Examinations were made by the teachers, and confined for that first year, to the incorporated villages. Of the 446 such villages, 425 made the tests.

"The number of pupils having their eyes, ears, nose, and throat examined in the 425 villages of the State was 105,767; 5,045 of these children were under 7 years of age and did not have their eyes tested. They, however, had their hearing tested and their nose and throat examined; 100, 722 then had their eyes tested as well as their hearing and an examination of their nose and throat. A little less than 10 per cent of the 105,767 examined had defective hearing and earache or both with discharge from the ears." (Corrected from letter of Dr. Schenck of Jan. 22, 1912.)

VON SHOLLY, Anna I. Trachoma: Its prevalence and treatment, especially in relation to the New York City school children. In American school hygiene association. Proceedings, 1912. Springfield [Mass.] American physical education review, 1912. p. 115-24.

The school children of New York since 1902 "have been under constant and careful examination for this disease. Twice a year, an inspection is made of all the children of the public schools. All children whose eyes show an abnormal condition of the lower lids with lymphatic dilations and follicles (the upper lids are not examined by the school inspectors) are obliged to put themselves under the treatment of a physician and continue under treatment until discl urged by him. They must show to the school nurse, twice a week, satisfactory evidence in the form of a dated dispensary card or a physician's cartificate that they are under treatment. Children whose eyes show muco-purulent discharge are excluded from school until this has disappeared. . . . In 1902, the health department opened a free clinic and hospital for infectious eye diseases in the lower East Side-the district most infected. Since then, three additional free infectious eye disease clinics have been opened by the department. . . .

"The statistical report of the child hygiene division of the New York City health department is as follows: In 1902, 20 per cent of the children were affected; in 1908, 7 per cent; in 1909, 6 per cent; in 1910, 3 per cent.

"Depending on what we call by the name of trachoma, we may take our choice as to whether, for example, in 1910, there were 20,915 cases of trachoma or whether they were approximately 498 cases of trachoma and acute catarrhal conjunctivitis and 20,417 cases of varying degrees of folliculosis and follicular conjunctivitis.

"About two months ago, we started, experimentally, a free clinic in a room in one of the public school buildings . . . and twice a week all the children with infectious eyes from this school and the neighboring schools are brought for treatment in squads at an appointed hour during the school session."

PENNSYLVANIA.

Pennsylvania. Medical society. Report of the Committee on trachoma. Pennsylvania medical journal, 13: 58-59, October 1909.

Chairman, C. P. Franklin.

To about three hundred ophthalmologists a set of questions was submitted regarding trachoma. The following was included: "Is there, in your community, systematic examination of school children, or of employees in large establishments engaging recent immigrants?"

The answers showed that each ophthalmologist sees annually from 1 to 200 cases. Answers revealed the fact "that there was then no systematic examination of either children in the schools or adults in employment, particularly in the regions where so many alien-born exist."

Recommendations: "1. That medical inspection of schools and homes be established. 2. That medical inspection of alien employees be undertaken. 3. The introduction of a bill into the next legislature, declaring trachoma a disease requiring quarantine, such quarantine to be at the discretion of the proper medical authorities. 4. The subsequent introduction, in the same legislature, of a bill to establish a State trachoma hospital in or near Philadelphia. . . 5. That this committee be continued, with power to act in carrying out the above recommendations."

POSEY, William Campbell and MCKENZIE, Robert Tait. Results of the examination of students' eyes in the Department of physical education, University of Pennsylvania. American medical association. Journal, 48: 1010-13, March 23, 1907. figs.

Examination of 883 students, by "the ophthalmologist of the department . . . nine physicians, all trained ophthalmologists, and his assistants in various hospital services.

"With the various classes divided into squads, these gentlemen prepared a short sketch of the ocular history of each student. . . regarding the existence of any known visual defect, headaches, ocular pain or fatigue after studying, or other symptoms which might be of ocular origin. Special inquiry was made regarding the wearing of glasses. After these facts had been recorded on a card ... the student passed to another assistant, who determined the range of accommodation and the degree of visual acuity by the Snellen type. Another examiner then noted the external configuration of the eyes and the pressure of any inflammatory condition or anomaly in their movements. On the com

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 3 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 fifth 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. Dental review, 25: 563–74, June 1911.

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 gospel of oral hygiene." WOODRUFF, Clinton Rogers. The city and the children's teeth. American city, 6: 479-81, February 1912.

Philadelphia's school dental clinic, city hall, has one chair; opened in October, 1910. More than 3,500 children were treated during its first year. Newark dentists maintain 2 dental chairs. Rochester, N. Y., 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.

East St. Louis. Board of education. Dental inspection. In its Annual report, 1910-11. p. 48-52.

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) Cotton 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. Oral hygiene, February 1911. figs. tables.

Reprinted.

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.

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. Nesbit'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