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matter that we cannot discuss here, although same time the children would enjoy the fait is evident that the best work cannot be ob- oilities for outdoor play which are such an tained from the underfed.
advantage to our boarding school obildren. When we consider the lack of facilities of The effort to protect school children from obtaining fresh air by our school children, we disease has brought about many improve. find one of the most potent elements in the ments in our publio school system, but has production of disease among them. The de- not as yet effected many changes in private fective ventilation of school buildings is in schools, although some inspection exists in common with all public buildings, and the many of the latter.
The excluding of sick popular fear of a draught often interferes with children has never been as rigidly carried out a sufficient opening of windows.
As it should be to protect those that are well. In the consideration of outdoor play, it is So far as I know children with colds are necessary to separate the private school child- excluded from only one private school in ren from the public school children, and we New York City, while it is well known that must also remember that it is not sufficient to 80-called oolds are often an evidence of influ. give all children an opportunity to get into enza, which is a very contagious disease; fresh air if they will, but that it is necessary that they exist for three days preceding the to force some children of natural sedentary eruption of measles, while what is known as habits to play out of doors.
a cold is the common phenomenon of the Children go to school in the morning, re- first two weeks of whooping-cough before the maining until noon; return at one, remain- characteristio cough develops. If children ing until perhaps three, after which some will with colds were absolutely excluded from our play in the streets and others return to their schools measles epidemios would not travel homes, having had practically no out-of-door so fast, whooping-cough would be much less play during the day.
prevalent, and through the diminution of inNew York has previously offered few fa- Auenza echool attendance would be markedly cilities for outdoor play for sobool children. improved. It seems to me that the provision for this I was recently called to see a boy sufferoutdoor play, which is essential to their ing from sore throat, who was attending a health, and thus must be obtained if they kindergarten class of eight children. I asked are to do good school work, should devolve him whether the children had all been in atupon the educational authorities.
tendance on the preceding day. He said no, This problem may be solved to some extent that he was the only child there. I visited by the public school, which could keep the the school the following day and found no children under supervision during the whole member of the class present, and on inquiry day, having a supervisor of physical exercise learned that one of the children had come to remain with them before and after school school with a slight cold the week before. hours, when they could play in enclosed Had that child been excluded it is not likely oages on the roofs or in adjacent public parks that the other seven children would have under supervision.
been absent at that time. The important influence that such super- Next to colds, the niost common evidence vision would have, not only upon the physj. of contagious diseases in children may be cal condition but on their moral development, said to be eruptions; so that no child with an would be worth to the city far more than the eruption should be allowed at sobool until expense for the suppression of crime when the eruption has been pronounced by a comthese children grow up.
petent person is not an indication of a con. In some of our best private schools provi. tagious disease.
The presence of dust in sion for play under supervision is made, but school rooms as naturally a source of danger, such play is too often carried on in closed and should be reduced to a minimum by carerooms, and not out of doors, so that a large ful and proper cleaning of the floors and fur. part of the advantage that might accrue from niture, it is thus lost. My own feeling is that the Fatigue in school children was well demon. time will soon come when our best private strated in a scientific manner by Dr. Christoschools will move to the suburbs of the city, pher of Chicago, who supervised some excelwhere, instead of occupying a plot fifty by lent work on the public school children of one hundred, they can bave several acres of that city. By means of the ergograph, which land. The child could sleep at home, go to tests motor activity in the middle finger, he the school in the morning, obtain the out- examined a number of children in different door play there, and return to his home late schools. In each case he found their activity in the afternoon. The parents would thus greatest wben entering school at nine o'clock; remain in touch with their children in a way that it diminished rapidly during the morn. not possible at boarding schools, while at the ing session, reaching its lowest point at noon,
when they were dismissed. At one, after re- There can be no question but that proper turning, it bad reached about the same maxi. physical development is more important for mum as at nine in the morning, and during our school children than any knowledge that the afternoon diminished even faster tban oan be imparted to them. The acquirment during the morning. He found the same re- of knowledge accomplished by physical insults in all the children tested, except in one jury is harmful, not beneficial. group of four boys in one of the schools, who
It is usually the case that when little showed no deterioration in physical activity children of five years, who have previously during the day. On investigating these cases
been kept out of doors all day, and bave had it was found that the teacher of these boys no concentration on any subject, enter kinhad been absent, and wbile they had been in
dergarten classes, where a session of one school all day they explained that they had hour should be sufficient, you will find two been having a good time. It, therefore, ap.
and one-balf hours required, during which peared that this deterioration in physical ac- period not more than twenty-five minutes of tivity, when present, was the result of pro
recess is allowed. As they grow older, at ten longed application, and not of the confine
years four hours will be required, with no ment in school.
more recess than the kindergarten child bad, The relief of school children from worry and with more time devoted to the preparaand from fatigue from prolonged application tion of lessons of the following day. can best be secured by shortened school hours, by short periods devoted to any one
It is my opinion that for ohildren between subject, and frequent recesses devoted to phys
five and ten years of age not more than ten or ical exercise. Such a scheme should be so
or fifteen minutes should be devoted to any worked out that, when controlled by some in
one subjeot, and that this period should be strument such as that used by Dr. Christo
followed by five minutes of aotive exercise in pher, school work would result in no appre
the open air or with the windows open; that
but one hour should be devoted to work by ciable deterioration
ohildren of five years, and that not more than Through tbe kindness cf Miss Carse, the .
one-half hour should be added each suoceedprincipal of the Charlton school, I have tested for fatigue certain children under her care.
ing year up to ten years; and that a part of
school day should be out-of-door play in the I choose for the test children wbo were for
afternoon under supervision. the first time andertaking work that required concentration that is, children of about seven
To summarize, then, our ideal private years. I applied the Crampton test for fa
school should be out of town, but within easy tig ue, the comparison of pulse rapidity and
reach of the homes of its patrons. It should blood pressure, taken standing and lying
have short periods of study, separated by fredown, and the test with the ergograph.* The
quent recesses, and ample time allowed for a children were tested just after coming to substantial midday meal, taken at leisure. school at nine o'clock and just before leaving morning hours, the lighter
work in the after; at half-past twelve.
of examined was any marked fatigue shown.
noon hours, to be followed by play out of Most of the tests average as good at twelve. doors, in which all the children must take thirty as at nine o'clock in the morning. The part, reason for this striking absence of fatigue
The ideal publio school should take the may be found in the examination of the daily children as many hours a day as practicable. program. The school day lasts only from They should come to school as early as eight nine to twelve-thirty. The session consists
in the morning and enjoy an hour's outdoor of periods of but fifteen minutes devoted to play under supervision before undertaking any subject, and each fifteen minutes the their tasks. The periods devoted to each sub. children are alternately standing and sitting. ject should be short, with frequent recesses. The middle of the session is interrupted by
At noon a nutritious but simple meal should a fifteen-minute recess out of doors, and an
be furnished them. In the afternoon the hour later by five-minute recess spent in
easier subjects, the manual work, and the jumping through the seats. These observa- preparation for the lessons of the next day tions of mine are too limited to base large
should be taken up. Opportunity for outconclusions upon, but the unusual absence
of-door exercise under supervision until late of fatigue in most of the children examined in the afternoon should be provided. would seem to indicate that the program was
In both private and publio schools a much very successful.
more severe examination for any evidence of *The writer is indebted to Professor E. S. Lee of the
contagious diseases should be made than at College of Physicians and Surgeons, Columbia University, present. All children with colds should be for many valnable suggestions and for the apparatus loaned to him for the experiments.
absolutely excluded from school, and child
The MEDICAL FORTNIGHTLY
ren with eruptions sbould be excluded until the eruption has been pronounced by a competent person noncontagious in character.New York Medical Record.
Issued Tenth and Twenty-Fifth of Every Month.
THOMAS A. HOPKINS,
Managing Editor. The king of the Belgians, as sovereign of the Congo Free State, is offering a prize of
Editorial Stat: 200,000 francs, open to all nationalities, for
0. E. LADEMANN, Internal Medicine.
JOHN MCHALE DEAN, Surgery. the discovery of a method of successfully F. P. NORBURY, Nervous and Mental Diseases.
R. B. H. GRADWOHL. Pathology and Bacteriology. treating sleeping sickness.
W. H. VOGT, Obstetrics and Gynecology.
WALDEMAR FISCHER, Ophthalmology. King EDWARD thinks the spread of sleep
A. LEVY, Pediatrics.
W. T. HIRSCHI, Therapeutics. ing sickness in Africa is one of interna
A. F. KOETTER, Otology.
HERMAN STOLTE, Laryngology and Rhinology. tional importance and has asked the Liver.
T. A. HOPKINS, Genito-Urinary Diseases.
ROBERT H. DAVIS, Dermatology. pool School of Tropical Medicine to submit
Editorial Rooms, Suite 319-321 Century Building, St. Louis. a plan for the prevention of the disease. He promised his co-operation if it is in any way possible or practicable. At the meeting of the Association of
EDITORIAL Military Surgeons, held in Buffalo recently, it was announced that the Enno Sanders LOCAL conditions seem to have designed prize had been awarded to Major Pilcher these as days of reform in many walks and for an essay on "The Training of the Med.
we, in the medical proical Officer of the State Forces to Best
fession, are not finding Qualify Him for Local Service and for
Honor for a
our lives free from need Mobilization with National Troops."
of greater or lesser im. EPILEPSY.-Two remedies have recently
provements. It is a litbeen introduced for the treatment of epi.
tle surprising that among the many sugges
tions as to needed medical reforms there has lepsy. One of these is verbenin, which has been higbly recommended by a number of
been such a speaking silence in the matter of clinicians; especially in cases of gastroin contract practice; in many sections this bas
been heralded as the foremost foe of legiti. testinal irritation from worms
or other causes. The other is solomine, the alkaloid
mate and honest medicine; societies have is. of the horse nettle. The plant has attracted
sued their pronouncement against it and
have banded their individual membership in a great deal of attention as remedy for the nervous irritability which render the epileptio
a pledge that it shall be effaced. Nothing of
the kind has happened in St. Louis; we have more liable than ordinary persons to suffer from these explosions. The Journal of Ad. struggled for the elimination of the 50-cent. vanced Therapeutics.
a-month hospital” and against examining
for life insurance for less than $5.00, and for DENATURIZED ALCOHOL will become a fact many lesser reforms, are we to conclude that in this country on January 1, 1907. Tbe contract practice does not exist here? Tbe rules and regulations have been published at suggestion seems something of a joke, for great length by the Department of Internal we all know that there is hardly a corporation Revenue. These provisions are being crit doing business in our city which has not its icized by those familiar with the denaturiz. physician, or its medical staff, and which is ing of alcohol in Europe. It is, however, not getting medical service at rates which best to wait for a few months of practical would surprise the average householder. We tests before expressing an opinion on the know of no legitimate reason why a physi. feasibility of the government regulations. cian should serve a corporation for less fee One point is, however, evident and that is per case than he will allow the wage earner the desire of the department to provide for who sweats for every cept he gets, and pays the use of denaturized alcohol in the vari. his physician with a warning to his family ous arts and industries. The small distiller that they njust exercise economies, because seems to have been left out of consideration so he has done so. Economies ! And that in that farmers will not become distillers but the face of such economy as few of us know profit by an increased demand for their alco. anything of. But the fattening corporation hol making products. Every precaution, as which deals in first dressings and plans for might be expected, will be taken to prevent protection from subsequent damage suits, can defrauding the government out of internal buy physicians body and soul for a paltry revenue.
$300 or $500 per year, and receive froni him in return, not only scientific service for A RECENT issue of the Journal of the Ameriwhich regular rates would net the doctor can Medical Association contains a commun. many times as much, but such protection
ication from Dr. W. W. in case of subsequent actions for legal re
Keen, calling attention
Errors in dress as could not be bought in an honest
to some of the
oommon and distressing Patients from such a practice net the doc
errors in medioal Engtor very little per capita, but they are great lish. The letter is one which merits wide as chair warmers, and to show that things republication, as every writer on medical subare doing in the doctor's line, bis is a busy jeots should be certain that his copy is office! To us such practice seems one of free from the errors, and he should also the worst prostitutions of medical honor have his attention drawn to the fact that that has been devised. The medical man's bis readers are critical and ind it difficult first interest should be in the patient and to excuse bad English. Dr. Keen says: remedying his ailment, to consider the em- “May I call attention to two very common ploying corporation and have thought of
thought of instances of faulty English which I am conprotecting it financially in connection with stantly meeting in letters, in print, and in work on the case is much more reprehensible conversation ? One is the assertion that the than is doing the work for a less fee than patient had no temperature.' I presume that would be charged the patient were be to pay the writer does not mean that the patient's the bill himself. It is the patient every time temperature was zero, but that he had no rise who should have every consideration, con- of temperature beyond the normal. Certainly cession and protection which it may be in a temperature of 98.4 F. is universal in the our power to give, and he who sells these well. Any rise above that should never be to an outside party is unworthy of the called 'temperature,' but a ‘rise of temperamedical mantle.
ture,' or 'an increase of temperature.' If It comes to our ears that there is an. temperature falls below 98.4, to 97 or 96 other class of physicians in St. Louis F., how would those who speak of any rise which, wbile nct openly employed by cor. above 98.4 F. as 'temperature' designate such porations, is tacitly pledged to their protec- a fall—'less than no temperature?' tion in return for favors received, we refer "The other instance is really an atrocious to those who ride on car tiokets, and who are misuse of the language. I constantly hear expected to interest themselves in case of it used orally. In a rceent letter occurred emergenoy accidents in their neighborhood, the phrase, since my case, I have seen two and that to the advantage of the company, others operated;' and in a single number of This would seem almost beyond belief, but an admirable, well-known medical journal the report comes with such persistence that occurs the phrases the first case to be diag. there must be truth in it. How a man who nosed or operated in P -,' 'three further holds a medical degree and poses as meriting cases have been observed and operated here,' the dignity which should be characteristic of and two other similar transgressions. every physician could allow himself to be “May I call attention also to a confusion party to such an arrangement is beyond com- of two similar terms? Tubercular' and 'tuprehension. Honor for a car-ticket!! To berculosis' are constantly used interchangeawhat are we coming ?
bly. At the last tuberculosis congress in It is not the newly graduated and strug. Washington I proposed to the executive gling physician who is in on these reprehen- committee that we should recognize definsible practices. The contract physician is itely in all our publications a distinction in the amen corner, and his voice is beard in between the words as follows: Tuberoulous oall for reforms. To bint at unrighteousness shall be used only of those lesions caused when speaking of his character is like ques. by the tubercle bacillus. Tubercular shall tioning the virtue of the gods, and is rarely bo used in describing those lesions which tolerated and never given serious considera- resemble tubercles, but which are not caused tion.
by the tubercle bacillus, for instance, tuberThese days of reforms and medical reforms cular syphilid, etc. This suggestion was are quite as much needed in high places as adopted and the proposed usage approved." elsewhere; it is time to make the profession of St. Louis, of New St. Louis, above reproach, and lets make a clean job of it.
ONE reason why some people are still the happy possessors of an appendix is that they didn't bave the price of the operation, and
were never picked up unconscious on the SUBSCRIBE for The Medical Fortuightly.
We present this issue excellent pictures of two of the Bethesda institutions, the Hospital and Home for Incurables and the Foundling Home. The Bethesda idea had its inception better than fifteen years ago in the hearts of some of God's faithful. Under the leadership of Mrs. Roger Hayne it has reached its present important position, being easily the largest protestant charity in our city. The Bethesda institution includes beside the buildings here pictured a Maternity Home and a Home for Old Ladies. The institution is conducted under a rational application of the faith principle. Mrs. Hayne is general directress, and the medical staff works under the supervision of Dr. E. W. Saunders.