Chapter VII: Appendix

As showing the need for the systematic examination of the special sense organs, I append a summary of the results arrived at and the conclusions reached by Dr. Wright Thomson after examination of the eyesight of children attending the Public Elementary Schools under the Glasgow School Board:--

"The teachers tested the visual acuteness of 52,493 children, and
found 18,565, or 35 per cent., to be below what is regarded as the
normal standard.

"I examined the 18,565 defectives by retinoscopy, and found that
11,209, or 21 per cent. of the whole, had ocular defects.

"The percentage with ocular defects was fairly constant in all the
schools, but the percentage with defective vision was very
variable--_i.e._, many children with normal eyes were found to see
badly.

"The proportion of these cases was highest in the poor and
closely-built districts and in old schools, and was lowest in the
better class schools and in those near the outskirts of the city.

"The proportion of such cases in the country schools of Chryston
and Cumbernauld was much lower than in any of the city schools; and
in Industrial Schools, where the children are fed at school, the
proportion was lower than among Board School children of a
corresponding social class.

"Defective vision, apart from ocular defect, seems to be due,
partly to want of training of the eyes for distant objects, and
partly to exhaustion of the eyes, which is easily induced when work
is carried on in bad light, or the nutrition of the children
defective from bad feeding and unhealthy surroundings.

"Regarding training of the eyes for distant objects, much might be
done in the infant department by the total abolition of sewing,
which is definitely hurtful to such young eyes, and the
substitution of competitive games involving the recognition of
small objects at a distance of 20 feet or more.

"Teachers can determine the visual acuteness, but they cannot
decide whether or not an ocular defect is present.

"Visual acuteness, especially among poor children, is variable at
different times.

"Teachers should have access to sight-testing materials at all
times, and should have the opportunity of referring suspected cases
for medical opinion.

"An annual testing by the teachers, followed by medical inspection
of the children found defective, would soon cause all existing
defects to be corrected, and would lead to the detection of those
which develop during school life."

An examination of 502 children attending the Church of Scotland Training College School, Glasgow, as regards defects in eyesight and hearing, was made by Drs. Rowan and Fullerton respectively, with the following results:--

"As regards eyesight--

"61.55 per cent. were passed as normal, while of those defective
7.57 were aware of the fact; some few of these had already received
treatment, but 30.88 were quite unaware that there was anything
wrong, these unfortunates being expected to do the same work as,
and hold their own with, their more fortunate classmates.

"As regards hearing--
54.4 per cent. were found normal.
27.6 " " were defective.
18. " " were distinctly defective."

I append the very valuable suggestions and conclusions of Dr.
Rowan, who conducted the examination on the eyesight of children:--

"After examining 502 children, which involved the examination of
1004 eyes, one is forced to certain conclusions. These children are
taken at random, and in this way they may be considered as a fair
sample of their age and class.

"I think one of the first things that force themselves on our
notice is the difficulties under which many of those children
labour, and of which they, their parents and teachers are quite
unaware. The children are considered dull, careless, or lazy, as
the case may be: they themselves, poor unfortunates, do not know
how to complain, and seem just to struggle along as best they can,
though this struggle, without adequate result, must discourage
them, and in this indirect way, too, make their future prospects
more hopeless.

"Some would be considerably benefited by treatment and operation,
or both, while for some little can be done. Some of those who could
be benefited are deprived of help by their parents' ignorance or
prejudice.

"In the case of those for whom little or nothing can be done, and
whose sight is very defective, it seems to me the question ought to
be raised as to whether their present mode of education should not
be replaced by some other, which would endeavour to develop their
abilities in other ways than through their eyesight; in short, they
should have special training with the view of fitting them for some
form of employment for which they are more fitted than the ordinary
occupations of everyday life. This raises a difficult question, and
each case would have to be settled on its merits. The difficulty
must be faced; otherwise the children will simply drift and become
idle and useless, while, if educated, at any rate partly, on the
system for the blind, they would become useful members of society.

"I think no one, after studying the result of this examination of
what may be by some considered a small number of children, can
doubt that a thorough medical examination of all school children
should be made when they enter school, and this examination
repeated at regular intervals.

"I hold this applies not only to the children of the poor, but to
children in all ranks of life, as one constantly, and that, too, in
private practice, meets with cases where children are considered
dull and lazy, while the real fault lies with the parents, who have
not taken the trouble to ascertain the physical fitness or
unfitness of their children.

"I am glad to say it is now becoming more common for children to be
taken to the family doctor, to a specialist, or to both, to be
thoroughly overhauled before starting school-life; and in many
cases with most satisfactory results, as their training can be
modified or treatment ordered which prevents the development of
those pathological conditions which, in many cases, would limit the
choice of occupation, or, if these are already present, they can at
least be modified or even overcome.

"I wish to emphasise the fact that those thorough medical
examinations should be repeated in the case of all children at
regular intervals, as in this way alone can a proper physical
standard be maintained, and deviations from the normal detected
promptly and in many cases cured before the sufferer is aware of
their presence.

"How often in examining our adult patients do we find them much
surprised when they are told and convinced by actual proof that all
their life they have depended on one eye only! This fact, of
course, they sometimes accidentally discover for themselves, and
come with the statement that the eye has suddenly gone blind. In
the majority of these cases the weaker eye is useless, and the
possibility of making it of any use is, at their age, practically
_nil_."

FOOTNOTES:

[16] Cf. _Special Report on Educational Subjects_, vol. ii.

[17] Cf. _Report on Elementary Schools of Berlin and Charlottenburg_, by G. Andrew, Esq.

[18] Cf. Appendix, pp. 62-65.

[19] _Report Royal Commission on Physical Training_ (_Scotland_), vol. i. (Neill & Co,. Edinburgh).