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MAINE.

Augusta, Maine. Board of education. Medical inspection. In its Annual report, 1910–11. p. 29-33. tables.

"Organization of this department is as follows: First, the employment of two physicians. ... Second, an annual ear and eye test, conducted by the teachers. ... Third, an annual inspection of the teeth by the dental inspector. ... Fourth, the distribution of the health leaflets issued by the State board of health. ...

“Medical inspectors shall visit and inspect monthly each building assigned to them; shall examine any teacher or school employee whenever such examination is necessary; . . . shall visit each schoolroom at least once a year and make a general examination of the pupils; shall examine all pupils referred by the board, the superintendent, principals, or teachers; ... and shall exclude from school any employee or pupil whose presence is dangerous to the health of the school. They shall furnish teachers such information and instruction as they may deem necessary in the interest of health. They shall report to the superintendent any insanitary condition in or around school buildings. ... Medical inspectors, and school employees acting as such, shall give no treatment."

TABLE III.-Eye and ear test.

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TABLE IV.-Showing results of dental inspection in the schools.

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Maine. State superintendent of public schools. Medical inspection.
Report, 1910. Augusta, Kennebec journal print, 1910. p. 105–14. map.

Map showing States having medical inspection, p. 114.
Law in effect, in Maine, July 1, 1909.

MASSACHUSETTS.

HANSON, Justice G. Medical inspection in public schools. Boston medical and surgical journal, 163:242–43, August 11, 1910.

"If careful systematic inspection is carried on throughout the State, succeeding generations because of it will be less burdened by physical and mental cripples, will be more free from contagious and infectious diseases, and will have a more intelligent conception of disease, and its cause and effect.”

Discussion: p. 243-45 (Dr. Thomas F. Harrington.)

MARTIN, George H. Medical inspection in the public schools of Massachusetts.

In Massachusetts. Board of education. Annual report, January 1911. Boston, Wright & Potter printing co., State printers, 1911. p. 164–193. tables.

Reprinted.

** All of the 33 cities and 297 of the 321 towns report in the annual school returns for 1909 that school physicians bave been appointed. ...

"In other words, 98 per cent of the school pupils in cities and towns are having nominal medical inspection....

"From the returns received at the office of the board of education and the published reports of city boards of health, it appears that during the year 1909 there was spent for the medical inspection of school children the sum of $101,745.59. This is an average of about 20 cents per child. But as in some cities, where the inspection is in the hands of the board of health, the parochial schools are inspected as well as the public schools, and in Boston, which has about one-fifth of all the enrolled children in the State, the cost of inspection is much above 20 cents, the actual average cost outside of Boston is much below 20 cents.

“What school authorities should do is stated by the statutes . . . to be twofold:

*First, to provide for a general examination of all the children in the public schools at least once a year for any defect or disability tending to interfere with their school work.

"Becond, a special examination of children (a) who show signs of being in ill health or of suffering from infectious or contagious disease; () who are returning to school after absence on account of illness or from unknown cause. ...

"There is another function of the school physician. ... The law says he shall make such further ex. amination of teachers, janitors and school buildings as in his opinion the protection of the health of the pupils may require.' ...

**Dental clinics for school children have been established in a number of localities.

"In Lynn a dental dispensary was carried on in 1910 in connection with a neighborhood house. Fifteen Lynn dentists and 10 out-of-town dentists gave their services. A nominal charge was made of 15 cents for cleaning, 10 cents for extraction and 25 cents for fillings. One thousand and ten operations were performed upon children. ..

"In Winchester ... the dentists in town, nine in number, each give one-half day a week to work with needy cases, at a nominal charge of 25 cents per case. . . . The school nurse works in cooperation with the dentists. ...

"The school returns show that the eye and ear tests have been given as required by law in all the towns and cities, excepting Otis and Mount Washington. Four annual examinations have been made since the law was passed. . .

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* One or more nurses are now employed in the schools of Amherst, Roston, Brocton, Brookline, Cambridge, Canton, Holyoke, Lancaster, Leominster, Lowell, Northampton, Northborough, Walpole, Wal.

tham and Winchester." SNEDDEN, David (Samuel] Problems of health supervision in Massachusetts.

In American school hygiene association. Proceedings, 1912. Springfield (Mass.)
American physical education review, 1912. p. 18-26.

Ale in Journal of education, 75: 458–60, April 25, 1912.
"1. Legislative provisions.
"II. Application of laws.

"III, Problems of health supervision: A. How can health supervision be planned and organized so as to promote effective administration? B. What should be the distribution of the functions of health supervision among various possible agencies, such as teachers, nurses, physicians, physical trainers, and the home? C. What must be the character and training of those cooperating in this work? D. What shall be their relation to the existing school authorities? E. What will be the necessary financial cost of such sortice? F. What shall be the control of health supervision over the actions of parents and other non-whool agencies affecting the children; and G. Is there needed provision of facilities for investigation and supervision by state authorities?"

BOSTON.

AYER, S. H. Medical inspection of schools in Boston, Mass. Boston medical and surgical journal, 164: 456-60, March 30, 1911.

Historical sketch; salaries, etc., Boston and New York.

Read at the Boston health conference, 1915, February 20, 1911. COUES, William Pearce. The medical inspection of schools in Boston, the pres

ent limitations and future possibilities. Boston medical and surgical journal, 160: 746–48, June 10, 1909.

“The teachers in the various rooms send a slip down to some central place with the child's name, number of the room and symptoms of trouble. ... The inspector summons the children to be examined ... (and) examines them, writing on the slip the diagnosis and advice. He sees only the children whom the teacher sends slips for, that is, the primary necessity for medical inspection devolves on the judgment of the teacher.

“One of the conditions which should be changed . ... so that the teacher can be freed from responsibility and care in this matter." COUES, William Pearce. Some problems of school inspection. Boston medical and surgical journal, 164: 814–16, June 8, 1911.

Result of examination of 158 retarded pupils.

Number. Per cent.

Defective vision.
Defective hearing.
Chronic enlarged tonsils.
Defective or carious teeth.
Marked pallor..
Markedly undersized.
Extremely nervous..

41

2 122 127 34 3 1

25.9

1.2 77.2 80.3 21.5 1.8 .63

... 72

“It is of interest to compare the result ... with that of: 212 children of normal mental caliber; per cent of these children showed chronic enlarged tonsils; 50 per cent showed carious teeth. ... It would seem from these statistics that chronically enlarged tonsils and the generally accompanying adenoids had little to do with the mental backwardness of these children, but that carious teeth might

play a considerable rôle in the causation of this condition." GALLIVAN, William J. Child hygiene. Monthly bulletin of the Health department of the city of Boston, 1: 29–36, 50, February 1912. tables.

Division of child hygiene "was created in March, 1910. It is concerned with the physical welfare of every child in Boston from the time of conception up to the age of 16 years. The work is classified ... as follows: 1. Pre-natal and post-natal work. 2. Medical inspection of schools. 3. Physical examination of licensed minors.

“Medical inspection of schools begins at the kindergarten class and ends with the high schools. Of equal importance are the three objects ... in view, as follows: 1. The detection of communicable diseases and the exclusion from school of every pupil so afflicted. 2. The protection of every pupil in the schools from contagion unrecognized by parent or teacher. 3. The detection of such defects which if untreated would result in permanent injury to the pupil.

“The board of health is emphatic in its stand against prescribing for any discase or defect discov. ered. . . . Every case requiring medical or dental aid is referred to the family physician or to the family dentist. Those who are unable to employ professional services are referred to reputable hospitals or dental clinics.

“Under the present system, the school physicians are under the authority of the board of health; the school nurses are under the authority of the school committee. The number of nurses employed is alto gether inadequate for the work required. The board of health is ready to employ a corps of nurses to assist in school inspection, but up to the present time, they have not been willing to duplicate a system maintained by the school committee. A transfer, then, of the nurses from the school committee to the board of health would render medical inspection of schools as nearly perfect as human endeavor can accomplish.

“The school population at this date is 123,091. This includes attendance in public and parochial schools. For this work there are employed 82 physicians, who are required to visit every school building on every school morning of the year.”

See same, 162: 215, February 17, 1910.

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Result of the physical examination of school children in Boston for the year 1911--1912. Total number of children examined.

118, 781 Total number of pupils without defects..

40, 850 Total number of pupils with defects..

77, 931 Deferts noted as follows: Mental deficiency.

501 Defective nasal breathing.

9,693 Hypertrophied tonsils

25, 121 Detective teeth..

51,340 Deketive palate

371 Cervical glands.

13,711 Pulmonary disease: Pulmonary tuberculosis..

133 Acute bronchitis..

1, 169 Asthma.. Pleurisy.

42 Miscellaneous.

987 Cardise disease.

3,091 Narvous disease

505 Orthopedio defects: Tuberculous.

693 Nontuberculous.

1,181

5, 243 Riekets.

1,019 Malnutrition

3,891

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SMITH, C. Morton. Diseases of the skin. Boston medical and surgical journal, 166: 623–24, April 25, 1912.

A complete physical examination, September 13 to December 31, 1911, showed 11,691 children in the Boston schools, having skin diseases. The number was exceeded only by decayed teeth, hypertroplied tonsils, defective nasal breathing and enlarged cervical glands. The common diseases are scabies, pediculosis, impetigo, and ringworm; these four were found in the schools no less than 6,428 times, or 55 per cent of all the skin affections reported. There were 5,257 children with pediculosis.

CAMBRIDGE.

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2 35

Cembridge. Board of health. School inspection. In its Annual report, year ending December 31, 1910. p. 37-41.

Siged: Bradford H. Peirce, M. D.
Coarerning the school nurse see p. 40-41.
Six public school and 5 parochial inspectors; and 2 school nurses.

Number of pupils ill and defective, 1,870.
Chicken pox.
Diphtheria.
Eczema.
Gonorrhen.
Laryngitis.
Measles.

German.
Munds.
Scarlet fever.
Syphilis.
Tonsilitis..
Tuberculosis, pulmonary
Tubereulosis, other forms.
Whooping cough..

Eyes.
Conjunctivitis..
Corneal ulcer or opacity.
Keratitis..
Strabismus.
Imperlect sight.

In two schools located in the same section of the city, one, rather closely surrounded, and not well ventilated, has had many cases of scarlet fever and diphtheria for several years. The other school, alder and in an open space, has had but two cases of diphtheria and one of scarlet fover in more than a year.

2 0 71 3

79 4 1 15 27

CANTON.

CABOT, Arthur Tracy, School inspection in small towns. In American school

hygiene association. Proceedings, 1911. Springfield, Mass., American physical education review, 1911. p. 40-43.

Also in Boston medical and surgical journal, 164: 633-34, May 4, 1911.

The town's appropriation being too small for payment for systematic medical inspection, at a town meeting in 1908, a school nurse appropriation of $500 was made, a trained nurse to begin at the opening of the next school year. The work, which also included the parochial school, was found to be so satisfactory that for the year following, $950 was appropriated.

The nurse looks after 900 children; makes examinations at beginning of year, keeping card record; keeps record of any illness they have; children with any infirmity of eyes, ears, throat or general condition, are referred to their physicians; children requiring specialist's aid are taken by her to a public clinic in Boston. She gives hygiene talks in the schools, and visits the homes. “We have found the work of the school nurse thoroughly satisfactory in giving the town what seems adequate inspection and control of contagious disease.”

The neighboring town of Norwood adopted same system; Milton, planning the same.

WELLESLEY.

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CANAVAN, Myrtelle M. Medical data of the examination of 2,333 supposedly

normal adult young women. In American school hygiene association. Proceedings, 1912. Springfield (Mass.] American physical education review, 1912. p. 76–91. tables. record blanks.

The physical examination system of Wellesley college; data covering cxaminations from 1906 to 1911; average age of students, 19 years. Percentages of orthopedic defects.

Per cent. 1. Back, curvature..

35 2. Shoulders, uneven..

53 3. Hips, uneven....

434 4. Legs:

(a) Knock-kneed.
(0) Bow-leg..

84 (C) Unequal. 5. Ankles pronated.

703 6. Longitudinal arches: (a) Flat.

12 () High.

5 7. Anterior arches, flat.

111 8. Toe joints enlarged..

34 Deaf or partly so.

23 Nose, hypertrophy of turbinate.

13 Tonsils enlarged..

281 While 174 per cent had had throat operations, and 15 per cent of these, for removal of tonsils or adenoids, tonsils were found enlarged in 28 per cent.

Per cent. Eye lesions.

12) Glasses worn..

37 Nutrition poor..

19 Teeth: (a) Missing.

124 (b) Cavities.

(c) Poor or irregular. Menstrual disorders.. Enlarged lymph nodes.

12 Heart lesions:

(a) Organic..
() Murmurs, no symptoms

17) (c) Other lesions. Sports: (a) Qualified.

56 (5) Disqualified Unusual lesions for the most part are stigmata of degeneration, 24 different sorts,

1 23

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