men giving instruction-teachers, not simply athletic coaches; and, more than anything else, elaborate precautions taken to safeguard the boy while making ample provisions for his well-balanced physical development, the whole plan operating under special legislative

enactment.

XI. THE TEACHING OF HYGIENE.

A. PROBLEMS IN THE TEACHING OF HYGIENE.

LILLIAN M. TOWNE, Boston, Mass.

Historical summary.-The teaching of health in the public schools has been before the people since 1797.

About 1830 the parents of children and the teachers in the schools were urged to cooperate in instructing the children. In 1837 came an investigation which showed that the teachers of Massachusetts needed to be trained in hygiene. From 1850 to 1860 textbook instruction and dogmatic teaching that should make for habit were both advocated.

In 1868 Horace Mann compiled statistics showing the standing of physiology in Massachusetts; and, through his efforts, its teaching was voluntarily extended.

In 1885 physiology and hygiene was made a compulsory study by the laws of the Commonwealth.

Present-day difficulties.-Sanitary conditions in the schools have improved. Medical men have aided; yet the subject is more neglected than it should be. There is textbook teaching, but not enough dogmatic and observational instruction in either elementary or high schools. The normal schools of the United States devote too little attention to this important department of training. For the prospective teacher, help is needed all along the line.

Advances in Boston.-In 1908 a committee of teachers planned a detailed course in physiology and hygiene. This course in 1910 was cut down to minimum essentials.

The board of superintendents adopted the teachers' plan, doubled the time given to the subject, replaced old textbooks with new books, added books for reference and supplementary reading, provided for a "Hygiene teaching exhibit," made possible the purchase of Langworthy's dietary charts for each district, and authorized a course in "Applied physiology and hygiene" for teachers taking promotional examinations. The Boston Physical Education Society devoted a meeting to demonstrations of grade teaching in physiology and hygiene that interested educators and medical men.

Needs of the future.-1. School authorities and associations must see that health teaching has its proper share of time in the school curriculum. Organized effort alone can accomplish this.

2. There is need for scientific combination of courses in hygiene and in nature study in the elementary grades.

3. This should be followed in the high school by a course in physiology and hygiene, differentiated to meet the needs of pupils entering specific types of vocations.

4. Normal schools must amplify knowledge in subject matter, and must give definite training in teaching method and in hygienic habit applicable to the schoolroom.

5. Teachers in service must be aided to keep in touch with advance in hygienic knowledge through distribution of pamphlets and by illustrated lectures.

There is immediate need of simple charts and models, of slides and apparatus, whereby the teaching of hygienic principles may be made concrete and experimental as in other subjects. A list of reading references for pupils is also needed.

6. If the application of hygienic principles is to have importance for the child, the carrying out of hygienic habits should be made a factor in his advance from grade to grade.

B. PROTECTION OF STUDENT HEALTH IN THE COLLEGE OF THE CITY OF NEW YORK.

By THOMAS A. STOREY, M. D.,

Professor of Hygiene, New York, N. Y.

The protection of student health in the College of the City of New York is accomplished through the organized activities of the department of hygiene and by certain committees appointed by the president of the college. These committees are "The advisory committee on hygiene and sanitation" and "The committee on student lunchrooms." The professor of hygiene is chairman of each of these committees, both of which are advisory to the president.

There is no dormitory life in this institution. There are, therefore, no problems in dormitory hygiene or sanitation. The students in the collegiate department and the pupils in the preparatory department live at home in the various boroughs of Greater New York. Their home conditions are, therefore, community affairs, and fall under the jurisdiction of the board of health and other divisions of the city government which bear upon community hygiene and sanitation.

The entire organization of the department of hygiene has been developed primarily in the interest of student-health intelligence

and student-health habits. For the accomplishment of these results the department has employed carefully planned lecture courses on hygiene, class and personal instruction in health habits, and individual examination and instruction in personal hygiene.

The courses in hygiene required of the freshman and sophomore classes in the collegiate department include a series of short lectures running through four terms, graded instruction in physical exercise, and regular inspection in personal hygiene throughout the same period. The individual instruction in hygiene is further accomplished by means of regular medical examinations applied to each individual student at least once each term throughout the first three years in the academic or preparatory department and throughout the first three years in the collegiate department. In all of this instruction emphasis is laid upon the individual. The lectures are organized with distinct reference to the health problems that arise in the daily lives of students living in a great city. The health habits taught are the simple, fundamental habits most essential to physiological efficiency, greater stress being laid upon the needs of the city boy. The individual instruction in personal hygiene is based upon information secured by means of thorough medical examinations of each individual concerned.

The lectures on hygiene are made up of a series of 16 short talks on "The Causes of Disease"; a second series of 16 short talks on "The Carriers of Disease "; a third series on "Our Defenses against Disease"; and a fourth series on "The Nature of Some of Our Common Diseases."

Classroom instruction in health habits is accomplished through four terms of work in the freshman and sophomore years in the exercising hall of the gynasium. Here are taught habits of physical exercise, habits of personal cleanliness, and habits of community hygiene. The sanitation of the exercising hall, the locker room, and the swimming pool, as well as the objective hygiene of the individual, are emphasized as matters of community importance and each student is taught his obligation to himself and to the community in which · he lives in his relation to his fellow students. In this connection it may be noted that the swimming pool serves as a sort of an index to the standard of hygiene maintained by the student community using the pool. If the bacteriological analyses show evidences of human contamination, the fact is brought to the attention of the classes using the pool and the responsibility is placed upon them. With repeated careful instructions concerning the need of thorough bathing before entering the swimming pool; the necessity of washing the private parts; and the importance of keeping all respiratory, bowel, or bladder excretions out of the water in the tank; the subsequent

bacteriological analyses invariably show an improvement in the sanitation of the water.

The medical examinations which form the bases for instructions given the individual students concerning their hygienic needs cover the skin, scalp, eyes, ears, nose, mouth, throat, heart, lungs, abdomen, and genitalia. Wherever it is indicated, chemical and bacteriological examinations are made. The college has recently equipped a departmental laboratory and employed the services of a competent man for the purpose of identifying disease carriers among the students and supplying the department with information upon which it can furnish advice to the individual student concerned. It is planned within the coming year to utilize this laboratory service for the possible detection of typhoid carriers and diphtheria carriers in the student body.

All individual instruction which admits of being followed up is followed up. The individual student concerned is required to report to the department until his case is closed. Failure to report as directed may lose to the student his membership in the institution. The success of this instruction and its follow-up feature is demonstrated by the fact that less than 1 per cent of the cases followed up fail to report as directed. About 96 per cent of them finally secure advice and treatment through their regular family advisors, while less than 4 per cent report to free clinics in the various hospitals of the city.

The characteristic and striking features of the work in this department are, first, its practical application of the laws of hygiene to the needs of the individual; second, its instruction in community hygiene; third, its successful follow-up system in the interest of individual instruction in personal hygiene.

C. SCHOOL HEALTH WORK IN MISSISSIPPI.

SUSIE V. POWELL,

Supervisor of School Improvement Associations, Jackson, Miss.

The Mississippi School Improvement Association is promoting better health conditions principally by the following means:

1. Special days.--(a) Clean-up-and-beautify day is observed at the close of the school in the spring, and again at the opening of the school in the fall. These days are observed by at least 2,000 schools and communities with direct benefit. On these days the people "work with their hands" and thus learn by doing. (b) A special health-day program is issued and observed by just as many schools. On this day, in addition to actual work done to improve health con

ditions, a formal program is given to educate the people in matters pertaining to health.

2. Correlation.-Plans, instructions, and suggestions for correlating the regular textbook work with the practical health work are issued to the teachers so as to reenforce the abstract theories with concrete examples. The pupils prepare booklets in which healthimprovement material forms the basis of exercises in the regular school branches as follows:

Spelling.-Spell and define words used on the health placard and in the bulletins issued by the State board of health.

Arithmetic.-What is the ratio of window space to floor space in your schoolroom? How many cubic feet of air does your schoolroom contain? How many pupils? If each pupil breathes 10 times in a minute, how long will this air last? What is the surface area of the dipper? If one square inch contains 1,500 disease germs, how many may the surface of the dipper contain?

Compute the cost of a sanitary closet. Find the area of the schoolroom floor and estimate cost of oiling it at $1 per gallon. Estimate the cost of putting the school in good sanitary condition: Cleaning, disinfecting, prevention of dust, pure water, etc. Compare with average cost of a case of typhoid fever, tuberculosis, pneumonia.

History.-Biblical; London plagues; yellow fever epidemics; vaccination, etc. Civics.-Rights and duties. Obligations of the community to the individual: To provide clean, comfortable, healthful environment; to provide expert supervision; to isolate those suffering from communicable diseases; to give inspection and instruction to the young on sanitation and hygiene. Obligations of individuals to the community: To refrain from promiscuous spitting; to observe laws of personal cleanliness; to avoid exposing others to communicable diseases; to do one's part in keeping house and premises in good order. Laws on Mississippi statute books relating to health.

Physiology.-Sanitation and hygiene; germ theory; ventilation; lighting; heating; bone structure and necessity for adjustable desk; the eye and necessity for proper lighting; ear, nose, and throat and teeth, with need for inspection and care; the skin and necessity for cleanliness; digestion and proper food (the children's lunches); the lungs, and proper ventilation; the blood and effect of air, light, and other hygienic conditions; bone and muscle structure; exercises in correct posture and physical culture; dangers from spitting.

English.-Classify words on the health placard as nouns, verbs, adjectives, adverbs, prepositions, conjunctions. Make sentences illustrating principles in grammar, regarding any health topic mentioned above. Write a paragraph each on "Danger, sources, and prevention of dust in the schoolroom." Write composition on: "How we observe clean-up-and-beautify day;" "health day;" "How we clean our schoolroom;" "The need for individual drinking cups;" "our water supply;" "The hookworm a greater menace to our State than the typhoid fly;" "Resolved: That we need medical inspection in our public schools."

Geography.-Surface water and ground water; drainage.

Writing.-Copy sentences from health placard. Copy the themes neatly and make into a booklet. Copy the poems about health.

Singing.—Motion songs; breathing exercises.

3. Addresses on sanitation.-The local and county school improvement associations have been put in touch with special agents of the