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Result of the physical examination of school children in Boston for the year 1911-1912. Total number of children examined.

118,781 Total number of pupils without defects.

40, 850 Total number of pupils with defects.

77, 931 Defects noted as follows: Mental deficiency.

501 Defective nasal breathing.

9,693 Hypertrophied tonsils.

25, 121 Defective teeth.

51,340 Defective palate

371 Cervical glands.

13,711 Pulmonary disease: Pulmonary tuberculosis.

133 Acute bronchitis.

1, 169 Asthma. Pleurisy..

42 Miscellaneous.

987 Cardiac disease.

3,091 Nervous disease.

505 Orthopedic defects: Tuberculous.

693 Nontuberculous.

1,181 Skin.

5,243 Rickets.

1,019 Malnutrition.

3, 891

63

SMITH, C. Morton. Diseases of the skin. Boston medical and surgical journal, 166: 623-24, April 25, 1912.

A complete physical examination, September 13 to December 31, 1911, showed 11,691 children in the Boston schools, having skin diseases. The number was exceeded only by decayed teeth, hypertrophied tonsils, defective nasal breathing and enlarged cervical glands. The common diseases are scabies, pediculosis, impetigo, and ringworm; these four were found in the schools no less than 6,428 times, or 55 per cent of all the skin affections reported. There were 5,257 children with pediculosis.

CAMBRIDGE.

Cambridge. Board of health. School inspection. In its Annual report, year ending December 31, 1910. p. 37-41.

Signed: Bradford H. Peirce, M. D.
Concerning the school nurse see p. 40-41.
Six public school and 5 parochial inspectors; and 2 school nurses.

Number of pupils ill and defective, 1,870.
Chicken pox..
Diphtheria.
Eczema..
Gonorrhea..
Laryngitis.
Measles.

German.
Mumps..
Scarlet fever.
Syphilis
Tonsilitis.

71 Tuberculosis, pulmonary Tuberculosis, other forms. Whooping cough.

23

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Eyes. Conjunctivitis..

79 Corneal ulcer or opacity. Keratitis. Strabismus.

15 Imperfect sight..

27 In two schools located in the same section of the city, one, rather closely surrounded, and not well ventilated, has had many cases of scarlet fever and diphtheria for several years. The other school, older and in an open space, has had but two cases of diphtheria and one of scarlet fover in more than a year.

CANTON.

CABOT, Arthur Tracy, School inspection in small towns. In American school

hygiene association. Proceedings, 1911. Springfield, Mass., American physical education review, 1911. p. 40-43.

Also in Boston medical and surgical journal, 164: 633–34, May 4, 1911.

The town's appropriation being too small for payment for systematic medical inspection, at a town meeting in 1908, a school nurse appropriation of $500 was made, a trained nurse to begin at the opening of the next school year. The work, which also included the parochial school, was found to be so satisfactory that for the year following, $950 was appropriated.

The nurse looks after 900 children; makes examinations at beginning of year, keeping card record; keeps record of any illness they have; children with any infirmity of eyes, ears, throat or general condition, are referred to their physicians; children requiring specialist's aid are taken by her to a public clinic in Boston. She gives hygiene talks in the schools, and visits the homes. “We have found the work of the school nurse thoroughly satisfactory in giving the town what seems adequate inspection and control of contagious disease."

The neighboring town of Norwood adopted same system; Milton, planning the same.

WELLESLEY.

CANAVAN, Myrtelle M. Medical data of the examination of 2,333 supposedly

normal adult young women. In American school hygiene association. Proceedings, 1912. Springfield (Mass.) American physical education review, 1912. p. 76-91. tables. record blanks.

The physical examination system of Wellesley college; data covering cxaminations from 1906 to 1911; average age of students, 19 years. Percentages of orthopedic defects.

Per cent. 1. Back, curvature....

35 2. Shoulders, uneven..

53 3. Hips, uneven..

431 4. Legs: (a) Knock-kneed.

21 (6) Bow-leg

81 (c) Unequal 5. Ankles pronated..

701 6. Longitudinal arches: (a) Flat..

12 (b) High.

5 7. Anterior arches, flat.

114 8. Toe joints enlarged..

34 Deaf or partly so..

23 Nose, hypertrophy of turbinate.

13 Tonsils enlarged...

281 While 17) per cent had had throat operations, and 15 per cent of these, for removal of tonsils or adenoids, tonsils were found enlarged in 28 per cent.

Per cent. Eye lesions.

12 Glasses worn.

37 Nutrition poor.

19 Teeth: (a) Missing.

12 (b) Cavities. (c) Poor or irregular.

1 Menstrual disorders.

23 Enlarged lymph nodes.

12 Heart lesions: (a) Organic..

3 (0) Murmurs, no symptoms

17 (c) Other lesions...

8 Sports: (a) Qualified.

56 (b) Disqualified. Unusual lesions for the most part are stigmata of degeneration, 24 different sorts.

WORCESTER. EMERY, George E. Medical inspection in two Worcester schools. Pedagogical seminary, 17: 111-18, March 1910. tables.

“Fifteen inspectors were appointed in Worcester by the board of health and began work in October, 1906.

“Our duties were to inspect such children as were referred to us by the teachers, and make weekly reports of such inspection.

* October of this year (1909) blanks were furnished by the board . . . and a systematic inspection of all the pupils was begun The tests for sight and hearing are conducted by the teachers, but ... they are by no means complete and many of the record cards show normal vision when serious defects are really present. ... There is no test card for astigmatism.

“In the fifth grade only 34 per cent had enlarged glands. . In the sixth grade 80 per cent ... and for the whole school 55 per cent. ... The general nutrition of the pupils is ... 63 per cent good, 32 per cent medium and only 4 per cent poor.

“I was not surprised that a large number should have poor teeth; but I was surprised that the average number per pupil should be so high; that is eight in the first grade and nearly four in the ninth grade....

The school nurse should be the link between the school and the home, but in Worcester that link is missing. . . The district nurses do help but . . . can give but little time to this work."

7 22 418

1 17 52 28 23 2

MICHIGAN. Grand Rapids. Board of health and Poor commissioners. Report of School examiner. In their Annual reports, year ending March 31, 1911. tables.

Inspection for physical defects was ordered discontinued by the board of health, on December 6, 1910, and inspection is now made for contagious diseases only. The following is a report of work from May 1, 1910 to April 1, 1911:

Contagious diseases discovered.
Itch
Whooping cough
Measles
Typhoid fever
Scarlet fever.
German measles.
Mumps.
Chickenpox.
Smallpox.
Total.

570 Physical defects discovered (May 1, 1910, to December 1, 1910.) Glandular

2 1 1

1 Nervous. Stomach. Hernia. Defective teeth

11 Deformities. Hypertrophied tonsils. Ear trouble Adenoids. Skin trouble Total.

70 The total number vaccinated was 245. The acting school examiner is Leland H. Gilleland. KIEFER, Guy L. Medical inspection of school children. Dental summary, 31: 264-68, April 1911.

In Detroit, 50,501 chidren were examined by the medical school inspectors; 3,499 excluded for contagious diseases; 818 cases of tonsilitis; 12, of scarlet fever. Physical defects were found in 2,118 pupils: of these 598 had defective eyesight; 204, diseased eyes; 136, defective hearing; 906, enlarged tonsils or adenoids, or both, and 210 had defective teeth.

Beginning October 23, 1909, to May 7, 1910, the Detroit district dental society, in its free dental clinic, attended to 234 children. MARTINDALE, W. C. How Detroit cares for her backward children. Psychological clinic, 6: 125–30, October 15, 1912.

In the fall of 1910 the department of special education was organized and the nine special rooms, the school for cripples and schools for stammerers, were placed under the direct supervision of the general supervisor.”

82883°—13—

1 45 1 3 4

Binet-Simon tests are used to determine the mentality. Il no results follow notification to parents. the school principal calls upon the regular school physician to make a physical examination of the child, to ascertain if the backwardness be due to defective vision, defective hearing, adenoids, enlarged tonsils, or nervousness. The principal reports result to parents; if parents are unable to provide the needed medical attention, the principal reports the case to the child study committee; upon note from the secretary of the committee, Detroit's best specialists give free assistance to the children. Where children can not afford spectacles, they are provided through fund set aside by the Detroit teachers' association.

Since September, 1911, 215 pupils have been tested for defective vision and provided with glasses.

After the child's physical defects have been remedied, if his mental condition still remains unchanged, the Binet examiner, appointed by the board of education. then visits the school and gives him the Binet test. The special physician, appointed by the board of health to work under the direction of the board of education, visits the school and makes a physical examination of the child. “The statement of the parent as given in the report sent to the secretary of the child study committee by the principal, together with the child's school history, reports of the Binet examiner and of the school physician are then passed upon by the child study committee.

"In the cases of low grade children whom the committee thinks it advisable to exclude, a second examination is made . . . by one of the mental specialists of the child study committee consultation staff ... and usually results in the exclusion of the child. ... Since September 1911. 488 cases have been

examined. The committee recommended 190 of this number to the special rooms.” MAY, George A. The result of one thousand nose and throat examinations. American physical education review, 14: 636-44, December 1909.

Examinations made at the Waterman gymnasium, University of Michigan.

There were found in 1,000 students, mostly freshmen, 157 deviated septa; nasal spurs and ridges, 398; adenoids large, 36, moderate, 145; chronic tonsilitis, 4; lacunar, 8; chronic tonsillar inflammation with hypertrophy, 191 casas; symptoms of frequent nasal bleeding, 170; 85 without accountable etiology; simple chronic rhinitis, 54 cases; atrophic rhinitis, 12; larynx, acute inflammatory conditions, 105. Eighty-three complained of more or less chronic hoarseness. There were 38 hay fever cases. Seventy-six gave a history of some nose and throat operation.

The main object of the paper is to point out the necessity of an examination of this character. The ideal time for such would be the childhood period. WARTHIN, Aldred Scott. Thy physical health of the University. Michigan alumnus, 16: 70–73, November 1909.

The University of Michigan.

At the beginning of the present college year the department of medicine and surgery adopted methods tending towards a better physical knowledge of the medical students particularly with reference to the occurrence of tuberculosis. Each medical student is to report once a semester to the department of internal medicine for an examination. . . . The need for such systemauic examinations has been strikingly shown in the medical department. For the last four or five years 3 to 6 cases of tuberculosis have been discovered annually in the junior and senior medical classes-about 4 per cent of the class on an average. Very few cases are discovered in the freshman or sophomore years. .

“Out of 200 women examined sin the gymnasium) the examiner discovered 8 suspicious cases, 6 of which gave positive evidence of incipient tuberculosis."

MINNESOTA.

MINNEAPOLIS.

Minneapolis. Board of education. Report of the Supervisor of hygiene and

physical training. In its Annual report, year ending June 30, 1911. p. 89-94 (98)

Signed: Charles H. Keene, M. D.

January 1, 1911, a system of medical inspection was inaugurated, conducted by seven physicians and seven nurses. During the five months medical inspection has been in operation, 19,082 inspections made, 7,102 being physical examinations. Of these, 72 per cent were found defective; most common defect, hypertrophied tonsil, 35 per cent of those examined having this defact; 32 per cent, defective teeth; 28 per cent, adenoids; 24 per cent, enlarged glands; 18 per cent, defective vision; 114 per cent of anemia; 64 per cent, malnutrition; 3,873 cases have been treated, “who would not otherwise have received treatment.”.

ST. PAUL.

MEYERDING, E. A. School health. St. Paul medical journal, 14: 246–55, May 1912.

General summary. Medical inspection in St. Paul, p. 248-250, 253. Page 253 contrasts conditions between two schools; one among a foreign-born and laboring-class population and the other “one of the best from a social standpoint."

Hill school (good social class).

Harrison
school
(labor
class).

Requiring dental attention
Malnutrition.
Uncleanliness.
Skin disease.

Per cent. Per cent, 40

82 19

20 2

10 11

5

I Less than.

St. Paul. Board of school inspectors. Medical inspection. In its Annual reports, school years ending June 9, 1909, and June 10, 1910. p. 57–59. illus.

Department of medical inspection established along lines outlined by the superintendent of schools. One physician employed to give three hours each day from 9 to 12 to the schools and to maintain office hours from 9 to 12 on Saturdays at the school board rooms. He began his work with one nurse assistant and later three nurses were assigned. Medical inspection entirely under the school authorities' supervision. “Our experience strengthens the conviction that it should always be so....

“The medical inspector shall make recommendations on matters affecting the physical environment of children such as the building lot, the drainage, heating, plumbing, ventilating, water supply, drinking facilities, sweeping, scrubbing, use of disinfectants, deodorizing, fumigating, etc.

“He shall go from building to building and shall make systematic examination of all pupils in the elementary schools reported to him by teachers and principals and such other pupils as may appear to him physically defective.

“He shall be accompanied and assisted in all his work by a school nurse who shall record all findings, and report to parents. The medical inspector shall not be permitted to give any treatment to children except temporary assistance, or in cases of emergency. ... The medical inspector shall also send notice to the parents or guardians of pupils lacking in cleanliness or needing treatment; he shall be authorized to exclude pupils.

“He shall give such instructions to principals and teachers as will make them familiar with the more conspicuous symptoms of physical and mental deficiency, to the end that they may suggest only those who are really abnormal to the inspector for examination. He shall give instruction to teachers, respecting vision and hearing tests, and on such matters relating to the physical inspection of children as will promise the assistance and cooperation of teachers and principals in the work of his department.”

During the school year 1909–10, a systematic examination of 3,265 found 2,088 behind grade; 28 per cent of them backward in studies beca use of physical conditions The following is a summary of the work of two nurses:

Total. Rooms inspected...

343 Contagious diseases discovered... Communicable diseases (not contagious).

243 Surgical dressings and treatments.

182 Pediculosis.

(Cured, 442.)
Taken to dispensary or doctor.
Defective vision, attention received..
Detective vision, glasses secured..
Defective nose and throat, attention received.

270
Defective nose and throat, operated upon.
Malnutrition...
Enlarged cervical glands.

25 Pulmonary diseases, attention received.

9 Tubercular diseases, attention received.

8 Heart disease, attention received.

20 Teeth, use of brush taught...

2,000 Teeth, attention received.

220

170

669

482 203 144

103 118

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