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p. 61-64.


Oakland. [Superintendent of schools] The Department of health development and sanitation. In his Annual report, 1909–1910.

(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. Diseased tonsils.

369 Diseased glands

327 Adenoids.

290 Defective hearing.

283 Malnutrition.

87 Skin diseases. Nervous diseases

11 Orthopedic defects. Heart disease.. Lung disease. Defective palate. Number with 1 defect.

711 Number with 2 defects.

739 Number with 3 defects.

336 Number with 4 defects. Number with 5 defects.

16 Number with 6 defects.




9 7



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 coffce? 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 14 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, 149 years Average age of pupils in sixth grade, 144 years." Pasadena. (Board of education] Report of medical examiner. In ils 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.

4,036 Defective in eyes.. Defective in ears. With nose defects.

202 With throat defects.. With defective teeth.

1, 230 Malnutrition..

195 Nervous defects.

685 117




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.


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 mcord and make written report of such examinations to the State superintendent of public instruction is he may require. Every teacher shall report the mental, moral and physical defectiveness of

my 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 cese 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 S4 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 2,978, hearing in 6,155, breathing in 8,045, and other unclassified defects, 21,825. There wero 3,071

mental defeetives and 746 moral defectives. WIXSON, 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 schoolstime 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?”

COMPLE'S NOTE.-Since medical inspection and care are for those school children whose parents are eat 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 ")


GOODENOUGH, Edward Winchester. Some problems connected with the

medical inspection in schools. In Connecticut State medical society. Proceedingx, 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 edueation 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 tospect 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.

p. 37-39.





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

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).

295 Enlarged tonsils.

113 Adenoids. Adenoids and teeth.

71 Tonsils and adenoids. Tonsils and teeth. Adenoids, tonsils and teeth. Teeth and markedly enlarged cervical glands.

15 Enlarged cervic glands. Miscellaneous..

16 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)..

37 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 be 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 com. munity 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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These statistics "have not before been announced," states the writer.


MACATEE, H. C. School laggards. Some comments on the local situation.
Washington medical annals, 10: 149–59, June 1911. tables (from Ayres, L. P.)


*1. The public schools here exhibit the same problems of retardation and elimination as do those of other cities.

"2. The schools here are no better adapted to the average child with the average health history than are those in other cities.

"3. Educators should modify the school course so as to allow for the factor of illness; physicians should endeavor to restore children to the schools as soon as possible so as to avoid elimination from age and grade disparity.

*4. Special schools have been established here for the care of incorrigible and mentally defective children; other special ungraded schools ought to be established to care for normal children during temporary retardation, in order that they may be restored to their grades, and for physically defective children so as to adapt the schooling to the capacity of each child. Such schools should perform the samne relative function in the schools as the convalescent hospital is designed to subserve in the care of the sick.

*5. The problems of retardation carry new things for the physician engaged in work among children to know.

"6. Adequate medical inspection is essential to the reduction of retardation in healthy children and in physically defective ones.

"7. Medical inspection as now provided is inadequate.
"E. Schod nurses are indispensable for the best results of inedical inspection.

"9. Congress is not willing to give to this city what is everywhere recognized as an essential weapon against retardation of school children, having at the last session reduced the medical inspection service and having failed to provide for school nurses.

“10. The Dillingham bill providing for the establishment and maintenance of a laboratory for the study of defectives in the District of Columbia should be enacted, both for its broad general purposes sind also for the proper study and classification of defective school children.

"11. Retardation is in part brought about by repeated failures to succeed and thus may be a causative factor in the neurasthenias and psychasthenias so frequent in American life. The problem should engage the attention of physicians.”


BYRD, Hiram. Medical inspection of schools. In Florida. State board of health.

Annual report, 1911. Deland, Florida, The E. O. Painter printing co., 1912. p. 331-41. (State board of health of Florida. Publication 96, June 1912)

Largely, the extent of hookworm disease in Florida and the need for medical inspection as a factor in its eradication.

"Let us pause here long enough to see if we can get the full import of this one disease.
* White people suffer from it more than negroes.
"Children suffer from it more than adults.
"The rural population suffers from it more than the urban.

"Our inquiry will be then to determine the cost in dollars and cents that hookworm disease entails upon our rural white children.

"Fifty-five per cent of our people are white. Seventy per cent of our people live in the country. Therefore 28 per cent of our white school children live in the country.

"A Canvass was made by the State board of health covering 6,000 rural school children and it was found that 52 per cent of them were hookworm sufferers.

"From which it is seen that 15 per cent of the total school children of the State are suffering from hookworms.

* The extent to which the sufferer's vitality is lowered varies. But it can be measured with a fair degree of accuracy by the color of the blood. That is to say, rich, healthy, deep red blood is indexed at 100. The hookworm sufferer's blood becomes pale and watery in proportion to his infection. And as the infection gets worse and worse the color index of the blood runs down and down, 90, 80, 60, and even to 20 per cent of the normal. Perhaps an average color would be 70 per cent. But, to be especially conservative, we will assume that it is not so low as that. We will assume that it is 80 per cent. That means that the sufferer is off 20 per cent in strength, 20 per cent in intellectual energy, 20 per cent in power of learning.

"Now if 15 per cent of our school children are off 20 per cent in power of development, that lowers the whole power of development of the school children of the State by 3 per cent.

“We expend upon our public education now about $2,000,000 a year. Three per cent of $2,000,000 is $60,000.

“Are these figures facts? Verify them for yourselves. Sixty thousand dollars of our all too scant educational fund wasted annually-literally devoted to the maintenance of hookworms. Sixty thousand dollars for hookworms, and we haven't taken into account any of the negro population. Sixty thousand dollars' loss, and we haven't taken into account any children under or over school age. Sixty

thousand dollars' loss annually." Florida. Committee on sanitation and public health for the schools of

Florida. Report and recommendations. In Florida. State board of health. Annual report, 1911. Deland, Florida, The E. O. Painter printing co., 1912, P. 325-27.

Chairman, Hiram Byrd.

"(a) That 'Medical inspection of schools' be defined as a systematic effort to proter: improve the health of any or all pupils. With this in mind we would recommend

(6) That the time is ripe for the medical inspection of schools. "(c) That the individual school, whether large or small, must of necessity be the unit of operation,

(d) That medical inspection may be as complete or as partial as the individual school desires or can afford.

"(e) That it may be carried out either by the board of education or the board of health. (This refers strictly to the local board of education and local board of health.)

"(1) That it may be undertaken by any school in the State, however large, or however small. “(9) That the larger schools can make it more thorough and complete than the smaller one; but

"(h) That no school is too small to introduce some definite systematic regéme looking to soine forma of protection of the health of the pupils.

"NOTE.-In many schools, particularly in the rural districts, the most important public health problem is hookworm eradication. This can be accomplished by the teacher, pupils, and parents, without any further advice than they can get from the State board of health.

"(i) That where it can be afforded medical inspection should be carried out by the combined efforts of the teacher, the doctor, and the nurse.

() That where all three can not be afforded, by the teacher and doctor without the nurse. "(k) That where a doctor can not be had, it can be carried on by the teacher.

“NOTE.-There is a considerable amount of work that the teacher can do without the assistance of a doctor. In Massachusetts the teachers examine the eyes of the pupils, not to determine what ails them, but to determine whether they are normal or abnormal. If any marked deviation from the normal is found, the pupil is referred to a physician.

(1) This presupposes a certain amount of definite information of a more or less technical character, that in the ordinary course of events the teacher does not get, to which end we believe that the teachers should receive definite instructions as to how to conduct such examinations as may be deemed advisable.

"(m) That the meeting of the teachers in the several county institutes, and at the State teachers asso ciation, and the summer normals, and the colleges, afford convenient fora from which the necessary instructions can be given.

“(n) That the State board of health is the logical body to undertake the instruction of the teachers for this work, hence we believe

“(0) That the immediate need is for the State superintendent of public instruction, and the State health officer, to cooperate in providing for a course of demonstrations in all the summer normals and similarly in all the colleges which have normal departments, and

“(p) That these demonstrations shall cover such features as may be adjudged of vital importance by the State health officer and the State superintendent of public instruction." STILES, Charles Wardell. Frequency of hookworm disease or ground itch anemia among public school children in Southern Florida.

Public health reports, 25: 351-54, March 25, 1910.

"Summary of 1,306 pupils in 8 schools in 6 towns in 3 counties.

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