also compels him to make use of them, unless we remove the causes of transmissible or infectious diseases and check an epidemic when we first hear of it, the collection of information is of little social value. "Statistics" is of the same derivation as "states" and statesmen." Statistics have always been distinguished from mere facts, in that statistics are instruments in the hands of the statesman. Wherever the term "statistics" is applied to social facts it suggests action, social control of future contingencies, mastery of the facts whose action they chronicle. The object of gathering social facts for analysis is not to furnish material for future historians. They are to be used in shaping future history. They are facts collected with a view to improving social vitality, to raising the standard of life, and to eliminating permanently those forces known to be destructive to health. Unless they are to be used this way, they are of interest only to the historical grub. No city or state can afford to erect a statistical office to serve as a curiosity shop. Unless something is to be done to prevent the recurrence of preventable diseases annually experienced by your community or your school, it is not reasonable to ask the public printer to make tables which indicate the great cost of this preventable sickness. A tax collector cannot discharge his duties unless he knows the address of every debtor. The police bureau cannot protect society unless it knows the character and haunts of offenders. A health officer cannot execute the law for the protection of society's health unless he knows the haunts and habits of diseases. For this he must look to vital statistics.

But the greatest service of vital statistics is the educational influence. Health administration cannot rise far above the hygienic standards of those who provide the means for administering sanitary law. The taxpaying public must believe in the economy, utility, and necessity of efficient health administration. Power and funds come

from town councils and state legislatures. To convince and move these keepers of the purse, trustworthy vital statistics are indispensable. Information will be used for the benefit of all as soon as it is possessed by all.

Fortunately the gathering of vital statistics is not beyond the power of the kind of health officer that is found in small cities and in rural communities. If years of study of mathematics and of the statistical method were required, we should despair of obtaining light within a century. But the facts we want are, for the most part, common, everyday facts, easily recognizable even by laymen; for example, births, deaths, age at death, causes of death, cases of transmissible diseases, conditions found upon examination of children applying for work certificates, etc. Where expert skill is required, as at state and national headquarters, it can be found. Every layman can train himself to use skillfully the seven ingredients of the statistical method which it is his duty to employ, and to know when to pay for expert analysis and advice. We can all learn to base judgment of health needs upon the seven pillars, desire to know, unit of inquiry, count, comparison, percentages, classification, and summary,

CHAPTER XIV

IS YOUR SCHOOL MANUFACTURING PHYSICAL

DEFECTS?

Last year a conference on the physical welfare of school children was told by a woman principal: "Of course we need physicians to examine our children and to teach the parents, but many of us principals believe that our school curriculum and our school environment manufacture more physical defects in a month than all your physicians and nurses will correct in a year." At the same meeting the physical director of schools of New York City appealed eloquently for "biological engineers" at school, who would test the child's strength as building engineers are employed to test the strength of beams and foundations.1 As explanation for the need of the then recently organized National School Hygiene Association, he elaborated the proposition that school requirements and school environment damage child health. Ocular defects are in direct ratio to the length of time the pupil has attended school. . . . A desk that is too high may easily be the indirect agent for causing scoliosis, producing myopia or astigmatism. . . . Physically examine school children by all means, but do not fail to examine school desks."

Fifty schools in different parts of New York City were examined last year with especial reference to the factors likely to cause or to aggravate physical defects.2 The results,

1 The Sanitation of Public Buildings, by William Paul Gerhard, contains a valuable discussion of how the school may avoid manufacturing physical defects.

2 By Professor Lila V. North, Baltimore College for Women, for the New York Committee on the Physical Welfare of School Children, 105 East 22d Street, New York City.

tabulated and analyzed, prove that the woman principal was right; many schools are so built or so conducted, many school courses are so devised or so executed, that children are inevitably injured by the environment in which the compulsory education law forces them to spend their formative years.

Recently I noticed that our little office girl, so anæmic and nervous when she left school that we hesitated to employ her, was becoming rosy and spirited. The child herself explained the change: "I like it better. I have more money

to spend. I get more outdoor exercise, and then, oh, the room is so much sunnier and there is more air and the people are all so nice!" And these were just the necessities which were lacking in the school from which she came. Moreover, it is a fair commentary on the school work and the school hygiene in too many of our towns and cities to-day. "I like it better" means that school work is not adapted to the dominant interests of the child, that the curriculum includes subjects remote from the needs and ambitions of the modern school child, and fails to include certain other subjects which it recognizes as useful and necessary, and

therefore finds interesting. "I have more money to spend " means that this little girl was able to have certain things, like a warm, pretty dress, rubbers, or an occasional trolley ride, which she longed for and needed. "I get more outdoor exercise" means that there was no open-air playground for her school, that "setting up" exercises were forgotten, that recess was taken up in rushing home, eating lunch, and rushing back again, and that "after school" was filled up with "helping mother with the housework." "The office is so much sunnier and I get more air" accounts for the

increase in vitality; and "the people are all so nice," for the happy expression and initiative which the undiscriminating discipline at school had crushed out.

For such unsanitary conditions crowded sections of great cities have no apologies to make to rural districts. A wealthy suburb recently learned that there was overcrowding in every class room, and that one school building was so unsanitary as to be a menace to the community. Unadjustable desks, dry sweeping, feather dusters, shiny blackboards, harassing discipline that wrecks nerves, excessive home study and subjects that bore, are not peculiar to great