will permit without hindrance from his own or his playmates' removable defects. He has the right to learn that simplified breathing is more necessary than simplified spelling, that nose plus adenoids makes backwardness, that a decayed tooth multiplied by ten gives malnutrition, and that hypertrophied tonsils are even more menacing than hypertrophied playfulness. He has the right to learn that his own mother in his own home, with the aid of his own family physician, can remove his physical defects so that it will be unnecessary for outsiders to give him a palliative free lunch at school, thus neglecting the cause of his defects and those of fellow-pupils.

PART II. READING THE INDEX

TO HEALTH RIGHTS

CHAPTER V

MOUTH BREATHING

If the physical condition of school children is our best index to community health, who is to read the index? Unless the story is told in a language that does not require a secret code or cipher, unless some one besides the physician can read it, we shall be a very long time learning the health needs of even our largest cities, and until doomsday learning the health needs of small towns and rural districts. Fortunately the more important signs can be easily read by the average parent or teacher. Fortunately, too, it is easy to persuade mothers and teachers that they can lighten their own labors, add to their efficiency, and help their children by being on the watch for mouth breathing, for strained, crossed, or inflamed eyes, for decaying teeth, for nervousness and sluggishness. Years ago, when I taught school in a Minnesota village, I had never heard of adenoids, hypertrophied tonsils, myopia, hypermetropia, or the relation of these defects and of neglected teeth to malnutrition, truancy, sickness, and dullness. I now see how I could have saved myself several failures, the taxpayers a great deal of money, the parents a great deal of disappointment, and many children a life of inefficiency, had I known what it is easy for all teachers and parents to learn to-day.

The features in the following cut are familiar to teachers the world over. Parents may reconcile themselves to such lips, eyes, and mouths, but seldom do even neglectful parents fail to notice "mouth breathing." Children afflicted by such features suffer torment from playfellows whose scornful epithets are echoed by the looking-glass. No fashion plate ever portrays such faces. No athlete, thinker, or hero looks out from printed page with such clauded, listless eyes. The more wonder, therefore, that

MOUTH BREATHERS BEFORE " ADENOID PARTY"

the meaning of these outward signs has not been appreciated and then causes removed; conclusive reason, also, for not being misled by recent talk of mouth breathing, adenoids, and enlarged tonsils, into the belief that the race is physically deteriorating. Three generations ago Charles Dickens in his Uncommercial Traveller pointed out a relation between open mouths and backwardness. and delinquency that would have saved millions of dollars and millions of life failures had the civilized world listened. He was speaking of delinquent girls from seventeen to twenty years old in Wapping Workhouse: "I have never

yet ascertained why a refractory habit should affect the tonsils and the uvula; but I have always observed that refractories of both sexes and every grade, between a Ragged School and the Old Bailey, have one voice, in which the tonsils and uvula gain a diseased ascendency." To-day we are just beginning to see over again the connection between inability to breathe through the nose and inability to see clearly right from wrong and inability to want to do what teachers and parents wish. Physical examinations show now, and might just as well have shown fifty years ago, that the great majority of truants and juvenile offenders have adenoids and enlarged tonsils. A recent examination made by the New York board of health on 150 children in one school made up from the truant school, the juvenile court, and Randall's Island, showed that only three were without some physical defect) and that 137 had adenoids and large tonsils. Dickens wrote his observations in 1860; in 1854 the New York Juvenile Asylum was started, and up to 1908 cared for 40,000 children; in 1860 William Meyer pointed out, so that no one need misunderstand, the harmful effects of adenoids. What would have been the story of juvenile waywardness, of sickness, of educational advancement, had examinations for defective breathing been started in 1853 or 1860 instead of 1905; if one per cent of the attention that has been given to teaching mouth breathers the ten commandments had been spent on removing the nasal obstructions to intelligence?

William Hegel, who is pictured on page 48, before his tonsils and adenoids were removed was described by his father in this way: "When playing with other boys on the street he seems dazed, and sluggish to grasp the various situations occurring in the course of the game. When he decides to do something he runs in a heedless, senseless way, as if running away, will bump against something,

pedestrian or building, before he comes to himself; seems dazed all the time. When told something by his mother he giggles in the most exasperating way, for which he receives a whipping quite often." The father said the whipping was of no avail. The child was restless, talkative, and snored during sleep. He had an insatiable appetite. He was removed or transferred from five different schools in New York City. To get redress the

father took him to the board of education, whence he was referred to the assistant chief medical inspector of the department of health, whose examination revealed immensely large fungous-looking tonsils and excessive pharyngeal granulations (adenoids). He was operated on at a clinic. The tonsils and adenoids removed are pictured on the opposite page, reduced one third. After the operation the child was visited by the assistant medical inspector. There was a marked improvement in his facial expression, - he looked intelligent, was alert and interested. When