the general organization of this work, is advancing satisfactorily under their direction.

While the content of the course in physical training is broadening, its extent, so far as the school period is concerned, is still small. As a purely instructional exercise perhaps 15 or 20 minutes a day is adequate, but from a "study period" point of view, or rather from a joy-of-living, developmental, and recreative aspect, two hours a day is not too much.

There is a healthy tendency for the educator to view again the recess period with the respect it so long deserved, and some added time is gained for supervised physical activity after school and on Saturdays with direction by special or by regular teachers. Probably the time is not far distant when the special teacher of physical training will begin his work in the afternoon and continue it after school hours and on Saturdays.

The development of playgrounds and swimming pools, with supervision through municipal or school authorities, has added much to the opportunity for physical and therefore mental and moral health of the school child. According to the last report of the Playground and Recreation Association of America, 711 cities now maintain playgrounds, with an expenditure of more than $20,000,000 a year for their upkeep and supervision. It is not sufficient that playgrounds should exist. They need to be in charge of well-trained directors.

The value of the summer camp as a place for training in physical education and hygiene has been mentioned elsewhere. It is the missing link between school sessions and is a place for physical education in its fullest sense. It should be made the connecting link for all pupils and not simply for those who can afford the present cost of this experience.

Besides the summer camp, the Boy Scouts, Girl Scouts, and Camp Fire organizations have been of much help in promoting physical and social education during vacation periods, and the work of these organizations is becoming more effective as its leaders are better trained. The Young Men's Christian Association and Young Women's Christian Association remain worthy all-the-year promoters of physical, social, and mental health and development.

Among the notable events along the line of the promotion of participation in sane physical activities has been the birth and development of the Women's Division of the National Amateur Athletic Federation of America. The aims of this organization are to secure the adoption by women of those forms of athletics which seem best fitted for them, to have all such athletics supervised by their own sex, and to encourage research in this field. The division already has

a large membership of colleges and secondary schools throughout the country and promises to be a great power for good.

SAFETY AND FIRST AID

In addition to fire drills, the efforts to reduce the number of street accidents has become a fairly necessary part of the school program. The number of accidents from speeding vehicles has been reduced not only by classroom teaching but by closing certain streets for play and the providing of better playgrounds, with special traffic directors in the neighborhood of schools at the beginning and end of sessions.

The teaching of rescue of the drowning and the resuscitation of the partially drowned has been stimulated by the American Red Cross. The subject of first aid has been furthered by the foregoing agency and by the United States Bureau of Mines, as well as independently by the local school nurses and other teachers.

PRESCHOOL WORK

Physical examinations with the purpose of finding and securing the cure of disease or removal of hampering defects were first carried on in this country in universities and colleges. From these higher institutions they filtered into the public schools, and after 50 years it is recognized that it would be wisest to extend the privilege of this examination and bodily betterment to children before they are admitted to school. In Germany, for a number of years, children have been examined on entrance to school and if found malnourished or otherwise unfit are returned to their homes until they are in better condition for school work. In this country more forehanded proceedings have been instituted in a few cities by the examination of children previous to entry.

The nursery school, which prior to the war flourished to some extent in England and Scotland under recognition by the educational authorities, has found a foothold recently in this country. It is not to be confused with the day nursery, but is related on the one hand to this institution and on the other to the elementary schools. We quote from the annual report of Sir George Newman, chief medical officer of the English Board of Education:

It will be generally agreed that the best place for the child under 5 years of age ought to be with his mother in his own home, but when the home surroundings are unsatisfactory and likely to retard the physical and mental development of the child a properly organized nursery school would seem to be the most suitable alternative. Such a school should clearly be free from the type of control and discipline which may be appropriate to older children. It should aim primarily at building up physique and fostering the mental growth of the children it cares for by placing them in happy, healthy surroundings where

they will be fed, warmed, and cleansed and taught by homely methods how to help themselves, contract good habits, and respect the wishes and desires of their fellows. * * * It is generally conceded that the nursery school should be in charge of a specially trained, certificated teacher with less highly qualified assistants for nursing and attendance.

Although the health of the child before he becomes a candidate for school may seem beyond the province of the school, it is of the greatest moment from every point of view that the grist which enters the educational mill should be of the highest quality which heredity will allow. It becomes, then, incumbent on the community of which the school is but a part to see that everything possible is done for the preschool welfare of the child.

Besides the nursery school, there have been developed for the earlier care and guidance of the child and his parents, under publichealth administration, habit clinics, infant welfare, and maternal welfare clinics, all of which aid in the delivery to the school of better material on which to exercise its very expensive machinery.

COLLEGE HEALTH

Attempts at putting and keeping the student in his best condition for school work began in higher institutions for learning. There were giants in such work in those days, a third of a century ago, and the health program in the college and university as carried out in a few schools, such as Amherst, Yale, and Harvard, have been surpassed since in only a few institutions, and in a very large percentage it has not yet been approached.

In the matter of exercise, however, there has been progress in most quarters in furnishing all students with facilities for and in the promotion of intramural sports, financed in part by returns from intercollegiate games.

Of 182 colleges and universities of the first rank about 70 per cent require a medical examination of some kind at entrance. About 60 per cent of the schools of liberal arts of these institutions require physical training for men, and of these, 61 per cent allow semesterhour credit. In the schools for women the percentage is somewhat less. Systematic exercise is required usually in the first two years only, but in some it is required for three or four years.

Although the number of colleges giving instruction in personal hygiene has greatly increased, more than 50 per cent of such institutions of the first rank do not yet offer such a course, and comparatively few present the subject' of personal and public health adequately.

Courses having reference to parenthood and the maintenance of a healthy home have been considered foreign to the academic atmos

phere of the college for women, but the endowment and establishment of a "course in euthenics" at Vassar is seemingly an entering wedge in the direction of education which has a direct bearing on the art of living.

HEALTH OF TEACHERS

The health of all workers is looked after to a very considerable extent, and conditions which make for the effectiveness of the teacher are not wholly neglected. The teacher-retirement acts of State and city schools have had their effect in reducing to some extent the anxiety necessarily felt for the future, and anxiety is depressing to physical and mental activities.

Some States and cities have made wise requirements as to the physical condition of teachers, so that the evidently unfit will not fall into an occupation for which they are not well adapted. The schooling in hygiene and physical training which the teacher in training is now receiving also improves her own health.

The improvement in the schools as to ventilation, light, and cleanliness react (unintentionally) for the benefit of the health of the teacher, as do also her efforts at improving the health habits of her pupils. It is easier to work with children who, with a minimum of defects, are clean, well fed, well rested, and sufficiently exercised than with a dirty, malnourished, fatigued, restless, or listless crew. In providing suitable houses for the teachers in connection with the schools many communities have done much to conserve the energies of the teacher and to improve her work.

TEACHER TRAINING

Facilities for training the grade teacher for work in hygiene and physical training are developing slowly. In some States, notably Connecticut, the departments of education are putting into execution very comprehensive courses of training beginning with physical examinations and the requirements that, within a given time, the candidates shall have their physical defects corrected. If such programs are carried out as planned, the teachers of a few years hence will constitute a strong force for improving personal and public health and vigor.

There has been of late a phenomenal growth in size and number of schools giving professional courses in hygiene and physical education. Whereas 40 years ago there were but two schools giving a two-year course in "gymnastics" or "physical training" to a handful of students, some 50 prominent universities and colleges now give courses in hygiene and physical education leading to a degree in this subject, while the number of State normal and of special

schools giving such courses will bring the total of schools to more than 100.

Very few school nurses have had any special preparation for school work, but opportunities for training in public health nursing are increasing in number, and school work is being included in the courses. Special summer courses have also been arranged for in a few instances.

Courses for oral hygienists are now offered in 10 dental schools, and the number of these schools will be increased in the near future. Most physicians have had to learn the special problems of their school work chiefly through experience, but the trend of medical instruction toward preventive work is fitting them better than formerly for this task. The special schools in public health, which had their beginning in 1906, now number 12, and these are adding a small quota of better trained workers to the public school field.

PARENT-TEACHER ORGANIZATIONS

Medical inspection brought the school, of necessity, into contact with the home in a new way. The earlier workers in this field, however, exhibited a strangely indifferent attitude toward those most interested, in that they never invited the parents to be present at the examination of their children. This attitude is, however, now corrected to some extent.

The attempt at modifying the fundamental habits of the child, his eating, sleeping, etc., made it again apparent that we must have the thorough cooperation of the home. By tactful address this can be accomplished to an unexpected degree and with a far-reaching benefit on the home, but again the contact has usually been a distant one.

The parent-teacher association, which has spread so widely, serves everywhere to bring the town and gown together in better understanding and has stimulated and improved school work for health, at the same time making the home more sensible with regard to its obligations toward the work of the school.

LEGISLATION

Legislation for health work in the schools in this country may be said to have originated about 40 years ago in the practically universal introduction of the teaching of physiology and hygiene with special reference to the effects of alcohol and narcotics. It was instruction in the effects of these rather than any other feature of hygiene that was aimed at, and the knowledge conveyed as to the mechanism of the human body was incidental.