as was hitherto supposed, the writers urge edu- cationists to keep a careful watch on any poss- lole form of eye strain, and outline the signs and symptoms whereby the need for immedi- ate reference to the oculist is indicated. They show, also, the many and varied causes of headache?a frequent complaint amongst schoolchildren.
1 he place of Mental Hygiene in the school as still to receive much recognition both in “judical and in educational spheres?especi- ^ y in this country. Several new chapters are 1 evoted to a very comprehensive survey of the causes, the treatment and the prevention of le difficult and the nervous child. 1his is vUl”ely the greatest problem school hygiene has yet encountered; once it is approached and ealt with on organised lines we may expect itSo^ution of the social questions of insan- ^ > delinquency and general maladjustment d? Hfe~~and not before. It is gratifying, in- eed> to find that the teacher and the doctor re beginning to adopt a saner and wiser atti- i lc e towards the child-mind, which in the past as been so completely and thoroughly mis- understood.
book on school hygiene would be com- plete without reference to the importance of the hygienic schoolroom, and the authors con- sider in detail the essentials to be observed in the lighting, the ventilation and the general cleanliness of the school. The health of the individual teacher, too, requires a very definite place in the general scheme of school hygiene, and it is suggested that periodical examina- tions by the school doctor would be of the ut- most service to the members of this profession. Health education in the school curriculum has never been taken very seriously in many countries. The writers show quite clearly why and how it should be done.
To teacher and to doctor alike this excellent and widely comprehensive text-book may be warmly commended. Its pages show how education has evolved from the mere teaching of the ” Three R’s ” to a means of prepara- tion for the great adventure of life. Efficiency in this supremely important social service will depend on a thorough understanding and a full co-operation between the educationist and the physician?and not otherwise.
N. R. B. Oliver Untwisted. By M. A. Payne. Cr. 8vo. vii. 120. Edward Arnold & Co. 3/6. This book tells of a brave woman’s endeav- our to reorganise a large Poor Law Institu- tion for destitute children in accordance with modern ideals of education and discipline. The author has presented her story in an attrac- tive form, and the book is full of ” human ” illustrations which enlist the sympathy of the reader for the unfortunate children who under the old regime were treated as ” numbers,” and not as individuals, and did everything to the sound of a bugle ! Gradually, in spite of obstacles from within and from without?from Managers who were content with what always had been and were distrustful of innovations, and from Staff and children who did not understand and could not make use of the new freedom that was offered them, the barriers of tradition were broken down and the Institu- tion began to be transformed into a real home, where members of a family loved one another and were trusted. Unfortunately, with a change in the personnel of the Managers, the experiment was abandoned, so that the results of this pioneer work will probably never be known.
The author has a very real sympathy and understanding of children and their needs; one is perhaps tempted to feel that the ” feverish haste ” of modern educationists, of which she speaks on p. 116 may perhaps have led her, in her desire to benefit the greatest number of children under her care, to be more revolu- tionary than a conservative but well-meaning body of Managers and Staff could bear, and that peaceful penetration, from the nursery upwards, might have enabled her work to con- tinue and develop. But the faith and the vision were there and those in themselves justify the experiment.
The book will give cause for thought to all workers interested in the care of children. The Special Services of Education in Lon- don. With a foreword by G. H. Gater, C.M.G., D.S.O., Education Officer, and F. N. Kay Menzies, M.D., F.R.C.P., D.P.H., County Medical Officer of Health and School Medical Officer. Hodder & Stoughton. 1/6 net. 1929.
In this booklet are described by those who know them well the whole scope and aim of the ameliorative work of the London County Council in respect of elementary school child- ren. A comparison here and there of present conditions with those of the past serves to make the more apparent the enormous pro- gress that has been made since the passing of the earliest Education Acts, in the realisation of public responsibility for social conditions, and the possibilities of raising the standard of health and living by means of a kindly and humane official supervision of certain aspects of the daily lives of children.
The first part of the book sets forth the methods by which the special needs of those children and young people who have not all the advantages to which youth and depend- ence give them the right, can be met. And in- deed, provision is made for the welfare of the whole child population, for circumstances arise nowadays in the life of every child in which the advice and help of a sympathetic public official is almost a necessity. So complete is the administrative organisation, that, provided its work is not hindered, we may reasonably hope that the growing population of London will be the healthiest and most energetic we have yet known.
A full description of the network of admin- istrative activity, beginning with the functions of the various committees and sub-com- mittees, and the powers invested in them, fol- lowed by the duties of the various officials who carry into effect the policy of the committees, shows clearly the extent and value of this humanitarian work. One of the interesting side issues achieved is the gradual education of the parents with whom dealings are held, to a more intelligent realisation of their respon- sibilities towards the children. This delicate and tactful task is undertaken by a band of social workers, school nurses and attendance officers, wThose intimate intercourse with the parents supplements and emphasises the sug- gestions of doctor, dentist, after-care com- mittee, or other agency.
The work falls into two departments; the Education Officer’s Department, and the Pub- lic Health Department. The Education Officer is represented locally by divisional officers who act as secretaries for the managers of groups of council schools, which are responsible for the work of the attendance officers whose work carries them into the schools and homes of the children attending them. The Medical Officer of Health is similarly represented by Divisional Medical Officers who organise the medical inspections, and supervise the work of the school doctors and nurses, who are in in- timate touch with the children in the schools. London is fortunate in having also a large body of honorary workers who are trained under the care of the Council for the type of work they undertake.
This machinery makes it possible to carry on all branches of ameliorative work, begin- ning with the feeding of the hungry, the med- ical treatment of the ailing, the supervision of the physical health of all. It has led to the formation of Medical and Dental School Clinics where slight ailments and teeth may be treated, to the growth of Special Schools where children with more serious physical defects can be closely watched, and receive the skilled attention they need, to the development also of Special Schools for the mentally defective, in which these children are given the type teaching suitable for them.
There is, in addition, abundant and conclus- ive evidence in the book of the co-ordination of the work of the various agencies by whicf1 the life of the young Londoner is influenced* so that once a child or young person has been 111 touch with any authority, he can be helped to grapple with any of the crises incident to his physical and mental development.
The work of all these organisations, amelior- ative, advisory, or reformative, is detailed in t”is book in a manner at once interesting and Ruminating. The illustrations and explana- 0ry graphs and maps, add incalculably to the Vcry strong appeal which the book should “lake to all who have the welfare of children at heart.
H. C. D. r*E Health of the School Child. Annual Report of the Chief Medical Officer of the Board of Education for the Year 1928. H.M. Stationery Office. l/-net. 1929.
It is always a difficult task to choose extracts So?* Sir George Newman’s Report. There is So^ch ?f it that is of interest to teachers and j?aal workers and which it is a pity to neglect. ut sPace is limited and it is therefore necess- ry to deal only with the section of this report ^Particular interest to readers of this Journal, m m Previous Reports, Sir George New- an lays great stress on the need for the co- 0fUT?a^on ?f the work of the Medical Officer ” sTlth an<^ ^ie School Medical Officer. ^ ‘ chool hygiene cannot be divorced from bo hy giene and this in turn is intimately c n UP w^th the hygienic conditions of the th !Tnity- Efficiency and economy require, (|ajjC ore, an organic relationship between the aunf WOrk school authority and of the 0r ority responsible for the administration Th*2 branches of public health.”
c . (%re has been a large increase in the work does6 ?U^ m”lor ailment clinics?which jn ? ,n?t necessarily indicate an increase in the tjj .ence of disease, but rather an increase in and 1!?tG”est *n health taken by the community a closer co-operation between e Medical service and those in a posi ion sponsibility towards school childien. Eight new Open-air schools have been estab- lished during the year and plans foi 1 c <? y ‘ 3 residential schools (providing oi -1’ children in all) have been approved. i ncr ^ has been an immense advance too in the nition of the value of air and sunlign in ordinary schools. Of the plans submitted to the Board of Education, 80% include pro- posals for throwing open to the outside air whole portions of the classrooms. In almost every report on the work of the open-air schools emphasis is laid on the improvement in general health after a comparatively short period of attendance.
The total number of educable mentally defective children remains approximately the same as last year and the provision for this type of child has not undergone much change. ” Excellent work continues to be carried out in many areas by voluntary associations for mental welfare, which not only conduct occu- pation centres intended primarily for cases under the Mental Deficiency Committee, but also visit the homes of children who are referred to them by the School Medical Officers and exercise supervision over these children.” An account is given in this Report of the clinic which has been opened at Highbury by the Child Guidance Council for the treatment of nervous, unstable and difficult children.
A chapter of the Report is devoted to a re- view of the Report of the Joint Committee on Mental Deficiency and a short account of the procedure adopted in the investigation and a summary of the results and recommendations are given. Sir George Newman comments on the increased incidence of mental defect as contrasted with the findings of the Royal Com- missions and several reasons are given which support the view that the investigation of the recent Committee must of necessity have been more thorough and complete than that of the Commission. But he also points out the fact that ” while we accept this study as a sub- stantial advance in the investigation of this intricate question, we must not hastily draw from his (Dr Lewis’) findings, conclusions which they do not justify or sustain In modern western civilisation the presence in a great population of a half per cent, or even one per cent, of mentally defective persons, is not in itself alarming or even surprising. Nor is it, as is sometimes suggested, a grave national disqualification, a scourge which threatens the future of civilisation or the sur- vival of races. Whilst it is none of these things, it is not less an important index of a condition of things which calls for serious attention.”
Sir George Newman comments on the great value of the Report in its attitude and spirit of constructive reform and suggests several ways in which much can be done with the present statutory powers on the lines of the recommendations made. The Local Education Authorities should immediately ascertain and notify all lower grade ” ineducable ” mentally defective children in their areas; they can facilitate the organisation of suitable educa- tion for the large group of high-grade defec- tives or the still larger group of the dull and backward. It is urged also that research should be advanced into the causation of mental defect as is suggested in the recom- mendations of the Joint Committee.
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