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As far as the simple treatment of children suffering from tuberculosis is concerned, there seemed little reason why it should differ from that in adults; but, besides treatment, provision for their education and general mental and scholastic training has to be made. Accordingly a teacher had to be found and a school equipped. Very early on in our experiment we found one of the extreme difficulties is the variability in the scholastic attainments of the children.
A good many of the children had never been to school, but on the whole their natural intelligence is well up to the average, and they make great and rapid strides in their general education. As is to be expected, their artistic side is highly developed, and their musical talent is very marked. Several of them 'play instruments, such as the violin and mandoline, and their singing is on a high level.
Owing to the War it was not until the beginning of 1916 that the East Anglian Children's Sanatorium was completed. The buildings consist of the administrative block and two pavilions for patients called “ Astor” and “Bartholomew.” Two other pavilions will be erected later. Temporary additional accommodation is provided in revolving shelters, and a large portable building known as the “Grey House." Nearly 100 children are now under treatment, the London County Council having sent the larger number. Others have been sent by the Essex County Council, and some come from Boards of Guardians and from private sources. The improvement in the morale of the children during their stay is often astonishing. They come looking askance and furtively at us, and oftentimes are silent and rather morose. They soon, however, lose morbid characteristics, and display a fearlessness and straightness of outlook, as well as manifest a real friendliness and other features which are characteristic of the normal child at its best.
The school is a co-educational scout school, and is run as possible on scout lines. There are five classes, the three upper ones being divided into clans containing three to four patrols of scouts in each clan. Each patrol has to look after at least one cub" (children between the ages of 7 and 9) and two “ squirrels ” (children under 7) from the lower classes. Each patrol has a leader chosen by the whole patrol, who is responsible for order in class, for preparing and clearing away after a lesson, and for the behaviour of the members of the patrol. The same system is carried out in their work outside school, such as keeping the brass work clean, sweeping the wards, dusting, &c. For meals the children sit in patrols at small tables,
each patrol having its cubs and squirrels to look after, and the leaders doing the serving at table.
The aim throughout is to make the children self-disciplined, selfreliant, and, as far as possible, self-governed ; to teach them sufficient reading, writing, and arithmetic that they may not be at a disadvantage with the children of their own age who are not handicapped by illhealth; and to make their time at the sanatorium as happy as possible. Each morning one hour and three-quarters is devoted to arithmetic, reading, and writing. History, geography, and grammar lessons are taken with reading and writing. The afternoons are devoted to handwork of all kinds, including gardening, carpentry, cookery, drawing, modelling, &c.
The average age of the children on admission has been ten years and two months; the average stay twenty-eight weeks, and their average gain in weight 9. Ib. The results of treatment have so far been very encouraging. After a very strict scrutiny we have been able to certify 116, or 31 per cent. as well on leaving the sanatorium, the disease being to all appearances arrested. Those whom we could declare to be “much improved ” were 233, or 62'3 per cent. Thus 349 out of a total of 374, or 93-3 per cent., were much improved or well.
Something of the life and work of our Medico-educational Colony is shown in the accompanying illustrations.
122, Harley Street,