to the State Department of Health a number of cases of typhoid fever among school teachers who have gone out to teach, fortified by a college education and holding a life certificate, only to be taken down with typhoid fever and compelled to spend their summer vacation battling with the dread disease. Perhaps it has left them in such a state of health that they will not be permitted to return to their school work this Fall if it has not ruined their health completely. If teachers would demand safe drinking water and healthful living conditions for their own protection before accepting a position to teach they would do much to advance the cause of public health in the rural communities, but unfortunately many teachers are not educated in the care of their health even though they have spent four or five years in college and may hold a life certificate to teach. Trachoma in The * * * Trachoma, the dread eye disease which has brought blindness or impaired vision to so many of the mountaineers of Kentucky and other Southern states exists right here in Ohio. It may be found in practically every section of the state. Medical inspection of the schools and the services of the school nurse will do much to eliminate it. A boy, 13 years of age, with an acute case of trachoma was brought to Columbus recently from a mining community in Ohio; by his father, who said the boy had "been suffering from pink eye off and on for two years" but he did not know it was serious. The boy had been in school during that time. Now the question arises, where was the teacher who had been trying to instruct that child for two years? Perhaps he, or she, had bad eyes too. The parent of the child may never have heard of trachoma and did not know it was highly infectious and might result in loss of sight, but there is no excuse for a school teacher permitting a child to attend school with the disease. Although long neglected by parents and teacher, this 13 year old boy was taken to a children's hospital for operation on his eye lids that his sight might be saved and that he might be spared the terrible. agony he has suffered for months because of the disease. * * * Communicable Diseases The closing of schools on account of the In The Schools. appearance of one or two cases of a communicable disease among the pupils is, as a rule, a most unwise procedure. The inference that schools are great distributors of disease is not sustained by experience. While it is true a communicable disease may be spread in a schoolroom, observation has shown that the danger is greater if the school is closed and the children are allowed to run loose and unrestrained. This is particularly true of the more serious of the communicable diseases. Medical inspection of the children in the room in which a case appears should be inaugurated, and continued for a few days following, to detect any new cases and to secure their removal before further infection can take place. If a diphtheria outbreak occurs in a school room, the physician should take cultures from the throats of all the exposed children in that room, in order to detect any carrier of the disease and to secure the immediate removal of any that may be found. Prompt examination may prevent a serious outbreak. The Laboratories of the State Department of Health offer every facility to assist medical inspection and other physicians in the required examinations to determine whether or not a child is a carrier. If there is no medical inspector, the teacher should be instructed to observe very carefully every child and, upon detecting the slightest evidence of illness, to send the child home for observation. If a communicable disease is prevailing to such an extent that parents are keeping their children at home, it may be advisable to close the school until confidence has been restored; but too often schools are closed by the local health officer or board of education, thereby committing a sanitary as well as an economic mistake. It is suggested that before such action is taken, the State Department of Health will be glad to advise as to the best course to pursue in the individual case upon being informed of the facts. New Hampshire Health Bulletin. * The Child Labor The national child labor committee and the Peril. federal council of churches have done a very timely and patriotic thing in issuing a fresh warning to legislatures and the general public against the hasty action taken, whose effect would be to abrogate child labor laws and bring youngsters of tender age into the work of the farms, the mills and the truck gardens. In the holy name of patriotism many dastardly things are done. In the name of country many a money-grabber sees his opportunity to get around and evade wholesome laws designed to protect the future men and women of the country. Already in Connecticut, Minnesota, New Hampshire, and Vermont no time has been lost in repealing or suspending the operation. of child labor laws. Everywhere the case is the same. There is a clamor to cut the school hours and the school months. The farmer declares he can't get along without child labor. The truck gardener echoes the call. The makers of munitions say they need children in their plants. The canners assert that without children they cannot put up the great amount of food products the country needs. The vast percentage of these claims are false. They are not made in good faith. They are founded in greed. They are inspired by a desire for cheap labor. They are marked by an utter callousness to the fate of the instruments they seek to employ and misuse. Columbus Citizen. New Plumbing Code * A new illustrated, cloth-bound book on "Plumbing and Drainage" has just been issued by the State Department of Health and will be ready for distribution on September 1, 1917. This book contains the laws of Ohio governing the location, construction, installation and inspection of plumbing and drainage and information pertaining to the installation of public comfort stations, public drinking fountains, public bath and wash houses, sanitary improvements for summer resorts, railroad sanitation, ventilation of school houses, hospitals, garages and sections of the general code relating to the sanitation of workshops and factories and public buildings. The State Printing Commission has ordered these books to be sold at cost, postage prepaid. The price fixed is 20 cents per copy. If you desire one sent to you, address the State Department of Health, Columbus, Ohio, enclosing 20 cents. The money will be turned into the state treasury to cover cost of publication. Lead Poison VS. Lead Bullets. * In February, 1884, in the Chicago Medical Journal and Examiner, Dr. S. V. Clevenger began a series of Clinical and Pathological Reports of Cases of Insanity, taken from his records at the County Insane Asylums. The first case he reported was that of a Swede who was suffering from melancholia due to lead poisoning. Clevenger ended his remarks with the suggestion, "Sanitary boards would do well to examine into the conduct of lead factories, and insist upon proper measures being adopted to protect workmen against plumbic toxemia.” Over thirty years have passed since these words were written, but the slaughter is still unabated. On the battlefields, lead kills men in time of war - but in the industries, lead kills men during war and peace alike. Medical Review of Reviews, August, 1917. The Army Draft And The large percentage of those drafted who Physical Disability. are exempted because of physical disability of one kind or another is a severe commen tary on American life says the Youngstown Vindicator. "Manifestly, American city conditions and industrial life are not conducive to the development of the best physical vigor," says the editor of this paper. "The ugly fact which England faced at the time of the Boer war, that her working classes were deteriorating physically, in a less degree seems to be true in the United States. "The statistics of American life insurance companies show that about 60,000 Americans under 40 years of age die of the disease of old age every year. Why is this? Certainly it cannot be regarded as a normal condition. Are the vital organs of the race being weakened so much by the stress or excesses of modern city life that they break down years before they did in the earlier days of the republic? The life insurance figures also show that about 75 per cent of these deaths are premature and that death could be deferred for years if our people were taught to follow healthful habits of living. "If the draft with its high rate of physical disability brings home to everyone the grave danger implied in these facts and results in methods that will correct this physical deterioration the war will have taught the American people a great and needed lesson. "The reduction of this waste in national vitality is a problem which must command national consideration after the war. Some of the causes of it are well-known. Bad housing, crowded living apartments, long hours of labor, the booze habit, lack of ventilation in homes and factories, confinement indoors instead of an open air life and the smoke evil all contribute to the result. Doubtless others could be named. "The fact is the government has given very little consideration to this problem. Congress has appropriated millions of dollars at various times to prevent or cure the diseases of cattle, horses, hogs and sheep. It has ignored the human race and its health and development. Yet that is the vital product of the nation. It is high time that the people should think of these things and demand a different attitude from the government." DRY STREET CLEANING CONDEMNED. That dry street cleaning is a decided menace to health is according to Dr. Henry Ritter who has recently contributed a number of articles on this subject to the "Good Health" magazine. Dr. Ritter bases his statement on the health danger from dust. He defines dust as simply a combination of the particles worn away from the earth and decaying animal and vegetable wastes, but containing living organisms such as bacteria, molds and yeast. He says that wherever there is a small accumulation of decaying matter such as sputum, slime, filth, garbage or manure on the ground or streets, these bacteria or germs feeding on it grow and multiply until the food supply is exhausted, and when through the action of the wind and sun they become dry and pulverized, the germs cling to the dust particles and with them are carried by the wind into open doors, open mouths and where not? Tubercle bacilli and other causative agents of respiratory diseases have been found in street dust. Dr. Ritter boldly denounces the rotary brush street sweeper. He says that it is not efficient, but that it simply stirs dust that is quiet and sends it flying through the city and into the homes of the people laden with disease germs. But the dust problem can be mitigated and in a more hygienic way than the rotary street brush, says the writer, who strongly advocates both the flushing system and the vacuum system of street cleaning, but particularly the former. Improved streets and pavements are other requisites recognized by Dr. Ritter as necessary to efficient street cleaning. Pavements having smooth surfaces can be kept more sanitary and freer from filth and dust than rough or rugged pavements. The latter makes the usual forms of street cleaning both difficult and ineffective. — North Carolina State Board of Health. PHYSICAL INSPECTION IN THE COLUMBUS SCHOOLS. A survey has recently been made of the Columbus public schools under the direction of Dr. J. H. Francis, Superintendent. The following report pertains to the Department of Physical Inspection, which has been in operation for four years under the supervision of Dr. H. M. Platter. - EDITOR. The Department of Physical Inspection of the Columbus Schools closely cooperates with the city department of health but is under the jurisdiction of the board of education. The staff consists of a consulting physician on part time and four graduate nurses. The city is subdivided into four districts with a nurse assigned to each district. As routine inspections are carried on there gradually develops a "clinic" - a number of problem cases which the nurse refers to the physician for advice as to methods of procedure to obtain corrections of defects found. The aims of the department have been (a) The control of communicable diseases. (b) The recognition and correction of physical defects. (c) Maintenance of sanitary condition. (d) Social service. In carrying out the first provision, its duties closely parrallel those of the board of health, except that the question of quarantine, the supervision of those in quarantine, and release from quarantine are recognized as belonging to the board of health while the control of the spread of communicable diseases in the school rooms, by common consent, the duty of the Department of Physical Inspection. For instance, the report of two cases of diphtheria in a school room calls for a culture or swab to be taken by the nurse from the throat of every individual in the room. These swabs are taken to the board of health laboratory for bacteriological examination. If the germs of diphtheria are found on any of the cultures, that individual is excluded from school and is quarantined by the board of health until two negative swabs are obtained. This procedure disposes of the "carrier" or "missed" case, the prolific cause of diphtheria outbreaks. Over 2,000 swabs are taken by the nurses annually. So effective has this supervision proven that the health officer of the city, Dr. Kahn, in his annual report estimates that the number of diphtheria cases among school children has been reduced one half. Physical Defects. In the discharge of the second duty the nurses are required to inspect each child in the grades at least once in two years. (Problem cases are inspected many times each year.) The results of these inspections are recorded upon an individual health card which accompanies the pupil as he is promoted or transferred. Vision is tested by the Snellen card and any apparent abnormality is recorded but notices are not sent to parents unless the defect is more than 2/3 or unless the child suffers from nervousness, squinting and frequent headaches. Approximately 26 per cent of school children. have been recognized by the department as needing glasses. The |