HANDBOOK OF COMMUNICABLE DISEASES AND SCHOOL HEALTH: A guide for Medical Officers of Schools

SCHOOL HEALTH: A guide for Medical Officers of Schools. By the Medical Officers of Schools Association. Fourteenth Edition. (Pp. xii+ 141. 15s). London: J. & A. Churchill, 1969. THIS is the fourteenth edition of a handbook that first appeared in 1885 issued by the Medical Officers of Schools Association, because, to quote the preface to the first addition, ". . . claiming immediate attention was the need for the general adoption of more definite rules for guarding our great educational establishments from the outbreak and spread of preventible infectious disease." The greater part of the book still deals with communicable disease in the form of an alphabetically arranged catalogue from Bornholm Disease to Worms, under the headings, Definition & Cause, Diagnosis, Infection and Transmission, Incubation Period, Period of Communicability, Immunity, Prevalence, Methods of Control, Treatment, and Return to School. The list covers all the common communicable diseases in this country including trichomonas and the venereal diseases, and; although it treats them more briefly than its nearest rival the similarly sized Control of Communicable Diseases in Man, of the American Public Health Association, the handbook is more up to date in many respects. For example, the mysterious epidemic syncope and immunisation against measles are included. Rubella and pregnancy are thoroughly discussed including the desirability of immunity to rubella in girls at an early age. Among diseases which are troublesome in Ulster plantalwarts and scabies are well described, but it is surprising to find that no exclusion from school is advised for ringworm, that no mention is made of contact tracing with Wood's light for the fluoreswent types of Tinea Capitis nor brush-and-comb culture for the non-fluorescent, and the role of pet cats and dogs in spreading the disease is not emphasised. The text is for the most part attractively written and unequivocal, though the entry under the heading Food Poisoning Immunity, "None per se", may leave some readers in doubt. Pages 119 to 126 were missing from the reviewer's copy, but the book is singularly free from typographical and alignment errors, and has a fresh, uncluttered, and consistent layout that makes for quick and easy reference. As well as communicable diseases the handbook now includes sections on some other aspects of the school medical officer's work such as hygiene, disinfection, immunisation, adolescence, medical examinations, and health education. Some of these matters are dealt with so briefly as to emphasise that we are reading a handbook rather than a textbook; Dental Supervision, for example, gets five lines advising that treatment be obtained during holidays unless the parents are overseas. A notable exception is the excellent article on menstruation which is modern in approach and deals quite fully with the problems of dysmenorrhoea, menorrhagia, menstrual irregularity, and amenorrhoea. It discusses hormone therapy, internal tampons and anaemia in schoolgirls, and the advice is clear, practical, and confident. This article is a model oif its kind and will be of great value for health visitors and others who have to advise pupils, parents, and teachers on menstrual problems, and to prepare material for health education. Adolescence is also treated at some length and the topics dealt with include alcohol, smoking, drugs, sexual problems, and emotional disorders. In this section the author is less assured, and it is difficult to agree with the passage on emotional disorders which begins, "Although the school Medical Officer may not have many cases of emotional instability to deal with, he will find that they can take up a lot of his tine. It is a truism to say that, although adolescence is physically the fittest time in life, emotionally it is the sickest. The school Medical Officer is at a considerable disadvantage in dealing with such cases". In spite of the gloomy despair of this passage the problems of promiscuity, homosexuality, and masturbation in the young are given very sympathetic consideration.