properly supported state health authorities will save many times the cost of their health work in addition to thousands of lives. County or district machinery is little known in America. For that reason rural sanitary administration is neglected and rural hospitals are lacking. In the British Isles rural districts are given almost as careful inspection as are cities. Houses may not be built below a certain standard of lighting, ventilation, and conveniences. Outbuildings must be a safe distance from wells. Dairies must be kept clean. Patients suffering from transmissible diseases may be removed by force to hospitals. What is more to the point, rural hospitals have proved that patients cared for by them are far more apt to recover than patients cared for much more expensively and less satisfactorily at home, while less likely to pollute water and milk sources or otherwise to endanger health. With national machinery the chapter on Vital Statistics has already dealt. We shall undoubtedly soon have a national board of health. Like the state boards, its first function should be educative. In addition, however, there are certain administrative functions where inefficiency may result in serious losses to nation, state, and locality. National quarantine, national inspection of meats, foods, and drugs are administrative functions of vital consequence to every citizen. Authorities are acquainted at the present time with the fact that the sanitary administration of the army and navy is unnecessarily and without excuse wasteful of human energy and human life. In the Spanish American War 14 soldiers died of disease for I killed in battle; in the Civil War 2 died of disease to I killed in battle; during the wars of the last 200 years 4 have died of disease for 1 killed in battle. Yet Japan in her war with Russia, by using means known to the United States Army in 1860, gave health precedence over everything else and lost but I man to disease for 4 killed in battle. Diseases are still permitted to make havoc with American commerce because the national government does not apply to its own limits the standards which it has successfully applied to Cuba and Panama. "The Japanese invented nothing and had no peculiar knowledge or skill; they merely took occidental science. and used it. The remarkable thing is not what they did, but that they were allowed to do it. It is a terrible thing that Congress should choose to make one of its rare displays of economy in a matter where a few thousand dollars saved means, in case our army should have anything to do, not only the utterly needless and useless loss of thousands of lives, but an enormous decrease of military efficiency, and might, conceivably, make all the difference between victory and defeat." CHAPTER XXX SCHOOL AND HEALTH REPORTS For every school-teacher or school physician responsible for the welfare of children at school, there are fifty or more parents responsible for the physical welfare of children at home. Therefore it is all important for parents to know how to read the index for their own children, for their children's associates, and for their community. School reports and health reports should tell clearly and completely the story of the school child's physical needs. It is impracticable at the present time to expect a large number of men and women to be interested in the reports published by school and health boards, for, with few exceptions, little effort is made to write these reports so that they will interest the parent. Fortunately, a small number of persons wishing to be intelligent can compel public officials to ascertain the necessary facts and to give them to the public. So backward is the reporting of public business General Public that at the present time there is probably no service that a citizen can render his community which would prove of greater importance than to secure proper publicity from health and school boards. Generally speaking, these published reports fail to interest the citizen, not because officials wish to conceal, but because officials do not believe that the public is interested. A mayor of Philadelphia once furnished a notable exception. He called at the department of health and complained against publishing the number of cases of typhoid and smallpox lest stories in the newspapers "frighten the city and injure business." A sanitary inspector who was in the room asked if Philadelphia's business was more important than the health of Philadelphia's citizens. As a result of her "impertinence " the inspector was removed. That same year an epidemic of smallpox spread through all the rural districts and cities of Pennsylvania, because physicians. thought it would be kinder to the patients not to make known to their neighbors the presence of so disagreeable a disease. Almost all health and school authorities, however, can be made to see the advantage of taking the public into their confidence, because public confidence means both public recognition and greater success in obtaining funds. With more funds comes the power to do more work. Other details with regard to health reports will be found in the chapter on Vital Statistics. As to school reports, little thought has been given in the past to their educational possibilities. A book was recently published School Reports and School Efficiency-by the Committee on the Physical Welfare of School Children, which tells the origins of school reports; contains samples of reports from one hundred cities; gives lists of questions frequently answered, occasionally answered, and never answered; and shows how to study at particular report so as to learn whether or not important. questions are answered. The United States commissioner of education has organized among state and city superintendents special committees on uniform and adequate reporting. His aggressive leadership is welcomed by school men generally, and promises vast benefits. Just because the physical welfare of the school child is an index to health needs, the school report can put into one statement for a city or a state the story told by the index. The accompanying card tells facts that the individual teacher and individual parent want to know about a child, what a superintendent wants to know about all children, and what a community wants to know about all children. A modification of this card will soon be adopted in New York City. It is both a card index and a card biography of the individual boy or girl. It is expected to follow the child from class to class, each teacher telling the story of his physical welfare and his progress. When the boy goes to a new school or new grade, his new teacher can see at a glance not only what subjects have given him trouble, but what diseases or physical defects have kept him out of school or otherwise retarded his progress. With this card it is easy to take a hundred children of the same age and the same grade, to put down in one column those who have eye defects, and in another those who have no eye defects, for every school, every district, and for the schools as a whole. Schools that use these record cards are enabled, by thus classifying the total, to learn where the defects of children are, how serious the problem is, how many days children lose from school because of preventable defects, and in what section of the city the defects are most prevalent. The mere reporting of facts will stimulate teachers, principals, and parents to give attention. For example, assume a table: FIELD OF INSPECTION Total number of public schools Public schools not under inspection 7 3 |