It will be readily conceded that every crippled or deformed child should, if possible, be spared from permanent disability, and no thoughtful parent should hesitate to act when attention is directed to the serious consequences of neglect. Poverty is no excuse for the "do nothing system," as the medical charities offer adequate facilities for treatment of persons unable to pay for the same.

Nor is there an excuse for not attempting to cure discharging ears, defective hearing or vision, since every observer is familiar with the sad consequences of such defects in the ultimate struggle for existence. Parents may not know that a child afflicted with a squint, harelip or cleft palate may be transformed into a vicious character, because it is the object of constant ridicule within and without school; and that all of this could be avoided by a timely operation. Parents are probably not aware that many of the nervous affections and even mental defects in boys are due to some slight malformation of the genital organs, for which the Hebrews instituted circumcision. Nor is it generally known that anemic and ill nourished children and those suffering from enlarged tonsils, cervical glands, or post-nasal growths, and the majority of "mouth breathers" are peculiarly susceptible to disease in general and to tuberculosis in particular.

Lastly, there is no good reason why special attention should not be given to the physical development of undersized children or those affected with slight muscular deformities, which, if left uncorrected, will be a source of regret and even reproach to the teacher and parent.

The remedy lies chiefly in education, and for this purpose the study of hygiene should be made an important part of the school curriculum. In this way the parents may be reached through the child. Instructive visiting nurses should be appointed for the schools so that they may follow the child to the home and point out to the parents the desirability of securing prompt professional advice in all cases where it is indicated, and especially in instances where neglect is likely to result in permanent disability. In this general educational campaign the Medical Inspectors of Schools, teachers, social settlement workers, agents and friendly visitors of the Associated Charities can render a distinct service to the child and the State.

INQUIRY FOR THE PRESIDENT'S HOMES COMMISSION MEDICAL INSPECTION OF PUBLIC SCHOOL CHILDREN, WASHINGTON, D. C.

In speaking of the health of a given locality it has always been deemed necessary that the climatic and telluric conditions should be considered. For the purpose of a comparative study I requested Prof. Willis L. Moore and Prof. A. J. Henry, of the United States Weather Bureau, to furnish me with meteorological data covering a period of thirty years for the city of Washington and six other cities where the climatic conditions are quite similar to those which obtain in this city. A careful analysis of these data and a study of the comparative mortality statistics justify the conclusion that there is absolutely nothing inimical to health in the

Defective Vision.

Defective Hearing.

Discharging Ears.

Subiect to Toothache in Past Year.

Total times defects

noted.

Total enrollment.

climate of Washington. It was found, however, that although the city enjoys practically the same climate as Cincinnati, Indianapolis, Detroit, Philadelphia, Springfield and Kansas City, it has the highest death-rate* -22.8 per 1,000, Philadelphia coming next with a rate of 21.2 per mille, while Detroit, Kansas City, Indianapolis and Springfield have an average of 17.5 per 1,000.†

As a matter of record, Dr. Busey, in one of his addresses, quotes the "Washington Gazette" of 1797, that "during that year, in a population of two thousand, but seven deaths occurred in this city." If, then, during succeeding decades, "fatal epidemics of bilious fever, intermittent bilious fever and bilious dysentery" and typhoid fever occurred, and the reputation of the National Capital as regards health conditions has suffered, it cannot be the effect of climate, but of something added to the climate, and students of the subject have long since recognized that, apart from temperature, humidity, atmospheric pressure, winds, sunshine and other meterological conditions, there are many factors such as soil, water, impure air, the presence of insects, social and racial problems -which play an important role in the healthfulness of a given locality.

It can be safely asserted that a number of causes have operated in the production of unsanitary factors in the National Capital.

The topography of the basin in which the city is located was undulating, interspersed with small valleys, ravines, morasses and lowlands subject to periodical overflows. The lowlands, according to Dr. Busey, "spread south of the F street ridge to the river shore, including a greater part of the White Lot and the Mall, and in the section known as 'the slashes,' lying along the northern boundary from the Tiber to Rock Creek, and dipping in many places far into the interior of the basin. When the city was first platted there were no Potomac and Anacostia river flats; the formation of the Potomac marshes is attributed to the construction of the Anacostia causeway in 1805 and the building of the Long bridge in 1808, and the Anacostia river flats to the construction of the Kentucky avenue bridge in 1795 and the Bennings bridge in 1797." Whatever their cause may have been, they increased from year to year by continuous depositions and soon became notorious breeding grounds for mosquitoes and the chief source for the propagation of malaria. The Potomac flats have been reclaimed since 1882, adding about 621 acres to

*Of these seven cities Washington had the highest death rates from malarial, diarrheal diseases, typhoid and consumption (Philadelphia exceeding in pneumonia).

†Considerably less than the general death-rate in the registration area in the United States, representing 10,000,000 inhabitants. For the census year 1900 this was 18.6 per 1,000.