pletion of these tests the student entered a dark room, where . . . the ophthalmologist to the department carefully estimated . . . the state of the refraction and studied the condition of the interior of each eye.

"Of this total, 14.70 per cent were... myopic, while the remaining 85.30 per cent were either hypermetropic or emmetropic. Among 633 students in the two lower classes, 87.25 per cent were hypermetropic and 12.75 per cent were myopic, while of 261 students in the upper classes, 80.25 per cent were hypermetropic and 19.75 were myopic.

"Five per cent more of myopia was found in the professional department in scholars of a similar age than in the college department. . . . The average age of all... was 21.4 years, and the statistics showed an increase of about 2.5 per cent of myopia for each year during the four years of college life.

"Six hundred and nine had full visual acuity in each eye, 94 in but one eye, while 180 had subnormal vision in both. Three hundred and three students wore glasses; of these, 217 were hypermetropic and 86 myopic. Eighty-seven complained of headache. Of this number, 47 wore glasses and 40 did not. Of those complaining of headache, 7.59 per cent had subnormal vision, while the remaining 92.41 per cent had full visual acuity. . .

"Of the 883 students examined, 58, or 6.68 per cent, had spinal curvature or scoliosis, and this condition was found 48 times among hypertropes and 10 times among myopes Of the total number of students with spinal curvature, this vision of one eye was perceptibly lower than its fellow in 13.79 per cent. . . . "As weak eyes are often associated with a physical condition which is below par, suitable exercise of a general nature is . . . insisted on for those who are so handicapped. . . . Violent exercises are forbidden myopes, and the endeavor is made in this class of subjects particularly to develop the chest and to impart a correct standing posture for the avoidance of scoliosis."

WESSELS, Lewis C. The standing in class of children with defective vision. Teacher, 16: 299-300, December 1912. chart.

The work of the Municipal eye dispensary, Department of public health and charities of Philadelphia. There were examined for eye defects, "in the past four years, 5,146 children; . . . 3,695 or 72 per cent were backward, due principally to their defective vision, as the majority. . . started to progress after receiving proper glasses.

"The following table graphically shows the ages and grades of the children refracted at the Municipal eye dispensary.

Figures on the broken lines represent the position of the normal average school child. "There are many interesting features connected with this table that are worthy of study. The 3,695 backward children represent a collective or a composite loss of 8,434 years or a money loss of $295,190, based on the actual cost of education, $35 per annum in Philadelphia. The cost to the child was considerably more.

"1,170, or 23 per cent, were in the average grades, and only 281, or 5 per cent, were above the average grades.

"The majority of the children were below the fourth grade; 4,297, or over 83 per cent, were below the Afth grade; only 1,909, or 37 per cent, were above the third grade; only 849, or 16.5 per cent, were above the fourth grade; only 297, or 5.75 per cent, were above the fifth grade; only 92, or 1.78 per cent, were above the sixth grade; only 33, or 0.64 per cent, were above the seventh grade."

TENNESSEE.

MINOR, James L. Some impressions of certain eye affections in the negro, as compared with the white race. Ophthalmology, 7: 36-38, October 1910.

Examination of the eyes of 1,849 negro, and 3,181 white pupils of the public schools of Memphis, Tenn. Results showed that refractive errors were just one-half as frequent in the negro as in the white pupils; proportion of normally seeing blacks 24 times greater than whites; badly seeing negroes 1 to 15, badlyseeing whites 1 to 6; omitting uncorrected myopic whites, badly seeing whites were 1 to 10; no case of myopia found in the negr es.

UTAH.

BATES, Edgar. Eye strain among public school children. Ophthalmology, 8: 188-92, January 1912. chart.

Of two schools of Ogden, Utah, 890 were examined for eye defects. Those suffering from eyestrain, sufficient for glasses, numbered 184, of whom 134 complained of headaches; 57 of blurring words; 29 of sensory symptoms, as "smarting"; 21 of frequent lachrymation; 2 of seeing double; 3 of dizziness; 2 of spots before the eyes; 11 of difficulty of reading from blackboard; 17 of blepharitis; 17 of scales at roots of eyelashes.

"The question is not settled even with the wearing of appropriate lenses. It is really a question of preventive medicine... the question as to the necessity of medical examination of all public school children."

MEDICAL INSPECTION OF TEETH-DENTAL CLINICS.

GENERAL REFERENCES.

CORLEY, J. P. Oral hygiene. Inauguration of the present movement. Dental cosmos, 52: 1117-20, October 1910.

Describes the work of the National dental association's oral hygiene committee, which was commissioned to go into the public schools of the land and instruct the teachers and pupils in the care of the teeth and mouth. The writer says: "We undertook to put the work into cooperation of the dentists throughout the land; and . . . sent letters . . . to men who were conspicuous in their associations and asked if they would go into the public schools and present the matter to teachers and pupils, but we found that not one man out of ten would volunteer to to so. . . .

"The general plan consisted, first, of having dental inspection made in the schools throughout the land.... Many of the State associations have volunteered to do this. A triple chart record of the conditions which they find is to be made, one to be given to the National association's committee, one to the school board, and the third to the child, to be taken home to his parents. These charts show the actual conditions of the mouth.

"The examinations which have been made so far show that between 96 and 97 per cent of the mouths of school children need dental attention.

"After the inspection is made, the next thing is to establish a free course of lectures. . . . There are three sets of lectures-one for children, one for mothers, and one for the general public. After these lectures, free dental clinics are established where all children of the indigent poor can have free dental attention.

"The National committee has placed in my hands, as chairman of the southern branch hygiene committee, some funds, together with three clinical equipments to be used in this territory. These cost from $750 to $1,000 each, and consist of a complete dental office outfit . . Material is furnished, and to

each child is given a tooth-brush and a package of dentifrice, and shown how to use the same." GALLIE, D. M. The time, the place, and the work. June 1911.

Dental review, 25: 563–74,

List of cities giving attention to school children's teeth: p. 566. Results of a questionnaire. MCCREARY, J. P. Dental inspection of public school children-the need of education of the masses along dental lines. South Carolina medical association. Journal, 6: 457-61, September 1910.

"The child's health, mental and physical, is a national asset. ... Nothing can stop the adoption of dental inspection. It must come."

The writer says it is estimated that 4 children only in 100 have good teeth. "These estimates and statistics are alarming. A wise plan. . . would be to give these facts the widest publicity possible. This can be accomplished by (1) lectures, (2) pamphlets, (3) through newspapers, (4) examination of children's teeth in the schools."

National dental association-Southern branch. Report of committee on oral hygiene. Dental cosmos, 52: 1103-05, October 1910.

Chairman, J. P. Corley.

"Our committee proposed to establish hygiene headquarters in one representative city, in as many of the cities in the southern territory as we could reach. . . . To this end the chairman was commissioned to visit these cities and endeavor to get the local societies to undertake the work of organizing their cities after the Cleveland plan. This plan consists in making a dental inspection of all the public schools, delivering a course of lectures in the schools, and establishing and maintaining a free dental clinic where all the children of the indigent poor who are public school pupils can have free dental service. . . . "It is the intention of the committee to submit at the Denver meeting, a plan whereby every section of the country can be effectively and systematically reached with the gosp! of oral hygiene." WOODRUFF, Clinton Rogers. The city and the children's teeth. city, 6; 479-81, February 1912.

American

More than 3,500 Rochester, N. Y.,

Philadelphia's school dental clinic, city hall, has one chair; opened in October, 1910. children were treated during its first year. Newark dentists maintain 2 dental chairs. dispensary was maintained in a public school, treating in one year, 1,700 children. New York City has 18 clinics distributed through the 5 boroughs; of these, 3 are maintained by the Children's aid society and the others are connected with general dispensaries or dental colleges. In recent examination of 400,000 pupils, New York City schools, it was found that nearly 300,000 needed dental treatment.

IN REPRESENTATIVE CITIES.

CONNECTICUT.

WATERBURY. Board of education. Inspection of teeth. In its Annual report, January 1, 1910-January 1, 1911. p. 17-21. tables (of eight public schools) Begun in June, 1910, by the Waterbury dental society, systematic inspection of teeth of all public school children of Waterbury.

The East St. Louis dental society, through its committee on oral hygiene and prophylaxis, reports its initial examination of 4,796 white children, and 432 colored.

Rules and requirements for examination (p. 49 51):

"First. Men must report at schools at 8 a. m. that they may get ready for the work before school opens, it being necessary to explain to the teacher what we expect and how they can aid you. “Second. Each examiner must have an assistant to help keep records and care for instruments. "Third. Each examiner must provide the following: (1) Only three mouth mirrors. (2) Two pairs pliers and lead pencil. (3) Cott, n holder and cotton. (4) One alcohol lamp for warming mirrors for use. (Dries off alcohol and also prevents condensation of breath.) (5) Two glass tumblers, one for carbolic solution and the other for alcohol. (6) One dish for soap and water for scrubbing mirrors. (7) One cake of toilet soap. (8) Towels and napkins. (9) Carbolic acid and alcohol. (Furnished by the board.) (10) Files will be furnished for filing blanks when finished by assistant. (By the board.) "Fourth. Examinations must be made by mirror only.

"Fifth. No examination with explorers will be permitted.

"Sixth. In marking the records, follow the chart.

"Seventh. If fair, mark the letter 'F': if in bad condition, mark the letter 'B'. Mark same for the condition of the gums. If they use toothbrush, the word 'yes' or 'no'.

"Eighth. In marking diagram, start at upper right hand side of mouth, which corresponds with No. 1 of the permanent teeth and letter 'A' of the deciduous teeth. If cavity is found, simply draw a

1 See under Medical inspection of teeth and dental clinics.

line through tooth on the chart. If two or three cavities are found, draw a line through tooth lines through tooth on the chart.

"Ninth. Instruments must be cleaned in soap and water, and immersed in carbolic solution until needed, then dip in alcohol bath and pass through flame of lamp to dry and warm, but not hot enough to burn the child's mouth.

"Tenth. The blanks are to be placed in the hands of all children when starting work, for them to fill in name, age, school, and grade."

A number of Hutchinson teeth, teeth with erosion, cleft palate, bad tonsils, and adenoids.

NESBIT, Otis B. Dental inspection at Valparaiso, Indiana. ruary 1911. figs. tables.

Reprinted.

Oral hygiene, Feb

Inspection of kindergarten, grade, and high school pupils, made by the dentists without compen sation. Results were tabulated. A dental hygiene exhibit was installed in each school. The dentists put the teeth of children of one grade in condition, free, for those unable to pay.

TABLE 3.-Showing number of cavities in permanent teeth and teeth in which they occur.

Age.

Total. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 22

By the middle of December, "The latest teachers' reports show that, of 772 pupils, 288 have had all work finished; 123 are being treated now, but their work is not completed. When it is, 411 pupils, or 53 per cent, will have hygienic mouths, and there are five school months yet to come." NOTE: The following is of interest regarding Dr. Neshit's experimental work:

Scarlet fever and dental hygiene in Valparaiso, Ind. Indiana State board of health. Monthly bulletin, 15: 32, March, 1912.

During the epidemic of scarlet fever in Valparaiso, Ind., Dr. Otis B. Nesbit undertook to control its spread by the care of the school children's mouths and teeth; inspection was made without pay by the local dentists. In 976 mouths inspected, 4,796 cavities were found; 2,197 in the temporary teeth, 2,579

in the permanent, and but 116 of the 976 pupils, free from decayed teeth. The cleaning of the months of the school children was followed by a subsidence of the epidemic and a notable improvement in efficiency and general health. Work for teeth free to pupils too poor to make payment.

MASSACHUSETTS.

Boston. The Forsyth dental infirmary for children. Washington, The International congress for hygiene and demography, September 1912. [Boston, Massachusetts, The Wood, Clarke press] n. p. illus. tables. plans. 8°.

Founded by John Hamilton Forsyth and Thomas Alexander Forsyth, in memory of their brothers. Incorporated, 1910, by a special act of legislature; it "represents the first attempt on adequate scale to satisfy the requirements" [of the acute dental needs of children]. "It will offer opportunity to all deserving children under the age of 16 to obtain freely expert advice and care for their mouths. ... Its functions will include not only care of the teeth, but also related oral conditions, including defective palates, adenoids, etc. . . . It will have to do in great part with the prevention of defects by oral prophylaxis. . . . It is expected to furnish valuable practical teaching in oral hygiene. A research fellowship has been established."

Brookline. School committee. [Work done in dental hygiene during the year 1910] In its Report for the year ending December 31, 1910. p. 32-34.

Pupils of primary and grammar schools, Brookline, Mass. An increase of 12 per cent in the number of mouths rated in good condition, and a decrease in number of mouths rated in poor condition, of 30 per cent as compared with the first examination held January 28, 1907 (Dr. W. M. Potter). KEYES, Frederick A. Institutional dentistry. Methods. Results. Boston medical and surgical journal, 167: 118-20, July 25, 1912. tables.

Dr. Keyes was requested by the Mother Superior of St. Vincent's orphan asylum, Boston, in November, 1910, to establish a dental infirmary for the care of the children's teeth. Two children were installed as assistants, a great aid in inspiring confidence in the children needing treatment. Monthly lectures were given to the upper grade children, in the schoolroom, and they were required to write compositions after lectures, as aid to the hygienic teachings. Morning and evening tooth drill was instituted, prize given to child with cleanest mouth at end of month, separate brushes and tooth powder placed in cabinet containing 250 compartments. These were inspected monthly. Every three months the children were lined up and inspected by the dentist, a separate mouth stick being used for each child-just taking two hours to inspect the children in this manner.

The following statistical table shows the "relation of oral prophylaxis to infectious diseases:
Record of infectious diseases in St. Vincent's Asylum.

"In the year 1905-6 the home was in quarantine for over three months-an epidemic of scarlet fever of over 75 cases.

"A comparison . . . will show that in six months after work was begun... the ratio of infectious diseases was reduced 59 per cent; and that in the subsequent year this ratio was reduced to approximately 2 per cent. . . .

"Is this absolute elimination of disease for a period of twelve months a coincidence? It may be so.... But certainly no such condition ever existed in St. Vincent's asylum prior to the installation of a dental infirmary."