Health Work in the Public Schools | Page 9

the facts can doubt. An overwhelming mass of incontrovertible
evidence can be found in every medical library. The mortality statistics
of different countries tell the same story. A single example shows the
general experience: In seven provinces of the Philippine Islands there
were 6,000 deaths annually from smallpox alone. In his 1906 report, Dr.
Victor G. Heiser, Director of Health in the Islands, describes how
drastic measures were taken to stamp out the disease. Under his
direction practically three million one hundred thousand persons were
vaccinated. The following year, instead of 6,000 deaths from smallpox,
there was not one.
For 13 years the Board of Education has had upon its books a rule
requiring vaccination as a prerequisite to admission to the schools. That
rule has never been adequately enforced. In July, 1914, City Ordinance
32846-B was passed, one section of which reads: "No superintendent,
principal, or teacher of any public, parochial, private school, or other
institution, nor any parent, guardian, or other person, shall permit any
child not having been successfully vaccinated, nor having had smallpox,
to attend school." Although passed a year ago, that ordinance has not
yet been enforced. Exact figures cannot be secured, but it is probable

that there are in the Cleveland schools today more than 50,000
unvaccinated children. For each of these the superintendent, principal,
teacher, and parent may be held liable to a $200 fine, 60 days
imprisonment, or both.

FUTURE DEVELOPMENT
Compared with other large cities, Cleveland has an unusually good
system of medical inspection. Where other cities are still struggling
with details of organization, record keeping, and the like, Cleveland is
ready to lead the way into new and immensely important fields.
Medical inspection includes four fields of endeavor: prevention of
epidemics, discovery and cure of physical defects, provision of
healthful surroundings, and formation of correct habits of thought and
action in regard to health. The first two are concerned with remedying
present conditions, and here Cleveland is doing excellent work. The
latter two provide health insurance for the future. In these, Cleveland
has made a beginning but should carry her efforts far in advance of
anything now attempted.
Thirteen years ago a crusade was started against the common drinking
cup. Today there is not a school in the city which is not supplied with
sanitary drinking fountains, and the common cup is a thing of the past.
Nine years ago individual towels were supplied to children in certain
schools. At the present time individual towels, soap, and hot water are
available in every building. In 1906 the first shower bath was installed
in an elementary school. Now there are 37 buildings so equipped. The
windows in some of the classes for the blind are made of amber tinted
glass. For years there has been agitation in favor of adjustable seats and
desks, and although conditions in certain schools are still very bad,
these are exceptions, and the general seating provision is in accordance
with the laws of hygiene.
[Illustration: Shower baths installed in an old building in a crowded
section.]

But the Division of Medical Inspection must go farther than this. The
physician must join with the psychologist and the educator in scientific
research to determine the conditions best suited to the education of the
child. Shall blackboards be of slate, composition board, or glass? Shall
they be colored black, green, or ivory white? Is light chalk on a dark
ground better or worse than dark chalk on a light ground? Is prismatic
window glass superior to plain? To what extent is glare from polished
desks detrimental to eyesight? How large must be the type in textbooks
in order that young children may easily read it? What variations from
the present school program are necessary in order to make adequate
provision for change in the use of different sets of muscles, and relief
from nerve strain?
These questions and hundreds of others are facing educational
authorities. The method of answering them affects not only the children
of one city but the children of all cities throughout the country.
Everywhere schoolmen are on the alert to gain information which will
help in solving these problems.
In addition to regular work of inspection and examination, the doctors
and nurses of Cleveland spend a great deal of time in conferences with
parents, talks with teachers, lessons and talks to children, toothbrush
drills, and the like. The importance of work of this kind can hardly be
overestimated, but it must be far more than "talks at people." It should
be the aim of the Department of Medical Inspection to establish right
habits in regard to health. For this reason, although both methods are
helpful, drill in the use of the toothbrush is more effective than lectures
on the need of using it. As a result