"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 protect health of any or all pupils. With this in mind we would recommend "(b) That the time is ripe for the medical inspection of schools. improve the "(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.) "(f) That it may be undertaken by any school in the State, however large, or however small. "(g) 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 some form of protection of the health of the pupils. "NOTE.-In many schools, particularly in the rural districts, the most important public health prob lem 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. “(j) 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 association, 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 "(o) 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. "These statistics of school children are exceedingly significant, from various points of view: "First. These children are growing up under a severe physical handicap. If they do not undergo medical treatment, not only will this handicap be appreciable in deaths due directly to hookworm infection, but this infection will so reduce their vitality that they will more readily fall a prey to other diseases, such as tuberculosis, pneumonia, malaria, etc. "Second. Their physical development is of necessity inhibited, and many of them may reach maturity stunted in their growth. "Third. Children in this condition can not possibly be expected fully to assimilate the education which is being given to them, and as a result the money being spent on education is not giving to these towns full returns. . . . "Fourth. Not only these three counties but all other parts of the South visited by winter tourists should awaken promptly to the self-evident fact that the danger is present that such tourists will soon avoid those rural portions of the South in which the soil pollution is so extensive as to lead to 55.9 per cent hookworm infection among the school children. . . . "At least five of the teachers in the schools visited showed clear and pronounced effects of hookworm infection. " GEORGIA. Atlanta. Board of education. Department of medical inspection. Signed: Robert G. Stephens, M. D. In its Medical inspection established in Atlanta, winter of 1909. Force, to date, consists of chief examiner, one white assistant, one colored, four white nurses and one colored. **Method pursued is that of routine examination. A school is visited daily by an examiner and nurse until each child in that school has received a physical examination." Defects are noted on individual cards. "If the defect is remediable a notice card is sent to the parents suggesting that dental or medical attention be given. . . . "Out of 5,838 recommended for treatment in 1910-1911, 50.9 per cent received treatment, but in order to get this number treated the nurses made 4,814 visits to homes. "Schools examined for the first time furnish in every instance from 60 to 94 per cent of the children defective." Augusta and Richmond County, Georgia. [Board of education] Medical inspection of schools. In its Annual report, 1910. p. 22-23; 111. "During the past year we have had a very satisfactory experiment with . . . district nurse visitation and inspection at the John Milledge school. The district nurse of the fifth ward has attended that school for two or three hours each week, has visited all the grades, and has had referred to her all suspected cases of disorder or disease. She then refers the cases to the regular physician of the city, or to specialists.... "There is also a movement on the part of the board [of education] to engage the cooperation of the board of health by which . . . at least one nurse and one physician shall be especially set apart for school inspection... as a part of the regular work of the board of health. by which a complete system of medical inspection can be inaugurated for all the schools." FORT, A. G. Examination of county school children. Medical association of Georgia. Journal, 2: 7, May 1912. table. "The combined results of the inspection of three rural counties in Georgia are as follows: "In the inspection of the sanitary surroundings of 59 of these schools, we found 17 privies only, and all of these poorly constructed. Is it any wonder then that 1,668 gave clinical evidence of hookworm infection and microscopical examination revealed that an average of 74.7 per cent of the suspects were infected?" FORT, A. G. [Hookworm disease among Georgia school children] American school board journal, 43: 39, October 1911. Defectives among the children of Stewart, Webster and Tift counties, Georgia. Savannah and County of Chatham. [Board of education] Health and sanitation. In its Annual report, year ending June 30th, 1910. p. 16-18. "Whenever in the judgment of the principal a pupil of the public schools needs medical treatment ... he shall notify the parent or guardian. . . . Such pupil shall not be permitted to continue in attendance upon the public schools until a certificate from the attending physician shall have been presented to the principal." This plan has been in operation since January 1, 1910. Cases reported, 191. [Stephens, Robert G.] Medical inspection of school children. In Georgia educational association. Proceedings and addresses, 1911. Atlanta, Ga., Bennett printing house. p. 65-73. General résumé, by the medical examiner of schools, Atlanta, Ga. "Out of a group of 2,375 examined in Atlanta in 1909, 1,452 were defective, or 61.1 per cent; out of 2,166 in Atlanta examined in fall of 1910, 1,653 or 76.2 per cent were defective." Two medical inspectors and four nurses work under control of board of education. Two weeks are allowed to elapse following notification to parents of defects, after which time a nurse visits the home of each defective child who has not returned a card signed by physician or dentist. IDAHO. HYDE, George E. Medical inspection of schools. Northwest medicine, n. s. 3: 340-43, December 1911. Rule V, of the State board of health of Idaho, requires the county physician to "report, on or about September 1 of each year, the sanitary condition of the public schools of the county in which he resides." The author receiving permission to examine the school children in his home town, Rexburg, "to see if the findings of inspection in other parts of the county could be bourne out" by his personal investigation. Teachers tested the eyes with Snellen's chart, took records of heights and weights, ages, grades, number of years attending school, and history of contagious diseases; Dr. Hyde examining the ears, nose, throat, and teeth. Ranging 20/50 to 6/200. (31 of these pupils had headaches on reading; 12 had change of posture at Defective teeth (of these, 25 per cent in very bad condition)...... "These results . . . show that the children in this western country have not nearly the same number of physical defects among them as examination shows exists among the schools of the East." ILLINOIS. Chicago. Board of education. Department of child-study and educational research. Child-study and educational research. In its Report of the Superintendent of schools for the year ending June 30, 1912. p. 44-50. table. From Report of directors, D. P. MacMillan. "Of the whole number of children, 2,095, examined during the year. .. with the exception of truants and incorrigibles . . . the maximum number, 469, falls in that group which is made up of children with nervous disorders, particular physical defects or general constitutional depletion. In the majority of cases they proved to be extremely backward pupils." Epileptics (most aggravated cases only). Children with constitutional depletion or nervous disorders or specific physical defects.. 115 125 58 34 466 259 66 12 13 469 276 Chicago. Department of health. Bureau of contagious diseases. Medical school inspection. In its Report, 1907-1910. p. 22-33, 39. tables. chart. forms. For the supervision of approximately 400,000 school pupils in the public and parochial schools. the city employs 100 medical health officers and 41 nurses, all of whom secure their appointments by competitive civil service examinations. For administrative purposes 5 medical health officers are selected to supervise without extra pay, the other 95; and 2 nurses, one receiving $15 per month more than the others supervise the other 39. The city is divided into 95 districts, to each of which is assigned a medical health officer, whose duty it is to inspect the pupils in the schools of the district. In addition, he has control and supervision of all contagious diseases in the territory to which he is assigned. . . . "The medical health officer makes daily visits to each school assigned him, commencing work at 9. m. At the beginning of the term he makes a rapid inspection of all pupils to determine if any bear evidence of a contagious disease. ... "For this preliminary inspection the health officer visits each room, stands with his back to a window, and has all pupils in the room file past him. . . . The pupil. . . exposes to view palms of hands and wrists; with the fingers of one hand pulls down the eyelid, exposing the conjunctiva; opens the mouth and puts out the tongue. This hurried inspection is made by the physician without touching the pupil.... After the completion of this preliminary inspection . . . the regular forenoon inspection is taken up. Inspections and examinations at high schools are done only on request or . . . emergency. Parochial schools desiring... have the same service as the public schools. Inspection for contagious disease in parochial schools is enforced. In making physical examinations, we begin with the pupils in highest grade, completing one school before beginning 'physicals' in another. "The daily routine is as follows: Inspection is first made for contagious diseases, after which ten or more physical examinations are made. "The health officers request principals to have all pupils in readiness for inspection who have been alent four consecutive days... "All children to be examined are sent to a room by themselves. . . . Inspection is made with refer. ence to communicable diseases and vaccinal status of pupils. "Pupils with marked defects needing immediate attention . . . referred by the principal, teacher or nurse, are examined without delay. If agreeable to the principal, Friday is [the]. . . day for such emergency examinations. "Health officers are forbidden to make any suggestions as to the treatment or management of pupils who are sick. This command is imperative. "Beginning November 1, each year, medical officers vaccinate free of charge any child or pupil who may apply to them for vaccination: . . . vaccinate no child without the consent of parent or guardian. "Health officers carry with them the following supplies Circulars on Prevention of consumption; The vaccination creed: special circulars on each of the infectious diseases, and warning slips to distribute and post in public places; wood spatulas for tongue depressors (Each tongue depressor is used only once and then burned]; culture media and outfits for Widal test." The blanks follow in the order in which they are used: Family history; physical record; medical inspection of schools exclusion; non-exclusion notification of abnormal condition; health officer's daily report; card for child to take to physician and return to school nurse; health officer's monthly report. A summary of the reports of the school medical inspectors of the Department of Health, of Chicago. for the year 1909, gives the following statistics: Of the total number of children examined, 123,897 (51 per cent) were defective. East St. Louis. Board of education. Retardation. 1910-11. p. 34-46. tables (Grades 1-12) In its Annual report, "Of 534 puplis marked to repeat the work of next term," 48 suffered from physical defects; 44, menta! defects. In all white schools, pupils, 6,842; over age, 676, or 39 per cent. In all colored schools, pupils, 1,082; over age, 714, or 69 per cent. HEDGER, Caroline. Physical examination of below-grade children. Illinois medical journal, 15: 433-39, April 1909. tables. Examination of 208 (125 boys; 83 girls) below-grade public school children in Chicago. |