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rangery up and down
Just as in that far away
OUR. Boyhood HAUNTS Ho! I'm going back to where We were youngsters - Mut me thert,
Dear old barefoot chum, and we
Hoof it our the sloping green,
This fac-simile is used by the courtesy of The Indianapolis News.
No one, save the physician and the broadly the lines which such knowledge sanitary policeman, stands in more inti- must follow, and the teacher must fill mate relation to the public health than this in, either by reading or by consultathe teacher. There is, however, a differ- tion with his family physician. ence. The work of the physician looks The teacher who is worthy of his high to the correction of the past errors of the calling aims at the formation of character individual; the sanitarian looks after the and the making of good citizens. Now, present health of the community, while that citizen who is not sound and well is the teacher building on the broad ground not so valuable to the state and the nation of a better knowledge of sanitary matters as the man or woman who is equally enworks for the future, both of the individ- dowed mentally and morally, but is ual and of the community. My own ex- stronger physically. Hence, the teacher, perience as a teacher is too limited to per- who is paid by the state to build its future mit me to speak with authority cn hygiene citizens, must have as his ideal the old as a pedagogical matter, and I shall con- Roman one of a sound mind in a sound tent myself with discussing it as a purely body. Guiding, directing and moulding practical matter, affecting the present as the teacher does, during the whole health of the teacher and his pupils. This formative period of the child's life, he is a subject which is only just now coming has many opportunities to make or mar to be generally understood. The larger the child's future cities are providing medical inspectors, Some of these opportunities at least are who examine children sent to them by the physical, and in some cases life or death teachers, especially those who seem to be may hang upon vigilance or neglect. To ill or who have returned after an absence use the most obvious illustration, many of more than one day. These physicians infectious diseases, through ignorance or do not treat the sick pupils, but simply carelessness on the part of parents, find a say whether they may safely remain for way into the school room.
The ability the rest of the day. These inspectors do on the part of the teacher to detect such the work which must in small places be a condition may save many of his pupils left undone, or else be done by the or himself from severe or even fatal inteacher. So far as I know there has been fection, which may follow from contact no effort as yet made to educate the with any case, however mild, of the comteacher so that he could do it. Naturally, mon infectious diseases. in the limits of a single paper, such as Passing this class of cases for a few this is, it is possible only to indicate moments, there is a type of child that is known to every experienced teacher. This fool in school, and he believed it. He is the dull or stupid pupil. He seems to never could see the blackboard with suffibe defective mentally. The countenance
cient distinctness to know what he was is often surly or frowning. The mouth is expected to do, and it was not until he open and the lower lip thick and hanging. fell into the hands of a competent oculist Frequently he is slow of speech and slower that he realized that he was not a fool, but still to respond when spoken to. He may only had bad eyes. The symptoms of eyeor may not be bad in his deportment, but trouble are headache, especially in the he is undeniably slow about learning. forehead; rubbing the eyes frequently; Such a condition is remediable under redness of the margins of the lids; and inskilled hands. It is not the teacher's ability to see clearly. These need not all province to cure such a case, but simply be present, but with serious trouble most to point out that there may be a cure. will be. Testing for eye troubles with test Several things may be the matter with type is done by hanging the card of tests the boy.
in a good light at a distance of twenty First. He may really be defective in feet, preferably. The pupil should be able brain and nerve structure, in which case to read that type which is marked D individual teaching adapted specially to twenty, or D fifteen if his distance is the needs of the child must solve the only fifteen feet. problem as far as possible.
You may construct these type for yourSecond. There may be some difficulty self by cutting from a newspaper or havwith the organs of special sense, either ing printed for you, plain Roman capital the eye or ear being defective.
letters five-sixteenths of an inch in height Third. And very frequently, especially for a distance of twenty feet, and exactly with those who have an impediment or one-fourth of an inch for fifteen feet. huskiness in speaking, the pharynx is These letters should not form words. filled up by a morbid growth, preventing Anything invidious in this or other tests breathing through the nose and in some may be avoided by having other children instances compressing the vessels supply- tested at the same time. The tests should ing the brain.
be made with each eye separately, using Taking up the eye more in detail, I a paper to screen the other eye, as the shall assume that your school physiologies pressure of the hand is disturbing to the have taught you the structure of the eye, after testing of the second eye. and shall not dwell on it. The principal Tests for astigmatism may be improanatomical defects of the eye are far- vised by drawing a number of concentric sight, in which the eyeball is short and circles on the board, being careful to have the light rays are brought to a focus be- the lines equidistant and of equal dishind the retina; near-sight, in which the tinctness. Another test may be made by rays of light are brought to a focus in drawing a circle and filling it almost solid front of the retina; astigmatism, in which with lines carefully drawn, all passing the lens or cornea is differently curved in from side to side through the center. different meridians and consequently
and consequently Both of these may be made more practical never focusses properly; muscular trou- by writing the hours around the circumbles, which are due to unequal pull ference as on the dial of a clock. on the part of the muscles which move the To use the test the pupil should sit at eyeball, and consequent straining to make twenty feet and use each eye separately. them pull evenly.
To the non-astigmatic eye the circles will Near-sight almost never causes head- look uniform, even though the individual ache, but the other forms of eye trouble radii or concentric circles can not be disusually do. Any of them may cause in- tinguished; but to the astigmatic eye the distinct vision and consequent apparent diagrams will be divided into sectors, two stupidity. I have heard one of the most of which will be distinct and two blurred. distinguished surgeons in a neighboring Some tact is necessary in using this test, state say that he was always rated as a because children like to answer whatever they think you expect. The tests for mus- danger, and if met by the old superstition cular trouble are difficult and require I have mentioned to stamp it as absolutely special apparatus.
false. The diseases of the eye other than the There are various throat troubles which ones named, which concern the teacher, the teacher should learn to diagnose, are granulated lids and running sore eyes. sometimes for the good of the affected Both of these diseases are contagious, the pupil, and sometimes for the good of the first being slightly so, and the second school. These troubles may be reduced eminently so. Either may cause loss of to one head-obstruction of the upper sight, and the pupil should be so warned. respiratory tract. This may be caused by Granulated lids are also indicative of de- enlargement of the tonsils, which may fective health in other respects, because easily be seen at the sides of the throat it is very rarely indeed found in people of near the base of the tongue; by enlargeany age who are otherwise vigorous. No ment of the third tonsil which lies at the child whose eyes are discharging should back of the pharynx and above the soft be admitted to the schoolroom, since the palate; by tumors of the pharynx, and by disease is almost sure to spread through tumors or catarrhal swelling within the the school and to leave many permanently
nostrils. injured eyes in its track.
The symptoms are very similar; mouthThe tests for deafness are easily impro- breathing and a general lack of life are vised and applied. The most convenient the first things the teacher will notice, but is the watch. The child is blindfolded there may be hoarseness or huskiness of and holds the ear not under observation the voice, the child talking as though he closed with one hand. The experimenter had something in his mouth. There may then moves the watch back and forth be drowsiness; I personally knew one case until the exact distance where the watch where the child could not be kept awake can barely be heard, is found.
in school. These persons are usually It should occasionally be taken away slender and not well nourished and are entirely and the child asked whether it not good students. still hears, in order to have a check on the Out of this condition grow deafness, answers given. Both with this and the deformities of the face and chest and susfollowing test, a number of observations ceptibility to all infectious diseases, esshould be made with different children to pecially those of the chest, such as bronobtain a standard for the particular in- chitis, pneumonia and consumption. strument you are using.
To examine the throat, the pupil should A tuning fork is very convenient, and stand facing a good light, and hold the is specially desirable because its vibra- tongue down with his forefinger. The tions can be damped at any time with the teacher should notice particularly the fingers, or indeed it need not be vibrating tongue, tonsils and back of the pharynx. at all during the check tests.
The earliest symptoms of almost all the There is one form of ear trouble which infectious diseases are first seen in the is regarded in a kind of superstitious way mouth. The eruption of measles shows as by many people; it is thought to be dan- red irregular patches with a bluish white gerous to stop a running ear.
center on the inside of the cheeks. Scarlet This arises from the fact that sudden fever shows as a bright inflammation of suppression of the external discharge is a the pharynx. Diphtheria is a dirty white frequent symptom of the invasion of membrane covering the soft palate, tondeeper structures, such as the formation sils, or pharynx, partly or entirely. Tonof a brain abscess. A chronically suppu- silitis may be known by the dark red rating ear is so dangerous a matter that angry looking tonsils, sometimes with no life insurance company will take a risk white specks. on such a life. Should the teacher notice While the teacher can hardly be exa pupil who wears cotton habitually in pected to diagnose such cases like a the ear it is his duty to warn him of the specialist in children's diseases, if he bears
in mind the one maxim, to allow no child in the school who has a severe cough or a sore throat, he will save the health of his pupils, and in many cases his own. In addition to the diseases I have just named, the teacher would by this rule exclude infectious colds, influenza or "grippe," and whooping cough.
After examination of the throat, the teacher may test the potency of the nostrils by having the pupil close each in turn, and breath gently. It is easy to see whether there is stoppage or catarrhal trouble, and if it seems to be severe, the pupil should be recommended to see his family physician.
Returning to the infectious diseases, no pupil who has had either measles, scarlet fever, or so-called scarlatina, which is merely Latin for scarlet fever, should be permitted to return to school without a certificate of disinfection of the house, and after all "peeling off” of the skin has stopped.
It would be a wise rule if school boards everywhere required a certificate of successful vaccination before admitting a pupil to the school. The opponents of raccination do not realize that only a century and a quarter ago, one person
in every seven died of smallpox and that this had been so from time immemorial; they do not realize that of those who recovered, the disease took awful toll in the way of blindness, deafness, hideous scarring of the face and terrible deformities. They do not realize that hygiene and cleanliness do little to protect against infection, and that of those who, unvaccinated, take the disease, we are unable to save any larger proportion than a hundred years ago. If they do realize, there is no word in the English language strong enough to condemn their captious opposition to a procedure which by modern methods is absolutely harmless and void of all bad after effects. There is no question that vaccination has saved the world more suffering than any other hygienic procedure ever invented or discovered, and that the bad effects ascribed to it by its enemies have been due to inoculation with contaminating bacteria, either from dirty hands or instruments.
There are also certain parasitic skin diseases, affecting chiefly the scalp and the hands, which do not require any description to diagnose correctly and which should not be tolerated for an instant in the schoolroom.
For the following report showing the methods of inspection and results in Chicago, I am indebted to my former teacher Dr. W. S. Christopher, professor of children's diseases in the Chicago Polyclinic and a member of the board of education of that city:
In January, 1900, fifty medical inspectors of schools were assigned to work under the jurisdiction of this department and technical direction of the department of health. From January 8 to April 15, 1900, the result of their work in protecting the health of pupils at the various schools was as follows: Total number of examinations....76,805 Contagious diseases detected and excluded
4,539 The emergency corps of inspectors on duty from April 17 to June 1, 1900, conducted sixty additional examinations and excluded thirty-five children from school for cause. The detailed report of exclusions of contagious diseases at school is as follows: