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PROVINCE OF BRITISH COLUMBIA Thirty-sixth and Thirty-seventh Reports of the Medical Inspection of Schools… British Columbia. Legislative Assembly 1950

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 PROVINCE OF BRITISH COLUMBIA
Thirty-sixth and Thirty-seventh Reports of the
Medical Inspection of Schools
For the Years ended June 30th, 1947 and 1948
VICTORIA, B.C. :
Printed by Don McDiahmid, Printer to the King's Most Excellent Majesty.
1950.  Department of Health and Welfare,
Victoria, B.C., January 23rd, 1950.
To His Honour C. A. Banks,
Lieutenant-Governor of the Province of British Columbia.
May it please Your Honour :
The undersigned has the honour to present the Reports of the Medical
Inspection of Schools for the years ended June 30th, 1947 and 1948.
GEO. S. PEARSON,
Minister of Health and Welfare. Department of Health and Welfare,
Victoria, B.C., January 23rd, 1950.
The Honourable Geo. S. Pearson,
Minister of Health and Welfare, Victoria, B.C.
Sir,—I have the honour to submit the Thirty-sixth and Thirty-seventh
Reports of the Medical Inspection of Schools for the years ended June 30th,
1947 and 1948.
I have the honour to be,
Sir,
Your obedient servant,
G. F. AMYOT, M.D., D.P.H,
Deputy Minister of Health. REPORT ON SCHOOL HEALTH SERVICES.
This report on the school health services presents information and statistics on this phase of the public health services for the years ended June 30th,
1947, and June 30th, 1948.
THE SCHOOL AND THE HEALTH SERVICES.
For many years, school medical inspections have been recognized as an
essential part of a public health programme. As a matter of fact, the public
health programme in British Columbia had its origin in a school medical service
which dealt only with immediate school problems, utilizing school nurses and
part-time School Medical Inspectors employed directly by the School Boards.
It was gradually recognized, however, that the health of the school-child cannot
be separated from the general health conditions of the community in which he
lives, and that factors influencing the physical and mental health of the pupil
have their beginnings in his earlier infant and preschool existence. The best
possible school health programme will only produce results in improving the
health of the pupils in so far as it is complemented by a well-integrated and
administered health service for the community as a whole.
In recent years there has been some question as to what constitutes a good
school health service. The routine physical examination and attempted control
of communicable diseases constituted the past programme in which emphasis
was concentrated upon the physical side of the problem of the school-child.
Both health and educational authorities have become disturbed at the number of
behaviour defects, attitude changes, social and emotional problems apparent in
school-children. Observations of the effects of these on the development of the
pupil have led to the impression that these require as much consideration and
attention in the school health programme as the physical problems.
The good school health programme should add to the community health.
It should pervade the whole life of the school and the whole life of each child,
so that its concepts will be carried beyond the school into the community. An
educated person is expected to possess sound information concerning health and
disease, and to work toward the protection and improvement of his own health
and that of his family and community. Opportunities are numerous in the
school to promote the health of pupils. The conditions of the environment in
which children are called upon to live, their efforts to solve their individual and
collective health problems, their learning of the facts and the principles of personal and public health lead them to acquire habits and social attitudes that
assure better living in better health in all its aspects—moral, social, emotional,
mental, and physical.
If these principles are accepted as the tenets of a good school health programme, it becomes a field enlisting the support of both educational and health
authorities. The effectiveness and success of the programme will become dependent upon co-operation between teachers, parents, children, family physician,
public health nurse, and School Medical Inspector.   Each has a responsibility to BB 6 BRITISH COLUMBIA.
assume in ensuring the development and maintenance of optimum health by
school-children, in which health is denned as " a state of complete physical,
mental, and social well-being and not merely the absence of disease or infirmity."
The school medical service is more directly concerned with the medical
and preventive health aspects of the school health programme, including the
mental, emotional, physical, nutritional, and immunization status of the school-
child. In this the classroom teacher and the public health nurse serve as the
spearheads of a service in which intimate collaboration is essential. The
teacher, by her day-to-day observation of the children, is able to detect early
disease symptoms, behaviour problems, attitude changes, and emotional tensions requiring immediate investigation. These observations are imparted to
the public health nurse, who can correlate them with her knowledge of the
case-history of the child. The teacher-nurse conference may provide sufficient
information leading to satisfactory treatment, but in other instances the support of parents, family physicians, or others will be required. The functions
of this service have been stated to be:—
(1) Recognition of the problems in a school-child, that is, the screening and assessing of school pupils in the various grades.
(2) Referral by the teacher to nurse, by the nurse to parents, parents
to family physician, family physician to specialists, laboratories,
etc.
(3) Clinical evaluation of the unsatisfactory child.
(4) Adequate treatment of the child.
(5) Follow-up of the treatment—usually done by a combination of
parent, teacher, nurse, and physician.
The public health nurse serves to link up the school with the health and
welfare of the community. She is vitally interested in the health education of
all members of the community. In the school, however, the health instruction
is the province of the teacher. This does not mean simply formal instruction,
but implies healthful living conditions in home and school, knowledge of the
normal child and his development, intelligent observation of deviation from
normal, the health of the teacher, a happy, helpful relationship between teacher
and pupils, and an appreciation of school health as a part of the life of the
community. Possessed of sound health information, the teacher can influence
attitudes, form habits, impart knowledge, and develop skills in her pupils.
Health education, aimed at this group of society, by whom it can be assimilated,
should yield results in improved school and community health.
ROUTINE MEDICAL EXAMINATIONS VERSUS
SCREENING METHODS.
Investigation of the results obtainable through the routine medical examination has been continued during the past two years. This is prompted mainly
by a desire for a reorganization of the school medical inspection to deal with
the nutritional, mental, and emotional, as well as the physical, aspects of the
pupil's health. There is continued questioning and searching for the most
efficient methods to provide the greatest service to the maximum number of
pupils, while giving more individual attention to those needing it most. One
method, suggested in the last Report, hinged upon the use of the public health MEDICAL INSPECTION OF SCHOOLS, 1947-48. BB  7
nurse and the teacher in some form of screening and referral system, whereby
the nurse conducts a preliminary examination and, in consultation with the
teacher, refers to the School Medical Inspector selected children for more
thorough examination and investigation. This method has been tried and
proven effective, and has been studied further during the past two years. It is
recommended as a definitely superior method over the former casual routine
examination of all the pupils.
Early in 1947 our attention was directed to a new method of assessing the
physical status of children on the basis of height and weight measurements
related to chronological age, plotted on a special chart known as the " Wetzel
Grid." As heights are plotted against weights, the child is automatically categorized into one of nine physique types or specific body builds which he is
expected to maintain with fidelity throughout his growing years. If, as a
result of subsequent measurements, the plottings show a deviation from this
preferred channel of growth, it is argued that something must be wrong—
physically, nutritionally, or emotionally—and the child should be thoroughly
investigated.
In addition to this physique categorization, a time-table or schedule of
development is presented on the basis of the height-weight plottings in relation
to chronological age. Just as each child has a preferential physique channel,
he also elects his own schedule of development—slow, fast, or average—but,
again, he must adhere to his own rate constantly, or there is a deviation in his
curve, indicating impending grief.
It would appear from a study of the grid that it would be possible to divide
children into two main groups: Satisfactory—those who maintained their
individual normal growth and development; unsatisfactory—those who deviated
from their anticipated growth and development patterns. In other words, the
grid might serve as a screening tool to select the children requiring special
attention by the school health personnel.
In this vein it was proposed that a study of the Wetzel Grid in the school
health service of the Province be set up, and in September, 1947, a survey was
organized as a collaborative effort on the part of Federal, Provincial, and local
health departments. The Department of National Health and Welfare supplied
the necessary grids and seconded their pediatric specialist from their Division of
Child and Maternal Health to act as director of the survey study. The Provincial Department of Health indicated the area for study, provided consultative
services of nutritionists and physicians, and supported the project with funds
necessary for employment of clerical staff. The Central Vancouver Island
Health Unit provided staff of two public health physicians and twelve public
health nurses. The area envelops the central portion of Vancouver Island and
includes six large school districts, involving sixty schools with a school population of approximately 8,000 children.
A preliminary report on this study was presented in May, 1948, in which
it was stated that the grid served as a finer screen than did the subjective
clinical examination, accentuating the previous studies, to show that approximately only one-third of the school population required concentrated attention.
Further, the survey emphasized a nutritional and emotional causation of
deficiency in addition to the purely pathological.    This indicated a need for a BB 8 BRITISH COLUMBIA.
reorientation of the school health efforts to include increased emphasis on an
improved nutrition while also endeavouring to prevent or compensate for
emotional stress on this group of the population.
In the final analysis the value of the grid technique will depend upon a
consideration of the effects of treatment among the unsatisfactory group.
Investigations of these were included in the preliminary survey to show that
good recovery, either partial or complete, was obtained in 78.8 per cent, of the
cases with the major recovery effects most appreciable, evident in those due to
disturbances of the nutritional state.
The preliminary report recommended that, as the grid yielded objectively
information which is vital, providing information in addition to that obtained
by subjective clinical means, it was worthy of further study in the school health
services programme. A more intensive investigation into all phases of the grid
technique as compared to a routine school health programme was outlined in the
terms of reference of the survey which was again set up as a joint effort of
Federal, Provincial, and local health services. The study on this occasion was
established as a research project under the Federal health grants, to be conducted
during the academic year 1948-49, under the direction of the same field director
from the Department of National Health and Welfare as in the preliminary study.
A report of this final study will be forthcoming in the next Annual Report.
SCHOOL ENVIRONMENT REPORTS.
A new type of report on the environmental conditions in and around schools
was brought out in 1946 and has now had three years of trial. It has provided
more definite information on the sanitation of the schools of the Province and
is of value in compiling statistical data for special reports on school sanitation.
These, however, have limitations, since the conditions may be altered between
the time of reporting and the preparation of the data. Probably the greatest
value of the report form lies in pointing out the sanitation deficiencies in certain
schools to the individual School Boards more directly interested in the schools
within their school district. Copies of the reports are forwarded to these Boards
through their own local health service each year, to be followed by discussion
at a Board meeting when indicated.
However, field experience with this report form would indicate that while
it has extreme value as an initial report, little is to be gained in repetition each
year, since so many of the factors remain constant, such as window area, floor
space, ventilation, playground area, etc. It has been suggested a short form be
adopted for the annual follow-up report; a committee has been set up to prepare
a recommended follow-up report form which can be utilized to present suggested
improvements for the guidance of the Board.
Incidentally, it is interesting to note the increased number of School Boards
that have appointed travelling handy men to visit each school regularly to effect
repairs immediately as required. This has promoted an improvement in the
rural school sanitation, where long neglected repairs, so common formerly, are
becoming less evident. There is, however, still much room for improvement in
school sanitation in many areas of the Province before even minimum standards
are obtained.   Evidence of this can be found in Report No. 1 of the National MEDICAL INSPECTION OF SCHOOLS, 1947-48. BB 9
Committee for School Health Research entitled "A Health Survey of Canadian
Schools," which contains data on school environment throughout Canada,
Province by Province.
MENTAL HYGIENE IN SCHOOL HEALTH.
The grid survey revealed a definite need for greater knowledge and understanding of the emotional stresses and tensions among school-children, which
interfere with normal growth and development and often create actual mental
disease when left untended. There are numerous mental health problems
among the school population which have received too little attention in the past
but are being given increasing attention by school and health authorities. The
first line of attack on dealing with them begins with early recognition of the
beginning symptoms, and in this the teacher is the person most likely to notice
them. Having interpreted them, the teacher-nurse conference may lead to a
derivation of the cause and a suggestion of the proposed remedy to overcome
further deterioration mentally.
A very definite responsibility rests upon the shoulders of the teacher, who
requires some training and guidance in the determination of mental maladjustments. An approach to this has been made during 1948, when three teachers
commenced the one-year postgraduate training in mental hygiene at Toronto,
to return to city schools to assist and direct other teachers in the handling of
mental problems. This is in the nature of a test study, but offers promise for
the future, as it is expected more teachers will be given the same opportunity in
subsequent years. The experiment is being conducted with the approval of the
Department of Education in collaboration with the local School Boards and the
National Committee on Mental Hygiene. The results will be studied with considerable interest, to be reported upon in other Reports. It is a definite step
forward in attempting to meet the mental health needs of the school group.
ABSENTEEISM IN SCHOOLS.
Steady progress has been made in protecting school-children against the
serious communicable diseases through immunization, until now somewhere in
the neighbourhood of 80 per cent, of the total school population is immunized
against smallpox and diphtheria, with a minority group protected against
scarlet fever, whooping-cough, and tetanus. Regular annual clinics are conducted in school districts to provide reinforcing doses to maintain the immunity
status of each pupil, while the increased attention to this among the pre-school
and infant group gradually decreases the amount of service necessary in schools.
Smallpox has become practically non-existent, while diphtheria is an extremely
rare occurrence.
The minor communicable conditions still flourish with a cyclic periodicity
as new susceptible groups enter the school. Control measures have proved
exceedingly ineffective throughout the continent, since little can be done after
the initial few cases appear in a community, and the contact exposures become
more numerous. It is anticipated there will always be a degree of absenteeism
in school-children due to these minor communicable conditions, such as mumps,
chicken-pox, rubella, and rubeola, more definite in cycles of every four to five BB  10 BRITISH COLUMBIA.
years. It is recognized that they have certain complications which may leave
their after-effects, often preventable by proper medical and nursing attention
during their acute phase, but they are not as serious conditions as the major
infections.
Further studies have been conducted into absenteeism in schools and are
embodied in Report No. 3 of the National Committee for School Health Research.
Two tables from that report have been combined herewith to show the comparisons in absenteeism in urban and rural schools in British Columbia. Most
absenteeism is due to medical reasons, but a surprisingly great amount of time
is due to non-medical causes, particularly in the rural schools, where it accounts
for 43.9 per cent, of all absences as compared with 24.8 per cent, in urban areas.
Respiratory diseases are the most common cause of school absenteeism, the
common cold being the greatest single factor, creating slightly more than
26 per cent, of all absences in both rural and urban areas. It is significant that
communicable diseases account for not more than 3 per cent, of all absences in
rural schools and only 1.8 per cent, in urban schools. On the other hand, it is
a sad commentary on the lack of dental care to note that 6.8 per cent, of all
absences in urban schools are due to dental conditions, and 4 per cent, in rural
areas. Stomach disorders are the second greatest medical cause of absenteeism—10.8 per cent, in urban areas as compared with 3.2 per cent, in rural
areas.
In the non-medical causes of absenteeism, home help, parental neglect, and
weather are the major causes of time lost from school. Strangely enough,
parental neglect bulks largest in the rural schools, causing 10.2 per cent, of all
school loss as compared to only 2 per cent, in the urban schools in the Province.
Incidentally, this cause was higher in rural British Columbia than in any other
Province in Canada and lower in the urban than in any other Province.
Weather was a greater cause of absenteeism in rural schools than the urban
schools—9.4 per cent, to 1.7 per cent.
NUTRITION SERVICES.
The preliminary Wetzel Grid study served to focus nutrition as one of
the major causes of deficiency in growth and development of school-children.
During the study, consultants in nutrition were actively enlisted to provide
some guidance in assessing the results of that study while preparing recommended lists of dietary changes to promote a recovery programme. The continuation of the grid study will provide further opportunity for an assessment
of that tool as an instrument in measuring a school population nutritionally and
in testing the effects of altered nutrition in prompting individual changes in
grid pictures.
In addition to this, consultants in nutrition have provided advice and
assistance to local health services in the promotion of improved nutrition for
school groups. Much of this has centred around the school lunch, where assistance in the planning and operation of these services in the school has been
requested by teachers and Parent-Teacher Associations. Parents have been
particularly interested in the brochures issued and prepared by the nutrition
service detailing the nutritionally best types of food to include in a school-lunch
basket, while allowing for some variation in content from day to day. MEDICAL INSPECTION OF SCHOOLS, 1947-48. BB  11
HEALTH EDUCATION.
Mention has already been made of the part that health education must play
in the total school and community health services and the very important part
that the teacher and public health nurse must play in promoting and guiding
the programme, each complementing the other. Health attitudes and habits
can be moulded in a very practical manner through a well-integrated school and
community health-education programme.
The Health Education Division of the Provincial Department of Health and
Welfare provides as much practical assistance as possible to encourage a more
active health-education programme in schools. Pamphlets, posters, brochures,
slides, statistical data, motion pictures, and film-strips are supplied in increasing
numbers to school principals and teachers through their local health services.
Consultants from the Division are available to meet with teachers and public
health personnel to review the school health-teaching programme and to suggest
ways of implementing the school programme with the public health programme.
The consultants have the advantage of a teaching background themselves, which
has served to acquaint them with the teacher's problem in the classroom in
contrast with the difficulties of health education in the home from the public
health nurse's view-point. Knowledge of the needs in both fields is an aid in
drafting suggestions to meet the universal problem of health education for the
population as a whole, whom it must finally serve.
SCHOOL MEDICAL INSPECTIONS.
During 1946-47 there were 137,827 school-children enrolled in 953 schools,
but in 1947-48 this had increased to 146,708 children in 965 schools. In the
academic year 1946-47 seventy-five School Medical Inspectors submitted medical
inspection reports for 34.7 per cent, of the school-children enrolled, while in the
following year school reports for 29.8 per cent, of the school-children were
received from seventy-eight school physicians. The percentage examined is
admittedly low and is in part explained by the fact that figures do not include
the schools in Victoria, Vancouver, or Burnaby.
It is particularly significant that in both years slightly more than 91 per
cent. (91.1 per cent, in 1946-47 and 91.7 per cent, in 1947-48) were in the "A"
category, exhibiting satisfactory physical condition clinically. Only approximately 8 per cent. (8.3 per cent, in 1946-47 and 7.8 per cent, in 1947-48)
appeared with slightly impaired physical condition, while about 0.5 per cent,
in both years (0.6 per cent in 1946-47 and 0.5 per cent, in 1947-48) had major
physical impairments. These results show a consistent improvement in physical
status year by year ("A" category—86.6 per cent, in 1943-44, 88.3 per cent, in
1944-45, and 90.4 per cent, in 1945-46). So many factors affect physical
conditions that it is difficult to determine any accountable reason for such a
continuously improved physical status.
Further study of the medical inspection reports reveals a slightly better
physical status among the children in rural municipalities in contrast with those
in urban municipalities ("A" category—92.5 per cent, in rural municipalities,
91.1 per cent, in urban municipalities). In a study of the results by grade it is
found that children in the higher grades have an apparent slightly improved BB 12
BRITISH COLUMBIA.
physical status over those in the lower grades, although the figures are above
90 per cent, in all grades.
The various tables compiled from the medical inspection of school reports
are presented statistically.
Number of Absences and Days lost for each Cause as a Percentage
of all Causes and all Medical or Non-medical Causes, 1946-47.
URB.A
n  Schools.
Rural  Schools.
Causes of Absence.
All Absences.
Medical
or Nonmedical.
All
Days
lost.
Medical
or Nonmedical.
Average
Days
lost.
All Absences.
Medical
or nonmedical.
All
Days
lost.
Medical
or Nonmedical.
Average
Davs
lost.
100.0
75.2
24.8
37.3
26.1
44
50
0.4
0.4
0.4
0.6
.
18
0.1
07
0.7
*
0.1
0.2
1.0
0.8
0.2
10.9
10.8
0.1
0.4
0.3
0.1
3.0
0.2
2.6
.
0.2
20.8
2.0
1.3
6.8
0.8
100.0
100.0
49.6
34.6
5.8
6.7
0.5
0.5
0.6
0.8
0.1
2.4
0.1
1.0
0.9
*
0.2
0.2
*
1.4
1.1
0.3
14.5
14.4
0.1
*
0.5
0.3
02
*
3.9
0.3
3.3
*
0.3
27.7
2.4
1.8
9.0
0.4
100.0
79.5
20.5
41.0
25.8
3.9
7.7
0.8
0.8
0.7
1.1
0.2
7.8
0.3
3.5
2.8
0.1
0.6
0.4
0.1
1.5
1.2
0.3
8.0
7.7
0.3
.
2.2
1.1
1.0
0.1
3.3
0.9
1.1
0.1
0.2
15.7
1.4
1.6
4.2
0.5
100.0
100.0
51.6
32.6
4.9
9.6
1.0
1.0
0.9
1.4
0.2
9.8
0.4
4.2
3.6
0.2
0.7
0.5
0.2
1.9
1.5
0.4
10.0
9.7
0.3
2.8
1.4
1.3
0.1
4.1
1.3
2.4
0.1
0.3
19.8
1.8
1.9
5.2
0.7
2.0
2.1
1.6
2.2
8.4
	
1.4
11.2
2.2
1.5
100.0
56.1
43.9
36.1
26.5
4.3
3.7
05
0.1
0.4
0.4
0.1
3.0
0.1
0.1
1.0
0.1
04
1.2
0.1
1.3
1.1
0.2
3.4
3.2
0.1
0.1
0.6
0.1
0.5
1.7
0.4
1.1
0.2
10.0
1.3
0.7
4.0
0.2
100.0
100.0
64.2
47.3
7.8
6.6
0.9
0.1
0.7
0.7
0.1
5.5
0.2
0.2
1.8
0.1
0.7
2.3
0.2
2.4
1.9
0.5
6.0
5.8
0.1
0.1
1.1
0.2
0.9
3.0
0.7
1.9
0.4
17.8
2.3
1.2
7.1
0.4
100.0
53.4
46.6
27.0
18.3
3.1
3.7
0.5
0.1
0.2
0.3
0.8
9.9
0.4
0.5
2.8
0.1
2.2
3.0
0.9
2.7
2.4
0.3
1.7
1.6
0.1
*
2.9
0.1
2.8
1.9
0.9
0.7
0.2
7.3
1.2
1.0
2.0
0.2
100.0
100.0
50.7
34.3
5.7
7.0
0.8
0.2
0.4
0.6
1.7
18 4
0.8
0.9
5.2
0.3
4.1
5.5
1.6
5.0
4.5
0.5
32
2.9
0.3
.
5.4
0.3
5.1
3.5
1.7
1.4
0.4
13.8
2.3
1.9
3.7
0.5
2.7
2.6
2.9
2.1
Bronchitis  	
	
Asthma, etc	
Pneumonia 	
8.7
Mumps    	
Measles	
German Measles	
	
Quarantine	
Whooping-cough 	
	
Skin disorders	
5.5
Non-contagious	
1.4
Stomach disorder._ 	
Severe intestinal	
Appendix attack	
Jaundice._ 	
	
Operations  ____ 	
Head	
12.9
Torso.   	
Limbs    ..
All injuries _     	
3.1
Fractures—out of school...
Injuries—out of school
Fractures—in school 	
Injuries—in school	
Miscellaneous ____     _.
Eye condition  	
2.0
* Less than 0.1 per cent. MEDICAL INSPECTION OF SCHOOLS, 1947-48.
BB 13
Number of Absences and Days lost for each Cause as a Percentage
of all Causes and all Medical or Non-medical Causes, 1946-47—
Continued.
* Less than 0.1 per cent.
Note.—Tables obtained from "Absenteeism in Canadian Schools,'
Health Research.
Urban  Schools.
Rural  Schools.
Causes of Absence.
Medical
All
Days
lost.
Medical
Aver
Medical
All
Days
lost.
Medical
Aver
All Ab
or Non
or Non
age
All Ab
or non
or Non
age
sences.
medi
medi
Days
sences.
medi
medi
Days
cal.
cal.
lost.
cal.
cal.
lost.
Miscellaneous—Continued.
Doctor's examination	
0.9
1.2
0.6
0.8
0.4
0.7
0.2
0.3
	
Headache  	
2.8
3.6
0.9
1.2
	
1.1
2.0
0.3
0.6
Nose-bleed	
0.1
0.2
0.1
0.1
2.3
0.3
3.1
0.5
1.4
0.5
1.8
0.7
0.9
0.1
1.7
0.1
1.2
2.2
Nervous disorders 	
Heart conditions	
*
*
*
*
Rheumatic fever	
.
.
0.1
0.1
Anaemia	
•
*
0.2
0.3
	
0.3
*
0.5
*
1.1
0.3
1.4
0.3
0.1
0.1
*
0.1
Meningitis	
Rare ailments .__ 	
*
*
*
*
3.7
24.8
5.0
100.0
2.8
20.5
3.5
100.0
1.6
1.2
43.9
22
100.0
1.2
46.6
2.2
100.0
Non-medical causes	
2.9
Weather  	
1.7
6.7
0.9
4.5
9.4
24
10.6
22.8
0.7
2.9
1.8
6.2
0.4
0.9
0.2
0.4
Home help	
13.2
53.1
9.6
46.7
14.3
32.6
10.2
21.9
Parental neglect	
2.0
8.3
1.1
5.4
10.2
23 2
14.6
31.4
Special days  _ 	
3.1
12.7
2.0
10.0
1.8
4.0
1.8
3.8
Working __ 	
0.6
2.5
1.0
4.9
1.8
2.9
2.5
5.3
Short absence from home _
2.0
8.0
3.2
15.4
36
8.8
4.8
9.2
Transportation  	
0.3
1.1
0.1
0.6
2.1
4.9
1.7
3.7
Miscellaneous 	
1.2
4.7
1.3
6.3
0.8
1.8
0.7
1.5
Report No. 3, National Committee for School BB 14
BRITISH COLUMBIA.
STATISTICAL TABLES.
Physical Status of Total Pupils examined in the Schools for the
Years ended June 30th, 1943 to 1947.
1942-43.
1943-44.
1944-45.
1945-46.
1946-47.
Total pupils enrolled in grades examined	
77,844
40,006
51.4
45.3
39.6
0.9
1.9
8.7
0.9
1.9
0.5
0.1
0.2
78,443
34,383
43.8
40.0
41.4
1.9
3.3
8.4
1.6
1.4
0.4
0.1
1.5
75,085
34,621
46.1
41.7
44.2
1.0
1.4
9.1
0.5
1.4
0.4
0.1
0.2
88,588
39,131
44.2
38.8
48.3
0.9
2.4
7.6
0.3
1.1
0.5
0.1
106,311
47,671
44.8
Physical status—percentage of pupils examined—
A	
Ad                                                          	
36.7
51.8
Ae    __          . _.  __ .        ._
0.9
Ade
1.7
Bd        _        	
6.7
Be 	
Bde                                                         	
0.3
1.3
Cd	
Ce                                                       ...
0.4
Cde	
0.2
Physical Status, Organized and Unorganized Territory, 1946-47.
Total.
Organized.
Unorganized.
106,311
47,671
44.8
36.7
51.8
0.9
1.7
6.7
0.3
1.3
0.4
0.2
88,551
34,770
39.3
33.8
54.8
0.9
1.6
6.6
0.3
1.3
0.5
0.2
17,760
12,901
Percentage of pupils enrolled examined	
Physical status—percentage of pupils examined—
A                                                                 	
72.6
44.3
Ad                                                          	
43.2
Ae                                                               	
1.1
Ade     	
2.1
Bd                                                                .
7.3
Be	
Bde                                                         	
0.3
1 3
Cd	
Ce	
Cde    __.         _.	
0.3
0 1
Grade I.
13,341
11,457
85.9
34.0
52.5
0.9
2.1
8.0
0.3
1.6
0.4
0.2
10,557
8,936
84.6
32.9
54.1
0.8
2.0
7.6
0.3
1.8
0.4
0.1
2,784
2,521
90.6
37 9
Physical status—percentage of pupils examined—
A  	
Ad                   .      _                  __	
46.6
1.3
2.6
9.5
0.4
1.0
0.4
Ae    _ ..        _.                _
Ade  	
Bd	
Be      	
Bde     	
Cd  	
Ce	
Cde	
0.3 medical inspection of schools, 1947-48.                        bb 15
Physical Status, Organized and Unorganized Territory, 1946-47—
Continued.
Grades II-VI.
Total.
Organized.
Unorganized.
52,384
18,196
34.7
35.2
52.6
1.3
2.0
6.8
0.2
1.4
0.3
0.2
42,022
10,862
25.8
30.8
57.4
1.4
1.8
6.4
0.2
1.4
0.4
0.2
10,362
7,334
70.8
41.8
45.7
1.0
2.2
7.3
0.3
1.4
0.2
0.1
Total pupils examined  	
Physical status—percentage of pupils examined—
A           	
Ad      	
Ae           	
Ade  	
Bd  	
Be          _              ____            	
Bde      	
Cd             --     .   _ -__
Ce    __ __                   	
Cde      _
Grades VII-IX.
25,297
11,477
45.4
37.6
52.3
0.7
1.4
6.0
0.2
1.2
0.6
21,771
9,064
41.6
33.7
56.0
0.6
1.4
6.1
0.2
1.2
0.7
0.1
3,526
2,413
68.4
52.4
37.6
1.0
1.4
5.8
0.3
1.2
0.3
Physical status—percentage of pupils examined—
A              _             _              -.   „  	
Ad    _.    	
Ae                                                             	
Ade                                                                  	
Bd                                                   .  — --.
Be                              -.         	
Bde                    _   	
Cd                          	
Ce                        _ _.    	
Cde            _         	
Grades X-XIII.
Total pupils enrolled in grades examined _ 	
15,289
6,541
42.8
43.8
46.8
0.7
0.8
5.7
0.7
0.8
0.6
0.1
14.201
5,908
41.6
41.2
49.4
0.6
0.7
5.9
0.8
0.8
0.5
0.1
1,088
633
58.2
68.1
23.1
0.9
2.1
4.1
0.3
0.8
0.6
Percentage of pupils enrolled examined	
Physical status—percentage of pupils examined—
A                                             -               	
Ad                                       - 	
Ae         	
Ade                                            	
Bd                                                           	
Be                                      - —-   -    	
Bde                                          -        	
Cd                                    	
Ce                                                       	
Cde                                                               	 BB  16 BRITISH COLUMBIA.
Urban and Rural Summaries of Physical Status, 1946-47.
Total Pupils examined.
Total.
Cities.
Urban
Municipalities.
Total,
Urban.
Rural
Municipalities.
Unorganized and
Villages.
Total,
Rural.
Total pupils enrolled in
grades examined 	
Total pupils examined	
Percentage  of pupils  en-
106,311
47,626
44.8
36.7
51.7
0.9
1.7
6.8
0.3
1.3
0.4
0.2
60,712
20,427
33.6
33.1
55.5
0.7
1.5
6.6
0.4
1.6
0.5
0.1
12,562
7,108
56.6
26.4
64.0
0.5
0.9
7.3
0.7
0.2
73,274
27,535
37.6
31.3
57.8
0.6
1.4
6.8
0.3
1.4
0.4
10,477
4,427
42.3
44.1
42.1
1.8
1.8
6.7
0.6
1.6
0.6
0.7
22,560
15,664
69.4
43.9
43.7
1.8
2.3
6.8
0.3
1.2
0.4
0.1
33,037
20,091
60.8
Physical status—percentage
of pupils examined—
A
44.0
Ad	
Ae	
43.3
1.4
Ade  	
Bd  ......
Be
2.2
6.7
0.4
Bde.  	
Cd                    	
1.3
0.4
Ce        _       _.      	
Cde	
03
Grade I.
Grades II-VI.
Total pupils  enrolled in
grades examined	
13,341
7,091
1,526
8,617
1,386
3,338
4,724
Total pupils examined	
11,455
6,014
1,282
7,296
1,115
3,044
4,159
Percentage of pupils en-
85.9
84.8
84.0
84.7
80.4
91.2
88.0
Physical status—percentage
of pupils examined—
A  	
34.0
33.3
21.9
31.3
42.8
37.4
38.9
Ad	
52.5
0.9
55.3
0.5
60.6
0.2
56.3
0.5
42.2
2.2
47.2
1.4
45.9
Ae  __ __ 	
1.6
Ade     ____
2.1
2.0
1.2
1.9
2.1
2.8
2.6
Bd	
8.0
6.3
15.1
7.8
7.7
8.7
8.4
Be	
0.3
0.2
0-2
0.6
0.5
0.5
Bde. 	
1.6
2.1
0.7
1.8
1.4
1.1
1.2
Cd	
0.4
0.2
0.3
0.2
0.4
0.7
0.6
Ce	
Cde	
0.2
0.1
0.6
0.2
0.3
Total pupils enrolled in
grades examined	
Total pupils examined	
Percentage  of pupils  enrolled examined	
Physical status—percentage
of pupils examined—
A	
Ad  	
Ae	
Ade	
Bd	
Be	
Bde 	
Cd	
Ce	
Cde	
52,384
18,189
34.7
35.2
52.6
1.3
2.0
6.8
0.2
1.4
0.3
0.2
27,445
4,785
17.4
30.0
56.9
1.2
1.7
8.0
0.2
1.5
0.4
0.1
6,334
2,953
46.6
25.7
68.1
0.4
1.0
3.9
0.7
0.1
0.1
33,779
7,738
22.9
28.4
61.2
0.9
1.5
6.4
0.1
1.2
0.2
0.1
5,830
1,890
32.4
38.0
45.5
2.4
2.5
7.2
0.5
2.4
0.5
1.0
12,775
8,561
67.0
40.9
46.6
1.3
2.3
7.0
0.3
1.3
0.3
0.1
18,605
10,451
56.2
40.3
46.3
1.5
2.4
7.0
0.3
1.5
0.4
0.3 MEDICAL INSPECTION OF SCHOOLS, 1947-48. BB  17
Urban and Rural Summaries of Physical Status, 1946-47—Continued.
Grades VII-1X.
Total.
Cities.
Urban
Municipalities.
Total,
Urban.
Rural
Municipalities.
Unorganized and
Villages.
Total,
Rural.
Total pupils  enrolled in
grades examined	
Total pupils examined	
Percentage  of pupils  enrolled examined	
Physical status—percentage
of pupils examined—
A	
25,297
11,477
45.4
37.6
52.2
0.7
1.4
6.0
0.2
1.2
0.6
0.1
15,117
5,640
37.3
30.5
59.0
0.4
15
6.1
0.3
1.4
0.7
0.1
3,106
1,771
57.0
28.6
61.2
0.5
0.6
7.5
1.1
0.4
0.1
18,223
7,411
40.7
30.0
59.5
0.4
1.3
6.4
0.3
1.3
0.7
0.1
2,351
1,002
42 6
48.5
42.2
0.8
1.0
5.6
0.8
0.8
0.3
4,723
3,064
64.9
52.4
37.9
1.2
1.6
5.2
0.3
1.0
0.4
7,074
4,066
57.5
51.4
Ad	
38.9
Ae  	
1.1
Ade        .
1.5
Bd	
5.3
Be  	
0.2
Bde     	
1.0
Cd     	
0.5
Ce            	
Cde       _      _ .____	
0.1
Grades X-XIII.
Total pupils enrolled in
grades examined	
15,289
11,059
1,596
12,655
910
1,724
2,634
Total pupils examined	
6,541
3,988
1,102
5,090
463
988
1,451
Percentage  of pupils  en
rolled examined	
42.8
36.1
69.0
40.2
50.9
57.3
55.1
Physical status—percentage
of pupils examined—
A          	
43 8
46.8
40.0
49.9
29.4
61.5
37.7
52.6
64.0
28.0
65.8
26.3
65.1
Ad   	
26.8
Ae __
0.7
0.8
0.6
0.6
0.9
0.6
0.6
0.6
0.2
0.2
1.0
1.9
0.8
Ade  	
1.4
Bd   	
5.7
0.7
0.8
6.0
0.9
1.1
7.0
0.4
6.2
0.7
0.9
4.3
1.9
0.2
3.8
0.2
05
4.0
Be
0.8
Bde	
0.4
Cd   	
0.6
0.7
0.2
0.6
0.4
0.5
0.5
Ce  	
0.4
0.1
Cde                       	
0.1
0.2
0.1
0.4
0.1
Medical Inspection of School Personnel, Organized and
Unorganized Territory, 1946-47.
Total.
Organized.
Unorganized.
Total personnel employed in grades examined    	
4,358
608
14.0
63.1
19.1
1.0
13.3
0.2
3.3
3,546
436
12.3
54.2
21.6
1.1
18.3
0.2
4.6
812
172
Percentage of personnel employed examined	
Physical status—percentage of personnel examined—
A                                      _       	
21.2
86 0
Ad                                      _ -       	
12 8
B                                            	
0.6
Bd                                            - 	
0.6
C                         --    	
Cd                                                          - BB  18 BRITISH COLUMBIA.
Medical Inspection of Rural and Urban School Personnel, 1946-47.
Total.
Cities.
Urban
Municipalities.
Total,
Urban.
Rural
Municipalities.
Unorganized and
Villages.
Total,
Rural.
Total   personnel   employed
in grades examined	
Total personnel examined.—
Percentage   of   personnel
employed examined 	
Physical   status — percentage   of   personnel   examined—
A	
Ad	
B	
Bd  	
4,359
608
13.9
63.2
19.1
0.9
13.3
0.2
3.3
2,557
271
10.6
49.0
22.5
0.4
20.7
0.4
7.0
457
110
24.1
57.3
19.1
3.6
19.1
0.9
3,014
381
12.6
51.5
21.5
1.3
20.2
0.3
5.2
350
995
227
22.8
82.8
15.0
0.4
1.8
1,345
227
16.9
82.8
15.0
0.4
1.8
C	
Cd   	
Physical Status of Total Pupils examined in the Schools for the
Years ended June 30th, 1944 to 1948.
1943-44.
1944-45.
1945-46.
1946-47.
1947-48.
Total pupils enrolled in grades exam-
78,443
34,383
43.8
40.0
41.4
1.9
3.3
8.4
1.6
1.4
0.4
0.1
1.5
75,085
34,621
46.1
41.7
44.2
1.0
1.4
9.1
0.5
1.4
0.4
0.1
0.2
88,588
39,131
44.2
38.8
48.3
0.9
2.4
7.6
0.3
1.1
0.5
0.1
106,311
47,671
44.8
36.7
51.8
0.9
1.7
6.7
0.3
1.3
0.4
0.2
121,542
Total pupils examined	
Percentage of pupils enrolled examined
Physical  status—percentage of pupils
examined—
A  	
Ad      _.
43,662
35.9
39.5
49.6
Ae  _
0.9
Ade 	
1.7
Bd .   ......
6.7
Be     _ _.    .    .
0.2
Bde      ■     __
0.9
Cd	
0.3
Ce    _ _
Cde     _
0.2
Physical Status, Organized and
Unorganized Territory, 1947-48.
Total.
Organized.
Unorganized.
Total pupils enrolled in grades examined-   	
121,542
43,662
35.9
39.5
49.6
0.9
1.7
6.7
0.2
0.9
0.3
0.2
104,072
34,323
33.0
38.0
51.8
0.6
1.4
6.8
0.1
0.8
0.2
0.3
17,470
Total pupils examined         _   .__
9,339
53.5
Percentage of pupils enrolled examined    _   ._
Physical status—percentage of pupils examined—
A      	
45 2
Ad  	
41 4
Ae._...._ 	
2 2
Ade        	
2 8
Bd :_    	
6 5
Be              ...
0 3
Bde	
1 2
Cd.__              	
0 4
Ce          ...    ...   ...
Cde    	 MEDICAL INSPECTION OF SCHOOLS, 1947-48.
BB 19
Physical Status, Organized and Unorganized Territory,
1947-48—Continued.
Grade I.
Total.
Organized.
Unorganized.
Total pupils enrolled in grades examined	
Total pupils examined 	
15,443
12,637
81.8
35.8
52.4
1.0
1.4
7.6
0.1
0.7
0.3
0.1
0.6
12,665
10,420
82.3
34.1
54.6
0.8
1.1
7.7
0.1
0.7
0.2
0.7
2,778
2,217
79.8
Physical status—percentage of pupils examined—
A                                                                            _    . _ -_	
43.9
Ad
42.3
Ae                                  .„_„„   	
1.8
Ade                      _   	
2.6
Bd__                                                       	
7.3
Be                                                	
0.4
Bde.
1.1
Cd_  _                           .
0.6
Ce._                                ...      	
Cde                                       _        . 	
Grades 77-77.
Total pupils enrolled in grades examined	
60.868
14,609
24.0
40 6
47.2
1.2
2.2
6.9
0.2
1.2
0.3
0.1
0.1
50,715
9,830
19.4
40.2
48.7
0.6
1.7
7.0
0.1
1.2
0.3
0.2
10,153
4,779
Percentage of pupils enrolled examined  	
Physical status—percentage of pupils examined—
A        _     _.     	
47.1
41.3
Ad  	
44.0
Ae    ._     	
2.3
Ade                                            .   	
3 3
Bd                                                                     	
6 9
Be                                                                .    	
0.4
Bde                                                 .. __    	
1.3
Cd .                                       _     	
0.4
Ce                	
Cde                                                  .       __. 	
0.1
Grades VII-IX.
28,065
10,383
37.0
38.9
50.6
0.9
1.7
6.5
0.2
09
0.3
24,704
8,599
34 8
36 3
53.4
0.7
1.6
6.7
0.2
0.8
0.2
0.1
3,361
1,784
Percentage of pupils enrolled examined  	
Physical status—percentage of pupils examined—
A ...               „      	
53.1
51.3
Ad                                        _    	
36.8
Ae 	
2.5
Ade                    	
2 0
Bd                                                   	
5.5
Be	
0.1
Bde                    	
1.4
Cd                                     .       	
0.4
Ce                                                 ■■      --
Cde                       	 BB 20
BRITISH COLUMBIA.
Physical Status, Organized and Unorganized Territory,
1947-48—Continued.
Grades X-XIII.
Total.
Organized.
Unorganized.
Total pupils enrolled in grades examined	
17,166
6,033
35.1
46.0
47.6
0.6
0.8
44
0.1
0.4
0.1
15,988
5,474
34.2
44 2
49.5
0.4
0.8
4.5
0.1
0.4
0.1
1,178
559      *
Percentage of pupils enrolled examined  	
Physical status—percentage of pupils examined—
A                                    	
47.5
63.5
Ad                                                        	
29.5
Ae                   _ 	
2.7
Ade                                                        	
1.1
Bd                                                          	
2.9
Be                                                                     _ -
Bde                         	
0.3
Cd                                                              	
Ce                                                            	
Cde                                                 -     	
Urban and Rural Summaries of Physical Status, 1947-48.
Total Pupils examined.
Grade I.
Total.
Cities.
Urban
Municipalities.
Total,
Urban.
Rural
Municipalities.
Unorganized and
Villages.
Total,
Rural.
Total pupils enrolled in
121,542
43,662
35.9
39.5
49.6
1.0
1.7
6.7
0.2
0.9
0.3
0.2
1
71.786     1     11.768
83,554
26,647
31.9
34.0
55.5
0.5
1.1
7.4
0.1
0.8
0.2
0.1
0.3
14,103
5,514
39.1
55.5
37.5
0.7
1.3
3.8
0.1
0.6
0.3
0.2
23,885
11,501
48.2
44.6
41.6
2.2
3.0
6.5
0.3
1.4
0.4
37,988
Total pupils examined	
Percentage  of pupils  enrolled examined	
Physical status—percentage
of pupils examined—
A	
Ad          	
Ae	
Ade    .       ___    	
22,628
31.5
35.3
54.5
0.5
1.1
7.1
0.1
0.7
0.2
0.6
4,019
34.2
27.0
61.7
0.2
0.9
8.7
0.1
1.1
0.2
0.1
17,015
44.8
48.1
40.2
1.7
2.5
Bd	
Be	
Bde	
Cd 	
5.6
0.3
1.1
0 3
Ce     	
Cde	
0.1
Total pupils  enrolled  in
grades examined	
Total pupils examined	
Percentage  of pupils  enrolled examined	
Physical status—percentage
of pupils examined—
A   __ 	
Ad	
Ae	
Ade	
Bd	
Be	
Bde	
Cd  	
Ce	
Cde	
15,443
12,637
81.8
35.8
52.4
1.0
1.4
7.6
0.2
0.7
0.3
0.6
8,341
6,649
79.7
30.3
58.2
0.6
0.8
8.2
0.1
0.5
0.2
1.1
1,507
1,465
97.2
24.4
63.9
0.3
0.8
9.6
0.1
0.8
0.1
9,848
8,114
82.4
29.2
59.2
0.5
0.9
8.5
0.1
0.5
0.2
0.9
2,053
1,627
79.2
56.2
35.2
1.4
1.0
4.8
0.2
0.7
0.4
0.1
3,542
2,896
81.8
42.8
43.2
2.0
2.8
6.9
0.3
1.3
0.6
0.1
5,595
4,523
80.8
47.6
40.2
1.8
2.2
6.2
0.3
1.1
0.5
0.1 MEDICAL INSPECTION OF  SCHOOLS, 1947-48. BB  21
Urban and Rural Summaries of Physical Status, 1947-48—Continued.
Grades 77-77.
Urban
Total,
Urban.
Rural
Unorgan
Total,
Rural.
Total.
Cities.
Municipalities.
Municipalities.
ized and
Villages.
Total pupils  enrolled  in
60,868
33,195
6,016
39,211
8,329
13,328
21,657
Total pupils examined 	
14,609
5,657
1,000
6,657
2,453
5,499
7,952
Percentage  of pupils  en
rolled examined	
24.0
17.0
16.6
17.0
40.9
41.3
36.7
Physical status—percentage
of pupils examined—
A  	
40.7
37.5
20.4
34.9
53.4
41.7
45.3
Ad.   -   	
47.2
50.8
64.7
52.9
40.3
43.3
42.4
Ae	
1.2
0.7
0.2
0.6
0.4
2.2
1.7
Ade... 	
2.2
1.3
1.4
1.3
1.6
3.6
3.0
Bd  	
6.9
7.9
10.7
8.3
3.2
6.9
5.8
Be..-  	
0.2
0.1
0.1
0.1
0.4
0.3
Bde            	
1.2
0.3
0.1
1.1
0.4
0.2
2.2
0.3
0.1
1.3
0.4
0.2
0.7
0.1
0.2
1.5
0.3
0.1
1.2
Cd    •	
0.2
Ce    .   -- 	
Cde
0.1
Grades VII-IX.
Grades X-XIII.
Total pupils enrolled in
grades examined   —
28,065
17,666
2,775
20,441
2,628
4,996
7,624
Total pupils examined	
10,383
6,089
998
7,087
1,003
2,293
3,296
Percentage  of pupils  en
rolled examined 	
37.0
34.5
36.0
34.7
38.2
45.9
43.2
Physical status—percentage
of pupils examined—
A   —      --
38.9
50.6
0.9
33.9
56.0
0.6
30.0
60.0
33.2
56.6
0.5
55.3
36.8
0.3
49.2
38.0
2.4
51.0
Ad  	
37.6
Ae	
1.8
Ade
1.7
6.5
1.5
6.8
1.2
7.9
1.5
7.0
1.3
4.8
2.4
6.0
2.1
Bd  	
5.6
Be     	
0.2
0.9
0.3
0.2
0.8
0.2
0.9
0.2
0.8
0.2
0.2
0.5
0.4
0.1
1.5
0.4
0.2
Bde
1.2
Cd	
0.4
Ce	
Cde	
.._„.._
0.4
0.1
Total pupils  enrolled in
17,166
6,033
35.1
46.0
47.6
0.6
0.8
4.4
0.1
0.4
0.1
12,584
4,233
33.6
42.3
50.9
0.4
0.8
5.0
0.1
0.4
0.1
1,470
556
37.8
41.0
54.1
4.7
0.2
14,054
4,789
34.1
42.2
51.3
0.3
0.8
4.9
0.1
0.3
0.1
1,093
431
39.4
65.1
32.0
0.5
1.0
1.2
0.2
2,019
813
40.3
58.6
34.3
2.3
1.2
2.9
0.2
0.5
3,112
Total pupils examined
Percentage  of pupils  en-
1,244
40.0
Physical status—percentage
of pupils examined—
A           —.        	
60.8
Ad   _  	
33.5
Ae           	
1.7
Ade	
Bd       --          	
1.1
2.3
Be   	
0.2
Bde    __  	
Cd    -    	
0.3
Ce        -...      --
Cde         — 	
0.1 BB 22
BRITISH COLUMBIA.
Medical Inspection
of School Personnel, Organized and
Unorganized Territory, 1947-48.
Total.
Organized.
Unorganized.
Total personnel employed in grades examined 	
4,365
3,635
730
395
9.0
280
7.7
115
Percentage of personnel employed examined   _
15.8
Physical status—percentage of personnel examined—
A  	
85.6
87.5
80.9
Ad	
12.9
0.2
12.1
0.4
14.8
B	
Bd	
1.3
4.3
C    	
Cd    	
Medical Inspection of Rural and Urban School Personnel, 1947-48.
Urban
Rural
Unorgan
Total.
Cities.
Municipalities.
Urban.
Municipalities.
ized and
Villages.
Rural.
Total   personnel   employed
in grades examined	
4,365
2,646
464
3,110
313
942
1,255
Total personnel examined...
395
221
39
260
3
132
135
Percentage   of   personnel
employed examined	
9.0
8.4
8.4
8.4
1.0
14.0
10.8
Physical   status — percent
age   of   personnel   ex
amined—
A	
85.6
95.5
43.6
87.7
100.0
81.1
81.5
Ad 	
12.9
4.1
56.4
11.9
15.2
14.8
B	
0.2
0.4
0.4
Bd       	
1.3
3.7
3.7
C  	
Cd	
	
VICTORIA, B.C.:
Printed by Don McDiarmid, Printer to the King's Most Excellent Majesty.
1950.
795-150-6251  

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