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Tabulation of the eye conditions of 850 students; eye-examination, 1909-10, has become a part of the regular physical examination given to all matriculants at the university.

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From the above table it will be seen that only 22 per cent of the students examined were normal.

CONNECTICUT.

Bristol. Board of school visitors. Eye test. In its Annual report, year ending July 14, 1911. p. xxix. table.

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"Once in three years the eyes of the pupils in the public schools are tested according to directions furnished by the Connecticut board of education."

MASSACHUSETTS.

COUES, William Pearce. The results of the clinical throat examination of 212 school children. Boston medical and surgical journal, 162: 215, February 17, 1910. The children examined were in 4 different buildings and 6 different rooms. The ages were from 6 to 15 years. About 50 per cent were native born, a large percentage being girls. Of the 212 children, 153, or over 72 per cent, showed marked chronic tonsillar hypertrophy-so marked in a number of cases that the tonsils practically met in the central line. Of the whole number examined, 103, or about 50 per cent, showed markedly carious teeth. Of the whole number, 141, or 66 per cent, showed enlarged submaxillary glands.

Of the 153 children with chronic hypertrophic tonsils, 90, or 58.8 per cent, showed marked dental caries; 120, or 77 per cent, exhibited marked enlargement of the submaxillary glands.

"In the large percentage of chronic tonsil cases. . . three factors act to a large extent as predisposing causes. 1. Poor home surroundings; lack of fresh air and sunlight. 2. Improper and insufficient food and neglect of the teeth. 3. The wretchedly unhygienic conditions existing in some of our public schools."

Fall River. School committee. Medical inspection [1907-1911] In its Annual school report, 1911. p. 15-18. table.

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"The most important occurrence of the year in this line was the establishment of free clinics at the Union Hospital."

Massachusetts. State board of health. Directions for testing sight and hearing (in accordance with Chap. 502, Acts of 1906, as amended by Chap. 257, Acts of 1910)

"1. Tests will be made as early in the school year as possible, preferably in September.

*2. Made under the most favorable conditions, as nearly as possible under the same conditions, preferably in well lighted rooms, in the early part of the day.

"3. Testing done by the teacher of the class, and supervised by the principal to see that the conditions of the test are as uniform as possible for the different classes.

"4. Children wearing glasses will be tested with the glasses, and if found normal will be so recorded. "5. Examine all children, but record as defective only those whose vision is 20/40 or less, in either eye. "6. Report to the State board of education the whole number of children examined and the number found defective according to the standard given in No. 5."

MISSOURI.

SNEED, C. M. A report upon medical inspection in the Jefferson City public schools. Missouri school journal, 25: 535-39, December 1908. tables.

An examination of the eyes, ears, throat and nose conditions of 1,000 white children and 100 negro children.

Normal.

Defective in vision.

White..

Negro..

635
81

365 19

A comparison was made between the percentage of defects found in the 116 examined in the high school and in 147 in the lower grades. The children of the high school showed visual defects in 40.51 per cent, while the children of the lower grades 29.43 per cent. Other defects were found in the 1,000 white and 100 negro children, as exhibited in the following table:

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Careful throat inspection was made upon only 377 children. The tonsils were considered enlarged if they were somewhat larger than an almond.

There were 551 cards of warning issued to pupils for the various defects found-74 out of the 423, or 17 per cent, who reported having received cards, had consulted a physician.

This study, differently arranged and credited to Dr. Sneed and Guy Montrose Whipple, is also in Psychological clinic, 2: 234-38, January 15, 1909. The following table is from the latter publication:

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TAUSSIG, Albert E. An investigation as to the prevalence of visual and aural defects among the public school children of St. Louis County, Mo. Interstate medical journal, 16: 721-31, November 1909. tables.

Also in Psychological clinic, 3: 149-60, November 15, 1909. Title: "The prevalence of visual and aural defects," etc.

Two thousand children were examined, about 30.6 per cent of whom had vision that was below normal in one or both eyes. A little over 14 per cent showed vision that was less than two-thirds of the normal in both eyes, children with vision less than half the normal in both eyes being a little less than 3 per cent of the total number examined.

Year.

Defective sight and hearing of public-school children (tables combined).

Visual Defective defects. hearing.

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Conclusions derived from data of the children examined: "1. Unrecognized or at least untreated defects of vision and hearing are nearly as common in our suburban communities as in large cities. Both call urgently for systematic medical inspection.

"2. Unrecognized adenoids, so extreme as to cause serious interference. . . were not found to be very common. In nearly 1 per cent of the children, however, the adenoids imperatively demanded operation...

*3. Defective vision seems a little commoner among girls and defective hearing among boys. . . . **4. In other communities a progressive increase in the prevalence of impaired vision was noted as the children grew older, whereas in St. Louis County the reverse was found to be true, both as regards slight and grave defects. . . . It does not, however, furnish an argument against inspection. . . . The fact that one-third of the children with spectacles wore unsuitable glasses is also suggestive in this respect. "5. Our data show that to a certain, though not very great extent, the children with impaired vision or hearing progress more slowly in their school work than their normal fellow students. The evil effects of unrecognized physical defects go, however, far deeper than this. . . . Adequate medical school inspection would lead to the recognition and to a great extent, to the correction of such defects. . . .

6. The marked divergence between the data obtained in different cities, or, in the same city, by different investigators, indicates the need for greater uniformity in methods of tabulating these statisties.... For statistical purposes it is important for the investigator to state just where he draws the line between defective and normal. As regards vision, hearing and adenoids, a division into slight and serious defects is to be recommended.

"7. In estimating the value of medical inspection of school children . . . the greatest benefit to be derived from inspection consists in the early recognition of contagious diseases and the prevention of school epidemics."

NEW HAMPSHIRE.

Manchester. School committee. [Medical inspection of elementary school children] In its Report, year ending December 31, 1909.

Teachers annually test the eyes and ears, records being preserved.

p. 17-18.

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Of these 1,852 pupils found defective in vision and hearing, 823 are over age for their grades and 491 have failed one or more times to be advanced with their classes.

NEW YORK.

DRESBACH, M. Examinations of the eyes of college students. Medical record, 82: 190-95, August 3, 1912.

References: p. 195.

Cornell University. Examination of 3,326 enrolled men, and 360 examinations of women.

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Percentage with symptoms of eye strain (no glasses worn) approximately

Percentage showing symptoms, and glasses worn..

Muscular imbalance of 5 or more (no glasses worn).

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Defects of 155 students from rural districts, attending for 12 weeks only.

Per cent.

40

50

10

Hyperopic astigmatism.

Myopic astigmatism..
Unclassified.

A questionnaire was sent out, and replies received from 105 institutions of learning, with the following results: Not requiring eye examinations, 22. Among these were 3 prominent schools of technology, 2 well known schools for women, and 1 great university. In about a dozen only is an eye specialist engaged. In 17 institutions estimates of students needing glasses ranged from 10 to nearly 100 per cent the latter figure being from a Government school, "where, it is stated, practically every student wears glasses before he finishes his course."

SCHENCK, Herbert Dana. [Inspection in New York State of the eyes, ears, noses, and throats of public-school children] In National education association of the United States. Department of superintendence. Proceedings, 1909. Published by the association, 1909. p. 117–19.

"No systematic effort. . . for an annual record of the condition of the sight, hearing, and nasal operations has been made by even the most progressive cities (of New York State]. At a conference

of the health officers in the fall of 1906 . . . a plan, essentially that in vogue for ten years in Connecticut, for four years in Vermont, and for the last two years in Massachusetts, where the examinations are compulsory, was adopted."

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 discharged 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 certificate 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, 107. figs.

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

With the various classes divided into squads, these gentlemen prepared a short sketch of the ocular story 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

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