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ST. LOUIS, MO. St. Louis. Board of education. Department of school hygiene. In its Annual report, year ending June 30, 1911. p. 141-48.

At the beginning of the year, a corps of six nurses was added to the Department. Duties and lines along which their work was carried on:

"1. To assist inspector of hygiene in his examinations and to carry out his instructions.

"2. To keep records of children examined, making special notes as to what treatment has been obtained.

“3. To examine all absentees returning to school before they enter rooms, with a view of detecting evidence of infectious or contagious diseases, excluding or holding children in suitable quarters for further examination by inspector of hygiene.

“4. To visit homes of all excluded children or children whose parents do not respond to repeated notices from the inspector of hygiene of the existence of some physical defects, which materially impedes the child's progress in school.

“5. To interview and advise parents, getting information of the social and hygienic conditions of the home of pupils incorrigible or morally weak, suggesting proper clothing, food and cleanliness.

“6. Advising parents or guardians of the need of certain medical or surgical treatment, also advising them where the free medical and dental clinics are, also where the free childrens hospitals are located.

7. When the time will permit, they can make eye and ear tests of children selected by the inspector of hygiene.

“8. To be responsible for the personal hygiene and cleanliness of all children under their caro.

"9. To observe the matter of ventilation, light, heat, and proper seating of children, and bring to the attention of the principal and supervisor of hygiene.

“10. To assist in caring for children who are in need of emergency medical or surgical treatment while in school, having an emergency chest at her disposal.

11. To assist principals, teachers and inspectors in determining the matter of unfitness or fatigue among the school children, especially in the matter of physical training.

12. Their visits to the homes of excluded and sick, absent children will be the direct means of having them returned to school at the very earliest possible moment."

Nurse record blanks, p. 143-46. Other blanks, p. 147, 149.

Summary of district nurses' reports.
Visits to homes of pupils.
Visits to hospitals.
Visits to clinics...
Operations secured through visits.
Fitted with glasses through visits.
Emergency attentions at school.
Dental treatments.

1,560

55 934 253

191 1,003

196

TRAINING OF MEDICAL INSPECTORS, SCHOOL NURSES,

AND SCHOOL TEACHERS.

American academy of medicine. Report of Committee for teaching preventive

medicine in universities and normal schools. Its Bulletin, 13: 20-22, February 1912.

Chairman, Henry B. Hemenway.
A preliminary report.

“Preventive medicine is not taught in a thorough manner by most medical schools. Very few hours are devoted to this branch in the advised curriculum.

Secondly, there are few competent to take positions as professors of public health in universities. ... At the University of Wisconsin, under . . . Prof. Ravenol, a course in public health has been inaugurated. Columbia and Cornell universities and the Massachusetts institute of technology are doing the same. Judging from results, the Massachusetts Institute of technology is today giving better instrua them in this line than any medical school in America." The Harris lecturer at the Northwestern aniversity for 1912 will be Dr. Müton J. Rosenau.

Discussion: p. 22–26. BURNETT, James. The teaching of school hygiene. Medical record, 79: 711-12, April 22, 1911.

Courses of instruction before a candidate for diploma in school hygiene is admitted to examination, in: *1, Practical instruction in children's diseases (three months). 2. Examination of the eye, ear, nose, and throat (three months). 3. School hygiene, as outlined above (six months), the course to include practical examination of school children under a specially recognized teacher."

The diploms would require but a year's additional special training. “If such a diploma were instituted, and satisfactory instruction given in school hygiene, the standard of the school physician would

be raised." DITMAN, Norman Edward. Education and its economic value in the field of

preventive medicine. The need for a School of sanitary science and public health. Columbia university quarterly, 10, June 1908, supplement. 70 p. diagrs, map. tables. (Appendix I, II)

Bibliography: p. 69–70. Reprinted.

A school of preventive medicine should be planned to give instruction to the following groups: L Students preparing for the practice of medicine. 2. Students preparing for offices of health boards and sanitary inspectors. 3. Students preparing for sanitary engineering-civil, military and naval. 4. Students preparing for work as school and college teachers, school nurses and school inspectors. S. Students preparing for work as officers of charity societies and institutions, visiting nurses and "social workers.” 6. Students preparing for the ministry. 7. Students preparing for the work of legislators. 8. The public.

Subjects of instruction proposed for school nurses and school teachers. Conditions concerned in the causation and occurrences of disease in individuals, groups of individuals, and communities.

+Modes of transmission, portals of infection, geographical and seasonal distribution of transmittablo and epidemic diseases, and the approved methods of prevention of these and other diseases.

+ Legal aspects of methods of isolation, quarantine, medical and sanitary inspection, compulsory reination and inoculation, school attendance, notification, and of methods for proventing the transmission of communicable and epidemic diseases. + The liquor

problem; insanity, pauperism and crime dependent on disease and intemperance. + American social conditions (including immigration, the growth and concentration of population in cities, with the attendant dangers).

+Sanitary legislation and organization. Principles of relief; organized charities. Social and moral prophylaxis.

+ Diseases of animals transmittable to man; relation of insects to disease. + Hygiene of the child and the adult, the school and the tanement

house, hygiene of ventilating, heating, atmospheric pollutions, and their influence on health and disease. + Theory and practice of physical education. + Correction of conditions which interfere with the physical welfare of school children. Social and vital statistics.

Adulterated and unwholesome food; markets, bakeries, hotels, restaurants, infected food, ico, canned goods and water supplies.

+ Dairy products; milk, etc.; inspection of herds and dairies; use of tuberculin test, pasteurization, milk analysis and laws. *Dangerous occupations and preventable accidents. + Excursions for sick children, fresh air lunds, visiting nursing, eto. + Sanitary museum exhibits (see Park's Museum catalogue).

Compiler's role: Cross mark (+) indicates subjects included in training of school inspectors; to which author adds: Medical and sanitary inspection.

Subjects marked with a star (*) may be omitted in training of school teachers; to which training the wuthor adds:

Municipal, State, and National Government.

Municiapl sanitation: (1) Pollution of water and ice supplies, methods of purification and relation to health and disease. (2) Construction of reservoirs, filtration plants, sewage and water systems; methods of sewage and refuse disposal; street cleaning. (3) Public baths, parks, and comfort stations. (4) Public

puisances, offensive trades, smoke, stables, noises and filth. YORCE, John Nivison. Standardization of the health and development require

ment. California. State board of health. Monthly bulletin, 5: 190-91, February 1910.

Medical inspectors in California.

"At the last session of the legislature a bill was passed authorizing school boards "to establish health was development supervision in the public schools of this state. The law further provides that the wamining staff for health and development supervision shall consist of persons holding a life diploma

the high school or grammar grade, and persons holding a certificate to practice medicine and surgery.

In addition persons so qualified must have a health and development certificate issued by county boards of education on presentation of a ‘recommendation from the State board of education certifying special fitness for the work. The law provides no standard of requirement by which the State board of education shall act in determining 'special fitness,' and the suggestion has been made that in choose ing the medical members of the staff, the endorsement of the candidate by his county medical associa tion be secured by the state board of education. This is a most excollont idea as an additional sale guard with regard to medical fitness, but takes no account of the 'special fitness' desirable in dealing with problems of the publio health. . , The following is an attempt to suggest a plan of procedure which will serve to standardize this requirement.

“Recommendations from the State board of education cortifying special fitness for health and dovolopment supervision in the public schools of this state will be granted only to:

“(@) Persons certified by the University of California or other institution of like standing as having completed a course in hygiene covering the following subjects:

“1. Sanitary engineering. Elementary knowledge of tho construction and sanitation of water supplies, the disposal of sewage and sewerage systems, and the disposal of refuse.

“2. Sanitary architecture. The plumbing, lighting, heating, and ventilation of buildings.

"3. Food inspection. The sanitation of the meat, milk, vegetable, and grocery supply and the deteotion of adulterants.

“4. Personal hygiene. The essentials of personal hygiene including anthropometry and the prescription of exercise.

“5. Vital statistics. The application of statistical methods to the conservation of the public health. “6. Epidemiology. The hygiene of transmissible diseases.

7. Sanitary law. The health laws of the State, the school laws of the State, and the Federal laws designed to conserve the public health.

(6) Persons otherwise qualified, passing an examination in the above mentioned topics to be given by the State board of health.

“The examination mentioned in section (6) could be given either by the State board of education, by the State board of health, by the State board of medical examiners, or by the State board of exam

iners for registration of nurses appointed by the regents of the university." HECHE, Arthur. A report on the teaching and practice of hygiene in the public

normal schools of the United States. Journal of educational psychology, 2: 429–39, October 1911. tables.

Questionnaire sent to 191 of the 203 most important normal schools listed in v. 1 of the Bureau of education report for 1909, elicited returns from 84. “Exactly one-half of the 84 heard from offer no hygiene courses aside from the hygiene given with physiology or incidentally in courses on school management, methods of classes, psychology, etc.Nine schools give neither physiology nor hygiene, and only one school

attempts to train special teachers of hygiene. HILL, David Spence. The cooperation of educational and of medical departments

of American universities. In American school hygiene association. Proceedings, 1912. Springfield (Mass.) American physical education review, 1912. p. 136-51. tables.

Also in Science, n. 8 36: 647–59, November 15, 1912. Title: The need of practical cooperation of edecer tional and of medical departments in modern universities.

Reprinted.
Questionnaire sent to medical colleges and departments embraces the following questions:

"I. (a) What courses intended specifically for teachers or prospective teachers are being offered by your medical department? (6) Duration of courses? (c) Number enrolled this year? (d) Any oor tificate or diploma awarded for completion of same by teachers or prospective teachers?

"II. (a) What courses in pedagogy are offered by your department of pedagogy or education for the benefit of physicians or medical students or nurses who are or intend to become inspectors of schools? (6) Duration of courses? (c) Number enrolled this year? (d) Any certificate or diploma awarded for completion of same by physicians, medical students or nurses?

“DII. Please write any other relevant information or practical suggestion regarding possible need for cooperation between medical and pedagogical departments.”

Of the 112 inquiries sent to the medical colleges, 69 responses were recetved; of the 160 sent to dopartments and schools of education, 105 responses were received.

Most of the responses from medical colleges indicate: "No work whatever for the benedt of prospective teachers"; from educational departments, “no work especially intended for medical inspectors, school nurses or school sanitarians"; from medical and from educational departments of certain universities, "no active affiliation reported.” Scarcely half a dozen universities report a reasonably effective scheme for cooperation of medical and educational departments. The cooperation of trained workers in the medico-pedagogical field has gained headway against difficulties. ...

“1. With reference to the need of the schools, provisions should be made for senior medical studente, and especially for graduates, in the educational department for instruction and training in the essene Hals of pedagogy. ... In basal study of psychology of common Interest to teacher and physican, tho majority of medical students obtain no systematic training whatever ... since, according to Floxner's report, 1 hall or more of the medical schools require less than a good high school course for admission. ...

"Medical students who undertake the work in pedagogy as prospective school inspectors or school physicians should undertake the extra training either in a graduate year or elect a minimum during the senior year of the medical course. ...

"2. Appropriate courses in education should be offered prospective school nurses.

"3. The college student who desires to become a specialist in school hygiene or a public sanitarian may ornit the regular medical course and proceed from the bachelor's degree to the doctor of philosophy in hygiene or to the new degree of doctor of public health ... candidates for the bachelor of arts in education should be permitted to follow hygiene as a major subject, extending through at least three Fears. ... In the courses in hygiene, preventive medicine, physiology and psychiatry, the medical department may be utilized. ...

"4. In the study of the school problems of olimination, retardation, repeating, and of the exceptional child, the department of education should lead. The educational laboratory and pathological clinic, an adjmet to the laboratory of psychology, is one point for concentration of effort upon these problems,

be cooperation of psychologist, physician, sociologist, and teacher." KOBER, George M. Hygiene and dietetics. American academy of medicine. Bulletin, 11: 779–86, December 1910.

Outlines lectures for a course intended to give to students such knowledge “as may enable them to differentiate between wholesome articles of food and drink. . The examination of air in rooms, the velocity, condition and quality of air currents are considered. ... The organic analyses of water and its various forms of pollution, together with the examination of soils.”

Under "List of lectures" are: The alcohol and tobacco question. Importance of good teeth. House sanitation. Lighting. Hygiene of schools, Medical inspection of school children and the prevention

of permanent disabilities in childhood. Social and moral prophylaxis. LANKFORD, J. S. The public school and the prevention of tuberculosis. Texas State journal of medicine, 5: 403-405, March 1910.

Reprinted. "A careful study of tuberculosis should be made a part of the curriculum of every school, beginning at the fourth grade and extending through the grammar school. ...

"First. It is the duty of the officials to see that buildings are located on ample grounds and in airy places, so bear as possible; that the premises are kept clean and sanitary; that the buildings are arranged to the best advantage for heating, lighting and ventilation, that extremes may be avoided; that seats sre adjustable and that everything is done to protect children from disease and to promote good health and development. The course of study ... should be ... lightened; the mental strain should be relieved and more attention given to the physical side of life. . .

"Second in importance is the health and preparation of the teacher. She must be free from tuberculosis ... (and) must be deeply impressed that the prevention of tuberculosis stands first in any system of education. ... She should have a keen insight into the general condition of her pupils, as well as a wide scope of information concerning illness. . . . She should urge that every practice promoting general health in school life is carried out.

"Third. Practical courses of instruction should follow this equipment.” PALMER, George Thomas. The short-comings of municipal public health administration. American city, 5: 64-68, August 1911.

“In but seven of the (44 Illinois] cities have the health officers been permitted to serve sufficiently long to become thoroughly conversant with the sanitary requirements of the city or to work out sanitary and public health reforms. In 16 cities changes have been made every two years, and in six ... every

ROSENAU, Milton Joseph. The department of preventive medicine and hygiene

and the new degree of doctor of public health. Boston medical and surgical journal, 166: 886–87, June 13, 1912.

Course authorized by the faculty of medicine on June 22, 1910, by Harvard university president and felors, leading to the degree Dr. P. H.

“While candidates for the degree of doctor of public health are advised first to take the medical courses, the medical degree is not a prerequisite. Those who desire to specialize in sanitary engineering, sanitary architecture, sanitary chemistry, vital statistics or other branches of public health work may receivo the degree after four years of work following the bachelor's degree. ... In any case a minimum of one year of residence is requtred.” Inerner, Abraham. Medical education in the United States and Canada; a Report ... New York City (- 19101 346 p. maps, tables. 8. (Carnegie foundation for the advancement of teaching. Bullo 89, s.

RUCKER, William Colby. The making of a health officer. California State journal of medicine, 9: 155–56, April 1911.

The course to be offered by the Oakland (California) college of medicine will cover one year and ... will include general and personal hygiene, sanitary engineering, especial stress being laid on the collection, storage, purification and delivery of water, and the collection, purification and disposal of sewage; theoretical plumbing; sanitary architecture; sanitary law, bacteriology, parasitology including medical entomology, sanitary chemistry and food inspection.

Discussion: p. 156-58. SHIPLEY, Alfred E. Training for public health. New York medical journal, 93: 985–87, May 20, 1911.

"Training for public health service involves the preparation of physicians and of purses. . . . Such & course should include:

“Hygiene studied from public, semipublic, and personal standpoints. Public hygiene includes municipal, State, and Federal hygiene. . . . State hygiene attends to the health affairs of towns and rural communities. . . . Municipal hygiene . . . will require the services of a vast number of medical men. . . . Consideration must be given to sewage, garbage, cleanliness of streets, water supply, food supply, sanitation of dwellings, including ventilation, lighting and plumbing, air pollution, transmissible diseases, and child hygiene.

“School hygiene is developing very rapidly, its phases already being so many that it should have the entire time service of medical men.

“In the proper consideration, therefore, of the many problems arising in the field of preventive medicine, social, industrial, economic, and medical factors must be given their due proportions." SMALL, Willard S. School hygiene in the training of teachers: The organizing

principle. In American school hygiene association. Proceedings, 1910. Springfield (Mass.] American physical education review, 1910. p. 124–31.

Also in American physical education review, 15: 586-92, November 1910; and in Atlantic educational journal, 6: 5-6, 40, September 1910.

“Health as an end in education requires that the various factors of the school life and environment shall be adequately understood. ...

“The three factors I have chosen as illustrative examples, would be acknowledged ... as of essential importance.

"1. Ventilation. The point of attack is the relation between air and life. This should be a matter of intimate knowledge on the part of teachers. As a matter of fact, this relation is little understood....

"2. Eye hygiene. ... The development of the eye must be understood. The specific strains and degenerations to which each important part is liable must be made clear. ... The principles of lighting ... the vicious effects of improper position; the dangers of too prolonged near work and of home study; improper methods in writing. ... Above all, it is essential that there should be a thorough study of the hygiene of reading and definition of the hygienic requirements for text books. ...

“3. Physical defects. . . . The statistics of retardation show relatively little retardation associated with visual defects, whereas the common defects ... 0. 8., adenoids, enlarged tonsils, are attended by a relatively large amount of retardation. The same is true of defective hearing. . . . Such defects inevitably mean retardation and perversion of development in the ordinary school environment. ... Teachers in training should study the more important physical defects-their physiological character, their specific effects upon psycho-physical development, their relations to school practices and condi

tions, and their remedies or alleviations." STEWART, Elsa. Sex hygiene. 9 p. 8°. (Cheney, Washington. Department of school hygiene. Bulletin H., no. 1, Sept. 27, 1911)

The Washington State board of education passed resolution, in January 1911, making sex hygiene a part of the curriculum of the State normal schools.

The course was first given at the Cheney State normal, summer session 1911. Frequent bulletins are to be sent out, detailing the plan and progress of the work.

The course " is concerned first with the primary principles of biology, (@) protoplasm, () life, (c) the cell theory, (d) germ cells and their life cycle; 2d, the evolution of sex; 3d, human reproduction presenting the (a) anatomical and (b) physiological phases briely, (c) embryological development touching upon prenatal influences, (a) birth; 4th, the phenomena of adolescence physical and psychical, the boy and girl problem and its solution, adolescent reading and amusements; 5th, the pathology of sex onanism among school children, causation and treatment, social diseases and the social evil. This phase of the subject will be treated briefly ... 6th, sociological aspects of sex, (a) recognized social conventions, what they are for and their meaning, (6) the nature and obligations of the family and the sancity of the home, (c) the centripetal tendencies of family life against the centrifugal tendencies of industrial life, (d) studies of the theories of inheritance and environment, (e) eugenics, ) infant mortality, causes and preventions, () race suicide and the duties of educators in the preservation of the race."

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