Health Work in the Public Schools | Page 6

unhesitatingly,
defective teeth." The development of the movement for dental
inspection of school children in Cleveland shows that the educational
system has been awakening to a realization of the truth and significance
of Dr. Osler's statement. The most salient fact in the situation is that the
commonest of all physical defects among school children is decayed
teeth. Cases of dental defectiveness are frequently greater in number
than are all other sorts of physical defects combined. Moreover, it is
probably true that there is no single ailment of school children which is
directly or indirectly responsible for so great an amount of misery,
disease, and mental and physical handicap. These are reasons why
Cleveland should steadfastly continue in the maintenance and
development of the dental clinics.

EYE CLINICS
An eye clinic is maintained by the Department of Medical Inspection at
the Brownell School. This clinic is open every afternoon during the
school year. The method of procedure is as follows: During the routine
physical examinations of children by the doctors in the different
schools, the vision is tested and, if found defective, the parents are
advised of it by note. The nurse then follows up the case and if she
finds that the parents are unable to pay for an examination by an oculist,

she takes the child to the school clinic, after having obtained the written
consent of the parent. There the child is given a thorough and accurate
examination, the eyes being first dilated with homatropin and the error
of refraction determined by means of the retinoscope. The proper
glasses are ordered for the child and in a few days he is brought back to
the clinic and the frames carefully adjusted. The nurse then keeps in
touch with the case, seeing to it that the child wears the glasses, that the
frames are straight, and that the symptoms of which the child
complained are relieved.
[Illustration: The eye clinic is advertised by its loving friends.]
Many parents are unable to pay an oculist's fee but are able and willing
to pay a small amount for glasses and in these cases a nominal charge is
made for them. Experience has shown that if a charge, no matter how
small, is made for the glasses better care is taken of them and better
results are obtained. In some cases there has been opposition on the part
of the parents to the child's wearing glasses, but usually the nurse has
been able to prove to them the necessity and has obtained their consent.
During the school year 1914-15, the total number of dispensary visits
was 1,913. In 665 cases the eyes were refracted and in 500 cases
glasses were furnished. In about 75 per cent of the cases the children's
symptoms are relieved and their scholarship is improved. In about 10
per cent of the cases the symptoms are not relieved. About five per cent
of the children refuse to wear the glasses. The remaining 10 per cent of
the children cannot be located because they have moved from the city
or been transferred to private schools. The value of the work of the eye
clinic is beyond question.
There are no other clinics in connection with the Cleveland public
school system. Mental examinations are made by a special teacher
appointed for that purpose. All surgical cases are referred to family
physicians or local hospitals for treatment.

CO-OPERATION OF COLLEGE FOR BARBERS

Rather an unusual form of clinical work is found in service rendered by
students of the Cleveland College for Barbers. In several districts an
arrangement between the school physician and the college provides that
free hair cuts be furnished pupils at intervals during the school year.
The coming of the barber is an event eagerly greeted, and principals
report that as a result children show increased pride in personal
appearance.

THE MEDICAL INSPECTION STAFF
The organization of the staff deserves special comment. The physicians
employed are mature men, graduates of well-known medical schools.
The youngest medical inspector on the staff is 29, the oldest 46, and the
average age of all the doctors is 36. They are picked men, selected for
the work because of their skill, intelligence, and social viewpoint. They
are splendidly representative of the medical profession in Cleveland.
They have fairly wide private practices and in many cases are carrying
on the school work at real financial sacrifice because of their interest in
the problems it involves. Their assistants are all registered nurses from
the Visiting Nurses Association and distinctly high grade women.
Medical inspectors receive $100 a month during the school year. They
are required to give three and one-half hours a day, five days a week, to
work in the schools, inclusive of traveling time between buildings.
Nurses are paid on the schedule