2. Thorough physical examination of every single child in every single school upon entering and periodically during school life.
We believe a vast number of things that "ain't so" about the health of country children as compared with city children, of private-school children as compared with public-school children. Where do we find more degenerate men, physically and morally, than in so-called "American settlements," where, for generations, children have had all outdoors to play in, except when in homes and schoolhouses that are seldom cleansed and seldom ventilated? Open mouths and closed minds clog the "little red schoolhouse"; there headaches do not suggest eye strain; there deafness and running ears are frankly attributed to scarlet fever which everybody must have with all the other "catching" diseases, the earlier the better; there colds begin in December and run until March, to the serious injury of attendance and promotion records; there bone tuberculosis is called "knee trouble" or "spine trouble in the family"; there boys like my little friend Fred count the bottles of cod-liver oil they take to cure adenoids that could be removed in two minutes.
The index to community life and community living conditions should be read in the country, not only for the country's sake, but also for the sake of the city whose milk and water, poisoned in the country, cause thousands of deaths annually, besides annual sick bills exceeding many times over the Russell Sage and Carnegie Foundations, which we rightly call munificent. Reading the index of private schools and colleges is important for their children and youth, but still more important for the community upon which unbridled passion, inability to work or to spend properly, inconsequential thinking, mediæval ideals of caste, etc., can inflict greater injuries than can typhoid fever or cholera.
The physical record of each child should be kept from date of entrance to date of leaving school, showing condition at successive examinations, absence because of illness, etc.
3. Thorough physical examination of children when leaving school, or when passing compulsory school age, as a condition to "working papers" and to "coming out."
To give working papers to children seriously handicapped by physical defects is to buy future industrial trouble, hospital and poorhouse bills. A boy with adenoids, a girl with eye trouble, should not be permitted to begin the fight for self-support without at least being clearly shown that the correction of these defects will increase their earning power. At present a schoolgirl with incipient tuberculosis, or predisposed to that disease, can get working papers, go to a hammock or tobacco factory, work long hours, breathe bushels of dust, deplete her vitality, spread tuberculosis among her co-workers and home associates, infect a tenement,—and all this without any help or advice or any protection from society until she is too sick to work and her physician notifies the health department that she is a danger center. We may disagree about society's right to control a child's act after the defects are discovered, but who will question society's duty to tell that child and her parents the truth about her physical needs before it accepts her labor or permits her to "enter society"?
4. Supervision by physicians of hygiene practiced in schoolrooms and on playgrounds.
Superintendent Maxwell, of New York City, and other educational leaders urge teachers to do their utmost to learn the physical conditions and home environment of the individual child, and to fit school treatment to the individual possibilities and handicaps. But experience proves conclusively that try as they will, teachers and principals have neither the special knowledge nor the time to acquire the special knowledge requisite to use the facts disclosed by the physical examination of school children. Physicians and nurses are needed, not so much for treating children, as for teaching children, parents, teachers, family and dispensary physicians.
Private schools have visiting physicians who may be consulted; they need physicians to supervise, with power to examine or to require certificates of examination. The Committee on the Physical Welfare of School Children found that when a visitor was detailed for that purpose it was easy to secure the coöperation of parents, teachers, family physicians, dispensaries, school boards, and charitable societies. The Hawthorne Club's school secretary has been similarly successful in Boston, as have those of Hartley House, Greenwich House, and the Public Education Association in New York.
5. Restriction of study hours at school and at home to limits compatible with health.