SCHEDULE OF MEDICAL INSPECTION.

(a) Previous Illnesses of Child (before admission).

Measles. Whooping Cough. Chickenpox. Scarlet Fever.

(b) Family Medical History (if exceptional).3

DISCUSSION.

DR. JAMES ROBERTS, M.O.H. (Hamilton, Ont.).-It is now little more than a year since our first systematic attempt was made at medical inspection of schools in this city, and even with the limited resources and facilities at our disposal for the carrying on of the work I think we can truthfully say that the results have been somewhat gratifying. Until recently our school inspection was limited to the control of communicable diseases, and, as I pointed out in my annual report, it is simply remarkable how much can be accomplished along this line with the assistance and co-operation of the teachers alone. When I undertook, at the request of the Board, of Education, something over a year ago an inquiry into the physical conditions of our school children, I was somewhat doubtful as to the urgency of this work in a city of our population and social characteristics. It is not difficult to unhesitatingly concur in the findings of those who have investigated conditions as they exist in the large and intensely congested centres, and I must confess that only personal investigation could ever have convinced me of the great importance of an early recognition on the part of the authorities and the public in general that the health of our school population is not all that could be desired. The multitudinous duties of a Health Officer in a city of even this size rendered it impossible for me to do more than merely touch the fringe of the work.

For some months past our school nurse has devoted her whole time to it, and has proved herself a capable and intelligent inspector. I am glad to be able to say that there has been at all times the heartiest co-operation with our department. Communicable diseases were never more promptly and completely recorded-the exclusion of these where present in school never so thorough, and a great many defects have been pointed out to parents-a considerable proportion of which have been remedied.

We have been able to accomplish a great deal toward the eradication of pediculosis, scabes, impetigo, ringworm, etc., which exist to an extent unrealized by those not specially interested in the subject. Our teachers concede that as a result of inspection in personal cleanliness, tidiness, and general morale of the pupils, we have gained a great deal. The establishment of a dental infirmary, which would do something for the deplorable condition of the 75 per cent. of school children's mouths is greatly to be desired, as is also some provision whereby defects in vision, which even on rough examination are found to exist to a surprising extent, may be remedied. Just at this point arises our chief difficulty. On all sides this school inspection is looked upon as a good thing. All

popular expressions of opinion favor it, and yet the necessary financial assistance to make it practical in results seems to come grudgingly. Where the excuse for this exists I have not been able to ascertain.

Our public men point with pride to increased expenditures in the cause of education, increases which may be largely wasted because we do not take into account the physical peculiarities of the boys and girls who, perhaps, are being tortured rather than educated. Once let an intelligent boy realize that the possession of a good set of teeth by him is of so little moment to the body politic, that it isn't worth a trifling expenditure on his behalf, and the conclusion that it doesn't matter much to anybody whether or no he becomes a saloon frequenter, gets drunk or goes to jail is not so illogical as it may seem. "Apathy," not malice prepense, seems to reconcile us to the strange irony of life that the expenditure which is denied in order to find out the mental and physical capabilities of a child is readily sanctioned for an education ill adapted to his needs and for the administration of criminal justice. "Apathy" it must be that allows without protest deliberations over railways, power and light schemes, and corporation franchises to consume almost the entire time of our municipal and parliamentary representatives to the exclusion of housing problems, sanitation of streets and public conveyances, parks and playgrounds, and the thousand and one other little considerations which contribute so materially to the public health, the comfort and wellbeing of the great mass of the people.

"Fully 25 per cent. of the deaths in the community," says Osler, "are due to this accursed apathy,' fostering a human inefficiency, and which goes far to counterbalance the extraordinary achievements of the past century. Why should we take pride in the wonderful railway system with which enterprise and energy have traversed the land, when the supreme law, the public health, is neglected? What comfort in the thought of a people enjoying great material prosperity when we know that the primary elements of life (on which even the old Romans were our masters) are denied to them? What consolation does the "little red schoolhouse" afford when we know that a Lethean apathy allows toll to be taken of every class from the little tots to the youths and maidens?"

Paton, in his recent work on Psychiatry, says: "The opinion of an expert is sought for in examining a new recruit, who is desirous of entering the ranks of the army or navy; and to-day the universities have physical directors to examine into and pass upon the

physical condition of students before they are allowed to compete in inter-collegiate sports. And yet at the same time a heterogeneous mass of humanity, without any form of selection, and utterly regardless of its fitness, is driven through a so-called education. Society at large must sooner or later awaken to the realization that the indiscriminate education of the masses cannot be too strongly condemned, for excessive demands upon the brain power of a community must ultimately lower not only the intellectual, but also the moral standards. Even with the crude and imperfect methods now used by the alienist, if the opportunity were given to him to apply his tests, it would be possible greatly to reduce the numbers of those who are seriously injured mentally and morally by a schooling ill adapted to their individual needs and necessities. Everyone admits that it is the duty of the physician to warn those with weak hearts or lungs not to overtax those organs. Is it not equally important that the mental welfare of the community be safeguarded? Only some men are born to be educated; how many more, unfortunately, have thrust upon them an education, which is disastrous not only to themselves, but also to the community at large?

To prevent the sins of over-educated fathers and mothers from being visited on the children unto the third and fourth generation is a problem of great sociological as well as economic importance to the State. The sudden expansion of mental powers may be quite as unfortunate as the sudden acquisition of riches, and the community that heedlessly imposes mental tasks indiscriminately upon the children in its Public schools adds greatly to the list, already appalling in length, of those who overtax the capacities of hospitals for the insane.

Gentlemen, only when we realize the truth of these observations by competent authorities will medical inspection rise as part of our school economy to its essential and proper proportions.

DR. ROBERT LAW (Ottawa).--I congratulate Dr. MacMurchy on her excellent paper, bringing forward this question which is now coming into prominence as a live matter, and consider that this matter will shortly be considered part of the regular routine of a Health Department's duties, and that the work should be under direction of Health Department.

In Ottawa the Health Officer has done such work as has been done; this was chiefly in control of contagious diseases, with the result that the schools have been kept free from any epidemic; and in throat inspection cases of scarlet fever and diphtheria have been removed from classes.

Teachers have been found allies in this work, and should be taken into account in any scheme of inspection, as the alert teacher, accustomed to the normal appearance of the child in health, will readily note any marked departure therefrom, and can notify Medical Officer.

The schools in Ottawa have been placed in first-class condition during the past five years through the employment of a permanent architect, who has made a special study of school sanitation.

I have recommended an outlay for medical inspectors to work with the Medical Health Officer, but the authorities have so far turned it down, owing to the plea of financial stringency. It will be necessary for us to show the authorities that it is a business proposition which will give an adequate return for outlay. The plan I proposed is to employ several inspectors to attend the schools at the opening of the fall term and examine all children, similarly examine any new-comers during term, and any cases referred to the officer by the teacher, or on the occurrence of any infectious disease. The inspector to be paid according to the amount of work done.

MEDICAL THOUGHTS, FADS, FACTS, AND FANCIES.

BY JAMES S. SPRAGUE, M.D., STIRLING, ONT.

You, no doubt, brother, have in quiet moments, and very frequently, too, thought what new specialty would arise to disturb our quiet, yet never-ending studies and researches. Dr. Waetzold has equalled, in fact has eclipsed, Dr. Gould, of Philadelphia, in extremism. While the distinguished lexicographer and oculistbiographer attributes numerous nervous ailments to "eye-strain," with equal learning and copious illustrations, Dr. W. claims "earstrain" as the prominent factor, and we, country doctors-in fact. all M.D.'s will await their published claims for the prize-for leisure moments' reading, and for our sanction and authority, provided we consider them intelligent and adaptable.

To one who is observant, there are many evidences most pleasurably afforded of the tendency of many medical journals to discontinue their publications or to form an amalgamation in publication with some other similar journals. Equally noticeable is the