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HINES, Linnaeus Neal. A study in retardation. In American school hygiene

association. Proceedings, 1912. Springfield (Mass.) American physical education review, 1912. p. 53–56.

Also in Journal of education, 75: 460–61, April 25, 1912.

An investigation of retardation in the Crawfordsville, Ind., schools, conducted with 1,229 grade pupils as the subjects; of these 605 boys and 624 girls, 114 boys and 93 girls came under the retarded classification.

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Physical causes, general bad health, anæmia, etc.
Lacking mental ability to do the minimum amount of work required.
Home and outside environment...

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of the 1,229 children, “887 belonged to the good health class and 342 to the poor health class. In the same body of pupils, only 207 are retarded, and of the retarded pupils, only 63 belong to the poor health class. The poor health pupils constitute 27.8 per cent of the entire number, 1,229 or 27.2 per cent of the nonretarded pupils come in the poor health class and ... only 30.4 per cent of the retarded pupils are in the poor health classification. Of the nonretarded pupils, 279 are in poor health or need medical attention. The term 'poor health'[includes) poor eyesight, defective hearing, or other similar troubles.

“It may be safely stated that from 70 to 80 per cent of school children have some defect.

“What, then, can be done about the matter. Employ school doctors and school nurses, improve the home conditions where possible, better the conditions in the schoolroom and on the play. ground. . . . If every pupil did his work in the open air all the time, if the school gave him a bath whenever he needed it, if the school kept him properly fed, if the school through the doctor and the nurse sought to remedy his defects, conditions would be changed for the better. ... The demand is insistent that the school shall take up this burden for society. The school will answer the call by assuming a

responsibility for the physical welfare of the child as well as for his mental and moral welfare." HOAG, Ernest Bryant. The teacher's relation to health supervision in schools. American academy of medicine. Bulletin, 13: 127-34, June 1912.

Reprinted in American academy of medicine. Conservation of school children.

“(1) Every teacher before certification should be obliged to give evidence of practical elementary knowledge of the functions of the body.

"(2) Every such teacher should be obliged to give evidence of practical knowledge of those ordinary physical defects of children in the schools, which interfere with school progress.

“(3) Every normal school and teachers' college should provide adequate instruction in the lines indicated above. Very few of them now do so, although when questioned most of them answer in the affirmative, regarding certain traditional courses in biology and physiology as covering the requirement, a supposition which the facts prove almost entirely unwarranted.

“(4) Teachers who are without experience in child hygiene but who are already certificated, should be instructed by properly qualified specialists in this subject.

(5) Physical educators must receive this special training in addition to that which they ordinarily acquire in their courses and with it their efforts will prove particularly valuable in this new sort of health supervision.”

The writer gives an outline for the health grading of the school child, to be made by the teacher at the beginning of the term. It embodies the following general heads: (a) General appearance; (6) mental conditions; (c) nervous conditions; (d) teeth; (e) nose and throat; (1) ears; (9) eyes; (h) communicable diseases of the skin; (i) eruptive diseases.

“When the outline is properly filled out,” says Mr. Hoag, “the teachers will be surprised with the information it develops on points often unsuspected. As a preliminary test before the arrival of the

school medical oflicer or nurse, it will surnish invaluable aid.” HOFFMAN, Frederick L. Medical and physical examination of school children.

American statistical association. Quarterly publications, 12 : 558–65, June 1911. tables.

“It would pay the community to reduce absence and retardation to a minimum by intelligent medical and physical inspection of school children and to employ methods of sanitary control. . . . We require to know the amount of floor space per pupil as well as the amount of cubic space. ... We require more accurate and conclusive statistics on the question as to whether there is a direct relationship between school attendance and epidemic outbreaks of acute infectious diseases. ... We require to know more definitely the actual temperature and air conditions in schoolrooms during the winter months. ... We need better mortality statistics of children at school, thoroughly analyzed according to causes and circumstances to determine the extent to which deaths from diphtheria, scarlet fever, and whooping cough are directly traceable to school infection."

Iowa State teachers' association. Educational council. Report of the com

mittee on medical inspection of schools. In its Proceedings, 1909. Des Moines, Iowa, Emory H. English, State printer, 1910. p. 59–76. tables.

Chairman, H. E. Blackmar.
Salaries of medical inspectors, etc.: p. 68-69. Bibliography: p. 74–75. Reprinted.

A résumé of medical inspection. In vogue in some form in France since 1833. In 1874 at Brussels in Belgium, medical inspection in its full modern sense of the term was successfully inaugurated. In Germany a beginning was made at Dresden in 1867, but not until 1889 was a system of true medical inspection established. In 1887 Hungary enacted a law providing for school physicians. Moscow has had school physicians since 1888. Japan has had medical inspection since 1898. The English law became effective January 1, 1908.

In the United States 9 States have passed laws relative to medical inspection. In 1899 Connecticut passed a law for the testing of the eyesight in all public schools. The New Jersey statute became a law in 1903. Vermont followed in 1904. The Massachusetts law was enacted in 1906. The New Jersey law was revised and became mandatory in 1909. Since September, 1908, medical inspection laws have been passed in Colorado, Washington, California, Maine, and Michigan, and are pending in Ohio and Indiana. Controlling authority in cities outside of Massachusetts (1908), p. 60-62. Established since November 1908, in additional cities, p. 65. Salaries of inspectors, p. 68; "cost varies with the extent and kind of work done."

Forms: p. 71-73. References: p. 74–75.

“Until statutory provision is made for medical inspection we urge upon the superintendents and school boards the wisdom of taking initiatory steps. . (1) By issuing each semester or oftener reports on the health and habits of the children. (2) By printing on this report card, or distributing in some other manner, simple rules of health for school children. (3) By printing and distributing leaflets relative

to the care of the teeth." MAXWELL, William Henry. The necessity for Departments of health within

Boards of education. In American school hygiene association, meeting with the Department of school superintendents, National education association of the United States, 1909. Proceedings of the First, second and third congresses. Published November, 1910, by the American school hygiene association. Springfield [Mass.] American physical education review, 1910. p. 207–12.

Also in National education association of the United States. Department of superintendence. Proceedings, 1909. Published by the association, 1909. p. 98-103; in National education association of the United States. Journal of proceedings and addresses, 1909. p. 252-257; and in American physical education review, 14:301-307, May 1909.

“So far ... as medical inspection deals with physical defects and with building up the constitution of children through their school work, it will be most efficiently conducted under the supervision of the school authorities. ...

“Some of the problems, which the physician equipped with the resources of modern science may help us to solve, are the following: (a) Problems of posture; (b) problems of vision; (c) problems of nose and throat; (d) problems of nutrition and growth.

“The problem of instructing parents in the feeding of children ... can be accomplished only through a well-organized corps of medical experts and nurses.

“A department of hygiene is necessary because teachers stand in constant need of the skilled physician's advice in the treatment and training of children. ... The crowning reason for placing this work under the supervision of the board of education is that the work of mind-training is so interwoven with the work of physical training that the work of the teacher and the work of the physician cannot be disassociated without loss to both.”

See also opinion of the New York City superintendent of schools. A department of school hygiene. In his Annual report, year ending July 31, 1907. p. 133-43.

“Dual responsibility in the school--that of the board of education and that of the department of health-always has resulted and always will result in confusion and inefficiency in the work affected. It is owing to this dual responsibility that the large annual appropriation made by the city for the physical examination of school children is to a great degree wasted. Efficient service will be obtained only when the board of education is made solely responsible for all the work that goes on in the schools. .

The school nurses would do much more and better work if they were made responsible to the educational

authorities." New England association of school superintendents. A report on the Physical

welfare of the public school child. . . May 1909. Hartford, Connecticut, Printed by R. S. Peck & co. 43 p. tables.

A résumé, with tables, of various medical inspection reports, showing association of physical defects with retardation; i. e., South Manchester, Conn.; Medford, Mass.; Camden, N. J.; New York, N. Y.;

New Haven, Conn.; and other cities; with special showings, also, of eye, nose, ear, throat, and teeth conditions in reports.

“The means taken to protect the health of the school children in the New Haven schools are:

“1. Children having contagious diseases, others in the same family, and those living in the same house must remain out of school until given permission by the health officer to return.

"2. All books and school material used by a child after the beginning of a contagious disease are promptly burned.

“3. Schoolrooms in which there have been cases of contagious diseases are closed and thoroughly fumigated. ...

“4. School physicians, local practicing physicians, are at their offices ready to respond to school calls every morning, if summoned by the school principal, to decide such cases as the principal does not feel competent to pass judgment upon. If the physician finds it necessary, he immediately dismisses the child temporarily from school. Bi-weekly visits are also made by the school physicians to every school building for purposes of general inspection and consultation.

5. A school nurse spends all her time in school assisting the physician, treating simple cases, and visiting the home to give parents necessary information about treatment to be continued there.

“6. The newer school buildings and many old ones are provided with the best systems of practical ventilation. ...

“7. Drinking fountains are being installed in increasing numbers in our schools and drinking cups are being abandoned.

“8. Paper towels are replacing the cloth towel." NEWTON, Richard Cole. Medical and sanitary inspection of schools. Medical record, 75: 480–82, March 20, 1909.

Résumé of the history of medical inspection, and of some inspections made in Brookline, Mass., and in Chicopee, Mass., where one child out of 500 examined had perfect teeth-but had also spinal disease. Not one child out of the 500 was without defects.

“Perhaps the greatest need in the educational world at present is for medical men, sanitarians, and architects on the boards of education. ... The plan now in vogue in Boston of hiring the best available architect, engineer, etc., in the city to supervise and construct all the school buildings, should be adopted in every city and should be extended to the employment of at least one thoroughly competent chief medical and sanitary inspector. This man should be responsible to the board of education ... and should have complete control of the sanitation and hygiene of the school buildings and of all the scholars. In the matter of ventilation, heating, drainage, playground space, control of athletic sports, hiring and discharge of physical and gymnasium directors and teachers, he should be subordinate only to the superintendent of schools and the board of education. ..

“Every town having 2,000 or more school children should employ medical officer of instruction, at a yearly salary of not less than $3,500, who should give his entire time to the schools during the school year, and should supervise the playgrounds, and the out-of-door physical instruction during the summer. He should be allowed to employ as many nurses as might be needed at a compensation of $75 a month, and as many physical instructors, both male and female, as might be required. He should have charge of all the records and statistics bearing upon the physical condition of the children and of the sanitation of the buildings."

Part of a report presented to the New Jersey State sanitary association, December 5, 1908. QUIX, F. H. Die prophylaxe der taubheit bei schulkindern. In III° Congrès

international d'hygiene scolaire, 1910. Rapports. Paris, A. Maloine, éditeur, 1910. v. 1. p. 679–83.

Literaturverzeichnis: p. 683.
Also in Internationales archiv für schulhygiene, 6: 422-28, July 1910.
Literaturverzeichnis: p. 427-28.

In no country have statistics been established by school physicians, showing the percentage of deafness among school children, presentable by judicious prophylaxis.

Ear specialist should test the school child's hearing at beginning of his school life, and to its close make annual examinations, to take place on school premises. Teachers should not be allowed to make these examinations.

In the study of the prophylaxis of deafness, the diseases to be examined are: (a) Adenoids; () infectious diseases, measles, diphtheria, influenza, scarlet fever, meningitis, typhoid fever, mumps; (c)

catarrh and tuberculosis of the superior air passages; (d) ear conditions. RAPEER, Louis W. Medical supervision of schools. American education, 15: 352–57, April 1912.

Contains a tentative standard classification of school ailments, with the following divisions: (1) Physical defects; (2) noncontagious ailments; (3) parasitic ailments (transmissible); (4) infectious diseases. Also Symptoms of children's ailments, as follows: For teacher, nurse, and parent-(1) Teeth defects; (2) nose, throat, and ear disorders; (3) eye ailments and defects; (4) nervous ailments; (5) digestive system disorders; (6) deformities and bad posture; (7) infectious and parasitic ailments.

RAPEER, Louis W. Tentative standard plan for medical supervision of schools. Some summary suggestions. School and home education, 31: 367–72, May 1912.

Also with verbal difference in Journal of education, 75: 583-84, May 23, 1912.

"1. Medical supervision and all other provisions for public health through the public schools should be administered by the boards of education.

“2. All school health provisions should be correlated in a department of hygiene with the following divisions: Medical supervision, school sanitation, physical education, health teaching, and tho hygieno of instruction.

"3. The supervisor of hygiene should be a physical educator with special medical knowledge of school children. . . . Ais whole time should be devoted to the work of the schools and his salary should be about $3,000 a year, for 12 months. . .

“4. Most of the work of inspection, examination and follow-up of school children should be done by specially trained and selected school nurses working 12 months in the year and not by part-time phy. sicians working a few hours or minutes each week.

“5. Where a supervisor for full time can not be employed a supervising nurse or part-time physician should direct and train the nurses for the school work, with the help of the superintendent of schools.

“6. In cities imder 15,000 population medical supervision should begin with the employment of nurses and a physician for consultation or examination only...

“7. The salary of $2,500 or $3,000 for the hygiene supervisor will mean in many cities very little extra outlay of money; the elementary supervisor of physical training may in certain cases be dispensed with; few or no physicians need be employed except on the nurse's basis; and the work of the school nurses can be made very much more efficient. The need is for men and women specially trained for school health work. ...

“11. The schools may well start with a nurse for each 1,500 elementary school pupils. . . . They should be employed 12 months in the year with a few weeks vacation, and receive a beginning salary somewhere between $70 and $100 a month.

"12. The year's work should begin with a preliminary room-inspection of all pupils from the lowest grades up; the nurse standing with her back toward a good light and having the pupils file slowly past her while she calls out by the code numbers ailments and defects observed-the teachei at her desk writing down the nurse's findings on each pupil's historical health-record card, and properly checking those to be referred to parents, excluded, given corrective exercises, and the like. ... Forty or fifty children can be room inspected in an hour in average rooms.

"13. The nurse should call at each of her schools each morning for the individual inspection of suspicious cases referred to her by the teachers ... and at the last school she should spend the remainder of her morning in making physical examinations, or helping the physician examiner, if any.

“14. About 10 children can be examined in an hour. . .

15. In the two lower drawers of the filing case the health record cards for the school may be arranged by sexes, left and right, and by rooms, alphabetically for each room, and the lowest grades in front. ...

“16. A simple standard set of blank forms should be used. Most blanks now used ... are woefully inefficient. . . . The New York bureau of municipal research and the Sage foundation are exceedingly helpful. ...

“17. A simple school classification and nomenclature of children's disorders should be adopted. Both the popular and the scientific names should be used. . .

“19. The school nurse with practice can inspect for contagious diseases. . .
“20. The final test of medical supervision and educational hygiene is prevention and cure. ...

“21. Daily reports throughout the year should be made by the nurse and physician while employed. These reports of cases found, referred, excluded, cured or improved should be summarized weekly and

printed in the newspapers." RAYCROFT, Joseph E. Function and administration of medical supervision in the school. Hygiene and physical education, 1: 38-42, 257–59, April, May 1909.

“The plan for medical supervision should provide for: (1) Careful consideration of all phases of the school environment. . . . (2) Regular physical era minations. . . . (3) Physical training. . . . (4) Medical

inspection which should be regular and systematic." RUSSELL SAGE foundation. Department of child hygiene. What Amer

ican cities are doing for the health of school children; Report covering conditions in 1,038 cities. New York City, Russell Sage foundation, Dept. of child hygiene (1911) 43 p. tables. diagr. 8°. (Health, education, recreation, no. 101)

Pt. I. Medical inspection. Pt. II. Hygiene of the schoolroom.

* See his Medical supervision of schools. American education, 15: 352–57, April 1912 (preceding reference).

82883°-13 -2

Summary of provisions for health of children in public schools, 1911.

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North Atlantic Division.
South Atlantic Division.
South Central Division.
North Central Division.
Western Division...
North Atlantic Division:

Maine.
New Hampshire.
Vermont..
Massachusetts.
Rhode Island.
Connecticut..
New York..
New Jersey.

Pennsylvania.
South Atlantic Division:

Delaware.
Maryland
Virginia...
West Virginia.
North Carolina.
South Carolina..
Georgia..

Florida.
South Central Division:

Kentucky.
Tennessee.
Alabama.
Mississippi.
Louisiana.
Texas.
Arkansas.

Oklahoma
North Central Division:

Obio.
Indiana.
Illinois.
Michigan.
Wisconsin
Minnesota.
Iowa...
Missouri.
North Dakota.
South Dakota.
Nebraska.

Kansas.
Western Division:

Montana.
Wyoming.
Colorado
New Mexico.
Arizona.
Utah.
Nevada.
Idaho.
Washington.
Oregon
California.

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SHAFER, George H. Health inspection of schools in the United States. Peda-
gogical seminary, 16: 273-314, September 1911. tables.

Bibliography: p. 301-302.
Appendix. School medical inspection in New York City, p. 303-14.

“In general it may be said, that in the older and larger cities of the East and Middle West the board
of health controls, whereas in the smaller cities of the East and the newer cities of the South and West
the board of education controls. ...

"It seems to be the general opinion that all matters pertaining to infectious and contagious diseases should remain under the control of the board of health, but with respect to the more complete health

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