Book- Gopyiiglit)^?. COPWIGHT DEPOSIT. SCHOOL llV(aENE SCHOOL HYGIENE BY LEO BURGERSTEIN, Ph.D., LL.D. '• (VIENNA) TRANSLATED BY BEATRICE L. STEVENSON, AND ANNA L. VON DER OSTEN WITH 43 ILLUSTRATIONS AND DIAGRAMS NEW YORK FREDERICK A. STOKES COMPANY PUBLISHERS \-> Copyright, 1916, hy Frederick A. Stokes Company All rights reserved U January, 1915 JAN 22 1915 S)CU391443 INTRODUCTION TO THE AMERICAN EDITION The present century is discovering that the care of children is the most important thing in the world. Except in so far as children possess vitality, integrity and intelligence, nothing is worth while. In the past our cities have been built as if manufacturing and commerce were the great aims of the world. The discovery of childhood is the supreme achie-^ment of our day. The time is coming when cities will be built so that children may be well and happy, so that the treasures of past civilization, the precious inherit- ance of the achievements of the human spirit, shall be passed on to them most effectively. One of the leaders in this world-reconstructing view is Professor Leo Burgerstein, who has taken as his special theme the health of the school child, realizing that children in school are kept in school and under school influence, most of the hours of most of the days of most of the years of childhood. He says that the school must itself become a health-promoting agency, and the school curriculum a means which shall so influence the children that those who take part in it shall be better off in health and vigor than those who do not. The world is indebted to Professor Burgerstein for his scientific achievement, for his V vi INTRODUCTION breadth of scholarship, as well as for the practical nature of his teachings. This little book will bring to those American readers who are not already familiar with Professor Burger- stein's larger work in German, his general point of view with reference to this whole subject of the health of the school child. Luther H. Gulick, M. D. New York, October, 1913. PREFACE TO THE THIRD EDITION The preface to the first edition closes with the words: *Tt is difficult to set forth the results of an investigation in a way so as to be readily understood b}^ all, I shall be happy if I find that I have succeeded in this endeavor." The rapid sale of the second, extensive edition has shown that the chosen way was the right one. In addition to a change of text and enlargement of the index, the new edition of this little l)ook, which has won many friends and received much recognition, has been altered only to include our present knowledge of school hygiene. A few parts have been omitted, some chapters have been made more comprehensive, and new and more instructive illustrations have been added. The great increase in material with no cor- responding increase in the size or price of the book is due to the good management of m}^ publishers, and 1 take this opportunity of expressing to them my thanks for their services. I desire also to thank my honored friend, Mr. Arthur Lieberman of Vienna, for his kind assistance in correct- ing proofs. Leo Burgerstein, Ph. D., LL. D. Vienna, April, 1912. vn MEASUREMENT EQUIVALENTS 1 meter 1 meter 1 centimeter 1 centimeter 1 millimeter 1 square meter 1 square centimeter X degrees Centigrade 3 . 3 feet 100 centimeters .39 inch 10 millimeters . 039 inch 1 , 2 square yard . 15 square inch (Xxl.8)+ 32 = X degrees Fahrenheit Vlll CONTENTS (The figures in parenthesis refer to the number of the page.) Introduction to the American Edition v Preface vii Introduction xv I. THE SCHOOLHOUSE I. General Planning and Erection Planning (1)— Site (2)— Cottage Plan of Schools (4)— Location of Schooliiouse (7) — Water Supply (8) — Wells (8) — Drinking Fountains (9) — Construction (11)— School- house Entrance (12) — Waiting Rooms (12) — Cloak Koonis (12) — Lavatories (13) — Indoor Playgrounds (14) — Ar- rangement of Rooms (15) — Ground Plans (16) — The Classroom (18). 2. Lighting Light Measurement (19) — Angle of Light (20) — Direction of Light (23)— Windows (24)— Curtains and Shades (25)— Light Reflectors (25)— Artificial Lighting (20)— Diffused Lighting (27)— Direct Lighting (28)— Gas Lighting (29) 3. Ventilation and Heating Condition of the Air (29)— Dust (32)— Airing (33)— Venti- lation (34)— Heating (36)— Stoves (37)— Gas Heaters (38) — Steam Heating (40) — Hot-water Heating (40). 4. The Classroom and its Equipment Size of Classroom (42)— Walls and Ceiling (44)— Floor (44) — The School Desk (46) — Adjustable School Furniture ix X CONTENTS (49) — Desk Dimensions (51) — Movable Desks (56) — Posture (58) — Blackboards (59) — ^Lavatory (59) — Ex- pectoration Receptacles (59). 5. Other Rooms, Grounds, and Facilities of the School Gymnasium (60) — Playgrounds (61) — School Gardens (63) — , School Baths (63) — Swimming Pools (65) — Rooms for Domestic Science (66) — School Feeding (66) — Toilets (67)— Urinals (71)— School and Dwelling (72)— Cleaning (73)— Fire Regulations (74). II. THE HYGIENE OF INSTRUCTION I. General Considerations Fatigue (75)— Constitution (78)— Defective Children (79)— Special Classes (80) — School Age (81) — Co-education (82.) 2. Number of Pupils and Curriculum Number of Pupils (88) — School Hours (91) — Carrying of Books (92) — Inspection for Personal Cleanliness (94) — Length of Instruction Periods (94)— Recesses (96) — Order of Subjects (101)— The One or Two-session Day (102). 3. The Hygiene of Different School Subjects Reading (106) — Writing (109) — Vertical or Oblique Writing (111)— Handwork (116)— Domestic Science (116)— Manual Training (116) — Gymnastics and Play (118) — Singing (122). 4. Homework, Examinations, etc. Homework (123)— Extra Work (127)— Examinations (127 — Graduation Examinations (Reifepriifungen) (128) — Overwork (130) — Punishments (131)^Corporal Punish- ment (133) — School Suicides (135) — Other Punishments (136)— Vacations (136)— Summer Vacation (137)— Mid- CONTENTS xi term Vacations (138) — Suspension of School on Warm Days (139) — Vacation Colonies or Camps (140) — Excur- sions in Vacation (141) — Recreation Day Camps and Open-air Schools (141). 5. Boarding Schools Open Air Boarding Schools (143). III. INSTRUCTION IN HYGIENE Hygiene in Training Schools (146) — Hygiene in I^lementary Schools (148)— Hygiene in High Schools (149)— Alcohol (150)— Tobacco (151)— Sex Hygiene (152). IV. SCPIOOL DISEASES AND MEDICAL INSPEC- TION OF SCHOOLS % Contagious Diseases (154) — Myopia (Nearsightedness) (150) — Spinal Curvature (157) — Subnormal Children (158) — The School Physician (159)— School Nurses (165)— School Clinics (166) — Historical Survey of Medical In- spection (167). V. HYGIENE OF THE TI^ACHING PROFESSION Difficult Schoolroom Conditions and Nervous Strain (173) — Overtime (174) — Consulting the School Physician (175). Bibliography 176 Index 178 ILLUSTRATIONS AND DIAGRAMS FIG . PAGE 1. Pavilion school at Drontheim, Norway. Perspec- tive 5 2. Pavilion school at Drontheim, Norway. Ground plan 6 3. Ground and cross section of a school unit at Dron- theim, Norway 6 4. A drinking fountain reciuiring no cup 10 5. Ground plan of a one-room Danish schoolhouse. . 13 6. Plan of the first floor in a London public schiol accommodating twenty classes 14 7. Ground plan of a public school (thirty-two classes) in Frankfort, Germany 15 8. A school and its grounds at ^'iroflay, France ... 17 9. Photometer by Wingen 19 10. Pleier's camera for measuring the angle of hght. . 20 11. Photograph taken with the Pleier camera for meas- uring the angle of light 21 12. Measuring the light on the desk farthest from the window 22 13. Diffused lighting by Welsbach lamp 27 14. The Meidinger stove 35 15. Ventilation by temperature differences 36 16. The Meidinger stove, interior view, showing ven- tilating system 37 17. Steam heating 39 18. Plan of a schoolroom with benches each accom- modating two pupils 43 xiii INTRODUCTION It is a well-known fact that the beginnings of many modern activities can be traced back thousands of years. Such is the case with school hygiene, for evidence of its existence has been found as far back as the days of Greece. Even the modern form of school procedure is much like that of a far-removed age; the schoolhouse of the present with its equip- ment agrees in some respects with the schoolhouse and equipment described by Furttenbach.* ^here have been times in Germany when public opinion was disposed to consider with indifference a sound physical development in relation to school work. Even to-day, while the teaching profession generally appreciates the importance of school hygiene from a theoretical standpoint, in actual practice we are still feeling the effects of the earUer prejudiced times, and much progress needs to be made. Nevertheless, the right of the child is one of the demands of the times, and this demand includes the protection of the child's health in pubHc institutions. As the father of modern school hygiene we acknowl- edge the eminent physician, Johann Peter Frank, who, in the second volume of his great work, " System einer vollstandigen medizinischen Policey,"t sum- *F\trttenbach. "Toutsches Schul-Gebaw," Augsburg, 1649. fFRANK, Johann Peter. "System einer vollstandigen medizi- nischen Policey," Mannheim, 1780. xvii xviii INTRODUCTION marized the meaning of school hygiene. The science has, however, been broadened and made effective only during the past fifty years, when medical special- ists, in the interests of scientific knowledge, have examined large numbers of school children to deter- mine what disturbances of health are traceable to school life. In the train of these examinations many thorough investigations were taken up to determine the physical condition of school children and the state of sanitary equipment of the schoolhouse; and much knowledge has been gained and many hygienic im- provements have been introduced. In comparison with research in these directions, the hygiene of in- struction made its appearance relatively late, and is therefore far from being cleared up sufficiently. The demand for it must come from the schools, its teachers, and the specially trained school physicians. The hygiene of the teaching profession, developed in the spirit of modern scientific research, is like- wise only in its infancy. Practical hygiene so far as it concerns all matters of the school will succeed only when schoolmen generally, teachers, and the pupils themselves, understand the rules of health. As for the actual instruction in hygiene in the school, the subject is so comprehensive that it is impossible that all teachers shall be experts in this particular field; hence a demand has gradually arisen for a person especially trained in this branch of school work, namely, the school physician. It is important that the teaching profession take an active interest in school hygiene; there is no better INTRODUCTION xix way toward realizing the ideals of the science or of verifying the results of research. The fundamental points to be emphas'zed in this book have thus been indicated. Their discussion, which will be concise, will include matters of theory and practice in various countries. It will materially aid the advance of the science if teachers everywhere will accept the suggestions concerning the theory and practice in other lands in the spirit in which these suggestions are made, and as an incentive to progress in their own schools. SCHOOL HYGIENE I THE SCHOOLHOUSE 1. General Planning and Erection The problem of schoolhouse planning differs from the ordinar}^ house planning in this respect that al- most every condition is altered. In a dwelling house the place where one sits to read is near the wi|^dow; in a schoolroom even the corners far removed from the windows must be used for this purpose. The very moment the threshold of the schoolhouse is crossed, the difference is apparent; many feet passing over a thres- hold bring in an unusual amount of dust. The school stairways, too, must at times bear the weight of crowds, and rooms which must accommodate many individuals make proper ventilation a serious matter. In fact, the characteristics of the schoolhouse serve to emphasize the difference ])etween it and the dwelling. Planning. — In order to avoid mistakes which cannot be remedied later, when the schoolhouse is being planned close attention must be given to the hygienic aspects. This requires careful study at the outset, a fact which has unfortunately been learned by experi- ence in those communities where it has been found that an attractive appearance does not always mean 1 2 SCHOOL HYGIENE good planning or suitable situation. Schoolhouse planning demands experts. In rural communities good model plans might be edited by the municipal authorities. In this way, even a small community could erect a satisfactory schoolhouse and be stimu- lated to undertake the work because those immediately interested, as, for instance, business men, could super- intend the matters of planning and erection. It is, of course, of material help toward the securing of good schoolhouses if the state is able to assist by subscribing loans without interest. Small and average-sized cities may succeed in securing good plans by initiating a building contest. The sketches submitted in the con- test should be passed upon by an expert in school hygiene. The primary aim in all cases must be to secure ideally hygienic conditions as far as the finances will permit. This necessity must precede all claims to beauty; panem et circenses, not the reverse, should be the rule. In the larger cities the aim should be a comprehensive study of schoolhouse construction in other countries as well. This study should include a review of the existing literature on the subject, and also the personal observations of an architect especially interested in this branch of his profession. Site. — It must be emphasized again that not every building will do for a schoolhouse and that the schoolhouse demands special construction. The choice of a site is important. The essentials are: quiet, air as good as the locality permits, and light which is not interfered with by adjoining buildings. A further essential is that these conditions be assured for the future. It happens frequently, especially in THE SCHOOLHOUSE 3 small towns, that an otherwise desirable schoolhouse is placed entirely without necessity on a thoroughfare, merely because the town is proud to show it. The noise and dust of the thoroughfare prove disturbing factors. If the building must be put on a principal street, by all means let the corridors be on that side while the classrooms face the rear; ])ut a more favor- able location should be found, if possible. Further- more, in small places the plans should be such as to admit of the addition of annexes or stories. In rural districts, in order to have a generally ac- cessible schoolhouse, one must take into account the lay of the land, the distribution of the population, and the state of the roads. Instead of a separate school for each small village, it might be desilable to have one large school for a number of villages. The pupils might be brought to the school by conveyances, as is the system in vogue in certain parts of the United States, where several of the states have already pa:?sed legislative enactment on this point. It would be most helpful, both from the standpoint of hygiene and from that of school attendance, if in rural districts it were possible during the inclement season when the snow lies deep and transit is difficult, to organize a system whereby particularly the smaller children may be carried in conveyances alternatively by the farmers to and from school. In the northern part of Scandi- navia, where the farms are widely scattered, it has been found feasible to form so-called Wander schulen. In these, a number of children are fully taken care of for a number of weeks, until the teacher must move on to the next post. 4 SCHOOL HYGIENE When quiet and good air are aimed at it is well to remember that these conditions are not likely to be secured where school buildings are situated in the vicinity of railway stations, near laundries where chemicals are used, or near factories. It would be a distinct advance if this matter could be controlled by law, for instance, the prohibition of such establish- ments within a mile of the schoolhouse. Cottage Plan of Schools. — In large cities, a realiza- tion of these ideals — quiet, good air and good light — is not easy, but the evils might be minimized if the municipal authorities would look ahead a few decades in the growth of their city and restrict certain sites in the suburbs for the use of schoolhouses and play- grounds. In the meantime, such tracts of land might be leased out for agricultural purposes. Some large cities have built their schools on the plan of one schoolhouse to so many thousand children, but this procedure does not always express a wise, far-sighted policy, for while the proportion of school children to the total population (in most countries from 13 to 20 percent) is known, in some sections, for instance where a factory is being set up, the school population will increase out of all proportion to the provisions that have been made. To meet such needs, large school barracks must then be constructed in haste. Such cheap, lightly built structures, while they some- times admirably relieve a temporary need and have been known to give good service for years, are not to be recommended for general use, and should merely serve as an emergency measure in large cities. It may be that from some of the advantages of the THE SCHOOLHOUSE 5 school barracks has originated the cottage plan of school building, i.e., instead of one large schoolhouse, a number of smaller, separate units. The advantages here are better air and less mutual disturbance; it is easier to clear the rooms in case of fire, and the closing at times of epidemics need only concern one unit. On the other liand, drawbacks are again met with in the tax put upon the central heating system, and if shower baths are used the danger in cold weather of having Fig. 1. — Pavilion school at Dronthoim, Norway. Perspective. the children pass after the bath from one building to another. The comparatively large amount of space required for the pavilion school renders it not generally practicable and for this reason but few such schools have been erected, though they are to be found here and there, especially since Beutner in Ludwigshafen (Germany) has supplied a model. Figs. 1 and 2 show examples of the Hakonson-Hansen pavilion at Dront- 6 SCHOOL HYGIENE heim in Norway. The schoolhouse is of wood, centrally heated by steam and ventilated mechanically. The house in the rear of Fig. 2 is the gymnasium STREET SCHOOL UNIT Thouse I'^^^ PLAYGROUND FOR GIRLS SCHOOL UNIT 5 ID 50 TOm |imHH 1 1 1 1 , j Fig. 2. — Pavilion school at Drontheim, Norway. Ground plan. 5 1 ' ' ' ■ I 10 30 m Fig. 3. — Ground plan and cross section of a school unit at Drontheim, Norway. where classes in physical exercise and training for sloyd work are conducted. Fig. 3 shows the ground THE SCHOOLHOUSE 7 plan and a cross section of one of the pavilions, with six classrooms, each accommodating 36 pupils. Points relating to the size of school plots will be taken up later; it is sufficient to say here that the grounds can never be too large when play spaces are taken into consideration. School buildings should never be placed on sites formerly used as refuse dumps, on ground where underground currents of water come near the surface, or in marshy places. Location of Schoolhouse. — A much discussed ques- tion is the location of the school building with respect to the point of the compass. The great influence that the sun has as a hygienic agency is well expressed by the forceful old Italian saying that, ''Where the sun never goes, the doctor must go." Sun^ine is especially important for the physical and moral health as well as the happiness of children. On the other hand, the sunlight which falls directly on the page when the child is reading or writing is harmful to the eyes. Curtains or screens are then necessary. It must also be remembered that a very sunn}' room well filled with children is decidedly uncomfortable in summer. Local conditions, such as a mild or a severe climate, strong or badly nurtured children, distribution of class hours, etc., play important parts. For the health of the children, sunny situations are on the whole preferable to the northern exposure . which has recently been advocated. The value of sunshine is not to be overlooked when ideal situations can be obtained. In the large city, where a school- house must be placed of necessity in a-street with other houses, the choice of location of the rooms is naturally 8 SCHOOL HYGIENE strictly limited to their distribution within the schoolhouse. Water Supply. — The quality of the water supplied to a school is a matter of the utmost importance, as impure water may be the source of dangerous disease. Filters are not to be recommended because they soon become choked with bacterial organisms and are sterilized with difficulty. At the first appearance of an epidemic which points suspicion to the water supply, care should be taken to sterilize all water used for drinking purposes. It should be boiled for at least half an hour in bottles placed in a kettle filled with water. A little cold tea or lemon juice added to the boiled water takes away the flat taste. A central water supply is gradually being recognized as a necessity in all large communities, for a badly situated or a badly managed well is too apt to become a source of epidemics. Wells. — In country places, which lack a central supply and where it is not always possible to have scientific supervision to insure purity of the water, especial care should be given to the location of the well; the site must be absolutely without question. Unfortunately rural wells are often a mockery of the laws of hygiene. Hence the school well should be a, model to the community. To inculcate this lesson in the children, on occasions it might be desirable to show a plan and cross section of a good well to the older pupils, and to explain to them the dangers of a bad location. Concerning a good situation for a well, the points are briefly these. If the ground has good filtration powers, a vertical depth of about 5 meters THE SCHOOLHOUSE 9 insures water free from bacteria; the filtration of water running obliquely to the well must also be considered. At all events, deep wells of at least 8 meters are superior to surface wells. It goes without saying that there should be no toilets, lavatories, or manure heaps nearby, or even within a radius of 10 meters. Wells should be dug to the depth of at least 5 meters, and the shaft should be water-tight. It is desirable to project the coping of the well about 30 centimeters alcove the ground; the cover also should be water-tight. It is better not to have the well-pipe- drop in the middle of the shaft. The spout of the pump should project beyond the well covering, and the trough to carry off the water should be water-tight and lead at least 5 meters away, so that there %hall be no soaking in of dirty water. Drilled or driven wells are to be advocated where the ground is adaptable. The school well has been discussed at length because investigation has proven that in rural districts it is frequently' found to be a menace to public health, and the opportunity of calling attention to this evil may often ])e presented to those informed on this important matter of hygiene. Drinking Fountains. — The drinking fountain is next in importance to the water supply. In most schools the only provision made is the common drink- ing cup, in some a few tum})lers are provided for a whole class of children. It will generally be found that school children rarely rinse the common cup ; or if they do, the operation lacks thoroughness. The saliva adhering to the rim can only be efficiently removed by a strong flow of water, and there is little inclination 10 SCHOOL HYGIENE on the part of children to do this thoroughly and sometimes also there is a lack of time. The serious consequences can readily be foreseen; a child infected with diphtheria may spread the disease among those who drink after it out of the same cup. Individual drinking cups, one for each child, should be used in place of the common cup. For those who are too poor to buy a cup, some charitable provision might be made. This individual cup should be kept in the school bag or in a special place provided for it in the desk similar to that pro- vided for the inkstand, or else the cups should be left in a designated spot and numbered for identifica- tion, the younger pupils having stars, or a cross, or half moon to identify theirs. It devolves upon parents and teachers to instruct the children not to lend their cups to others. Where running water of sufficient pressure is avail- able, a drinking fountain may be set up, one that requires no cup, but from which the water gushes directly into the mouth when a valve is pressed, as shown in Fig. 4. When the child has finished drink- ing, he releases the valve and the jet ceases, but the water continues to flow below the valve, washing away the drops which have fallen back from the I Fig. 4, — A drinking fountain requiring no cup. THE SCHOOLHOUSE 11 mouth. In this way the lips of the drinking person do not touch the opening of the fountain which is below him in the depth of the basin. Fountains such as these were introduced into a Vienna school in 1906 on the occasion of an anniversary.* It is greatly to be desired that other cities will follow the example of this school by the introduction of equally hygienic improvements on similar occasions. In the United States fountains are used extensively as a result of the legislation wliich has been passed prohibiting the use of public drinking cups. While New Jersey, Florida and Indiana led the other states in this action against the common cup, there are at present more than a dozen states and fully as many cities which have done away with the use of public (Mips in schools. Construction. — There is no special need for dwelling upon the hygienic side of building materials or con- struction further than to say it is generally conceded that a cellar is desirable, though not absolutely neces- sary when there is a good foundation of concrete and floors which will keep out the cokl. It is well to pre- vent the rise of ground water in the walls by using layers of insulating nt^aterial in the foundation under the floors. Onl}^ dry and moisture proof material should go into the making of partitions. To get the necessary warmth and required freedom from noi^e it is best not only to deaden the beam coverings and flooring, l^ut also partly to fill up the intervening spaces. Certain newly devised building materials, *The model was a good, cheap one invented by Oreffice of Padova (Italy). 12 SCHOOL HYGIENE made of iron and concrete, are admirable for filling in. House fungus, the presence of which may be- come unhygienic and a source of expense when it requires removal (though not considered a poisonous growth) may be avoided by the use of thoroughly dried wood. Staircases which are absolutely fireproof both as to the treadway and its covering are essential. The new schoolhouse should not be thrown open for use until it is thoroughly dried out. Schoolhouse Entrance. — No schoolhouse, not even the smallest, should discharge its pupils directly into the street. In large schools, at least one entry for every three hundred pupils is desirable. In the entry room of every schoolhouse, large enough provision should be made to have the pupils wipe their shoes thoroughly before coming into the classrooms. Since the prevention of dirt in the house is easier attended to than the operation of cleaning, the pupils should become accustomed to make systematic use of the dust mats, etc., from the beginning of their schooling. Waiting Rooms. — Waiting rooms situated near the entrance are most desirable in city schoolhouses, for the convenience of those who escort the children to and from school. Cloak Rooms. — Of especial concern to the health of the school population are the rooms where wraps and umbrellas are deposited. If these articles are kept in the schoolroom itself, the warmth of the room and the dampness of the clothing together will soon cause deterioration of the local atmosphere. It is by all means desirable to have a special cloak room. Such accessory rooms have gradually become an acknowl- THE SCHOOLHOUSE 13 edged necessity in many countries. (See Fig. 5.) It is also recommended that in the cloak room provision be made for drying the damp footwear of the children and that each child might have a pair of dry shoes and stockings for change. Cloak rooms should, of course, be well heated in winter and well ventilated at all seasons; children who come early to school might be appointed to attend to these conditions. Hallways may also be used as wardrobes. •*\\\\ CLOAK Fig. 5. — Ground plan of a one-room Danish schoolhouse. Lavatories. — The cloak rooms found in the London schools deserve special commendation, because of the hygienic provisions they make for the cleanliness of the pupils. As the children come in, a teacher inspects them, and those who are in need of soap, water and a towel, are accorded these privileges. There are four washstands for every one hundred children of the school. (See Fig. 6.) In respect to that much in- 14 SCHOOL HYGIENE volved question, the hygiene of the towel, we should like to suggest that in schools not frequented by the very poor, each child should bring his own towel with him to school and carry it home to be dried. The very poor children could have towels given to them. Indoor Playgrounds. — School children should have a well-warmed room in which to spend the recess in inclement weather. (See Fig. 8.) As it is generally admitted that the needed amount of play space for each child, even in large cities, is at least one-half J Boy's Stairs Boy's Stairs .10 40m Fig. 6. — Plan of the first floor in a London public school accom- modating twenty classes. square meter of space, the amount necessary for this purpose can easily be computed. The free space thus available for the recreation of the children may be augmented by the wardrobe space, i.e., where the clothing is hung in the corridor in a wire cage open to the air. On the whole, it would seem to be wise to make the corridors only just as wide as is absolutely THE SCHOOLHOUSE 15 necessary, and the stairways not more than a meter in width (but increasing the number of such stair- ways), in order that the common recreation hall for all the classes on a floor may be as large as possible. Fig. 6 shows a hall of this character. It admits of easy supervision and may be used as an assembly room by a number of classes. APPARATUS ROOM lom Fig. 7. — Ground plan of a public school (32 classes) in Frank- fort, Germany. Arrangement of Rooms. — In the arrangement of the rooms within the schoolhouse, the classrooms must necessarily receive first consideration with respect to good light and a quiet location; passageways, stairs, offices, showrooms for collections of educational appliances, reception rooms and assemblies take second place. The indoor recreation rooms, as well 16 SCHOOL HYGIENE as the playgrounds, should be located so as to be easily supervised. Most unfortunate is the location of a schoolhouse in a crowded quarter, where almost all space is used for stairs and classrooms; greatly to be recommended on the other hand is the type of schoolhouse with classrooms on only one side of the corridor as shown in Fig. 7. In the following paragraphs a few selected ground plans for different types of schools are described. Ground Plans. — One of the most significant means for the dissemination of education is the one-roomed schoolhouse of rural districts. The plan of a school- house of this type officially recommended in Denmark is shown in Fig. 5. Observe the small 'number of children accommodated, and also that the boys and girls have separate cloak rooms. The house is in- tended as a home for the teacher and his family and contains a guest chamber in the attic, besides other living rooms and premises not shown in the sketch. Fig. 6 shows the ground floor plan (girls' floor) of a three-storied London public school accommodating twenty classes. The cloak room with lavatory and hall, where children can gather in bad weather before morning instruction begins, will be seen. The boys' floor, the stairs leading to which are shown, is above, while the kindergarten is below. Fig. 7 shows the left half of a ground plan of the girls' division of a four-storied public school, accommodating altogether thirty-two classes, found in Frankfort-on-the-Main (Germany). It will be observed that the window posts are narrow and that the classrooms are situated THE SCHOOLHOUSE 17 10 50ni Fig. 8. — A school and its grounds at Viroflay, France. 2 18 SCHOOL HYGIENE only on one side of the corridor, the gymnasium being only one story high. In France and England, and recently in Germany and Italy, the kindergarten has been combined with the elementary school. Fig. 8 shows a ground plan of a French group of schools (groupe scolaire). The elementary school is designed for three boys' and three girls' classes, and the kindergarten is in the rear. The upper parts of the buildings not shown in the sketch contain janitor's quarters, which are accessible by a separate stairway. Of special interest are the covered outdoor recreation spaces and the playgrounds. The Classroom. — From a discussion of schoolhouse plans in general, we turn to a consideration of the individual rooms used for educational purposes, including the gymnasium. Of these, the ordinary classroom is the most important. It is the one room in the school building where the pupil spends most of his time and performs most of his tasks, including reading and writing, accomplishments which under unfavorable conditions may injure his health. A com- plete understanding of the hygienic requirements of this room will be gained only after a detailed considera- tion of lighting, airing, and heating. 2. Lighting Hermann Cohn of Breslau, who for years worked in the interests of school hygiene, once said that a school- room can never have too much (diffused) light. The light of the sun is not only an aid to cleanliness and a foe to pathogenic micro-organisms, but the degree of THE SCHOOLHOUSE 19 sunlight also has important bearings on the general health of the body, as regards its functions of respira- tion, digestion, etc., as well as in the preservation of unimpaired eyesight and good posture. At a distance of 2 meters from a window, the light is only about 80 percent as bright as at 1 meter, at 3 meters only 50 percent as bright. A realization of such values brings out the necessity for special study of how to light the schoolroom so as not to injure the sight of any of the occupants. Light Measure- ment. — The amount of light in different parts of the room can l)e ascertained and ex- pressed in figures by means of the photo- meter. It can be calculated in meter- candles, 1 meter- candle equalling the intensity of light which the flame of a standard candle throws on white paper at a dis- tance of 1 meter. The usual requirements are 25 meter-candles measured in white light. An excellent, though costly photometer, is that of Weber; one designed by Wingen is smaller and simpler but not so exact. The latter (Fig. 9) consists of a little box about a span high in which is a benzine flame B, observed through S. The height of this flame is Fig. 9. — Photometer by Wingen. 20 SCHOOL HYGIENE regulated by means of the knob K, so that the amount of light cast upon the prism within the box at C (observed at M) can be made to correspond with the daylight cast on the pupil's desk at C" . Since the actinic values in the benzine light and daylight are not the same, it is necessary to compare the red part of each (R, the red glass) , and afterward to mul- tiply by a factor, in order to obtain the equivalent candle power of the daylight. Angle of Light. — There are also instruments for computing the angle of light falling on a pupiFs desk. By dividing the equator S of a globe into 360 degrees and constructing a square over each degree, or a '^ square degree," we have over 41,000 such square degrees for the whole of the globe. If one plots the number of square degrees of sky sending light on a horizontal sur- face, the so-called room angle is ob- tained, of which 50 degrees are demanded for each pupil's place. No computations are necessary with a little apparatus made by F. Pleier in Karlsbad.* It consists of a pocket camera (Fig. 10) in which a glass screen is placed between the plate and the lens. *lDstitut, F. Schmidt & Haensch, Berlin. Fig. 10. — Pleier's camera for measur- ing the angle of light. THE SCHOOLHOUSE 21 This screen is made up of parallelograms each corre- sponding to 4 square degrees; but these parallelo- grams are of different sizes having been graduated according to the relative values of the light, corre- sponding to a greater or less angle of incidence. If the camera is placed on the child's desk and directed toward the light, a photograph can ])e taken like that of Fig. 11. It is possible in this way to estimate the light coming from four windows. In this picture the number of square de- grees of direct daylight, as well as reflected light is given, and all without further reck- oning, as the correct room angle is obtained because the differing light values in connection with the angle of incidence are already taken account of by the screen within the camera. By means of the photometer, especially by means of the apparatus to measure the room angle, it is possible to determine whether a room has sufficient light. Unfortunately, if this is found not to be the case im- provement seldom follows. As a matter of fact, the many badly lighted classrooms still in existence date from the time when hygienic matters were not considered; in such rooms children have suffered for decades. But as far as the building Fig. 11. — Photograph taken with tlie PI c i o r canuM-a for ineasuring the angle of light. 22 SCHOOL HYGIENE of new schoolhouses is concerned, our whole aim must be to see that badly lighted rooms shall no longer be erected, and this ideal does not involve the question of cost as an insurmountable difficulty. Still a school plan based on the most finished scientific methods may not be attainable even in large cities, not to mention the smaller towns, and on the other hand it is a fact that up to the present for various reasons the exact and scientifically incontestable minimum amount of light Fig. 12, — Measuring the light on the desk farthest from the window. necessary from the hygienic point of view has not been stated. But the following is a simple rule which any rural carpenter might follow when constructing a new school building. Thp rule merely demands direct daylight even on the desk farthest from the windows. Fig. 12 shows a carpenter's cross-section cut of a schoolhouse and one wall of a nearby building. The house shows the outside walls, one room with a window and a desk in the farthest corner. A line, THE SCHOOLHOUSE 23 o — a, is drawn from the pupil's desk to the top of the window and extended outward; another line, a — u, is drawn from the top of the nearby building or whatever obstacle cuts off the light, and is brought to the pupil's desk. The angle between these hues shows the path of direct light to the desk. This aim of direct daylight on the desk of the pupil in the farthest corner of the room should be possible even in the largest cities. If it can not be achieved for the lower stories, these should not be used for school purposes, but rented out, or other disposition made of them. It need hardly be mentioned that in planning a schoolhouse, the building laws of the com- munity shoukl be carefully considered, so that it may not happen that well-lighted rooms will subsequently be deprived of their light through the erection of towering structures in the neighl)orhood. Direction of Light. — When schoolrooms are lighted by windows on only one side, as is usually the case, the windows should by all means be situated to the left of the pupils, for light coming from the left is most desiral)le for writing. Lighting from the front is not to be considered; if the light comes from the rear it blinds the teacher and increases the difficulties of supervision, but lighting from high up is not to be condemned and msiy have the advantage of illuminating the blackboard in front of the pupils. The desirability of light coming from both sides is a matter of dispute. If the aisle is located to the right of the room, the light from that side, even where there are windows to both sides, can not be as strong as that coming from the loft. In so far as the space on the 24 SCHOOL HYGIENE righthand wall is not to be utilized for a door, or possibly for radiators and ventilators, it might be desirable to plan for windows above, in order to secure good ventilation. No disturbing shadows will be thrown by windows thus located. Windows. — The matter of the schoolroom window is not a simple one from a technical point of view. It goes without saying that the windows should be divided symmetrically and the spaces between should be as small as possible. A glance at the windows of the classrooms in Fig. 7 shows carefully studied construction. Broad frames not only take away considerable light in general, but they also especially darken the places of pupils sitting beneath, and much more so if the spaces between are used as wardrobes. Furthermore, the window must be rectilinear, rounded or pointed windows being entirely out of place in the classroom. The transom of the window should extend as far as possible to the ceiling, as in this way the angle of incidence of the light rays and the bulk of the direct beams will be increased. Window frames and intersections should be as small as possible and painted white. Window panes absorb quite a good deal of light, as Selter, in Bonn, has proved by his experiments; and this is particularly true of dusty windows. For this reason, the windows of the school- room should be washed frequently. It would be well to have double windows to insure warmth in winter, or at least in single windows to have two thicknesses of glass 5 centimeters apart. But the schoolroom window must also serve the purpose of airing. It is therefore necessary that THE SCHOOLHOUSE 25 the windows should be such as to admit of being opened quickly and easily, especially the upper parts; the lower sections when opened must not hinder passage.* Sash windows are better than French windows for the schoolroom. Curtains and Shades. — In connection with the high and large window, arises the problem of curtaining or shading with a minimum loss of light. The shades must often be drawn when the window is open, and they should be adapted for this use; and they should be so arranged as not to admit ol)lique rays of light at the sides. The shades when not in use should fit into an opening made in the window sill, which is preferal)lc to the folded shade at the top of the window where it obstructs necessar}% light. Shades which can be rolled up tightly are not objec- tionable when placed at the top of the window. The shade material is of importance; it must be of good quality, plain (not striped), not too thick, white or cream-colored. Fine white shirting, light in quality, is the most suitable. The shades should be arranged in such a way that they can easily be taken off to be cleaned. Light Reflectors. — It might be possible to improve the hghting of old, badly built schoolhouses by re- constructing the window spaces, making them broader and higher, but because of the prohibitive cost, this is rarely undertaken after a schoolhouse is once built. Improvements in lighting may also be affected by the use of glass reflectors, such as the American * (The windows which are considered here are of the casement order exclusively used in Europe. Translators.) 26 SCHOOL HYGIENE Luxfer prisms, or the French verres prismatiqueSf which are somewhat cheaper than the first named reflectors or mirrors. But in order to make these reflectors really serviceable, they must be kept absolutely free from dust. Artificial Lighting. — The discussion of lighting thus far has been with reference to daylight, but un- fortunately it is often not possible to depend upon that means alone, and artificial lighting must also be considered for the schoolroom. In the home it is possible to have the lamp on a table, to the left of the reader. It is not possible to give every pupil in the schoolroom an equal advantage, for a crowd of children must all have a free line of vision to the blackboard. How many children in brightly lighted rooms do we not see at work on their blank books in the deep shadow made by the book or the hand; that is, in a flood of light there are shadows just where the greatest intensity of light should be! Erismann of Zurich has found that an occupied desk did not have quite six percent of the light that fell on it when the desk was empty. But apart from this, unfortunately the light itself is not always of sufficient intensity, or it falls so that there is a glare in the eyes of the pupils as they glance at the blackboard. Further, the strength of the light depends as much on the distance as on the side from which it comes. It is also worthy of mention that some kinds of light have bad effects on the air of the schoolroom by generating noxious gases. Electric lighting, as well as lighting by Welsbach) lights, has done much to obviate such disadvantages. THE SCHOOLHOUSE 27 Kerosene or alcohol lamps are not desirable for school use because they require too much atten- tion. Modern lighting has achieved its greatest success in the electric bulb, which has enormously increased the intensity of available light with purity of the air and a minimum degree of heat and dryness. Diffused Lighting. — But the difficulty of overcom- ing, with any kind of direct artificial light, shadows made by the hands and bodies of the pupils still roinains. This disadvantage has been met by Jasper of Paris who dis- , covered a method for diffus- /"^j"^--^ ing light. For this plan of lighting, the ceiling and the upper third of the walls are painted a clean white. The lights are hung a short distance from the ceiling, about half a meter, and each lamp has underneath it an opaque shield which re- flects light on to the ceiling or on an upper shield, that Fig. 13.— Diffused lighting is, the lamp sends its light by Welsbach lamp, upward not downward. The utility of such lighting has been demonstrated in many localities. Fig. 13 shows a lamp designed by Egloff in Turgi (Switzerland). The advantage of indirect lighting is this, that the ceiling of the room, as well as the upper walls, throws the light in all directions, and while the intensity of light reaching 28 SCHOOL HYGIENE the desk is somewhat diminished because a part is absorbed, the distribution is much more even than in direct lighting; and, what is still more important, there are no shadows. Such diffused lighting resembles very closely the daylight of a clouded sky. Be- cause of these advantages, indirect or diffused light- ing is being rapidly adopted in all places where the formation of shadows is a handicap. In the use of this light, at first the absence of shadows is confusing. That less light is needed has been demonstrated by the experiments of Prausnitz in Graz (Austria). In a classroom measuring 105 square meters, where the pupils were receiving instruction in drawing, 18 Auer (Welsbach) lamps gave amply sufficient diffused light for the finest work. In the ordinary classroom there should be one Auer lamp for every 10 square meters of floor space; under such conditions, the light will be better than that supplied by an equal number of lamps with direct lighting. One dis- advantage, however, consists in this, that in dusty, sooty localities the white ceiling and walls, as well as the reflectors, quickly accumulate dust. The difficulty of cleaning is not insuperable if the person in charge of the cleaning is supplied with a small mirror adjusted on a long pole; but unfortunately, few janitors will bestow any care on surfaces over three or four meters from the floor. The lighting, of course, suffers a steady decrease in intensity as the room be- comes dingy. Direct Lighting. — Where direct lighting is used, lamp shades are necessary. It is well to have the shades large. If electric glow lamps are used they may THE SCHOOLHOUSE 29 be fixed without shades directly on the ceiUng, for though the intensity of Hght is lessened somewhat by the increased distance, the diffusion is better and the shadows are less pronounced, as is proved by the experiments of Reibmayr in Innsbruck (Austria). With Auer lights and direct lighting, eye shields should be used.. Flickering lights should never be tolerated in schoolrooms. Gas Lighting. — -Gas lighting is unsatisfactory be- cause of the danger of unsuspected leakages which may deteriorate the air of the rooms and constitute a money loss as well. Absolute freedom from leakage, however, may now be assured by a small, inexpensive apparatus by means of which a daily test can be made. It is well to insert cocks at convenient places ^hen the building is in course of construction, as it may be practicable to turn off the gas supply in unused portions of the building and during vacations, thus preventing possible leakages. The main cock should be in an accessible place, not in the cellar. 3. Ventilation and Heating Condition of the Air. — Dry air is composed of about 79 percent nitrogen, 20.94 percent oxygen and 0.04 percent carbon dioxide. The air as it comes from the lungs has about the same quantity of nitrogen, 16.03 percent of oxygen and 4.38 percent of carbonic acid gas. Its oxygen content has thus been reduced about 20 percent, while the carbonic acid gas has in- creased 100 percent. In addition, small quantities of volatile substances have accumulated which tend to 30 SCHOOL HYGIENE render a well-filled room unpleasant if there be no ventilation. The offensiveness of the room is in- creased when the occupants have not kept themselves clean nor provided themselves with clean undergar- ments (cf. school baths p. 63-64). It is difficult to demonstrate the presence of these volatile organic stuffs in chemical terms; hence von Pettenkofer in Munich took the quantity of carbonic acid gas in a room as an indication of the quality of the air. He claimed that air is injurious when the ratio of carbonic acid gas is over 1 per 1,000. Tests made in badly ventilated schoolrooms have revealed the presence of 14.8 parts of carbon dioxide to 1,000 of the air in the room. In a crowded, unventilated room the carbonic acid increases after only twelve minutes to the maxi- mum, 1 to 1,000. This applies to a room where 4 cubic meters of air space are allowed for each pupil. It must be mentioned, however, that von Petten- kofer's conclusions are open to question and that the experiments of Fliigge, made in his laboratory in Breslau (Germany), have shown results which are worthy of consideration. The human body constantly generates heat and must lose this heat if it is to maintain a constant temperature; i.e., it carries on unconsciously a system of loss of heat by conduction, radiation and water evaporation. When there are other bodies in close proximity, and these are also giving off heat and water at the same time, as we find in a schoolroom, the process of heat regulation is rendered much more difficult than it would be in the open air. The result is that in crowded rooms, heat accumulation takes place within the body, which in THE SCHOOLHOUSE 31 turn produces pathological symptoms, such as a sense of oppression, and even syncope. The ex- experiments of Paul and Ercklentz in Breslau (Ger- many) have shown conclusively that with a high temperature (up to 30 degrees centigrade) and a high degree of humidity, the individuals in his test chamber soon showed these ill effects, while with a low temperature (below 20 degrees) and average humidity, such symptoms were altogether absent, even after two hours' stay in this atmosphere, notwithstanding the fact that in both cases the carbon dioxide content of the air was greatly increased — in the first instance to 13 per 1,000, and in the second as high as 16 per 1,000. Hence it is clear that for general school conditions the temperature of the classroom should not be above 20 degrees centigrade, at which temi^erature the body can carry on its processes of regulating heat most effectively. But even when the temperature is kept at the recognized standard, occasional thorough airing of the classroom should not be regarded merely as a secondary need. The increased carbon dioxide in the atmosphere decreases the exchange of air within the lungs. The work of the lungs is therefore lessened, especially as the children remain inactive. As the children sit quietly at their desks, they are constantly breathing in a good amount of the air which has just been exhaled, because respiration for all of them is on practically the same level within the room. For this reason we need fresh outdoor air. The presence of poisonous substances in expired air has not indeed been conclusively proved, although the 32 SCHOOL HYGIENE investigations of Helwig of Zinnowitz (Germany) have shown that the bad air of unventilated, crowded rooms seems to have an influence on the red blood corpuscles, giving the cells an appearance of under- going degenerative changes. These characteristics of the red blood cells are not present under favorable conditions, i.e.j after bodily exercise in the open air. The investigations of Lobsien in Kiel (Germany) have likewise shown that breathing exercises have a favorable influence upon mental activity. As has already been mentioned, it is undesirable for children to sit in the schoolroom before the beginning of the session, when they can move about in a recrea- tion room, or better yet, may be exercising outdoors, as has become the rule in England. Dust. — Dust is another source of air deterioration and one which is being increasingly recognized. It is not well to keep children sitting for a long period of time, and yet when they move about the room they must stir up dust; for this reason, again, they should not come into the classroom long before school. Rooms must be cleaned and aired as often as possible; the air of even a clean room holds hundreds of organ- isms, while a dirty room contains hundreds of thous- ands to the cubic meter. The evil conditions that exist in many classrooms, so far as the presence of dust is concerned, have been brought out by the numerous investigations that have been made. Meyer in Leipsic, for example, found that with taking particular care to keep the shoes dusted, the quantity of dust which had accumulated from one bi-weekly sweeping to another equalled 191 grams in dry weather and 327 THE SCHOOLHOUSE 33 grams in rainy weather. Of the swept-up dirt a large part sinks to the floor after a quarter of an hour, but the finest dust requires from half an hour to an hour and a half to settle. In this dust disease may lurk. It is a noteworthy fact that many hygienists who in- vestigate the dust problem select the school as the most productive breeding place. From what has been said about the relatively long suspension of the fine dust particles in the atmosphere, it follows that dusting of furniture should not immediately follow sweeping, and also that the sweeping (which should never be dry) must not l^e undertaken shortly ])efore schooltime. Airing. — It is clear that the airing of the school- room bears an important relation to the health of its occupants. To have a constant interchange of air in the classroom would necessitate so large an accession of fresh outdoor air as to make the move- ment of air in the room plainly perceptible. This is mostly the case with artificial ventilators, and for that reason they are not always practicable. In the dwelling house with its relatively small number of occupants, conditions are different; there untight windows and doors often create unobserved channels of air. Even an unused stove and porous walls in themselves are ventilating agencies, which can be only slightly effectual in the case of the school. Direct airing is admirable, and can be readily achieved by opening doors and windows while the children are sent into the corridor. In cold weather a rapid exchange of air takes place in consequence of the difference of temperature. The air does not 34 SCHOOL HYGIENE contain much heat, whereas the furniture of the room and its walls contain on the average about 1,000 times as much heat in the same cubic space; the room loses very little of its stored heat during a minute's exposure to the cold and a minute of thorough airing, or even half a minute, suffices in very cold weather to effect a renewal of air. If the heating is good, the remainder of the recess time of say a dozen minutes will be sufficient to warm the air; the breathing of colder, fresher air in a room where the walls and furniture are still warm does not jeopardize the health. Valuable experiments with this simple method of ventilation have been carried on by Dankwarth and Schmidt of Dresden. Ventilation. — During the summer or in warm weather, the windows of the schoolroom can well be left open if the situation of the building warrants it, but in cold weather artificial aids to venti- lation are necessary. The best is the so-called mechanical ventilation, that is by means of an ap- paratus worked by motors. This type of ventilation is practicable where the power, ^.e., electricity, is not too expensive. It is being used extensively in the United States, even in small schools, and also here and there in the higher schools of Europe. As has al- ready been mentioned, this method of ventilation is in use in the Drontheim pavilion school. In all artificial ventilation to bring in fresh air is preferable to taking out vitiated air by suction, for in the latter case the source of the incoming air is questionable. Even a small school can have its ventilating system THE SCHOOLHOUSE 35 and, if the directions for operation are to be found posted conveniently in the schoolhouse, there should be no trouble in management. One method is to have an air pipe, leading say from a garden, where the best air may be had, with the opening protected against mice and cats by a screen. This air pipe (L. Figs. 14 and 16) enters a stove, or more correctly speaking, enters between the stove and its outside casing or mantle, where the cold air be- comes warmed, and then flows into the room. The heated air being lighter naturally rises in the room and constantly re- places the colder strata. The used air in the room which is colder sinks and escapes through an opening in a corner near the floor (W, Fig. 15), not near a pupil's desk. This opening leads to a conduit going to the roof, where the used air finds an out- let. Of course, in summer the conditions are reversed; the clean air is then the cooler air, and the opening for the escape of the used air should be near the ceiling (S, Fig. 15). This vent (S) open in summer should be closed in winter when W is in operation for the exit of used air. This method of ventilating by means of temperature differences unfortunately has its weak side. It works Fk;. 11.— ihe Aleid- inger stove. 36 SCHOOL HYGIENE admirably in severe weather when the temperature contrasts are sharp, sometimes too well, because so much air comes in, that the opening will have to be closed to save using so much coal; but when little heating is required, the amount of fresh air admitted by the ventilator will naturally be correspondingly small. Moreover the upper vent (S) is of use only when the air of the room is warmer than the air out- side. It might be possible during warm weather to warm the air in the conduit which carries out the foul air by means of a gas jet or a lamp, thus aiding the Fig. 15. — Ventilation by temperature differences. process of air exchange. Since the air in summer streams in at doors and windows, the ventilation canal L (Fig. 16) could be dispensed with entirely without spoiling the air of the room, for if it were open it would simply admit air which would immediately escape through S, without circulating in the room. Scientific ventilation demands that the air in dusty places shall be filtered. Heating. — The essential requirements of all school stoves are that they shall be safe, shall not give too much heat, shall warm quickly and evenly, and be an aid to ventilation, not a source of bad air. To avoid the latter possibility, care must be taken to see that THE SCHOOLHOUSE 37 no part of the stove, including the oven, becomes too hot, for overheating causes deterioration of the air through action upon any dust which may fall on the stove or which may linger in the atmosphere about the stove, as has been demon- strated by Nussbaum in Hanover (Germany) and by von Esmarch in Gottingen (Germany). This deteriora- tion begins at a temperature of 70 degrees centigrade. Stoves. — Of the many dif- ferent kinds of stoves adapted for the schoolroom the Meid- inger deserves description. Figures 14 and 16 illustra,te its construction. There is acjd- indrical body with a firebox, Fu, composed of skeleton iron rings, a neckpiece H, with a door, the opening of which can be regulated laterally to con- trol combustion, and which can be opened from above like a lid for the removal of ashes. The coal (egg or small coal) is put in at F and lighted while Z is open. When the coal burns F is to be closed and Z opened laterally to regulate the heat as it is wanted. M and M' are the tin casings between which the warmed air ascends; if the vent S is closed. Fig. 16.— The Meidin- ger stove, interior view, showing ventilating sys- tem. 38 SCHOOL HYGIENE FA will be open and fresh outdoor air then comes through the conduit L; this air circulates in the space between the stove and its casings. If S is opened, then the door FA closes the conduit L and only room air circulates between M and M', i.e., there is no ventilation whatever. This latter procedure, therefore, should only be undertaken before or after school hours; in very cold weather the regulator Z may be almost wholly closed after school ses^on, leaving only a very small slit-like opening so that the fire may burn the whole night through. This will insure a warm room in the morning, with a minimum consump- tion of coal. K is a little ventilation box which when open sends the air of the room directly into the chimney. This practical ventilating stove, which never needs cleaning for soot, may also be so placed that the firing and ventilation can be controlled from the corridor, as shown in Fig. 15, with the advantage that no fuel or ashes need be brought into the school- room. In that case, the outdoor air comes in through an opening in the outside wall, as shown in the plan, and enters the room at L (Fig. 15). To secure good management of the Meidinger stove, the directions for its operation should be easily accessible. Where the heating is by stoves, care should be taken in planning the school building to have a separate chimney for every stove. Gas Heaters. — The advantages of heating by gas have of late brought this method into popularity even in schools. The advantages are, cleanliness, convenience, and the ease with which gas heaters may be regulated as well as started and shut off; but, THE SCHOOLHOUSE 39 on the other hand, the cost of gas heating is often prohibitive. The ordinary gas stove used in the home is not adapted for the schoolroom, but a number of specially constructed heaters exist, all based on a special scientific principle. The attempt should not l)e made to introduce gas heating into old school- houses. Gas heating requires special, very narrow chimneys (10 centimeters wide) and the walls of Ficj. 17. — Steam heating. the chimney must be constructed of building materials especially adapted for this purpose, as the combustion of a oul:)ic meter of gas generates somewhat over one kilogram of water in the form of vapor which contains corroding chemical substances. With the old, wide chimney there is a possibility of the vapor settling on the walls, saturating them, and in combination with other products starting disintegrating processes in the chimney. 40 SCHOOL HYGIENE Central heating by steam or hot water is the most practicable system for large schools. Steam Heating. — The principle of low-pressure steam heating is illustrated in Fig. 17. There is a boiler (V) in the cellar, from which pipes (M) lead to the various rooms, and radiators (R) give out warmth in the rooms. When the steam has again been pre- cipitated into water, it descends by means of other pipes (broken line). It is also possible to elaborate this system into the low pressure hot-air steam heat- ing by using the steam from the boiler in the cellar to warm a big heater which receives fresh outdoor air through a vent, warms this air and sends it by conduits to the rooms. In particularly cold rooms, separate heaters, all supplied from the same boiler in the cellar, may be set up. This system has re- placed the old-time hot-air heating, which possessed the disadvantages of carrying, in addition to the warmed air, various gases generated by the burned dust, and when the brickwork of the furnace became loosened, also smoke into the room. Ventilation, however, is nicely secured in the case of low pressure steam heating by means of fresh-air conduits which bring the air from out of doors directly to the registers, where it is warmed and sent off into the rooms. This plan does away with the old difficulties ex- perienced with the combined hot-air heating and ventilation. Hot-water Heating. — The requirements for hot- water heating are similar to those for steam. As shown in Fig. 17, the water is heated in the boiler, it ascends by pipes to a tank on the upper floor, THE 8CHOOLHOU8E 41 goes from there to the rooms, giving off warmth, and sinks back to the furnace. The advantage of the hot- water system is, that the radiators retain their heat longer than with steam heating; but the cost of in- stallation is higher, and there is the possibility that the water in tlie pipes may freeze in winter, es- pecially during the Christmas vacation. Recently a device has ])een invented for the more rapid cir- culation of the water in the pipes. One point in connection with central heating is important; there must be no niggardliness or stinting in installation. Furthermore, the person in charge of the heating should be Tjompetent and intelligent, per- manently emi)loy(Ml, not one temporarily engaged who is obliged to seek other work in summer, l^etter employ a man the whole year, in summer time for cleaning in the schoolhouse, and engage a new person for cleaning purposes in the winter. To achieve the best possible management, the heating and lighting arrangements should be sul)ject to the direction of one who can give intelligent and expert supervision, as for instance, the instructor in physics. The com- fort of the school population depends upon properly managed heating, lighting and ventilation, and the significance of these from the standpoint of health is paramount. 4. The Classroom and Its Equipment Much of what has been said before underlies, rein- forces and will be repeated to good purpose under this heading. The whole question of classroom arrange- 42 SCHOOL HYGIENE ment is so involved and interactionary that it is not always possible to isolate and discuss separate aspects of the problem. The most serious hygienic consideration with regard to the school is this, that a relatively large number of individuals must be confined for a considerable period of time in one room. When we ask, what shall be the size of that room, the answer hygienically con- sidered must be, the larger the better, because of the better air. But practically, the size of the classroom is determined by the following conditions: the carrying capacity of the instructor's voice, the distance at which the desks can be placed from the blackboard, and the number of pupils which a teacher can instruct. The width of the room is controlled by the amount of light which penetrates to the farthest desk. The greater the width, the higher must be the ceiling, but the higher the room, the more difficult it will be to heat, and the greater will also be the cost of construction. Size of Classroom. — Considering all these condi- tions, it is safe to conclude that a classroom 9 meters long, 6 meters wide, and 4 meters high, is most practicable. In a room of these dimensions 50 pupils can be seated in good-sized, two-seated benches (cf. p. 89, also Fig. 18) ; that is really a large number and a greater can not be accommodated with comfort. Un- happily, conditions as we frequently find them lapse far below this ideal, to the detriment of teacher and pupils. In many highly cultured communities, mat- ters of expense and equipment are still patterned after the demands of a time which included no hygienic THE SCHOOLHOUSE 43 considerations. It is not always possible to recon- struct; hence it can not be too emphatically urged that in young communities which are still in the period of forming and developing their school systems, these matters should receive careful thought, in order that r-o L 0-5 5m Fig. 18. — Plan of a schoolroom witli benches each accomodat- ing two pupils. sufficient funds may be appropriated to carry out such hygienic plans. The most desirable ratio of length to the width of the schoolroom is 3 : 2. Of course, the limit of 9 44 SCHOOL HYGIENE meters for the length of a room applies only to class- rooms where the voice of the speaker plays the im- portant role; it does not hold for rooms where draw- ing is taught or for gymnasiums, where height and width are more, or at least equally important. Walls and Ceiling. — All corners, those of walls and ceiling, walls and the floor, should be rounded, in order to facilitate cleaning. The walls should be tinted a neutral tone, preferably a light green, the upper third whitened to augment reflected light, and the lower section, about IJ meters from the floor, finished in a durable material, for instance in tiling, as is done in London schools, or in cement, which may be painted with oil paint. The ceilings should be pure white. A preparation can be used for disinfecting the walls that is said to retain its efficacy for a considerable period. Floor. — The floor should be durable, well joined, not dust retaining, and easy to clean. Soft wood is to be condemned; it splinters, gets into the mops, and is a continual harborer of dust. Hard wood should always be chosen. Prepared beech wood and Ameri- can pitch pine are to be recommended; they are cheaper than oak, which, of course, is the most durable of all. When laid in the usual mosaic pattern these woods will give good wear. If the floor planks have joints which do not fit tightly, the yawning places should be scraped and trowelled with a mixture of fresh curds and slaked lime in the proportion of five to one. The result is a casein cement with lime, which is as hard as stone, and impermeable to water. Any coloring, for example, ochre, may be added. THE SCHOOLHOUSE 45 Unless this is done, the openings will harbor moisture after every cleaning, creating a situation favorable for the breeding of bacteria and vermin. Ordinary wood floors require surface treatment. The cheapest way is to have the floors thoroughly washed and dried and then painted with a thin coat of coal tar. This tar can be procured at any gas plant and can be applied after warming over a gentle flame, not more than 40 degrees centigrade, and since it must have that temperature when being applied it is best to keep the vessel during use in a kettle of water at 40 degrees. As the tar retains its odor for some time, the work should be done during a school vaca- tion. The oiling of floors is to ])e recommendecl, for good specimens of dustless oils have proved effectual in holding down the dust, which the movements of the children otherwise keeps in circulation. In clean- ing, the dust is swept into little balls by means of a hard broom. The oiling must be renewed three times a year or oftener if there is a great deal of dust. But notwithstanding the great hygienic value of oiled floors, they are not popular with women teachers who wear long skirts. This nuisance to the teachers could be avoided in some measure if a definite area around the teacher's seat were left free from oil. Again, footprints show very easily on the clear surface of the corridors. Because of these drawbacks, floor coverings such a Xylolith or linoleum are sometimes chosen. Xylolith would serve the purpose well for it is able to withstand wear, but it is not a good conduc- tor of heat and therefore makes the floor too cold. Linoleum, which is a mixture of cork and oxydized 46 SCHOOL HYGIENE flaxseed oil with resin and coloring matter added, makes a very good floor covering, but it is expensive and it requires care: the padding underneath must be very smooth and quite dry and the linoleum, which should be of a good firm quality, must be absolutely dry before it is laid. The School Desk. — The bugbear of school hygiene for a long time has been the school desk, or the desk form, as it is called in England. Naturally, the first requirement is that the desk shall be adapted to the user and yet allow him a good deal of freedom in movement. The child must be able to assume a freer posture in reading than while writing, when he must necessarily be in a somewhat cramped position; he must be able to stand up and sit down with comfort, to get in and out without difficulty. These matters are of prime importance. But the attempt to enforce good posture solely by means of the school desk must be abandoned at the outset. The desk should not have sharp corners, which may cause bruises. It should be such as not to render cleaning difficult, nor should the forms be of a shape to interfere with the teacher's vision of the pupils, and lastly, the desks should be practically noiseless. After conforming to these requirements, it is essential that the desk form does not take up too much room, nor must it be too expensive. , To maintain a sitting position for a long period of time is in itself unhygienic, particularly for children; to sit long in an upright position requires constant effort, even for adults, and the difficulty is increased when the child is sitting on a bench which is not suited FiG. 20. — Moulthrop movable and adjustable school chair, Model B, inaimfactiired by Langslow, Fowler Co., Rochester, N. Y. THE SCHOOLHOUSE 47 to his height. In consequence, he is obliged to as- sume positions which can not fail to be detrimental to health, i.e., the development of the thorax is hampered and there is interference with respiration, circulation of the blood, and digestion, besides possible injuries to the spine and the eyesight. It should be the serious aim of the school never to be the cause of any such injuries to health. To overcome the difficulty of long sitting it has been advocated that alternate sitting and standing be the rule in school, and certain types of German, French and American desks (cf. Fig. 20) which can be readily converted from sitting into standing forms are available. But long standing is even more fatiguing than sitting, and is not 1^ be recommended. Fig. 20 has a sliding desk top which can be pushed aside at will, thereby allowing the child to stand immediately and without difficulty.* Let us assume that a new schoolhouse is to be built on the site of an old one. In order to have the new desks of the right dimensions, the children of all classes ought to be measured before the desks are ordered, and the new school furnished with desks of various sizes to fit the children. At the beginning of the next school year, the previous assortment of desks in the rooms will probably not answer the purpose very well, the assortment of children will be differ- ent each 3'ear and there may not be as many chil- dren of a certain size as there were in the previous year. If one mixes them again in the second half ♦This model, the Moulthrop movable and adjustable school chair, is made by Langslow, Fowler Co. (United States), and is indorsed by Madame Montessori iu her school methods. 48 SCHOOL HYGIENE 8 175 and 6 year and compares their sizes with the various sizes of school desks, it will be found that a number of children in the age of rapid growing have grown out of their standard of desk. Even in small country towns the desks of the school should certainly not be ordered before the children have been meas- ured, and if possible, measurements should be made at the beginning and the middle of the school year. Un- fortunately the selection of the desk sizes is frequently left to the manu- facturer. Under favorable conditions a half yearly measuring of the school popu- lation and seating according to the re- sults found is excellent; it is a con- venient, easily to be obtained, and H{Bl26-13't ^^om the point of view of health a ^^^ A reasonable exaction. The work can ^-\,^ be done very quickly by means of a ?lZ6c.ni. measuring rod, which the author de- f I scribed in 1896 and recommended for manufacture. Fig. 19 shows one of these rods designed for use in the schools of Vienna. The measuring stick must have divisions marked off for the various sizes of desk; the teacher records opposite the name of the child the corresponding size of the desk. Duf estel of Paris has constructed a measuring stick which automatically records the height of the pupil in millimeters. If it is found that in one classroom there are desks 165-17^ Ibb-m Ikb-lbk 135-M Fig. 19.— Measuring rod numbered for the various sizes of desk forms. Fio. 21. — The "Princctoir' a(ljusta))lc desk and chair, niaiiufactuied l)y The New Jersey School-Church Furniture Co., Trenton, N. J. THE SCHOOLHOUSE 49 which do not fit the children in that room, the desks should be exchanged for others obtained from other classrooms. Adjustable School Furniture. — The ideal desk is one with adjustal^k! parts and which can ])e fitted to the child. Such single desks (Fig. 21 and 22) are used in many schools in Great Britain and the United States; or where their exclusive use is not prescribed, the requirement is made that at least one-third of the desks in the new school shall be of this type. Adjust- able school furniture has also begun to be introduced in Germany, and is being used in a small number of schools in conjunction with the older type of desk.* Desks which can be adjusted without a screw or key (Fig. 22) are better than those for which an implement is needed. One of the oldest adjustable desk forms is that put on the market by Hansen in Copenhagen; it has a movable foot rest to adjust the height of the seat to the body of the pupil, and a movable back to adjust the ''difference" and the depth of the seat. This type of desk has given good service in a number of schools of Denmark and received high commendation in a report of the Danish school health commission (1884). In secondary schools, where the classrooms are not always used for the same grade in succeeding years, or in schools where they are made use of for different purposes — for adult evening classes, assemblies or for * Adjustable desks are produced in Germany by Elsasser, Fuhrmann & Hauss, Kottmann, Lickroth & Co., Zachokke; in the United States by the New Jersey Sohool-Church Furniture Co., the American Seating Co., and others. 50 SCHOOL HYGIENE entertainments — the adjustable desk is by far the best, especially if it can be quickly arranged. A new model from a London manufacturer is made of wood, is adjustable by means of springs in the legs of the desk and bench, and is arranged so the top can be pushed away or brought nearer to the body. The correct height of desk and seat can be secured very simply by pressure upon the spring and then raising or lowering the parts in question. When a desk of this type is used, there is no need of taking measurements and notes; the older children especially do not require much instruction in adjusting, with the help of a fellow student, the desk and chair to suit them. The charm of newness which makes the pupils want to play with these adjustable desks will not last long; children do not want to play with ventilation valves or windows or doors although these things are movable toOi This difficulty will be lessened if the children are not admitted to the room before beginning of class nor during recess periods when the teacher is not present. Aside from these and other newer desks, the non- adjustable desk forms are used a great deal in Europe, and from three to ten different sizes may be pro- cured. There are hundreds of models on the market. When the desk can be found in a greater number of sizes, say from eight to ten, it is easier to choose a more fitting size for the body than if there are only three sizes of desks, but the practical difficulties ex- perienced with so many different sizes are increased. If a teacher has a room with desks of different sizes which are not bought after the above described meas- Horizontal Adjustment of Top at will of occupant. Adapted to varying uses. The only scientific and practical Plus and Minus ad- justment. Top has Horizontal Adjustment of 354 inchies. Inkwell exposed when top withdrawn for writing; covered and protected when top returned for study. Vertical ad- justment of Chair Seat Top of Seat from Floor: No.l.lS.^^'tolS" No.3.16'tol2>i" No. 5. 13 '<: "to 11" Not adjusted by occupant AMERICAN STEEL ADJUSTABLE BOX DESK WITH SLIDING TOP CHAIR EQUIPPED WITH ADJUSTABLE BACK SUPPORT Fig. 22. — Adju.st:il)le desk and chair, manufactured by the American Seating Company, Chicago, 111. THE SCHOOLHOUSE 51 uring of pupils, nothing can be done but to distribute these desks according to their dimensions, form the pupils in a row according to their height, and seat them in that order in the desks. Special attention must always be paid to the nearsighted and the deaf. The resulting arrangement, the best possible under those circumstances, is naturally not always satis- factory. Desk Dimensions. — It only remains to say a few words al)out the coni^tituent parts of the school form and their relations to one another. The seat should be just so high from the floor that the upper part of the leg is horizontal and the lower part perfectly perpendicular when the foot is placed firmly on the floor. If the seat is too high, the nerves and nblood vessels on the under part of the thigh are compressed, particularly those near the edge of the seat, and the child is apt to slide forward and to lapse from the erect posture. If the seat is too low, the thighs will be pressed against the abdomen. The depth of the seat, i.e., the distance from the forepart to the rear, is influenced by the length of the th'gh; the depth must be such that the child's back reaches the back rest, a support of two-thirds of the thigh is amply sufficient. The position is firmer when the seat is slightly curved as shown in Fig. 23. The level ot the desk top should be in the plane of the sitter's elbow when the arm is hanging down. If the top is too low, the child must bend down to write, assuming a position which is injurious to the spine, the chest, and to the respiratory and digestive organs. If the desk is too high, he uses his eyes too near the 52 SCHOOL HYGIENE work, and the arm can not be held near enough to the body when writing. The question of the tilt of the desk will be considered later. The back rest is absolutely necessary because a child can not sit for any length of time without some support. The rest may be of various heights, but it should at least support the lower third of the spine. At this point we reach a real difficulty, for if one surveys classes of children, in a school, one notices how seldom the back of the seat is used as a sup- port. The fact of the matter is that a back rest is comfor- table only when tilted back- Avard to a considerable degree, as in an easy chair; but if this were done in the school- room, the seat must also be tilted correspondingly (Fig. 23) in order to insure firm seating. Furthermore, the desk would then have to be tilted, otherwise there would be a strain on the eyes, for a great angle of vision is unbearable, while one of about 8 degrees requires no strain whatever. When reading, the pupil may hold the book in his hand, that is, in a tilted position; but in writing the tilt of the desk can not be so readily adjusted. The desk top can not be tilted too much, otherwise the arm must be held in such a way that the ink will not run from the pen. This would be very tiring Fig. 23.— a desk de- signed by A. Lorenz. THP] SCHOOLHOUSE 53 to the arm, even for a short time, but should there be no possibility of change it would be unbearable. The tilt of the seat involves many other problems. The best back rest has a uniform slant. Ortho- pedists formerly recommended a projection to curve into the lower part of the back, until Schulthess of Zurich showed that in a sitting posture the natural curves of the spine are not as pronounced as in stand- + - . % Fiti. 24. — Di-staut'cs hetwocn seat aiul desk. S — scat, D = desk. The cut to the left shows phis distance, the middle mdl distance and the one to the right minus distance. ing. Recently, Piesen of Prague has shown that this wooden projection may do absolute harm to children; in a number of children so placed albumin was occasionally found in the urine. Howev^er, a back rest is absolutely needed for the support of the lum- bar region of the spine. If as in Fig. 24 a perpendicular dotted line is dropped from the edge of the desk (D) to the floor, this line will meet the edge of the seat (S), or go to either side. This dotted line constitutes the ''distance.'' It is immediately clear that what is denoted as ''plus- distance" is bad because it demands bending forward during work, while the "minus-distance" is the proper one for writing, but restricts the movements in other 54 SCHOOL HYGIENE occupations and prevents the child from standing up. To meet this difficulty, distance adjusters have been designed in order that the bench can be so placed as to permit the child to write at minus, and to sit at plus distance from the desk; the latter distance also permits of easy standing up and ingress and egress. The value of a school desk is greatly increased by these distance adjusters; schools which are putting in new « "V-......, Fig. 25. — Movable desk top by Schlimp. For writing it is inclined in the dotted line a, 6 ; at other times it is in the line cd. The change is made easily and noiselessly by the joints, /,s^,/c,^. Fig. 26.— a readily adjusted seat designed by Schenk. furniture should install only desks so equipped. The distance may be adjusted in various ways; the desk top may fold on itself (Fig. 27), or it. may be pushed forward or backward (Fig. 23), or drawn out and pushed back again (Fig. 25);* or the seat can be turned up and put back, or moved forward and backward like a pendulum (Fig. 21 and *A model possessing distance adjusters in the desk is shown in Fig. 25, It was invented by Schlimp Brothers (patent expired), and is much used in Austria. It is one of the many modifications of the original adjuster designed by Kunze. Fig. 27. — Single pedestal desk coinbination, manufactured by Kenney Bros. & Wolkins, Boston, Mass. THE SCHOOLHOUSE 55 26). The seat adjustment merely makes i^oom for the pupil to' rise, but does not influence the sitting distance. It is essential that these adjusters should be tolerably noiseless and also that they be of such construction that they do not act as traps in which the hand may be caught and pinched. An adjuster like Fig. 25 has the advantage that the pupil when writing can easily set the desk at minus distance, and during the writing pauses can push the desk away from him for greater freedom in movement. But still the ''distance" referred to above does not entirely solve the question, the really significant distance being that between the slanting back rest and the desk edge. For writing, this space should be a few centimeters greater than the body thicKuess at the chest; it should correspond to the length of the forearm. The low desk forms of small children are a tax on the teacher, who must bend over to see the work. For this reason such desk forms should be placed on a pedestal or the form should be quite high, with a footstool to make the child comfortable. The footstool has a disadvantage in that if the desk has no movable ''distance" and the child wishes to stand for recitation he must first step out. Experience shows that this inconvenience frequently results in the teacher not requiring the pupil to rise, and the child thus loses the opportunity for exercise gained by the change of position — a distinct disadvantage from the standpoint of hygiene. In the non-adjustable desk forms each desk should be attached to its own chair, not a chair to the desk 56 SCHOOL HYGIENE behind, so that when shifting the furniture a chair will always correspond to its own bench. It is better to have non-adjustable desk forms which accommodate but two pupils, for with desks accomodating only- two, each pupil can step in and out, and the teacher can pass each place — a condition which does not hold for forms accommodating more than two pupils. The use of desk forms accomodating not more than two children has been prescribed by law in Sweden since 1878. Movable Desks. — To facilitate the cleaning of the floor, many ways have been suggested and one of these is to make the points of contact of the desk with the floor as few and as small as possible (Fig. 27). The idea has been developed in the United States and in France since 1877 under the ''Mittelholm" principle. In some places double-seated desks were merely turned over at cleaning time; this was first done with the Roux desk in 1887, in the Villamont School at Lausanne (Switzerland), and is still done in many other places. In 1893 Rettig patented a movable desk (similar to desks shown in Fig. 28) and in 1900' Zollinger of Zurich introduced the idea of having whole series of desks on casters, so that they can be readily moved out of place. Different sorts of appliances for rolling the forms have appeared in Switzerland, Austria and Germany. One plan is to have the rollers of the desks coupled together (Fig. 29) ; another plan, first suggested by Baudin of Geneva, is to have a whole line of desks on an iron rail (Q) in which the rollers are set (Figs. 30 and 31) . This plan of rolling away the benches when cleaning the floor is decidedly the best, Fi(i. 2.S.— Benches (Urania) designed by Piasecki, turned for cleaning the floor. over THE SCHOOLHOUSE 57 for with a clean sweep of floor there are no inaccessible places. It is easier to push the tiers to one side than to turn one desk over the other, at the same time there is no danger of spilling the ink, although the reversible desks do have special inkstands which when carefully handled can be turned over also. All kinds of desks with movable parts are better pushed than turned over; furthermore, iron desks, also can be rolled but they would be too heavy to turn. The question as to the injury which such roller benches may sustain from the children playing with them has already been rais- ed. The author personally does not knowof any such instances though he has in- quired concerning this point in places where such desks are used. The outer edges of the large projecting roll- ,. on t^ n i j /T^- r.V.N , Ti , 1 i<'- 29.— Rollers coupled ers {t Ig. 29) should be togethor for rows of benches, rounded off so that the designed by Walter. floors will not be scratched. At the Dresden Inter- national Exhibit a contrivance* was shown whereby the benches when in use stand without rollers, but are readily put on rollers at cleaning time. When three tiers of benches are pushed away, a large floor space for exercise can easily be had (Fig. 31); this would be impossible with stationary benches, or those which can only be turned over. In the United States gymnastic apparatus are arranged on rollers in a similar way. *This contrivance is manufactured by Lickroth & Co. 58 SCHOOL HYGIENE Posture. — Associated with the problem of seating is that of a correct sitting position. Where a school- room is equipped with practicable desk forms, a hy- gienic posture should be urged upon the child frord the outset. A definite amount of time should be allowed for acquiring a good position at the desk. Beginners, for instance, should not be required to assume the correct writing position for more than a fraction of an hour, being permitted during, the re- mainder of the time to assume an easier attitude, for to maintain a correct posture means considerable work for their muscles. Parents can help by admoni- tions at home and also by purchasing the right kind of a house desk which the shops offer in a variety of forms, or proper provisions can be made by means of a footstool and an upholstered chair. Many me- chanical means have been designed for helping a child to maintain an erect posture. The subject can not be discussed here in full, but mention should be made of a device sold by Iberg in Basel. This is the Bril- lenger.adehalter, a spectacle frame with two black cellu- loid flaps, which fall down over the eyes when the pupil bends over, but which adjust themselves and uncover the eyes when he straightens up. Another useful and inexpensive device is that introduced in the Guts-Muthsrealschule of Quedlinburg by H. Lorenz. It is a light metal ring, about 20 centimeters in diameter, which slips from the head of the child when he tilts his head too far forward or too far to one side. The term Geradezwinger (upright forcer) does not convey a pleasant meaning, and its use would be objectionable if the teacher should forget YiG. 30. — A sclioolroom in Ck'iiova with three rows of two- seated benches designed by Mauchain. The benches are placed on the Baudin rollers. Fig. 31. — The same room as shown in Fig. 30. The rows of benches have been moved close together, to give a large free floor space. THE SCHOOLHOUSE 59 to pay attention to the fact that the child can only bend his head forward a short distance, and the contrivance may overtax the child's back and neck muscles. Blackboards. — The ])lackboard should be of a dull finish, not too highly polished, and so placed that in looking at it the children will not be dazzled by light from a window. Large shiny blackboards on the wall opposite the windows are likely to take away much reflected light, as has been shown by Gstettner of Vienna, therefore dull ones would be more suitable. An antiseptic blackboard, which resembles an oilcloth scroll, has recently come into favor in New York City schools. Lavatory. — If the chiklren use chalk the>* should have a place where they can wash their hands. It is most desiral)lc to have the lavatory in another room, in the cloak room, the recess room, or the toilet, as has already been discussed. Expectoration Receptacles. — The question of dis- posing of the expectorations of the children is a more difficult one. Covered cuspidors attached to the walls are better than those placed on the floors. It seems hardly necessary to say that expectoration on the floor should never be tolerated. Children who have to expectorate should be placed near the cuspidor, so that when necessary they can step to it without causing a disturbance. Since Dettweiler devised an individual saliva cup, many others have been sug- gested. The question whether it would be better to provide these for the coughing pupils or to require the parents to furnish them for their children is no difficult 60 SCHOOL HYGIENE matter to decide by experimenting; but a highly cul- tured public is generally disinclined to discuss matters of this sort. 5. Other Rooms, Grounds, and Facilities of the School Gymnasium. — From the standpoint of hygiene the gymnasium is most important. It must be well lighted, convenient, easily ventilated and suitably heated. It should not be located in the basement. The apparatus must at all costs be safe and the wood work should not splinter, for serious injuries or even fatalities may result from neglect of these requirements. To see that such matters were at- tended to, in 1895, the government at Sigmaringen (Germany) ordered a yearly inspection of gymnasium apparatus. The greatest problem existing in the gymnasium is the presence of dust. For this reason, the children should not be allowed to enter in their street shoes, nor should the mattresses in the gym- nasium be allowed to become dust receptacles, which is hardly possible to avoid with cheap kinds. The floor covering must be good (for instance, strong linoleum), and not slippery. The use of floor oils has been decided against by some teachers though it is not generally objectionable, for the gloss will disappear after once using the floor and the oil when thinly ap- plied can hardly be a source of danger. It is to be recommended that in winter when much dust may be brought in and no precautionary measures for its prevention are taken, those exercises which would cause a dissemination of the dust be omitted. The author has had occasion to inspect a new gymnasium THE SCHOOLHOUSE Gl in a large city where no oil was used on the floors and no special shoes were worn by the children, and where such unhygienic conditions existed as to make the work in the interest of preventing tuberculosis a derision. This state of affairs in gymnasiums is all the more remarkable since von Pirquet has proved that a verj^ high percentage of children is infected with tuberculosis, even though the infection seldom reaches a dangerous stage. The question, then, may well be asked — how can a teacher manage to keep the room free from dust, when the streets are dirty and oil is not used on the floors, and no change of shoes on the part of the children* is required? Even when care is taken to wipe the shoes at entrance, it is impossible to exclude all dust. In view of tnis fact, it seems neglectful to do without floor oil. The gynmasium should have its own cloak room, a convenient, indoor toilet, and if possible, its own lavatory. Physical exercises carried on in the open air are preferable to work in an indoor gymnasium, for conditions in the open air are better adapted to meet the increased demand made upon the lungs. Hence, an open-air gymnasium situated in the school grounds partly roofed over, but open at the sides, is ideal for this purpose. In a large school, when choosing the site for this outdoor gymnasium, it should be re- membered that close proximity to the classrooms may disturb the work of instruction. Such details are all directly connected w4th the planning of the building. Playgrounds. — In this connection the general prob- lem of the recreation place comes up for discussion. The recreation room has already been briefly spoken 62 SCHOOL HYGIENE of and the indoor and outdoor gymnasiums have been mentioned in the preceding paragraph. In every case, a place in the open is very desirable where pupils can spend their free time when the weather permits and when waiting for school to begin. A playground should be as large as the available grounds permit; in small towns at least 5 square meters should be allowed for each child, and in even the smallest rural communities the total play space allowed should not be less than 200 square meters. In the most populous parts of large cities, the minimum should never be less than 1 square meter per child. The difficulty may be met in part by using the roof, as is done in London and New York. Fig. 32 shows the roof playground of a school building in New York as designed by Snyder. These roofs are used in that city on hot evenings as recreation places for mothers and children. Where it is possible to have the yard large enough to be used as a playground and as an ice field in winter, for instance in the smaller towns, a good step has been taken toward the healthy rearing of children. In the crowded districts of large cities where it is not possible to have the playground next to the school, the aim should be to provide an open space elsewhere for the children of each school, one easily accessible by car lines at a minimum rate of transportation, plus a short walk. The way of progress in the matter of the play of children has not been easy in Europe during the past generation. It is a long step from the epoch of the decree of 1882, effected by the Prussian Minister of WKKIm A^ Mm. Im mm \wmk \ m 1 »^j\m^ ■mm^ 7 ri THE SCHOOLHOUSE 63 Education, von Gossler, to the requirement of a definite afternoon per week set aside for play. School Gardens. — A school garden, where it can be had, is to be recoinnicnded from the hygienic stand- point. It serves when next the schoolhousc to keep the air pure and affords opportunity for healthful out- door occupation. School Baths. — Ainong the many products of school welfare work, the school bath takes high rank, be- cause of its hygienic significance. To the city of Gottingen (Germany) ])elongs the credit of having introduced, twenty-five years ago, the first school baths, an example which has since then been widely followed. The need for this extension of the field of education is shown by the following extract fi%m a Gottingen report, ''We state the shocking fact that with the exception of the face and hands, not a drop of water touches year after year the bodies of a great majority of the pupils in our German schools." Naturally, the argument is frequently advanced that these are not matters of the school, but rather of the home. It is an argument that needs constant refuta- tion by the statement that very possibly in an earlier time the present and generally recognized right of the state to impose compulsory education, may have been regarded in the same light in which obligatory cleanliness is now viewed. The school bath referred to above is the shower bath, which requires little room, and not much heating or water. It can be arranged that groups of children go to the baths at such times when a part of the class can be absent, for instance, during a penmanship 64 SCHOOL HYGIENE period. The baths may be placed in a well-hghted basement and should have a dressing-room large enough to accommodate a number of pupils, who can undress while others are bathing. For the actual bath the water is first run warm (35 degrees centigrade), soft liquid soap is applied and the body is washed and rinsed in a temperature which gradually decreases toward 20 degrees. A bath of this kind requires five minutes of time, about 20 liters of water for each pupil and costs perhaps half a cent per person. The process is a rapid one — a new troup of children goes in as soon as the other comes out of the room, and un- dressing, bathing and dressing follow in quick suc- cession. Thus a maximum amount of benefit is obtained at a nominal cost. The bathing should be done under the supervision of a teacher, and if nec- essary, an assistant might help the small children with their clothes. The general practice with regard to these baths has been to leave it optional to a pupil whether or not he will avail himself of the privilege. The results have shown that while at first only a part of the children participate, in the end almost every one takes part. The school bath wins favor quicker when the children are encouraged, treated with consideration, and the rooms are comfortable. The practice of furnishing school children with free tickets for public baths falls far short of having the baths in the school. On the other hand, it is entirely feasible to permit the general public also to use the school baths. A separate en- trance may be provided for this purpose, as has been done in some places. Such an arrangement might be THE SCHOOLHOUSE 65 particularly helpful in rural communities, where children who have enjoyed the school bath could thus continue its use after graduation. Swimming Pools. — Swimming pools and instruction in swimming are beginning slowly to be introduced into the public schools. Naturally this innovation depends upon the opportunities in this direction which the school possesses. It is encouraging to know, for instance, that from April 1, 1908 to October 1, 1909, 31,333 London school children were taught to swim in 60 of the public baths of that city. School instruction in swimming can readily be im- parted to large numbers of children by means of apparatus and exercises before the pupils enter the water, at least six such instruction periods being re- quired. After these exercises the fourteen or fifteen year old children can ])e admitted to the tank, where they are held by apparatus, a whole row hanging on a cable stretched across the basin. Having then acquired skill in the arm and leg movements in the water itself, after two or three lessons they are permitted to swim freely with belts or other support- ers, and under the supervision of a teacher. The '' dry swimming" is practised in the afternoon gymnasium periods; later on these periods are used for swimming practice in the water. This practice has been in- troduced in different cities. In adcUtion, in Germany, Austria and Switzerland there is school instruction in swimming under various other procedures, but the above-mentioned system will prove most valuable in teaching large numbers of children to swim. The rapid loss of body heat in the water, the increased 66 SCHOOL HYGIENE respiration necessary for swimming in consequence of the pressure of water, and the possibihties of ear diffi- culties, make a medical examination of the pupil a necessity. Rooms for Domestic Science. — Other marks of modern development in the school are classes in do- mestic science and provisions for school feeding. In- struction in cooking, especially for older girls in the higher classes, occupies a prominent place in Scandi- navian schools. The practice is also spreading in Germany, where it is being promulgated by the efforts of Auguste Forster, Kalle, Kamp and others. In England such instruction in the public schools is pre- scribed by law and the state contributes to the cost at the rate of four shillings per scholar. In London the dishes thus prepared are sold to the children, thereby making the establishment self-sustaining. These cooking classes date as far back as 1878. In the same city, in 1890 the first '^washing centers" were estab- lished for school instruction in laundry work. In 1903 there were 142 such centers in operation. At the present time, the cooking, washing and other house- hold activities are taught in small, easily accessible housecraft schools. Not every school in London has its own establishment, but a number of schools have access to a common center, convenient to all. School Feeding. — School feeding may be instituted either for the benefit of children who live too far from the school to go home for the noonday meal, or it may be for the purpose of giving good food to very poor or neglected children. The arrangement made in the public schools of Paris is excellent. There the THE SCHOOLHOUSE 67 children may have their luncheon (dejeuner) in the schoolhouse by presenting tickets, some of which have been paid for and some of which have been given gra- tuitously, and no one knows which child has paid and which has received charity. In some German cities also, in Munich for instance, provision is made quite as a matter of eburse for feeding the poorer children of the public schools. More than one-third of all German cities offer food in some way or another. The expense in such cases is usually defrayed by private benefac- tions, though there is a more or less definite tendency, especially in Switzerland, to regard it as an obligation of the state to supply sufficient and good food to the child who is badly nourished at home. The aim in many cities is to give aid where needed, an(% to ask for payment where the parents are able to afford it. Toilets. — Both with respect to location and usage, the toilets of the school demand special hygienic consideration, as under adverse conditions they may easily prove a menace to health. Experience in school life, as well as a mass of statistical evidence, points out the need for improvement in this direction. In the first place, the school periods must be so ar- ranged as to give the children recesses during which they may attend to their necessities, and in addition the children should be permitted to leave the class- room when necessary. Retention may often lead to harmful results, to maiming or permanent weakening of the bladder, to costiveness, as well as to sexual irregularities. In pubescent girls the increased flow of blood to the pelvic organs at certain times, accel- 68 SCHOOL HYGIENE erated by long sitting, creates a necessity for more frequent urination. Unclean toilets may be a menace to the air of the schoolroom; unclean fluids from the toilets may con- taminate the walls and even the drinking water. On the other hand, if the toilets are placed at some dis- tance from the building, the children are in danger of taking cold when going to them in winter, especially Fig. 33. — Location of toilets with entrances from the corridors. B = Boys, G = Girls. the older girls at certain periods and delicate younger children, and there is always the possibility that children will not take the trouble to go to such toilets when necessary. The dangers which spring from toilet gases in the rooms, and waste fluids penetrating the walls, have led to the demand that toilets shall be located outside THE SCHOOLHOUSE 69 of the school building, which vastly simplifies the schoolhouse plan, though if we stop to reflect we must admit that no architect would think of placing in the yard the toilets of a two or three-storied dwelling house. Why then, should this location be absolutely necessary for the school? The fact is, that with the use of the modern improvements it is not necessary for the school, as has been shown long ago in Austria. There can be no objection to toilets on every floor of the schoolhouse, if they are located in an annex. Fig. 33 shows toilet rooms divided off from the corridor, one section for girls (G) and one for boys (B) with en- trances from separate corri- dors. With a central water „ „ .,. , ^^ , , - m • . Fig. 34. — Siphon closet. supply oi sumcient pressure as found in large schools, detached siphon closets (Fig. 34) may be installed. These insure absence of odors, because not only is the waste immediately removed, but the standing water in the bowl (W) prevents the rise of sewer gases. At the commence- ment of the long vacation it is well to pour a little oil into the basin to prevent evaporation of the water. Where there are no sewers, the prevention of odors can also be accomplished by scattering saw dust into the pit after each use. But the whole mat- ter of chsposal of waste is so bound up with the conditions of the public removal of refuse in the locality in question that it is impossible to go into technical 70 SCHOOL HYGIENE matters here. The toilet rooms should be light, the walls of a glossy surface, so that they cannot be readily marked. The best way to accomplish this, though expensive, is to have the walls covered with glazed white tile, which is durable and can be washed. Where this is not possible, the walls might be plastered, the plaster laid in vertical grooves, after which the o Fig. 35. — A closet for country schools, used in Maine. whole surface is painted in a light color, care being taken to use no lead. Where pits are the only receptacles for waste, it is necessary to have these quite apart from the building and constructed in such a way that the leakage of the waste is avoided. For building the foundation, hard bricks laid in cement or asphalt are to be recommended, and the waste pipe must be constructed absolutely water-tight. Above all, the use of cesspools, which lead the waste fluid away by filtering through the ground, should be absolutely J THE SCHOOLHOUSE 71 prohibited. They are entirely unhygienic, for they are likely to contaminate the water supply. For little country places the practice proposed by the board of health in the state of Maine (United States) is to be recommended. Under the seat of the closet stands a water-tight bucket (Fig. 35), or one of cast iron, and in a box within the closet is a supply of earth, sawdust or ashes, of which the children are to throw a shovelful into the bucket after each use. One wagon load of this material is found to be sufficient for a school j^ear. Daily, after the close of scliool, the contents of the bucket are removed through a door in the rear and are thrown on a compost heap or turned into fertilizer and covered with earth. When one sees the manure heaps of the countryside to wfcch are added th(^ waste deposits of the closets, it is not difficult to imagine that infection may spread by means of the domestic animals. This emphasizes the need for the school to exert its educating influence also in this direction as well as in another direction — that of ventilation. Many persons in the country never open, their windows, with the result, as proved by statistics, that in rural districts preventable diseases are more frequent, comparatively speaking, than among urban populations. It is, of course, true that country children are more hardened than city children. Hence, it is permissible in country schools to have the closets out-of-doors, though it is desira])le to construct a covered passageway leading out to the facilities. Urinals. — It is not possible, with such simple arrangements, to keep urinals free from odors. For this reason, it is desirable not to install them, but to 72 SCHOOL HYGIENE have the children use only the above-mentioned closet. For special places the oil urinal* is an ideal ar- rangement. The walls are covered with a prepara- tion to which urine does not cling and the oil in the siphon which collects the urine, covers it and renders it practically odorless. These oil urinals, which are being widely used, can be kept odorless with very little effort, which can hardly be the case when only water is used. Bodily needs should be attended to during the re- cess periods; consequently the closets should be near the recreation rooms and the playground. Ordinarily one closet is planned for one class, but with classes of fifty or more additional facilities are needed. When the toilets are under supervision or the children have the impression that it is so, it is not necessary to limit particular ones to certain classes. Above all, the supervisors must see to it that the closets are not made untidy. Cleanliness can be best en- sured if the children themselves are urged to report immediately any toilet found in an untidy condition. It is very convenient to have the lavatories connected with the toilets, but with regard to washing accom- modation our schools leave much to be desired. School and Dwelling. — The combined school and dwelling house needs brief discussion. It is a plan not to be rejected because it is often the only feasible one. In large cities, the ground is so expensive that a separate house for the principal and teachers is pro- hibitive. And again a school of this kind may be used for such a variety of educational purposes as to *Made by W. Beetz in Vienna. THE SCHOOLHOUSE 73 make the residence of tlie director within the building very desirable, and the work of cleaning and heating is also facilitated if the janitor is lodged in the house. In country schools where the children come from a great distance, it is of advantage to them to be able to get a warm meal cooked by some one connected with the school, who may also in other ways show her motherliness. Of course, care should be taken that such accommodation of the teacher and his family in the schoolhouse shall not prove a drawback to the school, which might be the case if i)ationts with con- tagious diseases are kept within the schoolhouse, and odors from the kitchen or from impure water in the laun- dry, etc. are allowed to penetrate to the classrooms. In the interests of the director, his rooms should include at least one that is sunny and away from the noise of the children. The director is entitled to accommoda- tions which will afford him and his family a com- modious home; hence none of the rooms should be located in the ])asement nor should there be less than three living rooms. The use of the schoolrooms for other than school purposes may prove hygienically undesira})le; social gatherings may litter up the floor, and contagion from sickness may enter. It should be the duty of the city or town authorities to see that the health of the children is not endangered. Cleaning. — The cleaning of the schoolhouse has already been mentioned and it must be admitted that in this direction much progress needs to be made. In this respect, as with regard to lighting, ventilation, seating, toilets, etc., the school differs by virtue of its 74 SCHOOL HYGIENE intensified use from other dwellings and demands special means to keep it sanitary. Improvement will come when the general public has been hygienically educated to realize special menaces to health, as well as conditions necessary to safety and comfort. Cleaning operations which will stir up dust should never fall upon the pupils. In this matter of cleaning, Denmark has made a distinct advance by introducing into the law of 1905 for the fight against tuberculosis a .clause covering this point. Another exemplary provision is contained in an edict issued by the city of Copen- hagen in 1908. It is practicable in large schools to contract for the cleaning and heating, as is done in some cities of Germany. Where possible, a vacuum cleaner should be installed. Fire Regulations. — Large school fires and terrible panics among the children have taught the stern lesson that the construction of the school building and the order maintained during an emergency must be such as to avert like occurrences in the future. For this reason the fire drill at least ojice a month should be a matter of school routine. All large schools should be equipped with fire escapes, as is the case in American cities. II THE HYGIENE OF INSTRUCTION 1. General Consideration Fatigue. — Prolonged labor of any kind leads to fatigue. Fatigue is regarded as due to the accumula- lation in an organism of certain products of met- abolism, the presence of which tends to diminish energy. It must not be supposed, however, that the su})jcctive expression of fatigue, i.e., the feeling of bciii|5 tired, is an exact measure of the degree of fatigue, though it is usually an important indication. Following fatigue, rest, nourishment, and fresh air bring recovery from the tired state. But to aid the healthy develop- ment of the child more is needed than mere alternation of brain work and mental rest. The muscles of the child also require exercise for their growth; this ex- ercise likewise produces fatigue and in its turn demands periods of rest. Fatigue is essentially a general con- dition; the products of dissolution which accumulate through brain work produce a diminished capacity of the muscles as well as the nerve cells, and vice versa. Weichardt in Erlangen (Germany) who has succeeded in injecting into an unwearied animal a substance called kenotoxin extracted by him from the muscles of a tired animal, has observed in the former all the characteristic signs of fatigue. To overcome this 75 76 SCHOOL HYGIENE experimental^ produced fatigue, he then used an antibody, or reactive agent, which he injected into the animal. These facts are not cited as urging that a like procedure be undertaken with school children, though Lorenz in Berlin has proved that the spraying of an anti-kenotoxin in the air of the schoolroom diminished fatigue in the pupils. But such means of recuperation are not to be advocated, for fatigue signifies need of rest and if fatigue were artifically prevented new work would commence at the undue expense of the reserve power of the child. This is especially dangerous for children because they not only need to restore used material but to accumulate new material for growth. These are problems which still await definite solu- tion, though this much is certain — fatigue should never be permitted to reach the stage of exhaustion, that is, it should not be carried so far that the devel- opment of the child is hampered. The rule should be that complete recovery must follow a day's work before the next day's tasks are begun. Increases in height and weight are good indications of proper development. If a child who has healthy parents and to all appearances a hygienic environ- ment, Sftill shows signs of physical backwardness, this lack of development must be regarded as an un- favorable sign. Constant watchfulness of the de- velopment and the hygienic conditions of school children is a matter of public interest. In this con- nection it might be particularly valuable if we could know how near at any given moment the state of fatigue is to its physiological limit, or whether it has already reached the pathological condition. Our THE HYGIENE OF INSTIIUCTIOX 77 knowledge on this point is meager, which is not to be wondered at when we consider that research in this field has been undertaken only during the past few years. A full discussioti of the subject of fatigue would far exceed the limits of this book, but in order to give the reader an idea of the means taken to determine the presence of fatigue, a few methods will be presented. The psychological metho<^ls require the child to com- pute figures, to keep numbers or words in his memory, to recall previous happenings and to complete the sense of broken passages. Another way is to estimate the fatigue elements resulting from either mental or physical labor by testing muscle capacity with the ergograph, an mstru- ment designed by Mosso of Turin. The test nuide is of the amount of muscular work which can be per- formed by the middle finger, the subject lifting a weight rhythmically as many times as he is able. The weight hangs on a string which runs over a roller. The heights to which the weight is raised and the rapidity with which one stroke follows another are indicated 1t>' the instrument, and the sum of the results in the given time, with a given weight, constitutes the work, which is recorded in meter-kilograms. No matter what the cause of fatigue, the tired individual is able to perform only a fraction of the work that he is able to do in a rested condition. Another plan, that of Weichardt, is to estimate the degree of fatigue by dumbbell work and foot move- ments; or, according to Schuyten of Antwerp, by a dynamometer which registers the pressure power of 78 SCHOOL HYGIENE the hands. The ami of the phj^siological methods is to show the decreased power of the sense organs under fatigue. If the finger tip of a normal individual is touched with the two points of a compass, he will be conscious of two separate sensations, even when the points are very close together; but in order to get two separate impressions when the compass is placed on the upper arm, the two points must be placed relatively far apart. 'It has been found by Griesbach of Mlilhausen (Germany) that under fatigue the points of the compass on the finger tip must be widened to produce two sensations, and the degree of fatigue is indicated by the distance between the points. This is the sesthesiometric method. While the results achieved by these methods indi- cate the general usefulness of such procedures, some very decided objections can be raised and the results of one method do not always corroborate those of another. But nevertheless we must not abandon the hope of arriving at a method which shall be free from objections. As a matter of fact, the re- searches made in different laboratories with different methods have already shown a general tendency in one direction. Constitution. — That individuals differ in natural aptitude or constitutional tendencies as well as in de- velopment is a universal truth. The further fact, however, is not so well known that, as a rule, the children better equipped physically, that is the heavier and larger children, make better school progress on the average than the weaker ones, a finding which gives added meaning to the phrase, "a sound mind THE HYGIENE OF INSTRUCTION 79 in a sound body." This truth was wholly disregarded until Russian investigators emphasized its importance, and the extensive investigations of Porter in Boston, F. A. Schmidt and Lessenich of Bonn (Germany) corroborated the statement, which was further proved by the work of many other investigators, among them Graupner of Dresden, Quirsfeld of Prague, Rietz of Berlin and S. Rosenfeld of Vienna. Defective Children. — The very great differences existing in mental capacity are better detected in the elementary, than in the high school, where a more or less selective process has operated. Because of a realization of this wide difference of aptitude among children much is heard about subnorm^ and backward children. From the standpoint of school hygiene such discussions are to be warmly welcomed. Among the subnormal the first to receive consideration in the school are the mentally defective, then cripples and epileptics, and moral defectives. The blind and the deaf have always received special care and need hardly be considered in connection with the public school. Finally we have children who are retarded because of chronic diseases such as tuberculosis and trachoma, as well as constitutionally weak children and those who are nearsighted in a high degree. Public interest is aiming to provide for all these the advantages of education, of which they would other- wise be deprived to a greater or less extent. As a rule, mentally retarded children fall behind the normal in weight, as Schmid-Monnard in Halle (Germany) has shown. Malnutrition and sickness likewise play a large role among the backward. More- 80 SCHOOL HYGIENE over, because of their inability to keep pace with other, normal children, such pupils are at a disad- vantage psychically. It frequently happens that the teacher for a time misjudges such children, regarding them as lacking in ambition. That there are intelli- gent children among the defectives who are unfit for the public schools is instanced by the word- blind. Special Classes. — The normal, subnormal and ab- normal are not separated by wide gulfs; there are gradual stages of transition from one to the other groups. The diagnosis of defectiveness is not always easy to make and hence special methods for testing intelligence have been designed. By placing the backward pupils in a special class final decision can be deferred for some time, though, unfortunately, parents frequently object to this procedure, notwith- standing that it is the wisest course for the child, who is thus taught by a specially trained teacher, in company with only a small number of companions, perhaps not more than twelve. In the special classes, the pupils can have a maximum amount of recreation, medical attention, etc., that is, they are especially cared for also from the standpoint of their physical health. The carefully kept records of these classes are frequently of value, as in examination for military service, or in questions of liability in a court of justice. Moreover, the practical training received in these special classes is of great advantage to those who at the end of school must earn their living. It has been computed that from 1 to 2 percent of the school children in different countries are defective — a number sufficiently large to demand special study and atten- THE HYGIENE OF INSTRUCTION 81 tion. In the city of Mannheim (Germany), Sickinger has made an attempt to systematize the care of the various types of subnormal children. School Age. — Most children are ready for school when they have passed their sixth l^irthday, that is, they are then sufficiently developed to undertake school work. This age has been generally chosen because while up to the seventh year of life the brain grows rapidly, after this period, growth is at a much less rapid rate. That organ is therefore cjuite well developed when the child enters school, although not yet adaj^tcMl for abstract thinking. The worst feature at the l)eginning of school life is this, that the transition from a state of freedom to confinement is too pro- nounced; the hours of instruction are to