Health Work in the Public Schools | Page 3

education if, in order to attain
it, the child must lay down his good health as a price. Education must
comprehend the whole man and the whole man is built fundamentally
on what he is physically.

OBJECTIONS TO MEDICAL INSPECTION
The objection that the school has no right to permit or require medical
inspection of the children will not bear close scrutiny or logical
analysis. The authority which has the right to compel attendance at
school has the added duty of insisting that no harm shall come to those
who go there. The exercise of the power to enforce school attendance is
dangerous if it is not accompanied by an appreciation of the duty of
seeing to it that the assembling of pupils brings to the individual no
physical detriment.
[Illustration: Tony's tonsils need attention.]
Nor are the schools, in assuming the medical oversight of the pupils,
trespassing upon the domain of private rights and initiative. Under
medical inspection, what is done for the parent is to tell him of the
needs of his child, of which he might otherwise have been in ignorance.
It leaves to the parent the duty of meeting those needs. It leaves him
with a larger responsibility than before. It is difficult to find a logical
basis for the argument that the school has not the right to inform the
parents of defects present in the child, and to advise as to remedial
measures which should be taken to remove them.
The justification of the state in assuming the function of education and

in making that education compulsory is to insure its own preservation
and efficiency. Whether or not it is successful will depend on the
degree to which its individual members are spiritually prepared for
modern co-operation.
But the well-being of a state is as much dependent upon the strength,
health, and productive capacity of its members as it is upon their
knowledge and intelligence. In order that it may insure the efficiency of
its citizens, the state, through its compulsory education enactments,
requires its youth to pursue certain studies which experience has proved
necessary to secure that efficiency. Individual efficiency, however,
rests not alone on education or intelligence, but is equally dependent on
physical health and vigor. Hence, if the state may make mandatory
training in intelligence, it may also command training to secure
physical soundness and capacity. Health is the foundation on which
rests the happiness of a people and the power of a nation.

HOW THE WORK STARTED
The first work of this kind in Cleveland is described in Superintendent
Jones' report for 1900. In that year the schools became greatly
interested in the question of defective vision. Tests were made by
teachers in different grades, and as a result over 2,000 children were
given treatment.
In 1906, an agreement was reached with the Board of Health, so that
each alternate day a health inspector communicated with the principal
of every school. Teachers were warned to be on the alert for symptoms
of illness, and children showing signs of measles, whooping cough,
scarlet fever, or other common diseases of childhood, were reported to
the principal, and through her to the Board of Health. Contagious cases
were excluded from school as soon as detected, and a systematic
campaign started against the waves of disease which were sweeping
one after another through the schools.
In the same year Drs. L. W. Childs, J. H. McHenry, H. L. Sanford, and

other members of the medical profession volunteered their services as
school physicians, to detect not only cases of possible contagion, but
also the existence of physical defects. What was probably the first
school dispensary in the United States was opened at the request of Dr.
Childs by the Board of Education in 1907 at the Murray Hill School.
The value of school dispensaries was so immediately evident that by
1909 seven others were established for the use of these three
physicians.
Coincident with the dispensaries came the school nurse. When the first
nurse was appointed at the Murray Hill School, a remarkable change
was observed among the children. Absences became less frequent. Skin
diseases were rare. Children began to take an interest in health matters,
and there was a marked rise in standards of neatness and cleanliness.
Teachers and principals united in their demand for more nurses, until
within a year after the movement started there were six nurses
appointed by the Board of Education and regularly employed in school
work. In the same year, December, 1909, the Board of Education
formally voted to establish a Division of Health Supervision and
Inspection as part of the regular school system.

THE PRESENT SYSTEM
As it is at present organized, the Division handles inspection for
contagious disease, inspection for physical and mental defects,
follow-up work