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LESLIE, George L. Health and development supervision of the public schools of California. Western journal of education, 15:17-25, January 1910.

Assembly bill No. 303, p. 25-26.

Also in Sierra educational news, 6:27-34, February 1910; and with some verbal changes, in Psycho logical clinic, 4:33-39, April 15, 1910. TERMAN, Lewis M. Medical inspection of schools in California. Psychological clinic, 5:57–62, May 15, 1911.

Legislature, March 1909, “passed bill authorizing (not compelling) cities to make expenditures for carrying out an elaborato system of health supervision in the schools."

BERKELEY.

HOAG, Ernest Bryant. The cooperation of school health departments with other health agencies. California State journal of medicine, 9:18-19, January 1911.

Also in American academy of medicine. Bulletin, 12:36-39, February 1911.

The medical clinic organized in Berkeley after the San Francisco fire of 1906, was reorganized with staff of 15 representative physicians. The Berkeley charity organization joined with the medical clinic, and the two associations housed in a building near the school and city health department. The Alameda county dental society organized two dental dispensaries, one for Oakland and one for Berkeley, completely equipped in modern dental necessities. The board of education at once placed at the disposal of the Berkeley dental dispensary, offices in connection with those of the medical director of schools. The Red Cross and Tuberculosis societies will also cooperate with the others, and Berkeley will have united toward one common end the efforts of the following health agencies: (1) The school health department; (2) the city health department; (3) the charity organization; (4) the medical dispensary; (5) the dental dispensary; (6) the city charity commission; (7) the Red Cross society; (8) the tuberculosis

society. HOAG, Ernest Bryant. A general plan for health supervision in schools. California State board of health. Monthly bulletin, 5: 173–78, February 1910.

Of the first 750 children referred to the school physician by the teachers in Berkeley, Cal., nearly 70 per cent were found to be in need of medical or dental attention. Of 493 children in the third to the eighth grades inclusive, 53 per cent used tea or coffee or both daily. Of the 493 children, 25 per cent habitually slept in un ventilated bedrooms.

LOS ANGELES.

LESLIE, George L. Department of health and development-Los Angeles city

schools. California. State board of health. Monthly bulletin, 5: 180–85, Febru

ary 1910.

(a) All matters pertaining to contagious diseases are under the direction of the city board of health, which employs a staff of physicians and school nurses to attend to this work.

(6) All matters pertaining to non-contagious defects-to health, growth and development of pupils and teachers, are under the control and direction of the board of education, and conducted in accordance with the health and development law of California.”

Los Angeles staff examines approximately 50 per cent of the pupils of each school building, selecting: First-Pupils who failed to be promoted. Second-Pupils, two, three or more years behind schoo! grade. Third-All pupils selected by principals and teachers as needing medical aid (glasses, surgery, etc.). Fourth---All pupils of low vitality, unduly nervous, pupils not getting on well in their school work, pupils who need an unusual amount of discipline, of those with criminal tendencies, etc. Fifth-All applicants for positions as teachers in the city schools undergo physical examination by the staff. All

teachers in the schools report for examination when requested by the superintendent's office. SixthEspecial examination is given to exceptional children. Seventh-School buildings are inspected by the staff. Eighth-Follow-up-work is carried on by the staff, by principals and teachers of the schools. The following is a summary of examinations of Los Angeles city schools:

A pproximate summary of ten months' examinations.

A. All pupils examined by staff. Enrollment of schools when examined.

6,647 Number hastily passed upon by examining staff.

2,808 Number thorough physical examinations.

3, 846 Report of physical examination. Number defective in eyesight..

2,012 Notices sent to parents....

900 1,112 to be watched by teachers and examined further if pupil's health or school work indicates further examination. Number defective in hearing...

862 Notices sent to parents.....

175 Most of the defective hearing is due to adenoids and diseased tonsils and lack of care of the nose and throat. For this reason special notices of defective hearing were not sent to parents where the cause was otherwise clearly indicated. Number defective sets of teeth

1,395 Notices sent to parents...

1,395 Adenoids present..

1,322 Notices sent to parents.

6,670 652 to be watched by teachers and reëxamined if defective hearing or lowered vitality indicate such examination. Number abnormal and diseased tonsils..

1,517 Notices sent to parents....

669 688 cases to be watched as in case of adenoids.

Poor lung action and chest development; hard to judge accurately. Functional heart insufficiency..

314 Notices sent to parents..

70 Organic heart disease..

66

1, 129

259 446

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B. Special pupils only examined. Report of physical examinations of pupils, selected by teachers and examiners, because the need of examination was indicated by poor health, lowered vitality, or poor school work-all pupils undergoing the physical examination by examining staff. Notices sent to parents in almost all cases. Number examined.. Defective in eyesight.

434 Defective in hearing. Delective teeth. Adenoids present.

319 Abnormal and diseased tonsils..

332 Functional heart insufficiency.

144 Organic heart disease...

The above pupils were pupils especially selected from different buildings, or pupils of ungraded rooms, or of the special schools, or of the deal school, or office examinations.

Total number examined for the year, 7,776.

Report of defective growth and vitality and school work accompanying these defective pupils is hard to make. It is mostly measured by the number of repeaters in the schools, by considerable sickness and disease, and by more or less inefficiency and degeneracy.

Report of health examinations of teachers for positions in the city schools. Number of teachers examined....

107 General health below average; hard to judge accurately. Error in vision uncorrected, 25; wearing glasses, 23..

48 Hearing below normal (slightly). Throat only fairly healthy. Functional heart disturbances

12 Organic heart disease.. Lung action below normal. Disturbed digestion..

10 Slight pelvic weakness.

5 Nerve lorce reduced (somewhat)....

15 Sooner or later the main data which enter into the intelligent handling of pupils must depend to a greater or less degree upon physiological age, the physical and mental endurance of children and youths; the character and kind of work should be adjusted primarily to physiological, not chronological age.

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OAKLAND.

Oakland. [Superintendent of schools) The Department of health development and sanitation. In his Annual report, 1909–1910. p. 61-64. (Director, N. K. Foster)

"It was impossible to examine every child; hence only those who were defective enough to be observed by the teacher were examined.” Number examined, 1,965; not tabulated, 97. Defective vision.

641 Defective teeth.

635 Defective breathing.

369 Diseased tonsils.

369 Diseased glands

327 Adenoids.

290 Defective hearing.

283 Malnutrition.

87 Skin diseases.

20 Nervous diseases

11 Orthopedic defects.

9 Heart disease..

7 Lung disease.

7 Defective palate. Number with 1 defect.

711 Number with 2 defects.

739 Number with 3 defects.

336 Number with 4 defects.

62 Number with 5 defects.

16 Number with 6 defects.

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PALO ALTO. PAYNE, I. D. (The Palo Alto, California, elementary school children: Physical

defects and grade retardation) Psychological clinic, 5: 145–47, October 15, 1911. tables.

Of 467 enrolled, 110 reported as having no physical defect.

"Among the 38 children retarded two or more years there are only three who have no reported physical defects. . . . Four are confirmed cigarette smokers. ... Twenty-six have one or more serious physical defects."

PASADENA.

HOAG, Ernest Bryant. Some new problems in school hygiene. In American

school hygiene association. Proceedings, 1912. Springfield [Mass.] American physical education review, 1912. p. 205–208.

In the schools of Pasadena, California.

“The plan consists or two parts or features: 1. A scheme for a partial health survey to be made by the pupils themselves. 2. A scheme for a more extensive health survey on the part of the teachers.

“The questions given . ... in the sixth, seventh and eighth grades . . . with a general summary of the answers: 1. Have you ever had much sickness? Yes, 88. 2. Are you feeling weli now? No, 9. 3. Do you eat lunch every day? No, 8. 4. Do you eat lunch at school? Yes, 79. 5. Do you drink coffee? Yes, 128. 6. Do you drink tea? Yes, 125. 7. Do you have a ventilated bedroom (open window)? Yes, 263. 8. Have you ever been to a dentist? No, 71. 9. Do you ever use a toothbrush? No, 53. 10. Do your eyes smart in school? Yes, 57. 11. Do they trouble you in any other way? Yes, 71. 12. Can you read writing on the blackboard easily from your seat? No, 39. 13. Do you often have headache? Yes, 65. 14. Do you notice any blurring of the print? Yes, 50.

15. Do you have earache? Yes, 38. 16. Can you hear the teacher easily? No, 60. 17. Do you tire easily? Yes, 82. 18. Do you work any out of school hours? Yes, 122 (Average 11 hours per day). 19. How much do you study at home? (Average 40 minutes.) 20. Do you take regular exercise? Yes, 238.

"Total number of pupils questioned, 270. Average age of pupils in eighth grade, 15 years. Average age of pupils in seventh grade, 14 years Average age of pupils in sixth grade, 148 years.” Pasadena. (Board of education Report of medical examiner. In its Annual report, year ending June 30, 1910. p. 36-38, 41. table. p. 41.

Signed: R. C. Olmstead, M. D.

“Practically every child in the kindergarten and grades receives a physical examination. All high school students receive attention when necessary.” Total number examined.. Defective in eyes.

685 Defective in ears..

117 With nose defects..

202 With throat defects. With defective teeth.

1. 230 Malnutrition.

195 Nervous defects.

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4,036

240

COLORADO.

BATES, Mary Elizabeth. The Colorado method for the examination and care

of public school children. In (American academy of medicine) Conservation of school children. Being the papers and discussions of a Conference at Lehigh university, April 3 and 4, 1912 . . . Easton, Pa., Printed for the American academy of medicine, 1912. p. 216–37.

Reprinted.

Requires teacher or principal in every public school, or county superintendent, during the first month of each school year, to test the sight, hearing and breathing of all pupils under his charge; examinations to be made without using drugs or instruments, or coming in contact with said child; and shall keep a record and make written report of such examinations to the State superintendent of public instruction as he may require. Every teacher shall report the mental, moral and physical defectiveness of

any child under his supervision, to the principal or county superintendent. (CALLICOTTE, William Riley] Physical examination required first month (of each school year] Colorado school journal, 27: 25-27, September 1911.

Colorado law:

“It shall be unlawful for any person having the care or custody of any child willfully to cause or permit the life of such child to be endangered, or the health of such child to be injured, or willfully to cause or permit such child to be placed in such a situation that its life or health may be endangered, or in any other manner injure such child.”

For violation of this act, a fine of $100 or a three-months imprisonment may be imposed. It is the duty of county and city superintendents to enforce the law for physical examinations and report tho

results to the Superintendent of public instruction. Colorado. State superintendent of public instruction. Physical examina

tion (of school children] In her Report, 1909–1910. Denver, Colorado, The SmithBrooks printing co., State printers, 1910. p. 14-17.

Law enacted by the Seventeenth General Assembly.

In 54 counties complying with the law, 92,427 were examined; 41,546 were found defective, physically, mentally or morally to a degree sufficient to warrant reporting their condition. Defects in sight in 26,978, hearing in 6,155, breathing in 8,045, and other unclassified defects, 21,825. There were 3,071

mental defectives and 746 moral defectives. WKSON, Helen Marsh. Health of school-children. In National association for

the study and prevention of tuberculosis. Transactions, 1911. Philadelphia, Pa., Press of Wm. F. Fell company, 1911. p. 95–101.

"It is time for us to have a little sane legislation regarding physical examinations in the schools time for us to relieve overburdened teachers by giving this work to specialists and trained nurses, and and while about it, why not set up a minimum standard of clothing, cleanliness, nutrition, and education, and if the standard is not maintained by the child, make the parents responsible?”

(COMPILER'S NÓTE.-Since medical inspection and care are for those school children whose parents are not able financially or educationally to do these necessary things for these children, how could a “standard” be compelled? Why not say, rather, "make the municipality or state that is able, do these things”)

CONNECTICUT.

GOODENOUGH, Edward Winchester. Some problems connected with the

medical inspection in schools. In Connecticut State medical society. Proceedings, 1911. Published by the Society. p. 203–13. table.

In Waterbury, Conn.

Up to 1910, Waterbury had no permanent records of school inspection, either for department of education or department of health.

“My first duty was to observe the heating, ventilation and sanitation of the different school buildings. ...

“I have attempted to inspect all the children up to and including the fifth grade each month; ... to inspect the grammar grades in some manner each term.

"The Waterbury dental society has done ... an enormous amount of work in tabulating the condition of the children's teeth.”

Discussion: p. 21+221.

295
113
73
71

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New Haven. Board of education. Medical inspection. In its Annual report, year ending December 31st, 1910. p. 37–39.

Five school physicians and three school nurses.

Main effort of the physicians is to prevent the development of contagious disease. Whenever a pupil in school appears to the teacher to have symptoms of a contagious disease, the principal immediately

summons the school physician. School physicians do not prescribe in any case. SLOAN, Thomas G. The medical supervision of school children in South Manchester, Conn. Medical record, 82: 339-42, August 24, 1912. tables.

In the fall of 1906, out of over 1,600 school children, 72 were found to be a year or more behind grade, 51 whose backwardness could not be explained; on examination, 50 of the 51 had one or more defects. In 1907, 1,437 were examined for eye defects, and 91 were found needing treatment. In 1908, 204 were examined for nose and throat troubles, 126 found needing operations or treatment. In January 1910, a special examination was made of 1,564 pupils, all who were at that time in attendance; results as follows: Number examined.

1,564
Defective teeth (needing extraction).
Enlarged tonsils
Adenoids...
Adenoids and teeth.
Tonsils and adenoids.

62
Tonsils and teeth..
Adenoids, tonsils and teeth.

39
Teeth and markedly enlarged cervical glands.
Enlarged cervical glands.
Miscellaneous...

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In October 1911, 1,739 children were examined and defects found as follows:
Teeth (including those needing extraction and those needing filling).

707 Tonsils, needing operation.

83 Tonsils moderately enlarged.

123 Adenoids (marked)... Cervical glands...

23 The medical inspector is in his office at the school, with the school nurse in attendance at 10 a. m., two mornings a week. All children the teachers think need attention are sent to him. No child he sends home is permitted to attend school until seen by medical examiner.

In 1910–11 South Manchester suffered from a long-lasting epidemic of scarlet fever, starting before the opening of schools in the fall. The time lost by ill children amounted to 3,696 days; excluded children, 4,394 days. Total cost of time lost, about $2,500; with medical inspection cost, etc., and cost to families,

total about $15,000. Open-air school was opened January 25, 1911. Therapeutic value of medical inspection of school children. American medical association. Journal, 55: 596–99, August 13, 1910. tables.

Presents three view.points of the relation of the child to the matter in hand: "(1) Has the child, while in attendance at school, any need of medical supervision? (2) The relation of the child to the community at large. (3) The consideration of the child as an individual” (Kenna, W. Matthew. Regarding medical inspection of school children in New Haven. Table of results, also included in the excerpt given at length in this article).

Table of results of examination of 400 school children, New Haven, Conn. “A” denotes defect present, not requiring treatment; “B,” treatment advisable; “C,” treatment imperative:

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Apparent physical condition.
Adenoids.
Anemia..
Cardiac disease
Defect of nasal breathing.
Defect of palate.
Defect of teeth.
Skin:

Contagious.
Parasitic.

Vermin
Hypertrophied tonsils.
Orthopedic defect..
Pulmonary disease or tuberculous condition
Enlarged glands....
Vision:

Myopia or astigmatism.
Conjunctivitis.

Granular lids.
Nervous diseases.
Malnutrition.
Defect of hearing.
Backwardness.

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These statistics “have not before been announced,” states the writer.

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