UNIVERSITY OF CALIFORNIA 
 AT LOS ANGELES
 
 THE HYGIENE 
 
 OF 
 
 SCHOOLS AND SCHOLARS, 
 
 For Teachers and Parents. 
 
 '',.■..'. 
 
 ,,,,;, ........ 
 
 - » •.'.•■-.■. .. ; . - • . 
 
 BY 
 
 H. BEALE COLLINS, D.P.H., &c. 
 
 SURGEON ROYAL NAVY (RETIRED), MEDICAL OFFICER OF HEALTH 
 
 WW KINGSTON-UPON-THAMES, ETC. FORMERLY ASSISTANT INSTRUCTOR IN 
 
 HYGIENE IN THE KOYAL NAVY. 
 
 S8d 8 
 
 Martian : 
 
 Ralph, Holland & Co, 
 
 Temple Chambers, EC. 
 
 *346 2 190G - 
 
 rtfh 1907
 
 i r < < 
 
 
 
 Published May, 1902. 
 
 Second Edition, October, 1903. 
 
 Reprinted, April, 1905. 
 
 Reprinted, October, 1905. 
 
 Reprinted, October, 190G. 
 
 73^
 
 L3 
 
 -m PREFACE. *&• 
 
 oo>©<°* 
 
 It has often struck me in the course of my duty as 
 a Medical Officer of Health in town and country, how 
 deep seated is the belief that the ills which sanitary 
 officers endeavour to remove are part of the dispensation 
 of Providence. If we can teach the young that 90 per 
 cent, of the illness and trouble in this world is due to 
 man's own fault, mostly carelessness and selfishness, we 
 shall effect great progress in sanitary advance. There 
 are doubtless many books similar in scope to this little 
 handbook, but with such an inert resisting mass to 
 overcome, the teaching herein set forth can hardly be 
 overdone. 
 
 I have endeavoured to arrange the book round the 
 
 scholar's body to begin with, roughly entering on the 
 
 IV Anatomy and Physiology of the different parts. With 
 
 • this general knowledge of the child's physique, it should 
 
 ^ be easier to understand the effect of study and play 
 
 ) upon the organs and the body as a whole. 
 
 The subject of Ventilation and Warming is treated 
 first from the theoretical point of view, and then in its 
 application to building, etc. 
 
 The last chapter is devoted to School Accident ;. 
 
 I do not lay any claim to originality in this little hook, 
 it being largely a compilation from the works of many 
 authors. It has been my endeavour to simplify, as l'ai
 
 IV. 
 
 as possible, the descriptions so that they may be clearly 
 understood without any special knowledge of the sciences 
 on which Hygiene is founded. 
 
 It is quite impossible to quote all the authorities that 
 must be consulted in even a small work like the present, 
 but I have to thank Messrs. Geo. M. Hammer & Co., 
 School Furnishers, by whose courtesy we are enabled 
 to reproduce the diagrams in Chapter V. ; and also 
 the St. John Ambulance Association, with whose kind 
 permission we use the illustrations in Chapter XI. 
 
 I have also to thank Messrs. Curry and Paxton, 
 Opticians, for the use of their Table of Types, facing 
 Page 35. 
 
 H. B. C. 
 
 King slon-upon- Thames.
 
 CONTENTS. 
 
 ooi&Zo-o 
 
 Chapter I. 
 
 The Head.— Complexion.— Blood corpuscles.— Town dwellers 
 and fresh air.— Dimensions of the head.— The expression. Tin: 
 Mouth and Nose.— Cold in the head.— Causes and prevention.— 
 Exposure to wind and fog. — Adenoids. The Ears.— Malformations. 
 — The internal ear. — Hearing.— Earache and discharges. The 
 Brain. — Nerve cells and nerve fibres.— Afferent and efferent nerves. 
 — Sense stimulation.— Spontaneous movements. — Voluntary and 
 involuntary movements. — Production of mental aptitude. . . P. 9. 
 
 Chapter II. 
 The Eyes.— General appearance. — Movement of Eyes equal 
 and free, but not excessive.— Structure of the Eyes.— Sclerotic— 
 Cornea.— Vitreous and aqueous humours. — The Lens: convex; 
 changeable focus.— Iris : Pupil ; the Retina.— The Normal Eye.— 
 Parallel rays of light focussed on the visual spot.— Binocular 
 Vision.— The Plat Eye.— Parallel rays focussed behind the visual 
 spot.— Alteration in the convexity of the Lens.— The ciliary 
 muscle : headache, blinking, twitching.— Remedy by convex 
 glasses.— The Long Eye.— Later period of school life. -Parallel 
 rays in front of visual spot.— Concave glasses.— Book-reading easy. 
 ">— Wall-reading difficult -Cause, continued study of small objects — 
 JLong hours of study.— Home lessons injurious.— Astigmatism : 
 difficulty of seeing lines.— Type used in printing.— Disadvantages 
 of glazed or thin paper.— Names of Types: Solid, Tbinleaded, 
 Leaded. -Faults in the shape of the type letters: German type- 
 Testing the Eyesight : Cards marked with letters and distancos at
 
 2 THE HYGIENE OP 
 
 which they should be seen.— Where to place the child to examine.— 
 Registering defects. Page 20. 
 
 Chapter III. 
 The Neck and Throat.— Glandular swellings.— The Larynx : 
 A triangular-shaped box.— Voice production.— Vocal chords : bass 
 and soprano. — Movement of lips, tongue, etc., in articulate speech.— 
 Voice in school.— Proper articulation : Position of the Body. — 
 Tight clothing, corsets, belts, etc., interfere with clear speech.— In 
 voice production the extremities are fixed and the chest in 
 movement. — Singing should not accompany general exercise. — 
 Hoarseness : Mucus on the vocal chords.— Clergymen's sore 
 throat.— Bad speakers trying to speak loudly.— Stammering : 
 Spasmodic contraction of diaphragm ; more common in boys.— Thick 
 voice. — Adenoids.— Whispering.— Speech without voice. — Voice 
 changes more marked and later in boys. The Chest.— Respiration. 
 
 Expiration slightly longer than inspiration. — Measurements of 
 
 the Chest : half the height of body ; greater in country public 
 schools, — Inspiration increases size of Chest. — Action of the 
 diaphragm.— The Lungs.— Bronchi. -Air cells.— Oxidation of air.— 
 Respiratory capacity. —The Heart.— Pulse beat 90 at six years, 
 decreasing with age. The Spine.— Its curves ; its construction ; 
 its muscles. — Unsuitable postures cause curvature.— Constitutional 
 and local causes. -Position of children in standing : legs apart ; 
 military stand easy.— Real cause of deformity.— Necessity for 
 physical exercise.— Tone to the muscles. — Increased physical 
 capacity entailing increased mental power. . . . Page 36. , 
 
 Chapter IV. 
 
 The Arms and Hands. — Blueness of Hands in warm weather.— 
 Imitation of movements.— Hand postures : the nervous hand ; the 
 energetic hand ; the straight hand ; the tired hand ; the hand in 
 rest; the feeble hand; the hand in fright; the convulsive hand. 
 The Legs and Feet.— Knock knees.— Bowed legs. — Arched instep. 
 —Skipping.— Crippled children.— Special arrangements for teaching.
 
 SCHOOLS AND SCHOLARS. 3 
 
 — Rickets, commoner in towns and in boys : lack of milk diet. 
 The Skin. — The epidermis ; the chorium, — Fat beneath skin. — 
 Maintenance of equable temperature.— Respiration through skin. 
 — Sebaceous secretion : sweat. — Water does not pass through 
 epidermis. — Removal of epidermis by blisters, injury, etc. The 
 Teeth. —Development of the teeth. — Cleaning teeth. — Particles 
 of food as breeding grounds for germs. — Hard fibrous food as a 
 cleanser. - Loss of teeth disqualifying for Army, etc. — Teeth and 
 their development. — Lessons immediately after meals. Growth. — 
 Varies for different portions of body. — Brain develops early : rates 
 of growth for boys and girls. — Weights at different ages. — Relation of 
 physical to mental growth.— Precocious children. . . Page 49. 
 
 Chapter V. 
 
 Effects of Instruction and Exercises on Growth. — Writing. 
 — Bad positions. — Oblique and Vertical Writing. — Position of the 
 light. Seats and Desks. — Too long maintenance of one position. 
 — Length of writing lessons; break for muscular exercises. — Girls 
 at needlework.— Children with loosely folded arms: disadvantages. 
 Play and Games. — Action on the muscles ; absorption of oxygen ; 
 discharge of carbonic dioxide ; increase of muscle ; increase of 
 sinew ; automatic action ; saving of nervous energy ; difficulties of 
 the beginner in working new muscles. — Heat produced in muscles 
 by exercise. — Use of fat. —Effect of exercise on fat people ; poisonous 
 products not got rid of quickly ; difficulties from bulk. — Fat men 
 thinner; thin man puts on flesh. — Exercise as a controller of 
 nutrition ; digestion improved ; constipation obviated. — Effect of 
 exercise on personal appearance; on moral character; on mental 
 work. Physical Training. — Suitable time for games and exercises ; 
 out of doors. — Much oxygen needed during exertion. — Fresh air 
 during exercise. — Walking : parts exercised. — Running : not for 
 middle-aged. — Jumping and skipping: strengthening of joints. — 
 Riding: certain deformities increased. — Dress. — Swimming: excel- 
 lent general exercise. — Cycling: precautions to be taken.— Cricket 
 and football. — Hockey. — Lawn tennis. — Baseball and Rounders. —
 
 4 THE HYGIENE OP 
 
 Suitable clothing. — Development of chest. — Inquiry into physical 
 condition. ......... Page 62. 
 
 Chapter VI. 
 
 Fatigue. — Breathleesness. — Short and long runs. — C0 2 given 
 off by a man. — Engorgement of the lungs. — Physical effects of 
 exercise : exhilaration : discomfort ; pain in heart, etc. ; loss of 
 colour ; prolonged inspiration ; fainting. — Training : second wind. 
 — Relative fatigue : certain parts affected ; galvanic current. — 
 Complete local fatigue. — Fatigue arising from poisonous accumu- 
 lations ; from damage to structure of muscles. — Muscular stiffness. 
 — Over fatigue ; listlessness ; inability to take food ; prostration ; 
 fever predisposing to other diseases ; absolute rest essential.— 
 Muscular exertion measured as foot-tons. — Tuberculosis and spinal 
 curvature. — Continued bad health as the result of excessive fatigue. 
 — Exposure to cold after fatigue. Training. — Regularity of life ; 
 smoking and alcohol ; indigestible food ; sleep ; ventilation. Influ- 
 ence op Health on Efficiency of Work. — Paget's experiment ; 
 underfed children ; mental fatigue. Neglected and Dirty 
 Children. — Example of cleaner children.— Pediculi. — Verminous 
 Persons' Act. — Eczema. — Itch. — Ophthalmia: contagious; exclu- 
 sion from school. — Depressed Health in Children. — Pallor ; 
 overfeeding ; unsuitable foods ; constipation. — W.C. accommodation 
 in boarding schools. — Re-absorption of poisonous matter from 
 retained discharges ; effect upon learning capacity. — Scrofula.— 
 Washing ; worms ; overwork. Page 78. 
 
 Chapter VII. 
 
 Food for Children. — Nitrogenous. — Animal tissue chiefly 
 nitrogenous. — Constant oxidation ; urea ; uric acid. — Proteids of 
 blood ; reserve ; wasting. — Non-nitrogenous. — Fats ; heat energy. — 
 Starches ; food sparers partly take the place of proteids and fats. — 
 Diet of the poor.— Minimum daily need of foodstuffs. — Fluids : 
 after meals. — Salt ; vegetable feeders. — Increase of food with 
 exercise. —Diet of children. — Proportion of nitrogenous to non- 
 nitrogenous food. — Effect of sleep on digestion. — Too great frequency
 
 SCHOOLS AND SCHOLARS. 5 
 
 of meals. — Excess of food : indigestion ; increase of body weight ; 
 fat ; gout, etc. ; excess of water. — Underfeeding ; starvation ; 
 muscular twitchings ; inattention to work. Clothing. — Protection ; 
 normal temperature ; radiation and conduction. — Woollen ; variable 
 climate ; absorption of moisture ; non-conducting properties of air ; 
 effect of washing on wool.— Cotton : not very absorbent ; conduction 
 of heat. — Flannelette ; inflammability. — Linen : more absorbent 
 than cotton. — Silk : good absorbent and non-conductive qualities. 
 —Tight clothing.— Bare limbs.— Feet. — Damp clothes.. Neevous 
 Children. — Infancy ; early symptoms ; exciting causes. — Educa- 
 tion. — Over-pressure. — Explosiveness of nervous tissue. — 
 Results p ag e 88- 
 
 Chapter VIII 
 
 Infectious Diseases. — Measles. — Premonitory symptoms; cold 
 in head ; spots in mouth ; rash on body. — German Measles different 
 from Measles. — Common cold ; difference of symptoms. — Whooping 
 Cough ; character of cough ; sickness.— Diphtheria ; suspicious 
 sore throat ; glands of neck ; examination for the bacillus.— Anti- 
 toxin ; early application ; decrease of mortality.— Scarlet Fever ; 
 sore throat ; sickness ; rash ; appearance of the tongue. — Mild 
 character. — Epidemic waves. — Effect of sanitation. — Peeling. — Dis- 
 charges. — Continuance of infection.— Kidney Disease. — Premonitory 
 rashes.— Smallpox.— Difference from Chicken Pox ; pain in back.— 
 Vaccination ; a preventive ; confers immunity against Smallpox. — 
 Re-Vaccination.— Meningitis ; sometimes infectious ; tuberculous. 
 — Ringworm ; fungus ; in scalp ; on body.— Contagious Impetigo ; 
 originating in pediculi ; easily inoculated. — Chorea ; girls ; onset 
 gradual; movements; loss of weight. — Ophthalmia; photophobia; 
 redness of conjunctiva; watering; discharges. — Acute conjunctivitis. 
 — Chronic conjunctivitis; follicular conjunctivitis; trachoma. — 
 Epilepsy; fits; suddenness; drowsiness; treatment. . . Page 98. 
 
 Chapter IX. 
 Warming and Ventilation (Theoretical).— Heat requires a 
 continuous supply of air.— Air for ventilation warmed. — Combustion 
 of fuel.— Carbon and Hydrogen forming, with oxygen, carbon-dioxide
 
 6 THE HYGIENE OP 
 
 and water. — Removal of products of combustion. — Heat by friction. 
 — Energy. — Foot-lbs. — Thermal units. — Heat of fuels. — Amount 
 of beat for a penny. — Latent heat. — Specific heat. Distribution 
 of Heat.— Conduction. — Good conductors : metals. — Non-con- 
 ductors : still air ; asbestos. — Radiation. — Transparent media. — 
 Polished surfaces. — Reflection. — Sun-burn from snow fields. — 
 Convection. — Movement of air : warm air rises ; cold air sinks. — 
 Hot climates ; lessened convection ; punkahs. — Scents. — Convection 
 in liquids. — -Good building and fuel economy. — Damp walls and 
 fuel consumption. — Moisture from gas. — Indirect ventilation. — 
 Proper inlets. Air. — Composition. — Impurity. — Weight. — -Low 
 barometer. — Density decreased by rise of temperature. — Carbon 
 dioxide. — Standard of organic impurity. — Impurity. — Microbes. — 
 Dust : when deposited. Page 111. 
 
 Chapter X. 
 
 Methods of Ventilating, etc. — Variation of barometric 
 pressure ; air of differing densities ; currents. — Fall of barometer 
 or rise in temperature ; air heavier ; volume requires larger space. 
 — Direct impact of wind ; open door or window. — Wind blowing 
 across an opening ; release of pressure. — Up-draught ; cowls ; 
 smoky chimneys; steam jet. — Ventilation by fans. — Circular fans. 
 — Natural ventilation and mechanical. — Organic impurity. — 
 Vacuum and plenum systems. — Relative exposure. — Difficulties of 
 ventilation in lofty buildings. — Death rates in crowded tenements. 
 — Air space per head. — Air entering a room from a tube. — Natural 
 ventilation. — Outlets high. — Fresh air should not cause draught. — 
 Window with bottom board. — Tobin*s ventilators. — Louvre windows. 
 — Ventilating fireplaces. — Perforated bricks. — Sherringham's venti- 
 lator. — Cornices. — McKinnell. — Tubes over gas burners. — Size of 
 openings. — Outlets smaller than inlets. — Filtered air. — Gas lights. 
 — Increased ventilation. — Advantages of electric glow-lamps : no 
 impurity ; no absorption of oxygen. — Chimneys — Up-takes in 
 winter, downtakes in summer. — Cubic capacity per head. — Measure- 
 ments of cubic capacity. — -Temperature. — Floor space. — Board of 
 Education requirements too low. — Cleaning schoolrooms. — Blow
 
 SCHOOLS AND SCHOLARS. 7 
 
 through. — Open fire radiation — Closed stoves. — Impure gases. — Cast 
 iron. — Carbon monoxide; danger to life. — Gas stoves. — Hot air. — 
 Hot water. — Low pressure. — High pressure. — Steam pipes. — Pro- 
 tection to pipes. — Summary. — Effects of Overcrowding. — Head. 
 ache. — -Thirst. — Rise of temperature. — Death. — Black Hi 
 Tubercle bacillus : destroyed by sunshine ; spread by dust ; spread i if 
 infectious diseases — Sewer air. — Typhoid. — Pneumonia. Drainm ,e. 
 — Straight lines. — Automatic flushing. — Inspection. . Page 121. 
 
 Chapter XI. 
 
 School Accidents. — First Aid of St. John Ambulance 
 Association. — Contusions ; black eye. — Abrasions. — Wounds. — 
 Bleeding ; arterial jets ; venous bleeding. — Course of blood vessels. 
 — Tourniquets. — Haemorrhage from lungs and nose. — Concussion ; 
 unconsciousness for short time; quiet. — Fainting. — Fits. — 
 Epileptic ; danger of injury. — Hysterical ; freedom from injury. — 
 Stings of bees, wasps, etc. — Bites of animals ; binding of limb above 
 the injury. — Choking; removal of obstruction. — -Frostbite; chil- 
 blains. — Burns and scalds ; lying down, covering with rags, etc. — 
 Corrosives; sulphuric acid. — Poisons; emetics. — Shock and collapse ; 
 after severe injuries. — Foreign bodies in nose and ears ; not to be 
 meddled with. — Foreign bodies in eye ; removal. — Electric shock. 
 — Artificial respiration. — Apparent drowning. — Broken bones ; sup- 
 porting the limb ; danger of wound of skin ; temporary splints. — 
 Sprains; rest and cold. Page 13G.
 
 CHAPTER I. 
 
 -^MS^OO- 
 
 •~ w- w ^7 
 
 The Head. — Complexion. — Blood corpuscles. — Town 
 dwellers and fresh air. — Dimensions of the head. — The 
 expression. The Mouth and Nose. — Cold in the head. — 
 Causes and prevention. — Exposure to wind and fog. — / 
 Adenoids. The Ears. — Malformations. — The internal ear. 
 — Hearing. — Earache and discharges. The Bhain. — Nerve 
 cells and nerve fibres. — Afferent and efferent nerves. — 
 Sense stimulation. — Spontaneous movements. — Voluntary 
 and involuntary movements. — Production of mental 
 aptitude. 
 
 Physical and mental development in the scholar are so 
 closely related that a general survey of the human body 
 is necessary to their proper consideration. The different 
 parts are so intimately connected that undue attention 
 to symptoms pointing to irregularities may easily prove 
 misleading unless considered as a whole and in relation 
 to the conditions existing in health. 
 
 The Head. — The head should be well balanced and 
 the features symmetrical. In children, plump cheeks, 
 with a smooth skin and absence of pimples, sbould be 
 looked for. Tbe complexion varies according to the 
 amount of pigment in the skin, from fair to dark, but 
 should be reddish in good health, pink in fair children 
 and a ruddy brown in those of darker complexion. The 
 lips and the inner surfaces of the eyelids should never be 
 pale, but the latter should not be unduly injected. 
 Children of southern races are sometimes pale though 
 healthy. The red colour is due to the red blood
 
 10 THE HYGIENE OE 
 
 corpuscles. These are microscopic discs observed in the 
 blood, 3^0 of an inch in diameter, and their function is 
 to convey oxygen to the tissues of the body for the 
 maintenance of life. Their number varies, but when 
 greatly diminished there is impairment of health. 
 
 Town dwellers suffer very much from anaemia, or 
 pallor, the result of indoor life and absence of sunlight. 
 Much can be done, even in town life, by exercise in the 
 open air and proper ventilation of living-rooms and 
 bedrooms. A child should be taught to sleep with the 
 windows open all the year round. The clothing of the 
 child should be warm, and if plenty of open-air exercise 
 is taken there is increased physical tone, and there- 
 fore lessened danger even when entering living rooms 
 overcrowded and unduly heated. Colds are rarely con- 
 tracted by persons living in the open air, except from 
 patients already suffering from catarrh, with whom they 
 are unavoidably thrown in contact in crowded rooms, 
 railway carriages, etc. 
 
 Measurements may be taken of the Head : (1) the 
 horizontal circumference ; (2) the transverse arch, from 
 ear-opening to ear-opening ; (3) from the bridge of the 
 nose to the prominence felt just above the nape of the 
 neck (occipital protuberance). In nervous children these 
 measurements may be compared from time to time. 
 A circumference of between 20 in. and 22 in. is normal 
 for school children. 
 
 Observe the profile, and note the curve of the top of 
 the head ; whether the forehead is prominent or receding ; 
 the shape of the nose, whether with marked bony bridge 
 or sunken ; the mouth, whether large, small, or well
 
 SCHOOLS AND SCHOLARS. 11 
 
 shaped ; and the chin, whether strongly shaped or 
 receding. Some of these particularities have a marked 
 
 effect on physical health, whilst others may be indicative 
 of mental deficiency, or the reverse. 
 
 Undue prominence of the upper part of the forehead, 
 giving the appearance of a large cranium, may be due to 
 rickets, and not to mental development. A small cranium 
 may go with fair mental development ; but in such cases 
 headaches are common. The head should be held erect. 
 In nervous girls it is often held on one side, and in 
 cases of nervous weakness it may be bowed. 
 
 A healthy, normal child has a calm expression. There 
 should be neither twitching of mouth, nor continual grin. 
 Wrinkling or puckering of the forehead is out of the 
 normal. It may be seen, causing horizontal lines in 
 deficient intellectuality, or by drawing of the eyebrows 
 together, so as to form vertical lines, in over-stress of 
 mental action. 
 
 The Mouth and Nose. — A small, narrow mouth may 
 interfere with proper breathing, whilst an unduly large 
 mouth with loose lips may accompany imperfect mental 
 development. Cleft palate may, or may not, accompanv 
 deficient intellect. The teeth should be regular and the 
 presence of caries (decay) may have marked effect on 
 health by interference with mastication, leading on to 
 digestive troubles. 
 
 On opening the mouth, the condition of the tongue 
 should be noted. It should be evenly red, without 
 fissures or sores. The insides of the lips and cheeks 
 should be even of surface, without sores or irregularities,
 
 12 THE HYGIENE OP 
 
 Such irregularities may be due to jagged teeth, dyspeptic 
 troubles, or signs of specific diseases. The mucous 
 membrane covering these surfaces is well supplied with 
 blood vessels, and is moistened by a clear fluid called the 
 saliva. * This may become excessive, thickened, or sticky, 
 owing to derangements in teeth, and then becomes a 
 suitable soil for the cultivation of disease germs, which, 
 in a state of health would find no lodgment. 
 
 Children should be taught to thoroughly masticate 
 their food, so that it may be well chewed and mixed with 
 saliva before being swallowed. It is then in a condition 
 more easy of digestion ; but, in addition, the use of the 
 teeth thoroughly in this way is beneficial to the teeth 
 themselves, the movement of the coarser particles over 
 and round about the teeth having a cleansing effect 
 upon them, whilst the increased flow of saliva washes 
 away particles of food from the teeth, which, if not 
 removed, may tend to set up decay. 
 
 At the back of the mouth is seen a fleshy arch, the 
 fauces, leading from the mouth to the throat. On either 
 side of this are the tonsils, which are normally slightly 
 rounded bodies lying between the pillars of the fauces, 
 whilst from the centre hangs a fleshy pendant called the 
 uvula. If the tonsils are enlarged, or covered with small 
 sores, or grey-looking particles, disease is probably 
 present. Behind the root of the tongue is the larynx, 
 where the voice is produced, and behind this is the gullet. 
 On either side of the upper part of the throat, behind 
 and above the tonsils, are the small openings of the 
 Eustachian Tubes, leading to the middle ears. 
 
 Behind and above the fauces, are the posterior or
 
 SCHOOLS AXD SCHOLARS. 13 
 
 internal openings of the nostrils, through which we are 
 intended to breathe whilst keeping the mouth closed. 
 The nose is therefore of great importance in respiration. 
 From the external, or anterior, openings of the nostrils to 
 the posterior openings is a large chamber divided up by 
 thin plates of bone, well covered with blood vessels, etc., 
 so that the ah', instead of rushing straight through the 
 nose, as it would do through a tube, is directed back- 
 wards and forwards, and from side to side, like a person 
 entering a maze, thus being brought into contact with a 
 large amount of surface in a restricted space. The inner 
 surfaces of the chambers of the nose are covered with 
 mucous membrane, well supplied with blood vessels, so 
 that the air becomes warmed and moistened before 
 going down into the lungs, instead of entering at the 
 temperature of the atmosphere, as it would do if taken in 
 by the mouth. Not only so, but particles of soot, etc., 
 adhere to the surfaces, and are worked outwards by 
 certain minute projections from the mucous membrane, 
 called cilia. 
 
 Blind, and deaf and dumb, persons sometimes have the 
 sense of smell sufficiently increased to detect persons and 
 things by their odours. 
 
 Discharges from the nose are of great importance, as 
 they frequently continue after supposed recovery from 
 scarlet fever and diphtheria, and are potent means of 
 spreading infection. 
 
 Catarrh of the nose, or cold in the head, may be an 
 early symptom of measles. Cold in the head results 
 from a general chill to the system, which lowers the 
 general vitality and renders the membranes of the nose,
 
 i; 
 
 14 THE HYGIENE OP 
 
 etc., liable to be attacked by germs coming from other 
 persons suffering from catarrh. In robust health the 
 membranes of the air passages have sufficient resistant 
 force to throw off the poison germ, so that it cannot take 
 root and germinate. This poison is most prevalent in\ 
 /crowded places, where persons with the disease are 
 / congregated, and it is therefore necessary, under like 
 I circumstances, to empty class-rooms frequently, so that 
 a* full current of air may be passed through them and 
 (the air revivified with oxygen to kill the poisonous germs. 
 ^ To preserve the mucous membrane from catching cold 
 it is necessary to bathe it frequently with pure fresh air. 
 Absolutely pure air is only found on mountain tops, or 
 mid-ocean ; but even the air in open places in cities 
 is sufficiently pure to give tone to the air passages and 
 render them fairly resistant to germs. The air of the 
 smallest lane, or alley, is purer than in crowded rooms, 
 churches, theatres, etc., in which the air is laden with 
 decaying organic matter from the lungs and skin, dust, 
 dirt, and germs. Sudden exposure to cold from a heated 
 room is inadvisable and sometimes dangerous. The 
 temperature of the room should be kept at about 60°, 
 and if there is cold wind or a very low temperature a 
 short, but rapid, exercise sufficient to start a vigorous 
 action of the heart should be taken before going into the 
 cold air. 
 
 The opening of the windows to revivify the impure air 
 of crowded rooms, whilst they are temporarily emptied, 
 serves also to lower the temperature of the room. If 
 this is done, children coming from the fresh air do not 
 suddenly enter an overheated room, full of organic
 
 SCHOOLS AND SCHOLARS. 15 
 
 particles and germs, which may be vigorously inhaled 
 owing to quickened breathing and the quickening of the 
 heart's action due to exercise. 
 
 East wind may be dangerous to any other than 
 very vigorous children, but all exposed to it should be 
 well clad and kept in rapid exercise. For school 
 exercises, as much shelter as possible from the wind 
 should be secured, and care should be taken to see that 
 the children are not kept longer at the exercise than is 
 necessary to set the circulation going thoroughly. 
 Anything like fatigue may be specially dangerous with 
 cold wind. 
 
 Fog, especially London fog, is dangerous for delicate 
 or poorly nourished children. Well fed children properly 
 clothed may be sent out into the London parks even in 
 foggy weather, and will probably suffer less from " colds " 
 than those who are kept indoors. 
 
 The posterior nostrils are sometimes obstructed with 
 fleshy growths called adenoids, or by enlarged tonsils 
 interfering with respiration. The child keeps the mouth 
 open, and the voice is harsh and thickened. M's and 
 N's are changed into B's and D's. There may be " cold 
 in the head," headache, or shortwindedness. If not 
 attended to, the respiration, by being impeded, prevents 
 proper expansion of Vho chest and lungs, and thus 
 the blood does not get properly oxygenated, causing 
 general debility, ill nutrition of the brain, etc. Growths 
 of this kind should be attended to in early life, and the 
 teacher must be on the look-out for thick utterance and 
 discharges from the nose, so that notice may be sent to 
 the parent and the child taken to a doctor for treatment.
 
 16 THE HYGIENE OP 
 
 The Ears and Hearing. — The ears should be alike, 
 well formed and symmetrical. There should not be 
 over-prominence with great convexity behind, and the 
 pleats should be well marked and regular. Malformations 
 of the ears are common enough in persons of weak intellect. 
 
 The oponing of the ear on either side is the orifice of a 
 short tube about 1J inches in length, which is closed 
 internally by the membrane of the drum of the ear. The 
 bottom of the tube is longer than the roof, so that the 
 membrane of the drum closes the tube in a slanting 
 direction. This tube is lined with skin having a few 
 hairs projecting into it, and it is liable to be affected 
 with skin diseases. 
 
 Inside the membrane is the drum of the ear, con- 
 taining three little bones called ossicles, which, being 
 attached to the membrane, act as levers, and convey the 
 impressions of the sound waves, coming through the air- 
 tube on to the membrane to the labyrinth, or internal ear, 
 where the sounds are registered and sent on to the brain. 
 
 The Eustachian Tube extends from the drum to the 
 upper part of the throat. It is not an open tube, except 
 during the act of swallowing, when air is allowed to enter 
 the drum or middle ear. If this tube is occluded by 
 catarrh or pressure from enlarged tonsils or adenoids, 
 hearing is interfered with, and singing in ears — tinnitus 
 aurium — with deafness is caused owing to the air in the 
 drum being more rarified than the external air. Hearing 
 is re-established as soon as the Eustachian Tube is 
 cleared and fresh air enters. 
 
 In order to test hearing, a watch may be used. A 
 number of persons with good hearing should be taken,
 
 SCHOOLS AND SCHOLARS. 17 
 
 and the watch held at measured distances from the ear, 
 so that the distance of hearing for that particular watch 
 should be gauged. The person to be tested should not 
 see the watch, and the opening of the opposite ear tube 
 should be closed. The watch should be suspended by 
 the handle on a level with the ear. 
 
 The teacher should test the power of the voice in the 
 school-room by placing a pupil at a distance of about 
 20 ft. with his back to the teacher, to avoid all chance of 
 lip reading, and the teacher should then speak in his 
 ordinary voice advancing a step or two till the spoken 
 words are distinctly heard. The teacher will then know 
 at what distance he should stand in order to be distinctly 
 beard by the class. 
 
 General noises such as are present in a school-room 
 have no prejudicial effect upon hearing. Earache is 
 frequent in children whilst cutting their second teeth. 
 It is caused in these circumstances by chill, and the patient 
 should be kept quiet in an equable temperature till well. 
 
 Discharges from the ear tubes are very common after 
 such diseases as Diphtheria and Scarlet Fever, and whilst 
 they continue the patients are liable to spread infection, 
 as the disease germs are usually present in these dis- 
 charges. Such discharges have also an offensive smell. 
 The discharge may be thin and glairy, or yellow and 
 thick, and may also be streaked with blood. If unattended 
 to, the discharge may spread to the inner car and deafness 
 be caused, or the bones may become diseased and abscess 
 of the bi-ain set up, causing death. All children with such 
 discharges should be placed under the care of a medical 
 man.
 
 18 THE HYGIENE OP 
 
 The Brain.— The brain is protected from injury from 
 without by the skull and within that by delicate mem- 
 branes. It consists of the cerebrum, the larger and upper 
 portion, and the cerebellum. It is in direct connection with 
 the spinal marrow, or spinal cord, which extends the whole 
 length of the spine. The cerebrum is divided into right 
 and left hemispheres and into lobes. The brain matter 
 is arranged in convolutions and consists of white and 
 grey matter. The more important structures are in 
 the central portion, in direct continuation with the 
 spinal cord. Portions of the outer portion of the brain 
 substance have been entirely removed without causing 
 death. For our purpose we may regard the brain as 
 consisting essentially of nerve cells and nerve fibres. The 
 nerve fibres are of two kinds, afferent and efferent, and 
 there are also fibres connecting the different cells. The 
 afferent nerves extend from the organs of special sense 
 such as the eye, ear, etc., to the nerve cells, whilst the 
 efferent nerves act from the nerve cells to the various 
 organs, and set up the action demanded by the organ 
 of special sense. The nerve cells act much in the 
 same waj T as a galvanic battery and become in time 
 exhausted and require replenishing. This can only be 
 accomplished by rest and a fresh supply of oxygen being 
 conveyed to them by the blood. If an apple is placed in 
 front of a young child, he looks at it ; the impression on 
 the eye is then taken by the afferent nerve to the brain, 
 and from the brain cell by the efferent nerve to the muscles 
 of the hand and arm, which is extended to seize the fruit. 
 Brains must not only be fed with oxygen, but by education, 
 for the nerve cells increase by stimulation through the
 
 SchooLs and scholars. 19 
 
 organs of sense. The movements in infants are spon- 
 taneous and they continue to be so to a considerable 
 extent up to school age. The movements of young 
 children should not be unduly controlled in the progress 
 of education. In young children, eye movements, however, 
 are not very extensive and training should be given to 
 their proper movement. The movements controlled from 
 the nervous centres are some voluntary and some in- 
 voluntary. The involuntary movements are those 
 concerned in the circulation, respiration, etc. 
 
 Much may be learnt from the study of a sleeping child. 
 
 " The body is quiet ; if you raise his hand gently, it 
 falls lifeless — no muscular energy is being expended. 
 The body is motionless in full sleep, except for the move- 
 ments of breathing, which are quiet, regular, and uniform. 
 If sleep is full and complete, on raising the eyelids, the 
 pupils are seen to be very small or contracted. The 
 body and brain are in complete rest ; no currents are 
 generated by the brain in perfect, dreamless sleep. You 
 then hear sounds in the house, which send currents from 
 the child's ear to his brain ; we then see movements of 
 his limbs. As sounds grow stronger in the house and 
 light comes in at the windows, the movements increase 
 and the eyelids open. The child wakes and sits up, 
 hence currents are now passing from the brain to the 
 muscles. Before school he is all movement owing to 
 spontaneous brain activity. Spontaneous brain action is 
 the basis on which you work in producing mental 
 aptitude; it must be co-ordinated or regulated, but not 
 so as to destroy spontaneity." — Warner.
 
 20 THE HYGIENE OF 
 
 CHAPTEE II. 
 
 oo>fr;o-o 
 
 The Eyes. — General appearance. — Movement of Eyes 
 equal and free, but not excessive. — Structure of the Eyes. 
 — Sclerotic. — Cornea. — Vitreous and aqueous humours. — 
 The Lens: convex; changeable focus. — Iris: Pupil; the 
 Retina. — The Normal Eye. — Parallel rays of light 
 focussed on the visual spot. — Binocular Vision. — The 
 Flat Eye, — Parallel rays focussed behind the visual spot. 
 —Alteration in the convexity of the Lens. — The ciliary 
 muscle : headache, blinking, twitching. — Remedy by 
 convex glasses. — The Long Eye. — Later period of school 
 life. — Parallel rays in front of visual spot. — Concave 
 glasses. — Book-reading easy. — Wall-reading difficult — 
 Cause, continued study of small objects. — Long hours of 
 study. — Home lessons injurious. — Astigmatism : difficulty 
 of seeing lines. — Type used in printing. — Disadvantages 
 of glazed or thin paper. — Names of Types: Solid, Thin- 
 leaded, Leaded. — Faults in the shape of the type letters: 
 German type. — Testing the Eyesight : Cards marked with 
 letters and distances at which they should be seen. — 
 Where to place the child to examine. — Registering defects. 
 
 The Eyes. — The eyes should he bright and clear. 
 The whites should not be tinged red. There should not 
 be sores, or styes on the eyelids, and the eyelashes 
 should not fall out. The eyes should be of equal size, 
 and the eyelids should rise and fall together. The eyes 
 should together follow an object moved about, two or 
 three feet in front of the face. When looking at near 
 objects, about ten inches, the eyes turn equally but 
 slightly towards one another. Horizontal movements 
 are made without much movement of the eyelids, but 
 vertical movements are accompanied by raising and
 
 SCHOOLS AND SCHOLARS. 
 
 21 
 
 lowering of the eyelids, or if necessary of the head itself. 
 Unnecessary movement of the head shows an absence of 
 eye training and is common in very young children. 
 The movements of the eyeball are affected by small 
 muscles (Fig. 1, 8) attached to the outside of the 
 eyeball and the walls of the orbit. 
 
 Excessive and unnecessary movement of the eyes or 
 eyelids may be a sign of nervous weakness. The eye 
 is a very complicated structure easily deranged, and with 
 little power of re-adjustment. In education the first 
 object should be to train and care for the eye so as to 
 
 MO 
 
 >-8 
 
 Fig. l.—The Eye. 
 improve it and make it a valuable commercial asset for 
 the life long use of its owner, but, in practice, education 
 has proved a source of injury to the eye, and it therefore 
 becomes imperative that the teacher, as representing the 
 State, should see that this state of misuse should cease
 
 22 THE HYGIENE OF 
 
 and that, at the least, care should be taken that no 
 injury should be done to the eye during school life. 
 
 The eye (Fig. 1) consists of a globe formed by a tough 
 opaque membrane called the sclerotic (2) and contain- 
 ing a jelly like transparent medium called the vitreous 
 humour (6). At the front part of this globe the sclerotic 
 merges into a clear transparent watch-glass-like modifica- 
 tion of the wall of the globe called the cornea (1). The 
 cornea has a fixed but different curvature to the sclerotic. 
 Behind the cornea and in front of the vitreous humour 
 is the crystalline lens (4), a resilient body supported in 
 position by the suspensory ligament and in intimate 
 connection with the choroid. The lens is convex and its 
 curvature can be changed (4a), and its form altered by the 
 action of the ciliary muscles (7) which lie behind the 
 sclerotic like flat circular rays beyond the circumference 
 of the lens. In the space between the lens and cornea 
 is the aqueous humour (5). 
 
 In front of the lens is the iris. This is a circular 
 curtain with a hole in the centre called the pupil, for 
 the transmission of light through the lens and the 
 vitreous humour, to form a picture on the retina (9), a 
 sensitive registering arrangement of nerve-filaments, on 
 the inner side of the sclerotic opposite the opening. 
 The colour of the iris depends upon the presence of 
 pigment cells. These are absent in the pink-eyed albino, 
 but become more and more numerous for blue, hazel, and 
 brown, or black, eyes. When light is strong the circular 
 muscular fibres cause the pupil to contract to a pin point, 
 and when light is dull the radiating fibres cause it to 
 dilate so that more light is admitted to the retina. The
 
 SCHOOLS AND SCHOLARS. 23 
 
 back of the iris is well supplied with pigment cells. At 
 its circumference the iris is intimately connected with 
 the choroid (3), a vascular lining membrane to the eyeball, 
 which is continuous with, but distinct from, the sensitive 
 retina at the back of the vitreous humour. The dark lining 
 of choroid and iris serves to absorb superfluous rays of 
 light so that all rays may be concentrated on the retina. 
 
 The retina is a delicate nervous membrane consisting 
 of two varieties of nerve structures, called rods and cones, 
 from which proceed nerve filaments conveying the 
 impressions received from the light rays to the brain 
 centre. This membrane is a very delicate structure in 
 seven layers about -^ inch thick. The central portion is 
 about half that thickness, and is the most sensitive to 
 light. It is to the perfection, or imperfection, of eyesighl 
 in the central point that all references to standards of 
 vision are made. The outer parts of the retina enable 
 us to see large objects, and by this means we are able to 
 walk safely along a road whilst the central point of 
 vision is occupied with reading a letter or book. The optic 
 nerve (10) enters the eyeball in the outer part of the retina. 
 
 Normal Yision. — The normal eye is known as the 
 emmetropic eye. In this eye the rays of light coming 
 from a distance as parallel rays, are focussed by the 
 convex crystalline lens to converge at the visual point of 
 the retina so as to form a perfect picture. Rays proceed- 
 ing from a near object are divergent, and these musl hi' 
 made to converge to the visual point of the retina by the 
 convex crystalline lens. This convexity is, however, 
 fitted for converging the parallel rays coming from a 
 distance, and in order to converge the near divergent
 
 24 
 
 THE HYGIENE OE 
 
 B 
 
 rays the convexity of the lens must be increased. This 
 is effected by the contraction of the ciliary muscles 
 drawing the choroid forward and lessening the strain 
 upon the suspensory ligament of the lens. The lens 
 being of a resilient 
 nature in construction 
 springs forward and in- 
 creases the convexity 
 more particularly that 
 of the anterior surface 
 (Fig. 1, 4a). 
 Binocular Vision — 
 It must be remem- 
 bered that proper 
 vision is binocular, 
 that is, both eyes are 
 used to see one object. 
 The optic nerve is 
 peculiar in its con- 
 struction for this 
 reason. Thus the fibres 
 rising on either side 
 of the brain supply 
 not only the eye of 
 the same side, but 
 
 send fibres across through the optic commissure to 
 the eye of the opposite side. Fibres also pass through 
 this commissure from one side of the brain to the other, 
 and from one retina to the other. From Fig. 3 it is 
 apparent that an object nearer the eye, say at 2 feet, 
 appears larger than the same object at 4 feet, and it may 
 
 Fig. 2.— (A) The Normal Eye; 
 
 (B) the Hypermetropic Eye ; 
 
 (C) the Myopic Eye.
 
 SCHOOLS AND SCHOLARS. 
 
 25 
 
 therefore be asked why it should not be looked at 2 
 feet away instead of 1 feet. The reason is that at 
 four feet away there is less necessity for the eyeballs to 
 converge in order to see a single picture of the object, 
 and therefore less need to bring the action of the ciliary 
 muscle into play than at two feet; also as the object is 
 seen by both eyes, both ciliary muscles would be brought 
 into use and made tired. As this muscle very readily 
 becomes fatigued it is better to look at the object at a 
 
 Why an Object appears larger wlien near the Eye. 
 
 greater distance, as less convergence of the rays is needed 
 to focus it on the retina, and there is consequently less 
 fatigue of the muscles. When the child tires from 
 looking at the object, the picture on the retina becomes 
 blurred because — the focus not being exactly maintained — 
 instead of both eyes seeing the object as one, there is a 
 little irregularity, and the object appeals with a ghost- 
 like double beside it. As the fatigue increases, the error in
 
 26 THE HYGIENE OF 
 
 vision increases, and under continued exertion the eyeball 
 becomes lengthened and short sight is induced. 
 
 Hypermetropia. — At birth the eye is always flat. 
 It is, in fact, an immature eye, and under favourable 
 circumstances tends to become a normal eye at manhood. 
 Hill tribes are usually found with normal sight, but in 
 school children in civilized countries the normal eye has 
 become abnormal from its rarity. In the junior classes 
 88 per cent, of the eyes of the children are hypermetropic, 
 and a little over 4 per cent, are myopic, but in the 
 senior classes hypermetropia is reduced to 67 per cent., 
 and myopia increased to 19 per cent. Normal vision is 
 respectively 8 per cent, and 14 per cent. In hypermetropia, 
 parallel rays from the distant point of vision converge from 
 the crystalline lens to a point beyond the retina, so that 
 the picture instead of being focussed to a point is focussed 
 to a circular disc and is consequently blurred, owing to the 
 flatness of the eye (Fig. 2 B). The ciliary muscle in 
 consequence is brought into action and the convexity 
 of the lens increased so as to bring the long distance 
 parallel rays to a focus point on the retina. This action 
 of the ciliary muscle is, however, intended to be used for 
 near objects, and it is clear that if used in addition for 
 distant objects it must become overworked. The ciliary 
 muscle is very readily overstrained and then does not 
 respond quickly when required to change the focus. 
 Overstrain causes blinking and winking ; especially on 
 exposure to light. The eyes ache or there may be 
 neuralgia which is perhaps attributed to some other 
 cause, and may come on hours after the strain ; twitch-
 
 SCHOOLS AND SCHOLARS. 27 
 
 ings of the eyelids, sometimes extending to other muscles 
 of the face and resembling St. Vitus's dance. The eyes 
 are congested and red, and watering. Styes are common 
 and the eyelids stick together in the morning. In had 
 cases there may be squint, dizziness and nausea, for 
 which skilled aid should be called in. 
 
 In order to remedy the defect of the flat eye, a convex 
 glass is placed in front of the eye, of such a convexity 
 that the parallel rays from the distant visual point are 
 focussed correctly on the retina without bringing the 
 ciliary muscle into use to increase the convexity of the 
 
 Fig. 4.— The Use of Spectacles for Longsightedness. 
 
 lens (Fig. 4). Thus the flat eye is made equal to 
 a normal eye for distant sight, and the accommodation of 
 the eye by the action of the ciliary muscles on the lens is 
 left unused except for the adjustment of near objects for 
 which it is intended. 
 
 Children do not call attention to defects unless pain is 
 caused, as they have no standard of vision bj which 
 they can estimate errors. In addition to the ill effects 
 arising and already mentioned, it will be noted thai 
 flat-eyed children begin to read well, hut as the ciliarj 
 muscles tire the child makes mistakes. It then shuts 
 the eyes, rubs them and tries to read again, but
 
 28 THE HYGIENE OP 
 
 quickly tires. Such children are always slow in learning 
 to read. 
 
 Hypermetropia may be mistaken for myopia because 
 the child brings the book nearer the eyes to read. This 
 is done partly because spasm of the ciliary muscles is 
 caused by the effort to see small objects at a moderate 
 distance, and because by so doing the image appears 
 larger and this compensates for the indistinctions. The 
 child usually sees worse in the morning, as the ciliary 
 muscles have not got into proper working trim. 
 
 Proper glasses effect a remedy in most cases, but in a 
 certain number it is necessary to leave off lessons and 
 keep the child at play in the open air for a lengthened 
 period. 
 
 Myopia — The elongated eye, or shortsighted eye is 
 chiefly found in the later periods of school life. In this 
 eye, the eyeball being lengthened, the parallel rays are 
 focussed to a point in front of the retina from which 
 they diverge so as to fall on the point of sight 
 
 Fig. 5. — TIlc Use of Spectacles for Shortsightedness. 
 
 as a disc instead of a point, and thus give a blurred 
 picture. Eays from near objects being divergent, these 
 eyes can focus objects up to a given distance without 
 exertion, but not beyond (Fi.u'. 6). 
 
 Inorderti the parallel raj iswithou (don,
 
 SCHOOLS AND SCHOLARS. 
 
 •29 
 
 concave glasses are place. 1 in front of the eye, by which 
 these rays arc made slightly divergent as they fall on the 
 convex crystalline lens, and are then less convergent as 
 they pass "ii from the lens, so that they focus to a point, 
 on the retina behind those from parallel rays (Fig. 5). 
 
 Fig. 6. — Divergent Rays in Myopic Eye. 
 
 Short-sight or myopia is caused by the continued study of 
 small objects by persons with eyes having a weakened 
 enclosing case. This may he moderate, in which ca.se no 
 harm results, or excessive, such as when bulging of the 
 sclerotic increases the length of the eye and still further 
 increases the myopia. 
 
 Children should be suspected to he myopic when 
 they read well from books that are readilj adjusted 
 to the right focus, but not from the blackboard or 
 
 Fig ','. Parallel Bays in Myopic Eye. 
 
 diagrams on the wall, which being fixed, the parallel 
 
 in focn ied in front of i be c I ina h\ the myopic; 
 
 eye. Natural objects in. i ■.. easilj I" distinguished by
 
 30 THE HYGIENE OF 
 
 persons who only see distant objects slightly blurred, 
 as they can readily compare a blurred haystack with 
 a blurred house. Some letters may even be dis- 
 tinguished if they are of markedly different shape. It 
 is therefore necessary to test the eyesight for certain 
 definite objects at certain definite distances. A slight 
 amount of myopia may not be any disadvantage for town 
 life, but is a bar to employment in the navy and to a 
 lesser degree in the army and mercantile marine. 
 
 It has been shown before that children are born with 
 flat eyes or hypermetropia. These eyes when disposed 
 to myopia, gradually pass from the flat to the elongated 
 type till they reach a certain point when the progression 
 may stop and a serviceable eye result. 
 
 In other cases the change is not gradual, but by fits 
 and starts, probably owing to unsuitable surroundings 
 and to straining of the eyes at small objects. The 
 eyes may progress at different rates so that one eye only 
 is habitually in use, and the other assumes an excessive 
 squint, making a very ugly deformity. These cases may 
 cease to progress after manhood is reached, but in 
 extreme cases continue to get worse into middle life. 
 
 It is thus clear that short sight is greatly aggravated 
 by the usual methods of education. It arises in children 
 with predisposition, but also in those suffering from 
 general weakness, either physical or nervous, and 
 particularly in those convalescing from febrile diseases. 
 Fever hospitals should not, therefore, have books with 
 small print for the amusement of the inmates. 
 
 We will proceed to deal with the chief causes of 
 aggravation of this disorder. Beading and writing cause
 
 SCHOOLS AND SCHOLARS. 3l 
 
 physical exertion in the accommodation of the eye, and 
 should not be continued for long periods without intervals 
 of rest for recovery of tone in the ciliary muscles, which 
 have been shown to be particularly liable to fatigue. 
 Tasks should not be too long. The change from a study 
 of near objects to distant objects should not he immediate, 
 but separated by an interval of exercise, singing, etc. 
 
 Impositions of writing should be condemned, and 
 writing exercises should he limited, as they are only useful 
 for classification, and do not assist the memory as much 
 as is often supposed. 
 
 Home lessons may be useful to the teacher in working 
 the classes, but they are extremely prejudicial to the 
 scholar. In the evening the child is tired and sleepy, 
 and in the majority of homes there arc not proper desks, 
 proper light, or proper quiet for doing the work. The 
 eye is almost first to show signs of desire for sleep, and 
 it is clear that under such conditions it is not in a fit 
 state to be used. 
 
 Astigmatism. — This form of eye disease usually 
 accompanies hypermetropia and myopia and is caused 
 by variations in the curvature of the cornea, or the 
 structure of the lens. It is sometimes caused by 
 ulcers, etc., of the cornea. 
 
 There is usually difficulty of distant vision. There 
 may be headache, and sometimes the patient sees better 
 by putting bis bead on one side 30 thai some of the rays 
 of light are cut off h\ the bridge of the nose. The tests 
 usually made use of are radiating lines, some of which 
 will he blurred if this condition exists. The condition
 
 THE HYGIENE OF 
 
 may vary in the two eyes. Special cylindrical glasses 
 have to be used to correct the errors. 
 
 Printing Types. — The type used in printing is often 
 harmful to the sight. In newspapers it is frequently 
 indistinct and on thin paper, showing signs of the print on 
 the back of the sheet. In books the paper is glazed and 
 shiny, reflecting light and making the print look faint. 
 A list of the names of the different tvpe, with specimens 
 of the size, will be found useful. 
 
 Name. 
 
 Height of Letters. 
 
 Brilliant ... ... ... 
 
 ... ... 0"75 mm. 
 
 Pearl 
 
 ... 10 
 
 Minion 
 
 1-25 
 
 Bourgeois ... 
 
 1-5 
 
 Small Pica 
 
 ... 1-75 
 
 Pica 
 
 2-0 
 
 English 
 
 2-5 
 
 It is evident that Bourgeois is the smallest that should 
 be used constantly, whilst for school books Pica for 
 older children and English for the beginners is absolutely 
 necessary, as the book should be seen at least 24 inches 
 from the face. The book should not be held in the hand . 
 but propped up on the desk in front whilst the scholar 
 sits straight on the seat, with the back supported. 
 
 p, q, d, are legible, but h is like b, making easy 
 recognition difficult. IE3I and XT are too much alike, 
 the cross line being very thin. f-| \J are much easier 
 to distinguish. The time of exposure for the recognition 
 of a letter varies from ten to fifty one-thousandths of a 
 second for different letters.
 
 SCHOOLS AND SCIIOl. 33 
 
 If the letters are too close together, the rapidity with 
 which they have to be received on the retina causi 
 some blurring of the outline, consequently the words 
 should be well spaced from one another, and an arrange- 
 ment, winch is known as " leading," made use of to 
 separate the lines. The same sentence is shown solid, 
 thin leaded, and double leaded in different types. 
 
 PICA. 
 
 "Ido not know what I may appear to the 
 world, but to myself I seem to have been only 
 a boy playing on the seashore, and diverting 
 myself now and then finding a smoother 
 pebble, or a prettier shell than ordinary, whilst 
 the great ocean of truth lay all undiscovered 
 before me." 
 
 " I do not know what I may appear to the 
 world, but to myself I seem to have been only 
 a boy playing on the seashore, and diverting 
 myself now and then finding a smoother 
 pebble, or a prettier shell than ordinary, whilst 
 the great ocean of truth lay all undiscovered 
 before me." 
 
 " I do not know what I may appear to the 
 world, but to myself I seem to have been only 
 a boy playing on the seashore, and diverting 
 myself now and then finding a smoother 
 pebble, or a prettier shell than ordinary, whilst 
 the great ocean of truth lay all undiscovered 
 before me."
 
 34 THE HYGIENE OP 
 
 BOURGEOIS. 
 "I do not know what I may appear to the world, but to 
 myself I seem to have been only a boy playing on the sea 
 shore, and diverting myself now and then finding a smoother 
 pebble, or a prettier shell than ordinary, whilst the great 
 ocean of truth lay all undiscovered before me." 
 
 " I do not know what I may appear to the world, but to 
 myself I seem to have been only a boy playing on the sea 
 shore, and diverting myself now and then finding a smoother 
 pebble, or a prettier shell than ordinary, whilst the great 
 ocean of truth lay all undiscovered before me." 
 
 " I do not know what I may appear to the world, but to 
 myself I seem to have been only a boy playing on the sea 
 shore, and diverting myself now and then finding a smoother 
 pebble, or a prettier shell than ordinary, whilst the great 
 ocean of truth lay all undiscovered before me." 
 
 MINION. 
 " I do not know what I may appear to the world, but to myself I 
 seem to have been only a boy playing on the seashore, and diverting 
 myself now and then finding a smoother psbble, or a prettier shell than 
 ordinary, whilst the great ocean of truth lay all undiscovered before 
 me." 
 
 " I do not know what I may appear to the world, but to myself I 
 seem to have been only a boy playing on the seashore, and diverting 
 myself now and then finding a smoother pebble, or a prettier shell than 
 ordinary, whilst the great ocean of truth lay all undiscovered before 
 me." 
 
 ''I do not know what I may appear to the world, but to myself I 
 seem to have been only a boy playing on the seashore, and diverting 
 myself now and then finding a smoother pebble, or a prettier shell than 
 ordinary, whilst the great ocean of truth lay all undiscovered before 
 me." 
 
 The lines of a book should not be too long, so that 
 if a book is wide it is better divided into two columns for 
 ea,sy reading. 
 
 Paragraphs should also be short, and the Bible printed 
 in good type, being in verses, is easy to read. Dialogue 
 is also a form that does not tire the eyes.
 
 u 
 
 o 
 
 LJ 
 
 m 
 
 > 
 
 H 
 
 J) 
 O 
 
 c
 
 N H 
 
 A 
 
 T N Z L 
 
 D U H N 
 
 Z A E X P L 
 
 FLTCDVZN 
 
 UOPNZAEXL 
 
 AHLDEXFCNPVO
 
 SCHOOLS AND SCHOLARS. 35 
 
 The printed letters themselves should be plain and 
 simple with the spaces well marked. All kinds of 
 unnecessary finials, or seriphs, and extreme contrast 
 between the up and down strokes should be avoided. 
 
 German type is especially trying to the eyes and is 
 gradually ceasing to be used in Germany, more especially 
 in works of a scientific nature. 
 
 Maps are best studied from large clearly printed sheets 
 hanging on the walls. Small maps crowded with detail 
 are very trying to the eyes. 
 
 Testing the Eyesight. — The sight of school children 
 should be tested twice yearly. This is done by the use 
 of types specially printed and marked with a figure 
 indicating the number of metres at which it should be 
 seen. Taking the type 6 and placing the child at 
 six metres distance, if it is read distinctly the sight may 
 be uniformly expressed by placing the distance as the 
 numerator and the type read as the denominator of a 
 fraction thus, § or normal vision, but if at six metres 
 the type eighteen is the smallest seen distinctly, the 
 vision is expressed as T ° g or i of the normal. 
 
 The child should be placed so that the light falls on 
 the typos and does not dazzle the child's eyes. A variety 
 of tests should be kept so that the children should not 
 learn the order of the letters. Children should generally 
 see better than the standard, but with young children 
 allowance must be made for want of familiarih with the 
 letters. Each eye should be examined separately by 
 covering one eye with a card. If any defect is discovered 
 the parents should be informed so that means may be 
 taken to obtain proper spectacles.
 
 36 THE HYGIENE OP 
 
 CHAPTEE III. 
 
 -oO^Oft- 
 
 The Neck and Throat. — Glandular swellings. — The 
 Larynx : A triangular-shaped box. — Voice production. — 
 Vocal chords : bass and soprano. — Movement of lips, 
 tongue, etc., in articulate speech. — -Voice in school. — 
 Proper articulation : Position of the Body. — Tight cloth- 
 ing, corsets, belts, etc., interfere with clear speech. — In 
 voice production the extremities are fixed and the chest 
 in movement. — Singing should not accompany general 
 exercise. — Hoarseness : Mucus on the vocal chords. — 
 Clergyman's sore throat. — Bad speakers trying to speak 
 loudly. — Stammering : Spasmodic contraction of dia- 
 phragm ; more common in boys. — Thick voice. — Adenoids. 
 — Whispering. — Speech without voice. — Voice changes 
 more marked and later in boys. The Chest. — Eespiration. 
 — Expiration slightly longer than inspiration. — Measure- 
 ments of the Chest : half the height of body ; greater in 
 country public schools, — Inspiration increases size of 
 Chest. — Action of the diaphragm. — The Lungs. — Bronchi. 
 — Air cells. — Oxidation of air. — Respiratory capacity. — 
 The Heart. — Pulse beat 90 at six years, decreasing with 
 age. The Spine. — Its curves ; its construction ; its 
 muscles. — Unsuitable postures cause curvature. — Consti- 
 tutional and local causes. —Position of children in 
 standing : legs apart ; military stand easy. — Real cause 
 of deformity. — Necessity for physical exercise. — Tone to 
 the muscles. — Increased physical capacity entailing in- 
 creased mental power. 
 
 The Neck and Throat. — The neck is comparatively 
 small in children. Particular attention should be paid to 
 any general fulness (particularly under the jaws), or 
 swellings of the glands of the neck, as these become 
 enlarged in many diseases, especially the ordinary 
 infectious disorders ; but small chains of swollen glands 
 sometimes exist in the neck as a consequence of pediculi
 
 SCHOOLS AND SCHOLARS. 3? 
 
 (lice) in the head. The swelling of the glands may also 
 be due to scrofula. 
 
 In the front pari of the neck the larynx or voice organ 
 is situated. This is commonly called Adam's apple, but 
 
 it only becomes prominent in men at puberty. It is a 
 triangular-shaped chamber with hard cartilaginous walls, 
 the angle pointing forward. The vocal chords are folds of 
 membrane at the upper part of the larynx. When at rest 
 the opening is triangular with the apex in front and air 
 passes in and out of the lungs without sound being 
 produced. These chords can he tightened by the action 
 of certain muscles, and they are then brought closer 
 together, when the air passing between them causes 
 vibrations which produce notes varying from low to high 
 according to the tightness with which they are stretched. 
 The amount of tension for each particular person varies, 
 and notes are caused by the number of vibrations, 
 ranging for chest notes from 42 for the lowest bass, to 
 1,708 for the highest soprano. These notes are modified 
 by the movements of the tongue, teeth, and lips for 
 articulate speech. 
 
 The voice is not greatly exercised in school, because 
 much time is given to study, writing, etc., but every 
 child should be taught to speak slowly and deliberately, 
 raising the voice so thai the sound may carry, and 
 opening the mouth so as fco articulate properly. 
 
 The' pupil should band ereel with the head raised and 
 the shoulders tin-own back so as to allow of the tree 
 expansion of fche chest. It is much easier fco speak 
 clearly when standing than when sitting; and in the 
 correct attitude than in any other position.
 
 38 THE HYGIENE OF 
 
 There should be no constriction round the waist in the 
 shape of belts or corsets as the abdominal muscles should 
 have full play when breathing. The teacher should 
 notice whether there is undue action of the collar bones 
 during singing or speaking as this is a sign of abdominal 
 constriction. Singing is very useful as a chest exercise 
 if properly conducted by a teacher who can show the 
 pupil how to draw in the breath properly, so that the 
 notes may be sustained for a longer or shorter period. 
 Singing should be taught in a quiet class room, and there 
 should be avoidance of sudden and unsuitable inter- 
 ruptions. It is not to be used as an accompaniment to 
 muscular exercises. In muscular exercises the upper 
 extremities, and to a certain extent the lower extremities, 
 act with the trunk as a fixed point from which the 
 movements are made. In singing, and to a lesser degree 
 in speaking, the chest is in movement and the extremities 
 at rest, that is, the extremities become practically the 
 fixed points from which the muscles of the chest act. 
 
 Hoarseness is caused by mucus on the vocal chords, 
 but the character of the voice is affected by the healthy, 
 or unhealthy, condition of the mucus lining of the mouth, 
 nose, and throat, as well as of the larynx. 
 
 Clergymen's sore throat is caused by an attempt being 
 made to speak long and loudly, by persons whose usual 
 articulation is slovenly and indistinct. 
 
 Children, from shyness, often speak in a mumbling way 
 with closed teeth and half-opened lips and the teacher 
 must overcome this timidity, before further progress can 
 be made in teaching the child to speak properly. 
 
 Stammering is a disturbance of the formation of sounds
 
 SCHOOLS AND SCHOLARS. 39 
 
 and is due to long continued spasmodic contraction of the 
 diaphragm. Speech being dependent upon an expiratory 
 
 blast, is hindered through the spasm preventing expira- 
 tion. The treatment is to regulate the respirations. One 
 way in which this is done is by making the person sing 
 instead of speak. Stammering may be brought on by 
 mental excitement or emotional disturbance. 
 
 In stuttering, the defective speech is due to inability 
 to form the proper sounds. 
 
 Stammering and stuttering are more common in boys 
 than girls and may be acquired by imitation in children 
 predisposed by inheritance. In stammering there is 
 usually visible muscular spasm in the face and other 
 parts, and the teacher should try to lessen the duration 
 and severity of each attack by arresting the spasm when 
 it commences, telling the boy to stop speaking and 
 try again presently. 
 
 Amongst other defects of speech are a thick and 
 indistinct utterance in mouth breathers due to impedi- 
 ments to proper breathing through the nose, such as 
 adenoid growths and enlarged tonsils. 
 
 Whispering is speech without voice, that is to say, it is 
 produced by the action of the tongue, teeth, lips, and the 
 resonant cavities, nose, mouth, and throat, but not by 
 the action of the vocal cords. 
 
 A remarkable change takes place in the voice at 
 puberty. The larynx increases in size, and, in boys, the 
 Adam's apple is seen. The voice change is more 
 troublesome in hoys and much more marked than in girls. 
 
 it also occurs later — in girls at about thirteen, and 
 boys at about sixteen years. At this time the voice
 
 40 
 
 THE HYGIENE OP 
 
 should not be over exercised. This more particularly 
 applies to singing. 
 
 The shouting of boys and girls in games need not be 
 interfered with as it is due to natural ebullition of spirits. 
 
 The Chest. — The chest contains the lungs, heart and 
 great vessels. The lungs extend from about one inch 
 above the collar bone to the lowest rib at the back, but 
 in front to between the sixth and seventh ribs. The 
 respirations in children range fi - orn 26 per minute at five 
 years to about 20 per minute at the termination of school 
 life, i.e., between the ages of fifteen and twenty. In 
 adults, from 16 to 18-7 per minute is the normal range. 
 Expiration is slightly longer than inspiration, the ratio 
 being about eight to six in the case of children and 
 seven to six in the case of adults. 
 
 AVERAGE CHEST GIRTH. 
 
 AGE NEXT 
 BIRTHDAY. 
 
 TOWN ARTISAN 
 CLASS. 
 
 (Dr. Robert's.) 
 
 ALL CLASSES. 
 
 (Report of 
 Anthropometric 
 
 Committee.) 
 
 10 Years. 
 
 24-08 ins. 
 
 26-10 ins. 
 
 11 
 
 24-34 „ 
 
 26-53 „ 
 
 12 
 
 24-93 „ 
 
 27-20 „ 
 
 13 
 
 25-24 „ 
 
 28-03 „ 
 
 14 
 
 26-28 „ 
 
 28-46 „ 
 
 15 
 
 27-51 „ 
 
 29-74 „ 
 
 1G „ 
 
 28-97 „ 
 
 31-53 „ 
 
 17 
 
 29-38 „ 
 
 33 64 „ 
 
 18 
 
 30-07 „ 
 
 34-19 „ 
 
 The girth of the chest during moderate expansion is 
 about half the height of tbe body. The chest increases
 
 SCHOOLS AM' SCHOLARS. 11 
 
 in inspiration about five or six inches in the case of 
 adults and proportionally less in children. The lowesl 
 limit of the lungs in inspiration is about one inch lower 
 than the line maintained during rest, and in expiration it 
 rises about one inch above that line. A comparison is 
 shown in the table of chest girth in certain cla It 
 
 has been shown that in country public schools it is 
 comparatively greater than in elementary and other 
 schools where less attention is paid to physical develop- 
 ment. 
 
 The chest is closed in below by a flat muscle called the 
 Diaphragm. The central portion is tendinous and 
 supports the heart, and is relatively fixed whilst the 
 surrounding muscular fibres act in inspiration. The 
 increase in the chest capacity is partly by the chest 
 walls being raised, and partly by the lowering of the 
 diaphragm or floor of the chest. In expiration, the 
 diaphragm is passive and is pushed up by the abdominal 
 muscles. 
 
 The lungs, with the heart and big blood vessels, occupy 
 the cavity of the chest. 
 
 Tpie Lungs are the organs affecting the aeration of the 
 blood; together they weigh about forty-two ounces, the 
 right lung being about two ounces the heavier. The air 
 passes through the larynx or voice organ into the trachea, 
 or wind pipe, a tube which is continued well down into 
 the chest where it divides into the bronchi, which 
 divide again and again, like the branches of a, tree, 
 into the bronchia] tubes. These terminate in the air 
 
 cells, where the air comes into contact with the 
 small blood \'>sels, whose walls, heme, very thin, are
 
 42 THE HYGIENE OF 
 
 able to absorb the oxygen of the air and give up 
 the carbon dioxide, which is the result of oxidation 
 in the body. 
 
 The mass of the lungs is made up of the air cells, and 
 is of a spongy nature. It completely surrounds the 
 bronchi and bronchial tubes, which are lined with 
 ciliated epithelium and are kept in an open con- 
 dition by the cartilaginous rings in their walls. 
 These cilia resemble very minute hairs and act so 
 as to eject foreign bodies, such as dust particles, from 
 the lungs. 
 
 The respiratory capacity of the lungs is about 
 230 cu. in., of which about 100 cu. in. of residual air 
 always remains in the chest ; 20 cu. in. is expired 
 and inspired as tidal air, in ordinary respiration. 
 110 cu. in. of reserve, or supplemental air, may be 
 expelled from the lungs by additional effort after a 
 normal expiration. An additional 110 cu. in. can be 
 inspired in forced respiration; this is called comple- 
 mental air. 
 
 The Heart is on the left side of the chest and the 
 beats may be felt 2 in. below the nipple, and 1 in. towards 
 the middle line of the body. The pulse beats are about 
 ninety at five years of age decreasing to about seventy at 
 twenty years. 
 
 The heart's action is easily accelerated in children 
 by slight ailments, and is, of course, increased by 
 exercise. 
 
 The child's chest should be broad, and he should 
 stand with his shoulders square, level one with the 
 other, and well set back.
 
 SCHOOLS AND SCHOLARS. 
 
 43 
 
 The Spine. — The vertebral column or spine is at the 
 
 back of the chest. When looked ai from behind it 
 
 should he perfectly 
 straight and erect. 
 There is, however, 
 always a slight lateral 
 curvature, with the 
 convexity towards the 
 right side, except in 
 left-handed persons, 
 when it is towards 
 the left. This is 
 caused by fche extra 
 amount of us • of one 
 side The spine is 
 made up of small 
 bones called verte- 
 bras. Seven of these 
 are the neck bones 
 (cervical vertebrae), 
 then come twelve 
 hack hones (dorsal 
 vertebrae), and five 
 loin hones (lumbar 
 \ er t e l> r ae), t h e 
 termination of the 
 spine being in the 
 sacrum and coccyx, 
 or r ii (1 i m e a t a r \ 
 tail. 
 Looked at in profile the spine has several curves. 
 
 Fig. 8.— The Spine and Bones of 
 the Ti unk.
 
 44 THE HYGIENE OP 
 
 The neck or cervical curve is slightly convex in front ; 
 the dorsal curve is concave in front, changing to convex 
 in the lumbar or loin region, and becoming concave 
 again for the sacrum and coccyx (Fig. 8). 
 
 The separate bones of the spine called vertebrae are 
 piled one above the other, large in the loins, and getting 
 smaller towards the neck. These bones consist of flat 
 masses of bone forming the bodies, and certain processes 
 behind forming the ring for the c 
 
 spinal cord, and behind that the 
 spines which act as a protection 
 for the delicate spinal cord or 
 marrow, and also for the attach- 
 ment of the muscles which keep 
 the body erect. Between the body 
 
 of each vertebra there is a flat _.. n 
 
 Fig. 9. — A Vertebra 
 
 disc of hbro-cartilage which acts as in Section, (a) Spinal 
 
 , ,.„ . , , ah ,i Canal for Marrow ; (b) 
 
 a buffer against shock. All the Body of Vertebra ; (c) 
 
 parts are intimately bound together Processes for attach- 
 ment of Muscles. 
 by ligaments, and the whole is 
 
 embedded in muscles. There is a very limited move- 
 ment of the spine, both laterally and backwards and 
 forwards. 
 
 The spine is kept erect, in part only, by its bony 
 structure ; the upright position being largely maintained 
 by the action of the muscles of the back, etc., balancing 
 the body correctly. The curves of the spine should not 
 be excessive, and it must constantly be borne in mind 
 that the constant use of unsuitable postures may have a 
 marked and lasting effect upon the curvatures, and that 
 chiefly in the weakly children who are the most likely to
 
 SCHOOLS AND SCHOLAKS. 45 
 
 assume the awkward pose, on account of earlier fatigue 
 of certain sets of muscles. 
 
 Undue curvature in the lumbar region is found to 
 exist in children with weakness of the spinal muscles, 
 and arises from the fact that when the arms are thrown 
 forward the centre of gravity is thrown forward. This 
 can be counterbalanced by strong spinal muscles 
 maintaining the erect position. If, however, the muscles 
 are weak, the shoulders fall back as a counterbalance to 
 the extended arms and the loin is unduly curved. This 
 position was once a temporary fashion, known as the 
 " Roman Fall," in distinction to the " Grecian Bend." 
 It is often to be found in children with weakness of the 
 nervous system, and is referred to as lordosis. 
 
 Lateral curvature of the spine may be suspected if the 
 scholar is noticed to constantly lean to one side whilst 
 at work. One shoulder seems higher than the other, and 
 there may be twitching or uneven movements of the two 
 sides. The postures may arise in a child with defective 
 vision through the endeavour to find an easy position for 
 effective sight of the object placed before it. 
 
 Lateral curvatures are most frequently caused by 
 unsuitable postures, but they are usually divided into 
 three classes : (1) Constitutional causes, (2) A mixture 
 of constitutional and local causes, and (3) Local causes, 
 chiefly mechanical, and due to the continued use of 
 muscles on one side or the other, instead of alternately. 
 There is often slight normal convexity to the right side 
 which may be disregarded. In the first-class the 
 deformity comes on in very early life. It may be 
 hereditary or due to the improper surroundings of the
 
 4G 
 
 THE HYGIENE OF 
 
 child as regards food, air, etc. The second and third 
 classes form about ninety per cent, of the whole. 
 In the second-class the local causes may combine with 
 hereditary causes or with rickets. The commencement 
 of the deformity 
 may arise from an 
 unsuitable posture 
 in nursing, the child 
 being held con- 
 stantly on the one 
 arm so that the 
 infant has always 
 the same arm round 
 the nurse's neck. 
 If the child is 
 nursed on the left 
 arm, the child's 
 right shoulder is 
 elevated to throw 
 the right arm round 
 the nurse's neck, 
 and the left 
 shoulder is lowered 
 and the spine hol- 
 lowed towards that 
 side. The devia- 
 tion of the bodies of the vertebrae is greater than that of 
 the spines, so that the curvature is really greater than it 
 appears externally. The third class of cause occurs before 
 the completion of growth, and usually arises from unsuitable 
 attitudes in the posture assumed for standing, sitting, etc. 
 
 Fig. 10. — Lateral Curvature of the Spine.
 
 SCHOOLS AND SCHOLVKK. 17 
 
 In standing, children rest principally on one leg, or 
 
 cross-legged, but rarely in the best position with the fi 
 slightly apart and the body supported evenly od both 
 
 js. This is the position of least fatigue. Standing 
 at attention causes considerable muscular effort, whilsl 
 the force of supporting the weight on one leg whil 
 other is thrust forward causes a convexity of the -pine 
 towards the side on which the weight is supported. 
 In the position of the military stand easy, the weight is 
 on the left leg, and the convexity to the left counteracts 
 the frequently normal convexity to the right. 
 
 When examined in the nude condition the curvature 
 may not be immediately discovered by the unpractised 
 eye, but the dropping of one shoulder will readily be 
 noticed and also the raising of the hip on the same side. 
 The lower tip of the shoulder blade may then he noticed 
 to project unduly. Such a position naturally tends 
 to increase the deformity the longer it remains 
 uncorrected. 
 
 The real cause of the deformity is found in debility 
 of the system. The muscles become easily tired, and 
 the child assumes the wrong position as a relief. 
 Badly made desks and seats still further increase the 
 bad tendency. Muscles not in proper condition require 
 physical culture to improve the tone, and it is also 
 necessary to give tone to the muscles at different 
 changes of work, as when changing from resl to strain. 
 Before a writing lesson, short dumb-bell ise should 
 
 be given so that the trunk muscles maj be stimulated to 
 resist the lopsided tendencies of the writing position. 
 
 Muscular ex< rcise brings an increased supply of blood
 
 48 THE HYGIENE OF 
 
 to the parts and promotes growth of muscle and bone. 
 Unused muscles degenerate. 
 
 Muscles, if not frequently exercised, lose the power 
 of co-ordination, or working in harmony, hence the 
 sedentary student becomes more ungainly without 
 acquiring greater knowledge than the student who takes 
 that proper amount of physical exercise which renders 
 him graceful and not less learned. The time devoted to 
 moderate physical exercise induces an increased physical 
 well-being. The increased blood supply which results 
 enables a greater amount of brain work to be done in a 
 given time, owing to the increased energy of the brain, 
 due to the more perfect oxidation of the brain cells.
 
 SCHOOLS AND SCHOLARS. 49 
 
 CHAPTER IV. 
 
 ^k>j**;oo- 
 
 The Arms and Hands. — Blueness of Hands in warm 
 weather. — Imitation of movements. — Hand postures : the 
 nervous hand; the energetic hand; the straight hand; 
 the tired hand ; the hand in rest ; the feeble hand ; the 
 hand in fright ; the convulsive hand. The Legs and 
 Feet. — Knock knees. — Bowed legs. — Arched instep. — 
 Skipping. — Crippled children. — Special arrangements for 
 teaching. — Rickets, commoner in towns and in boys: 
 lack of milk diet. The Skin. — The epidermis ; the 
 chorium, — Fat beneath skin. — Maintenance of equable 
 temperature. — Respiration through skin. — Sebaceous secre- 
 tion : sweat. — Water does not pass through epidermis. — 
 Removal of epidermis by blisters, injury, etc. The 
 Teeth. — Development of the teeth. — Cleaning teeth. — 
 Particles of food as breeding grounds for germs. — Hard 
 fibrous food as a cleanser.— Loss of teeth disqualifying 
 for Army, etc. — Teeth and their development. — Lessons 
 immediately after meals. Growth.— Varies for different 
 portions of body.— Brain develops early : rates of growth 
 for boys and girls. — Weights at different ages. — Relation 
 of physical to mental growth. — Precocious children. 
 
 The Arms and Hands.— The upper limbs should be 
 in proportion, not over long, and with well developed 
 muscles. The hands should be neither dry and hot, nor 
 cold and clammy. Hands blue with cold, even in 
 summer, are often found in nervous children. When 
 told to bold out the hands, they should be sin ■k;bed out 
 in front firmly and decisively with the bands fiat in the 
 plane of the arm, and the thumbs held out by the 
 side of the fingers. When told to imitate movements 
 and the right arm is held out for an example, very young
 
 50 
 
 THE HYGIENE OE 
 
 children facing the teacher will hold out the left which is 
 opposite. This shows a lack of mental quickness which 
 may be one of a number of serious symptoms in children 
 over seven years of age, if persisting after the error has 
 been pointed out. 
 
 Dr. F. Warner gives eight types of hand postures 
 which are of use in estimating any nervous deviation in 
 children. 
 
 Fig. 11. — The Nervous Hand. 
 
 In the nervous hand the wrist is dropped and the 
 fingers extended. (Fig. 11.) 
 
 Fig. 12. — The Energetic Hand. 
 
 In the energetic hand the wrist is extended back- 
 wards, and the fingers and thumb are gently flexed. 
 (Fig. 12.)
 
 SCHOOLS AND SCHOLARS. 
 
 51 
 
 Fig. 13.— The Straight Hand. 
 
 The straighi hand when extended is the normal type, 
 
 fiat, with the thumb level with the fingers. (Fig. L3.) 
 
 Fig. 14.— The Tired Hand. 
 
 The oired hand is the hand held out straight, but with 
 the thumb dropped. It may be noticed if children at the 
 end of an examination are asked to extend their hands. 
 In several of them the thumbs will be dropped. 
 (Fig. 14.) 
 
 Fig. 15, — Tlie Hand at Rest. 
 
 The hand at rest is slightly flexed at the wrist and 
 fingers. (Fig. 15.)
 
 52 
 
 THE HYGIENE OP 
 
 Fig. 16.— The Feeble Hand. 
 The feeble hand is an exaggeration of the last. (Fig- 16.) 
 
 Fig. 17. — TJie Hand in Fright. Fig. 18. — The Convulsive Hand. 
 The hand in fright is extended at the wrist and also at 
 the fingers. (Fig. 17.) 
 
 The convulsive hand is a closed fist, but the thumb is 
 fixed on the palm of the hand while the fingers are 
 closed over it. (Fig. 18.)
 
 SCHOOLS AND SCHOLARS. 53 
 
 The Legs and Feet. — The lower limbs should be 
 straight without weakness at the knees or ankles. The 
 feet should be very slightly turned out; the position of 
 a soldier, or a ballet girl, is exaggerated. Knock knees, 
 or bowed legs are usually the result of rickets. The 
 child should stand evenly on the legs, if the child 
 constantly rests the weight of the body on one leg, 
 hip joint disease may be suspected. 
 
 The feet should be arched. Skipping is an exercise 
 that tends to strengthen the arch of the foot. 
 
 The toes should be separated and not compressed 
 into narrow pointed shoes. 
 
 Crippled Children. — Special arrangements may be 
 provided for crippled children whose physical defects 
 render them incapable of receiving instruction with 
 ordinary children. 
 
 Many cripples can be taught in the ordinary schools. 
 Special attention must be given to children with club 
 foot, those with limbs shrunken from infantile paralysis, 
 bow legs, or knock knees, and similar partial disable- 
 ments, as they are, many of them, incapable of perform- 
 ing sustained mental work. Special physical exercises 
 should be arranged for them, as they will naturally be 
 unable to join in regular drills with more robust children. 
 Every case of this kind should be known to the 
 managers, and special arrangements should be made, as 
 such cases must be considered separately. 
 
 Eickets. -Children suffering from this condition are 
 frequently seen in towns, more commonly in the infants' 
 school, and amongst boys than girls. They are short for 
 their age, and grow up stunted; the head is misshapen,
 
 54 THE HYGIENE OF 
 
 and the forehead bulgy, giving tbe head the appearance of 
 increased size and brain power. Legs are either bowed, 
 or knock-kneed, and the child's movements are con- 
 sequently impaired. The ends of the bones near the 
 joints are enlarged, or the child may be pigeon-breasted. 
 Lack of proper milk diet from infancy onwards is the 
 chief cause of rickets. Such children are usually dull, 
 and delicate in health. Improved knowledge of the 
 proper management of infants will do much to prevent 
 this condition. Avoidance of bread and farinaceous 
 foods for babies under nine months old. and the disuse of 
 the cheaper kinds of patent foods are to be recommended. 
 
 The Skin. — The skin of the body is constantly grow- 
 ing, and constantly wasting and renewing itself. It is 
 impermeable to water from without, but moisture readily 
 passes from within outwards. In health the surface 
 should be cool and moist, but not unduly so. It is 
 elastic and flexible, easily folded and unfolded, and it is 
 transparent — as may be seen from the appearance of the 
 veins beneath it. 
 
 The skin consists of the epidermis and the chorium, or 
 true skin. 
 
 The Epidermis consists of several layers, the outside 
 of varying degrees of hardness according to the position 
 on the body. In dark coloured races pigment cells are 
 abundant in the deeper layer. 
 
 The Chorium, or true skin, contains the hair and 
 sebaceous follicles, the sweat glands, blood vessels, 
 fat, etc. The fatty tissue beneath the skin fills . up 
 depressions and protects projecting parts. It is a bad
 
 SCHOOLS AND SCITOLARS. 55 
 
 conductor of boat, and is therefore of great use in 
 maintaining the equal temperature of the body. The 
 elastic movable skin with its fatty padding beneath 
 
 affords protection against injuries from without. The 
 dry and hard epidermis, devoid of blood \ . affords 
 
 protection against the absorption of poisons. It exerts a 
 pressure on the minute cutaneous blood vessels, so that 
 when the epidermis is rubbed away the skin is always 
 red and moist. There is respiration through the skin, 
 carbonic dioxide and water being given off. Varnishing 
 of the skin will cause death from asphyxia sooner than 
 ligature of the lungs. A child gilded to represent Cupid 
 in a procession died almost suddenly of asphyxia. 
 
 There is sebaceous secretion from the skin. This is a 
 fatty material which keeps the skin supple, and the hair 
 from becoming dry. Sweat is alkaline, becoming acid by 
 mixture with the sebaceous fatty excretion of the skin. 
 The amount excreted is very large and is increased by high 
 temperature. Watery solutions will not pass into the skin, 
 but fatty substances maybe rubbed in. When theepidermis 
 is removed, as by a blister, absorption may readily take 
 place. Gases may also be absorbed through the skin. 
 
 Teeth. — The nails and teeth are merely special 
 developments of the skin. The teeth should be carefully 
 attended to, and it is advisable to teach children to brush 
 their teeth, or at least wash out their mouths at night. 
 This will remove the particles of food left between the 
 teeth which is the chief cause of the decay of teeth, 
 the particles of food forming good breeding grounds for 
 the growth of the decay germs.
 
 56 
 
 THE HYGIENE OP 
 
 Decayed teeth cause foetid breath, and undue salivation. 
 Secondary abscesses are set up, causing pain and loss of 
 sleep, and the tenderness of the teeth and mouth make 
 the child avoid the harder parts of farinaceous food, 
 which are so necessary to the proper growth of the 
 poorer children who are debarred from tender meat on 
 account of its expense. 
 
 A certain amount of indigestible fibrous matter in food 
 is most useful in keeping the teeth clean, and much of it 
 is useful in bone formation, as in whole meal of wheat, etc. 
 Thus unsuitable food, resting in the interstices of the 
 teeth, may lead to decay, which entails underfeeding 
 of the child ; this induces physical weakness, with 
 the ensuing mental weakness. Not only so, but the 
 loss of teeth, removed for tooth-ache, is a very serious 
 detriment in after life, as it may debar a man from 
 entering the army, navy, etc., and, by causing deficient 
 mastication, render the person liable to indigestion. 
 
 The teeth appear at the following periods : — 
 
 Temporary, 
 
 or Milk 
 
 Teeth, 
 
 Central incisors 
 
 
 7th month 
 
 Lateral ,, 
 
 
 7th to 10th „ 
 
 Anterior molars 
 
 
 12th „ 14th „ 
 
 Canine 
 
 
 14th „ 20th „ 
 
 Posterior molars 
 
 
 18th „ 36th „ 
 
 
 INCISORS. CANINES. MOLARS. 
 
 Upper jaw 
 
 4 
 
 - 4 1 20 
 ... 2 ... 4 J 
 
 Lower ,, 
 
 4 
 
 The permanent teeth form beneath the temporary or 
 milk teeth, which at about six years of age begin to be 
 shed. The bony partitions above the permanent teeth
 
 SCHOOLS AND SCHOLARS. 
 
 57 
 
 are absorbed, and tbe fangs of the milk teeth disappear 
 so that they are loosened and easily removed. 
 
 I 'BRW \\i;vr Tr.i in. 
 First molars ... 
 Central incisors 
 
 Lateral incisors 
 Anterior bicuspids 
 Posterior bicuspids 
 Canines 
 Second Molars 
 Wisdom teeth 
 
 6th year. 
 
 7th „ 
 
 . 8th 
 . 9th 
 .10th 
 11th to 12th 
 12th „ 13th 
 17th „ 25th 
 
 INCISORS. CANINES. BICUSPIDS. MOLARS. 
 
 Upper jaw 4 ... 2 ... 4 ... 4 
 Lower „ 4 ... 2 ... 4 ... 4 
 
 WISDOM. 
 
 32. 
 
 !}' 
 
 There is no reason why a child should not do lessons 
 immediately after a meal. Digestion requires a large 
 supply of blood to the digestive organs, and therefore 
 there is less blood relatively supplied to the brain, but 
 there is no reason to suppose that the blood required by 
 the brain in a lesson is more than that required in play. 
 Moreover, the lesson may be a sitting one and of a 
 recreative nature, so that blood need not be drawn away 
 unduly from the digestive tract. 
 
 Growth. — The old saying that the body is renewed 
 every seven years is a misleading one. The brain cells 
 are not renewed, but added to, in the course of growth 
 and education. The brain has reached |th of its natural 
 size at three years of age, and at seventeen it has 
 reached ^{jths, but the nerve cells will go on increasing 
 till forty-five years of age. 
 
 The body stops growing at twenty-five, except for the 
 addition of fat. The boy is, age for age, heavier than the 
 girl, but lip to ten years the boy grows faster than the girl.
 
 58 THE HYGIENE OP 
 
 Then the girl grows more rapidly up to about fourteen 
 when the boy takes the lead and maintains it. Surround- 
 ings have considerable influence on growth. In country 
 public schools the average height of boys of ten to 
 twelve is two and half inches higher than that of boys in 
 town elementary schools. This is partly due to country 
 air, as is shown by the slighter superiority of the country 
 elementary school over that of the town ; but the real 
 advantages are due to better food and more physical 
 training. The public school boy exercises his muscles in 
 all possible ways, cricket, football, swiming, gymnastics, 
 and all kinds of athletic sports. Not only so, but this 
 training is continued to a later period of life ; the 
 elementary scholar closes his school life at fourteen, 
 whilst the public school boy goes on to seventeen 
 years. 
 
 Increase of weight should correspond with growth. 
 Children in a high class for their age should show a 
 corresponding physical development, and no child below 
 the average weight should be allowed to compete in his 
 lessons with older children as there is extreme probability 
 of breakdown from mental overstrain. We are all some- 
 what lower in stature on going to bed than on rising in 
 the morning, and this is more marked in children. This 
 difference depends upon higher general tone of the 
 tissues after rest. Children are said to increase most 
 in weight during the holidays, especially between July 
 and November. 
 
 A person who at birth weighs from 6 to 12 lbs., will, 
 when fully grown, weigh from 130 to 180 lbs. Measure- 
 ments of children should be taken from time to time ;
 
 SCHOOLS AND SCHOLARS. 
 
 59 
 
 height, chest, girth, and weight. These measurements 
 will not only interest the child, Imt will give the teachei 
 the opportunity of making a more intimate acquaintance 
 with the pupil, so that the effect of instruction and 
 exercises will be more readily noted, and Jn> advantages 
 of experience brought to bear on any necessary modifica- 
 tions of routine. 
 
 THE AVERAGE HEIGHTS AND WEIGHTS OP SCHOOL 
 
 CHILDREN. 
 
 
 Great Britain- 
 Town and Country. 
 (Report of the Anthropo- 
 metric Committee, 1SS3.) 
 
 Boston, United 
 
 States ok America, 
 
 (Dr. Bowditch, 1877.) 
 
 AGE 
 
 boys. 
 
 GIRLS. 
 
 BOYS. 
 
 GIRLS. 
 
 LAST 
 BIRTH- 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 DAY. 
 
 INS. 
 
 LBS. 
 
 INS. 
 
 LBS. 
 
 INS. 
 
 LBS. 
 
 INS. 
 
 LBS. 
 
 5 yrs. 
 
 41-03 
 
 39-9 
 
 40-55 
 
 39-2 
 
 41-74 
 
 41-20 
 
 41-47 
 
 39-82 
 
 6 „ 
 
 44-00 
 
 44-4 
 
 42-88 
 
 41-7 
 
 44-10 
 
 45-14 
 
 43-66 
 
 43-81 
 
 7 „ 
 
 45-97 
 
 49-7 
 
 44-45 
 
 47-5 
 
 46-21 
 
 49-47 
 
 15-94 
 
 48-02 
 
 8 „ 
 
 47-05 
 
 54-9 
 
 46-6 
 
 52-1 
 
 48-6 
 
 54-43 
 
 48-07 
 
 52-93 
 
 9 „ 
 
 49-7 
 
 604 
 
 48.73 
 
 55-5 
 
 5009 
 
 59-97 
 
 49-61 
 
 57-52 
 
 10 „ 
 
 51-84 
 
 07-5 
 
 51-05 
 
 62.0 
 
 52-21 
 
 66-62 
 
 51-78 
 
 64-09 
 
 11 ,, 
 
 53-5 
 
 72-0 
 
 53-10 
 
 68-1 
 
 54-01 
 
 72-39 
 
 53-79 
 
 70-26 
 
 12 „ 
 
 54-99 
 
 76-7 
 
 55-56 
 
 76-4 
 
 55-78 
 
 79-82 
 
 57-16 
 
 81-35 
 
 13 „ 
 
 50-91 
 
 82-6 
 
 57-77 
 
 87-2 
 
 58-17 
 
 88-26 
 
 58-75 
 
 91-18 
 
 14 „ 
 
 59-33 
 
 920 
 
 59-80 
 
 96-7 
 
 61-08 
 
 99-28 
 
 60-32 
 
 100-32 
 
 15 „ 
 
 62-24 
 
 102-7 
 
 00-93 
 
 106-3 
 
 G2-90 
 
 110-84 
 
 61-39 
 
 108-42 
 
 16 „ 
 
 64-31 
 
 119-0 
 
 61-75 
 
 11. l-l 
 
 65-58 
 
 L23-67 
 
 61-72 
 
 112-97 
 
 17 „ 
 
 66-24 
 
 130-9 
 
 62-52 
 
 115-5 
 
 66-29 
 
 128-72 
 
 61-99 
 
 115-84 
 
 .18 „ 
 | 
 
 66-96 
 
 137-4 
 
 02-44 
 
 1211 
 
 66-76 
 
 L32-71 
 
 62-01 
 
 115-80 
 
 1 
 
 N.B, — Height without shoes. Weight in ordinary clothing.
 
 60 
 
 THE HYGIENE OF 
 
 Relative Height of Boys 11 to 12 Years. 
 
 average height. 
 
 Public schools (country) ... 
 
 Middle Class schools (towns) 
 
 Elementary schools (agricultural districts) . . . 
 
 (towns) 
 
 „ ,, (factory, country districts) 
 
 ,, ,, (factory, towns) ... 
 
 ,, „ (industrial)... 
 
 54-98 ins 
 
 53-85 
 
 5301 
 
 52-60 
 
 52-17 
 
 51-56 
 
 50-02 
 
 In 
 
 considering mental development with a view to 
 testing the capabilities of school children, the physical 
 condition of the child must be taken into consideration, 
 
 together with the mental. 
 
 AVERAGE HEIGHT 
 OF AMERICAN 
 
 CHILDREN 
 5 TO 18 YEARS. 
 
 AVERAGE WEIGHT 
 
 OF AMERICAN 
 
 CHILDREN, 
 
 COMPARATIVE 
 WEIGHT OF ENG- 
 LISH CHILDREN OF 
 THE SAME HEIGHT. 
 
 BOYS. 
 
 GIRLS. 
 
 BOYS. 
 
 GIRLS. 
 
 BOYS. 
 
 GIRLS. 
 
 55-2 ins. 
 
 54-1 ins. 
 
 82-3 lbs. 
 
 78-3 lbs. 
 
 81-7 lbs. 
 
 71-0 lbs. 
 
 From the tables it is clear that surroundings have a 
 considerable effect upon the development, the American 
 children showing not merely a greater average height 
 than the English, but a comparatively greater weight. 
 
 The same difference may be seen by comparing the 
 height of boys in different social spheres. 
 
 "The human body is an economical machine, which yields 
 a very large return of energy in comparison with what is spent 
 upon it in the way of fuel, that is to say, food. Physiologists 
 calculate the work done by the body in foot tons, a foot ton of 
 work being represented by the energy required to raise one ton 
 weight one foot high. A hard-working man in his clay's labour 
 will develop power, I suppose, equal to about 3000 foot tons, 
 this amount representing both the innate work of his frame 
 involved in the acts of living, and in his external muscular
 
 schools \ni> SCHOLARS. 01 
 
 labour as a hewer of wood and a drawer of water. A mans 
 heart, in twenty-four hours, shows a return equal to L20 foot 
 tons; that is, supposing we could concentrate all the work 
 of the organ in that period into one big lift, it would be capable 
 of raising 120 tons' weight one font high. Our breathing 
 muscles, in twenty-four h >l> energy equal bo about 
 
 21 foot tons, and when we add in the actual work of the 
 muscles, and that expended in heat production, we arri. 
 our 3000 foot tons, or thereby, as the daily expendituri 
 energy. All this power, moreover, is devel on about 
 
 SJ lbs. of food per day, the supply including solid food, wa 
 and oxygen. No machine of man's invention approaches near 
 to his own body, I an ecom mical 
 
 and this for the pracl tint the human en| 
 
 ! work directly, and without loss of power entailed in 
 other appliances that have to transmit energy through ways 
 and means involving friction and other untoward conditions." 
 — Wilson.
 
 62 THE HYGIENE OP 
 
 CHAPTER V. 
 
 -a-o^^oo- 
 
 Epfects of Instruction and Exercises on Growth. — 
 Writing — Bad positions. — Oblique and Vertical Writing. 
 —Position of the light. Seats and Desks. — Too long- 
 maintenance of one position. — Length of writing lessons ; 
 break for muscular exercises. — Girls at needlework. — 
 Children with loosely folded arms : disadvantages. Play 
 and Games. — Action on the muscles ; absorption of 
 oxygen ; discharge of carbonic dioxide ; increase of 
 muscle ; increase of sinew ; autoiuatic action ; saving of 
 nervous energy ; difficulties of the beginner in working 
 new muscles. — Heat produced in muscles by exercise. — 
 Use of fat. — Effect of exercise on fat people ; poisonous 
 products not got rid of quickly ; difficulties from bulk. — - 
 Pat men thinner ; thin man puts on flesh. — Exercise as 
 a controller of nutrition ; digestion improved ; constipation 
 obviated. — Effect of exercise on personal appearance; on 
 moral character ; on mental work. Physical Training. — 
 Suitable time for games and exercises; out of doors. — 
 Much oxygen needed during exertion. — Fresh air during 
 exercise. — Walking : parts exercised. — Running : not for 
 middle-aged. — Jumping and skipping : strengthening of 
 joints. — Riding : certain deformities increased. — Dress. — 
 Swimming : excellent general exercise. — Cycling : precau- 
 tions to be taken. — Cricket and football. — Hockey. — Lawn- 
 tennis. — Baseball and Rounders. — Suitable clothing. — 
 Development of chest. — Inquiry into physical condition. 
 
 It is most important to observe accurately the effect 
 of instruction and physical exercise upon the pupil. 
 During instruction it is of great importance that the child 
 should be made to assume a correct attitude, as it has 
 already been shown that if the general physique is 
 below par, constant use of a particular pose may cause 
 permanent deformities. 
 
 In writing, children are liable to lean too much to the
 
 SCHOOLS AND SCHOLARS. 63 
 
 left, — sometimes, even resting the elbow on the desk and 
 supporting the head with the hand. This position may- 
 be assumed merely through laziness, or the child may be 
 tired, and in the result, one eye being nearer the pap< r 
 than the other the writing is oblique. It is for this 
 reason that vertical writing is advocated, the child being- 
 obliged to sit straight in order to make the up and 
 down strokes upright. A twisted position cramps the 
 chest, and throws the weight of the body on the hip. 
 
 It is inadvisable to give the same seat in the class- 
 room always to the same scholar, as the light being always 
 on the same spot slight spinal deviations may be set up 
 by the constant assumption of the same pose. Light 
 should properly come from the left side and slightly 
 behind the pupil so that shadows should not fall where 
 the writing is. It is very difficult to arrange this in the 
 older school-rooms, as windows were put in less with a 
 view to educational necessities than the saving of expense. 
 
 Seats and Desks. — Seats and desks are of great 
 importance in maintaining a proper posture, but length 
 of lessons must also be considered. Even the most 
 suitable position if maintained too long at a time, tends 
 to relaxation of the muscles, drooping at the shoulders, 
 and imperfect expansion of the lungs, if not to any 
 actual curvature of the spinal column. 
 
 If the desk be too high when the scholar begins 
 to write, one shoulder is raised in order to rest fche arm 
 on the desk. On the other hand, if fche desk be too low 
 the scholar bends forward and the shoulders become 
 rounded. The head may become congested by being
 
 64 
 
 THE HYGIENE OP 
 
 held too low, and imperfections of vision may be 
 increased through the eyes being too close to the paper. 
 The desk should be slightly sloped and not too far from 
 the seat. The latter defect causes the same errors in 
 posture, as when the desk is too low. 
 
 Fig. 19. — Desk with Adjustable Slope and Movable Seat. 
 
 Seats must be of a suitable height for each particular 
 child. If the child is too tall for the seat his thighs are 
 bent up towards the body and a cramped position is 
 produced. If the child is too short for the seat his legs 
 dangle and his feet do not rest on the ground or on the 
 foot-rests. This causes pressure on the nerves and 
 bloodvessels at the back of the thighs, and the sensation 
 of "pins and needles" arises. This may also occur
 
 SCHOOLS AND SCHOLARS. 65 
 
 when the seat is too narrow to support the length 
 of thigh. A back-rest is also necessary, or immediately 
 
 the spinal muscle-! become tired the scholar will lean 
 forward on the desk and compress the chest, and thus 
 interfere with respiration. 
 
 Writing should not continue in any class for more 
 than half an hour without a break, and for infants and 
 young children a few minutes at a time is sufficient. 
 A short interval of exercise of the arms and shoulders 
 will give sufficient stimulus to the muscles to prevent 
 them readily relaxing to the forced positions and will 
 enable the writing to be resumed without inconvenience. 
 
 For writing, the edge of the desk should slightly over- 
 hang the front edge of the seat ; for other purposes the 
 seat may be about the same distance further back. 
 Movable desks or movable seats are made for the use of 
 schools, as chairs are inadvisable for ordinary scholars. 
 It is recommended that the difference between the height 
 of the seat and the desk should equal the length of the 
 forearm, that is, about one-sixth the height of the scholar. 
 The best desks are usually made with an adjustable 
 slope ; 30 deg. is the angle best suited for writing, and 
 40 deg. or 45 deg. for reading. 
 
 The height of the seat should be such that the scholar 
 when seated upright should have the thighs ll;it on 
 the seat, and the feet planted firmly on the foot-rest, 
 provided beneath the desk. If there is no foot-rest the 
 feet must be placed flat on the floor so that there may 
 be no stretching of the muscles. 
 
 The back-rest should be slightly inclined backward, 
 and so made as to support the small of the back,
 
 66 
 
 THE HYGIENE OP 
 
 and extending as high as the bottom of the shoulder 
 blades. Single desks are preferable to long desks, 
 as with the latter children are apt to adopt awkward 
 attitudes in order to prevent copying. 
 
 Fig. 20. — Desk with Fixed Slope and Seat. 
 
 Desks and seats of various sizes should be provided, 
 so that all scholars may be properly suited. This is 
 hardly practicable in elementary schools. Children 
 who stand or sit for any length of time with their 
 hands upon their heads are liable to assume a position 
 with the head poked forward. Leaning over desks 
 that are too low for them induces in children the same 
 awkward position, and results in rounding of the back 
 and contraction of the chest.
 
 SCHOOLS AND SCHOLARS. (V7 
 
 Girls at needlework frequently sit sideways with 
 their legs crossed and the head bent over the work. 
 In such a position the spine is bowed and the weight 
 is thrown on one hip. Children should not sit with 
 their arms folded loosely in front of them as the arms 
 drop and the weight is thrown on the abdomen, whilst 
 the shoulders and head arc thrown forward. The action 
 of vhe diaphragm is thus restricted and respiration 
 is impeded. The weight falling on the abdomen may 
 also interfere with digestion. 
 
 Play and Games. — In exercise, the blood vessels of 
 muscles are dilated, and the chemical re-action from being 
 alkaline when at rest becomes acid. Carbon di-oxide 
 is driven out and carried off by the veins, and oxygen is 
 absorbed from the arteries, the blood supply being 
 increased. The amount of water in the muscle is 
 increased, whilst the amount in the blood is decreased 
 and heat is formed. 
 
 By exercise the muscular tissue is increased — " Muscle 
 makes muscle " — but the various tissues, other than the 
 muscular tissue, and the fat amongst the meshes are 
 diminished. The tendons or sinews become strengthened ; 
 but there is a limit to the growth of every muscle, after 
 which it begins to waste. Muscles in good condition 
 contract readily, find acquire the habit of acting in 
 concert without the direct influence of the will. In this 
 way the nervous system is saved the expenditure of 
 energy, and tin athlete in training makes manj of his 
 actions automatically. This may be readily understood 
 by the novice in learning new movements. A beginne 1
 
 68 THE HYGIENE OF 
 
 with the bicycle rapidly tires because he is using muscles 
 in maintaining his equilibrurn, etc., that have hitherto 
 been almost unused. This is not merely because his 
 muscles are weak from want of use, but because they do 
 not act in co-ordination, and so save the expenditure of 
 nervous force by the brain and spinal cord. As soon as 
 practice causes these muscles to act almost automatically, 
 this expenditure is saved, and the feeling of weariness *. 
 is no longer felt. A memory has been developed in the ._.-- 
 muscular centres of the brain and spinal cord and the 
 element of fatigue is removed. 
 
 Not only are individual muscles improved by exercise, 
 but the trained man learns to breathe with economy ; 
 he ceases to breathe with needless vigour. The nervous 
 system is also improved in tone. Eestless movements, 
 twitchings, etc., cease, and the man improves in 
 deportment, gait, and expression. The art of the 
 athlete is to carry out all his movements with the 
 least expenditure of energy. A novice will expend 
 as much force in cycling one mile as will carry the 
 trained cyclist twenty. The heat devoloped in the 
 muscles causes them to contract more readily, hence 
 the expression " warming to his work." 
 
 Heat thus produced by action causes certain chemical 
 changes, mostly oxidations. Carbon di-oxide, urea, uric 
 acid are formed, and as these are poisons they must be 
 got rid of by the lungs, skin, etc. 
 
 By exercise fat is got rid of. Fat in the body exists 
 largely as a reserve fuel for combustion. When a fat 
 man begins to exercise he rapidly becomes exhausted, 
 because his fat or reserve fuel is being burnt up too
 
 SCHOOLS AND SCHOLARS. 
 
 C,9 
 
 quickly, and he is unable to ge< rid of the poisonous 
 products of combustion (urea, etc.) fast enough. He 
 is also hampered by weakened muscles, and by the 
 mechanical obstacle of. h i>t size. 
 
 As the muscle^ are trained, they become harder, and it 
 is more difficult to cause a bruise. In judicious training 
 the fat man gets thinner, but the thin man gains flesh 
 and weight. 
 
 Exercise may be regarded as a controller of nutrition, 
 it enables the thin man to assimilate or take up from 
 his food for the increase of useful tissue, and the fat man 
 to dissimilate or reject from his food undesirable matters 
 so that useless tissues cease to be formed. 
 
 In exercise, the action of the heart is increased from 
 ten to thirty beats, the skin becomes red from the 
 increased circulation of blood, and perspiration is given 
 off. Digestion is stimulated and appetite increased, 
 and more particularly when the abdominal muscles are 
 exercised, the bowels become more regular in their 
 action and constipation is decreased. A large amount of 
 carbon is given off in exercise, therefore a corresponding 
 amount of carbon must be consumed in the food. 
 
 Table of the Amount op Carbon Given off in 
 Rest and Exeecise. 
 
 1 
 
 Exercise 
 
 SORPTION OF 
 
 I . IN 
 GBAMMES. 
 
 ELIMINATION IN GBAMMES. 
 
 CARBON 
 DIO CD] 
 
 WATER. 
 
 708-9 
 954-5 
 
 911-5 
 1284-2 
 
 828-0 
 2042-1
 
 70 THE HYGIENE OP 
 
 Nitrogen is given off in greater amount after exercise 
 rather than during exercise. Those in exercise, therefore, 
 require more meat or other nitrogenous food. 
 
 Exercise has considerable effect upon personal comeli- 
 ness. The thorax becomes well developed, and the man 
 or woman breathes with ease. The shoulders are 
 squared and thrown back. The spine appears as a valley 
 amongst the muscles of the back and not as a mountain 
 range of spinous processes beneath the skin. The skin 
 is firm and clear, and there is an absence of flabbiness. 
 The walk is springy and the postures are graceful. The 
 development of the body by training, also has good 
 mental and moral effects. Boys who work hard and 
 play hard do not ape the vices of men, they are not 
 loafers, but simple wholesome-minded straightforward 
 lads. 
 
 Taking part in games teaches the young to be quick of 
 hand and eye, and prompt in judgment, and to learn 
 the advantages of discipline and self-control. Patience, 
 fairness, and unselfishness are necessary in the proper 
 playing of all games. 
 
 Games are necessary as a relaxation from the discipline 
 and restraint of the class-room. The child longs 
 for movement. The moment the class is over the 
 scholars rush with a shout for the playground, pleasing 
 excitement takes the place of mental concentration, 
 respiration is quickened, circulation is increased, and 
 the spirits become buoyant and lively. The most suitable 
 games for the young are those providing free play of the 
 muscles and unrestrained use of the voice, with little 
 need of mental exertion, and, of course, without using
 
 SCHOOLS AND BCHOLABS. 71 
 
 voice and general movement simultaneously, ('<■ 
 to have their proper effect upon physical and mental 
 development need supervision. Care must be taken 
 that the backward retiring children arc allowed to 
 their lull share of the exercise, as they are the very ones 
 who arc most in need of it. Not only so, hut i 
 those who are lively and vigorous are apt to devote 
 themselves to the exercises for which they are hy nature 
 most adapted, and in which they most easily attain 
 proficiency. Though this is good in a general way, it is 
 inadvisable that in games development should be 
 specialised instead of being generalised, as even special 
 attainments are not best carried to success, except in 
 company with general development. 
 
 Physical Training. — In elementary schools in towns 
 it is not possible to develop games to the extent 
 that is effected in public schools in the country. It 
 is therefore advisable to arrange systematised exercises 
 as a part of the school curriculum. These physical 
 exercises should be taken during breaks in the school 
 hours, and not during play time. The morning is 
 best for the more arduous exercises, and those with 
 the hardest work should bo taken early when the 
 scholar is fresh. These exercises should be taken — 
 when possible — out of doors, but choice should he made 
 
 of a part of the playground sheltered IV wind in cold 
 
 weather, and from the sun in hot weather. During 
 exercise the sunshine should not be allowed to fall for 
 too long on the scholar's back, nor directly in his eyes. 
 
 In cold weather exercises entailing rapid movements
 
 72 THE HYGIENE OF 
 
 of the lower limbs are best suited to send a pleasant 
 glow through the body. The playground should be well 
 drained so that water should run off quickly and leave 
 the ground dry. Children when perspiring freely should 
 not be allowed to stand in cold winds, as muscular 
 rheumatism, or worse ills may follow. When it is 
 necessary that the exercise should take place indoors 
 every possible opening for the supply of fresh air should 
 be made use of on account of the extra amount of oxygen 
 required to make up for the loss by oxidation in the 
 contracting muscles. 
 
 The system of exercise for school children should be 
 free from complicated or difficult movements. The 
 exercise should be easy to learn, and should be performed 
 with little or no alteration. Musical accompaniment is 
 useful, especially for the younger children. 
 
 It is necessary that the ordinary dress should be 
 suitable for the performance of the exercise, and the 
 whole exercise should be accomplished whilst the child 
 -^ standing on the feet. No part of the body or the 
 hands should touch the ground during exercise. The 
 teachers must be capable of performing the exercises 
 themselves, as children can learn by imitation quicker 
 than by explanation. 
 
 Walking. — This is the easiest form of exercise for all 
 ages. It exercises chiefly the leg muscles, but also the 
 muscles of the loins, back and abdomen, and respiration 
 and circulation are increased. The spine should be kept 
 straight, the head erect, and the shoulders well back. 
 The position of the body is easier than in marching. 
 The walker should not roll like a. country lout walking
 
 SCHOOLS AND SCHOIiABS. 73 
 
 from the hips, nor like the fashionable lady on her toes 
 and high heels, nor with a slouch like an untrained 
 school boy. 
 
 Boots and shoes should be properly made with 1. >w 
 broad heels, and the inner side of the shoe straighl so 
 that the great toe maybe free and not pressed up against 
 the other toes as in the common pointed shoe. The 
 heel part of the shoe should lit neatly, and the toes 
 should have room for movement. 
 
 Walking with an object is to be recommended. 
 Shooting and golf are excellent reasons for walking. 
 
 Skating. — This is a modified form of walking. 
 
 Running. — Running is essentially an exercise for the 
 young, in the aged it is dangerous, but in very young 
 children it seems to be less tiring than walking. 
 
 Jumping and Skipping. — Jumping encourages well 
 co-ordinated muscular contractions which must be 
 vigorous and instantaneous. Skipping employs nearlj 
 all the muscles of the body. It strengthens ankles and 
 knees and the arches of the feet. It increases the 
 respiratory movements and should be practised in the 
 open air. 
 
 Riding. — Riding is an exercise for the rich, but an 
 admirable one. The muscles of the thigh and back are 
 mostly brought into use. A good scat depends more 
 on the art of balancing the body than of gripping the 
 saddle. 
 
 It is not good for girls with commencing lateral 
 curvature of the spine, and overgrown girls are apt bo 
 become round shouldered. Close-fitting habits and long 
 skirt ;ai treat hindi ance b< i ..'■inch in riding.
 
 74 THE HYGIENE OP 
 
 Swimming. — Swimming increases the respiratory 
 movements and straightens the back. The movements 
 of the limbs are free, but the arms tire before the legs, 
 and the sense of exhaustion is most felt about the 
 shoulder. Arrangements should be made for swimming 
 in connection with every school, and it could be taught 
 in a very small bath. A bath 3ft. 6in. deep, and just 
 wide enough to give the arms free play, and about 
 18ft. long would serve for teaching children, who could 
 perfect themselves elsewhere. 
 
 Girls should be taught as well as boys, as it is an 
 exercise which gives a graceful figure and carriage. The 
 water should be warmed to about 70 deg. F., and bathing 
 should not be allowed till about two hours after a full 
 meal, nor when the person is exhausted or chilled. If 
 arriving at the swimming place hot, the bather should 
 plunge in directly, and not cool down first. Children 
 who have suffered from ear discharges should put a 
 piece of cotton wool into the ears before diving. It is 
 better to take several baths during the day than to 
 remain too long, at one time, in the water. It is also 
 dangerous to stand about, except during very hot 
 weather. 
 
 Fencing, Boxing, and Eowing. — These are all of them 
 very useful exercises, but more suitable to the older 
 young persons than to school children. Rowing should 
 not be attempted when wearing tight corsets, belts, etc., 
 or rupture may result. 
 
 Cycling — This pastime should not be indulged in by 
 children under nine or ten years of age. Care must be 
 taken that the machine is not too heavy for them ; some
 
 SCHOOLS AND SCHOLARS. 75 
 
 light ladies' machines are better suited than those made 
 specially for children. The gearing should be low, as 
 the rapid pedalling is much better for the growing child 
 than the slower exercise of greater force with a high 
 gear. Care must be taken that the saddle is properly 
 adjusted, neither too high nor too low, and not causing 
 any undue pressure. Children learn quickly and soon 
 acquire great facility. They should be encouraged in 
 trick cycling and short runs at a moderate pace, but long 
 journeys and tours should be forbidden. 
 
 Cricket may be played by girls as well as boys. 
 
 Football is one of the best of games for boys. " The 
 very function and final cause of rough sports is to work 
 off the supex-fluous animal energy for which there is little 
 vent in the piping times of peace. Health, endurance, 
 courage, judgment, and above all, a sense of fair play are 
 gained upon the football field." (SJierman). Standing 
 about to look at football matches in wintry weather is 
 often fraught with danger. 
 
 Hockey. — This game has lately been much played 
 by girls and young women. It is an admirable exercise 
 when taken under general supervision. The limbs should 
 be protected by thick stockings, gloves, etc., as serious 
 bruises are sometimes caused by the clubs or ball. 
 The jacket should be removed during play, and put on 
 immediately active exercise ceases. My daughter's 
 schoolmistress, who has had much experience, tells me 
 that since the introduction of hockey she has noticed 
 that the complaints of headache, etc.. are much fewer 
 than formerly. 
 
 Lawn Tennis. — This game can be played on any
 
 76 THE HYGIENE OP 
 
 lawn or flat place, and by the two sexes together. 
 Care should be taken to prevent children over-exerting 
 themselves, and it is advisable that an interval should 
 be insisted on between each set. 
 
 Baseball and Bounders. — These games can be 
 played both in boys' and girls' schools. Baseball may 
 be a very violent exercise if played with the full rigour 
 of the game : face guards, pads, etc., being required to 
 protect the more delicate parts. The game can be 
 easily modified for use by girls and young children, 
 when it makes a very suitable exercise. Rounders is 
 practically a modification of the other game. 
 
 In all these games suitable clothing should be insisted 
 upon. Not long ago, I saw ladies playing hockey in 
 November in thin transparent blouses and light shoes. 
 Woollen is the wear for all active sports, and extra 
 wraps should be at hand for use during the intervals, 
 more especially in winter. Boots or shoes should fit easily, 
 and stout soles are indispensable for all winter games. 
 
 Physical Training of children should be begun early, 
 and exercises should be made interesting by being 
 conducted in classes. Such exercises should not take 
 the place of outdoor games. Upper limbs may be 
 encouraged by such amusements as battledore and 
 shuttlecock, and the lower by such games as hop-scotch. 
 Exercises which develop the chest must not only 
 exercise the muscles, but increase the volume of the 
 respiratory movements, and should be such as involve 
 rapid limb movements in the open air. Large tonsils 
 stand in the way of chest development. Young children 
 must avoid exercises of strength or great speed.
 
 SCHOOLS AND SCHOLARS. 77 
 
 Before arranging the child's exercises, inquiry should 
 be made into his physical condition, and a record should 
 be taken of each child. (1.) Name ; (2.) Age ; (3.) Height ; 
 (■4.) Weight ; (5.) General appearances; (6.) Chest girth ; 
 (7.) Breathing capacity ; (8.) Span of arms ; (9.) Girth of 
 arms ; (10.) Girth of legs ; (11.) Presence of deformities 
 or defects; spinal curvature, hernia, rickets, infantilo 
 paralysis, enlarged tonsils, etc.
 
 78 THE HYGIENE OF 
 
 CHAPTEE VI. 
 
 Fatigue.— Breathlessness. — Short and long runs. — C0 2 
 given off by a man.— Engorgement of the lungs.— Physical 
 effects of exercise : exhilaration : discomfort ; pain in 
 heart, etc. ; loss of colour ; prolonged inspiration ; fainting. 
 — Training : second wind. — Relative fatigue : certain parts 
 affected; galvanic current. — Complete local fatigue. — 
 Fatigue arising from poisonous accumulations; from 
 damage to structure of muscles. — Muscular stiffness. — 
 Over fatigue ; listlessness ; inability to take food ; prostra- 
 tion ; fever predisposing to other diseases ; absolute rest 
 essential. — Muscular exertion measured as foot-tons. — 
 Tuberculosis and spinal curvature. — Continued bad health 
 as the result of excessive fatigue. — Exposure to cold after 
 fatigue. Training. — Regularity of life ; smoking and 
 alcohol ; indigestible food ; sleep ; ventilation. Influence 
 of Health on Efficiency of Work. — Paget's experi- 
 ment ; underfed children ; mental fatigue. Neglected 
 and Dirty Children. — Example of cleaner children. — 
 Pediculi. — Verminous Persons' Act. — Eczema. — Itch. — 
 Ophthalmia : contagious ; exclusion from school. — 
 Depressed Health in Children. — Pallor ; overfeeding ; 
 unsuitable foods; constipation. — W.c. accommodation in 
 boarding schools. — Re-absorption of poisonous matter from 
 retained discharges ; effect upon learning capacity. — 
 Scrofula. — Wasting ; worms ; overwork. 
 
 Fatigue. — Breathlessness is usually considered one 
 of the signs of fatigue. Breathlessness is produced when 
 the power of the lungs to throw off the carbon di-oxide 
 produced by the contraction of the muscles in exercise is 
 less than the power of the muscles to contract. When 
 the contraction of the muscles is greater than the lung 
 power, breathlessness rapidly ensues — as in running for
 
 SCHOOLS AND SCHOLARS. 79 
 
 short distances. In long distance running the muscles 
 tire through general poisoning by carbonic acid, and 
 breathlessness follows. 
 
 If the muscles put into action are very powerful, or if 
 the action is very rapid, the production of carbonic 
 di-oxide is so rapid that breathlessness comes on quickly 
 as in short races, performing gymnastics, etc. : there 
 is no fatigue of the muscles. On the other hand, after 
 prolonged exercise, as in long distance running or paper 
 chases over a stiff country, there may be sudden collapse 
 through accumulation in the blood of the poison ex- 
 creted by exercise. Breathlessness in such cases is not 
 marked. In a given time there is given off by 
 a man : — 
 
 In sleep 0-35 gramme C0 2 . 
 
 In sitting ... O60 ,, ,, 
 
 In running ... ... 1-65 „ ,, 
 
 The engorgement of the lungs with blood also helps 
 to cause breathlessness, as prolonged inspiration is 
 needed to cause the blood to circulate freely through 
 the air-cells, but inspiration is cut short in exercise by 
 the prolonged expiration needed to throw off from the 
 lungs the poisonous products resulting from exercise 
 of the muscles. 
 
 When exercise begins, the lungs readily throw off the 
 organic products, but as the exercise continues, more 
 blood comes to the lungs and gradually the engorgement 
 of the blood vessels tends to make inspiration fight 
 against expiration and thus cause breathlessness. 
 
 Hence the first physical ligns of exercise ari ineral 
 
 sensation of warmth, Hushing, an animated appearance,
 
 80 THE HYGIENE OP 
 
 sparkling eyes and cheerfulness due to throwing off of 
 poisonous matters from the lungs in expiration. 
 
 This period of exhilaration may last from a few 
 minutes to an hour or more, then come feelings of 
 discomfort, pain over the heart, or in the head. The 
 chest feels as if tightened by a band, there is clouding of 
 the eyesight, sparks before the eyes, singing in the ears, 
 etc. ; the nostrils are dilated, the mouth and eyes widely 
 opened. The flushing of the face is succeeded by a 
 pale, wan tint, with a blackish violet colour of the cheeks 
 and lips. 
 
 The violet colour is due to the retention of blood in 
 the minute blood vessels of the skin, and the blood 
 being charged with carbonic di-oxide is blackish like 
 venous blood. The pallor of the skin is due to the 
 emptying of small arteries, as the heart losing energy 
 through the poisoning of the blood cannot send the 
 blood into them. The pallor may be followed by a 
 leaden hue. The period of inspiration becomes three 
 times as long as expiration instead of being somewhat 
 shorter. The symptoms become more urgent till the 
 person faints. 
 
 Trained athletes soon learn to manage their breathing 
 to the best advantage. As it is termed, they get their 
 " second wind." A man out of condition is unable to 
 do this. 
 
 Muscles may become fatigued without there being 
 general fatigue. If the arm is held out at right angles 
 to the body for a short time, the particular muscles 
 become fatigued and the arm is dropped. This fatigue 
 is only relative, as if a suitable electric current is applied
 
 SCHOOLS AND SCHOLARS. 81 
 
 the muscles contract and the arm can be raised again. 
 This may be repeated again and again until the muscles 
 of the arm refuse to contract by any current or stimulus 
 because the fatigue has become absolute. 
 
 Muscles will only do a certain amount of work. 
 Muscles doing complicated work tire more quickly 
 as the nervous energy is exhausted in directing the 
 movements. 
 
 The poisonous organic matters resulting from the 
 working of the muscles may in some way add to the 
 fatigue. The muscle from being alkaline becomes acid 
 Lactic and uric acids are present, and substances like 
 urea are formed ; these are of a poisonous organic 
 character. 
 
 The fatigue may also be due to actual damage to 
 the structure of the muscle by compression or rupture 
 of the fibres. 
 
 Muscular stiffness depends rather upon the condition 
 of the individual than upon the amount of work done. 
 Muscles may be fatigued without becoming stiff. Over- 
 fatigue may leave a person merely listless, or there may 
 be heaviness in the head, inability to take food, restless- 
 ness, sleeplessness, and utter prostration. In some cases 
 there is fever (T. 104 deg. F.) that lingers about for a 
 time till the patient falls a victim to some comparatively 
 mild disease. Absolute rest and careful treatment is 
 needed in these extreme cases. 
 
 The amount of work done by different kinds of muscular 
 exertion is sometimes reckoned in foot-tons of energy, 
 but this reckoning is not of much value in considering 
 fatigue, as no calculation is made for relative matters,
 
 82 THE HYGIENE OP 
 
 such as the time occupied in the work, etc. Rowing 
 one mile at racing speed = 18 - 56 foot-tons. Walking one 
 mile at ordinary pace = 17 , 67 foot-tons. (For units of 
 energy see Page 113). 
 
 The rowing race occupies 6 minutes 
 
 The walk , 20 
 
 Violent and extreme exercise may lead to injurious 
 results. Boys are often knocked up for days after a 
 paper chase, when the course has been too long, or the 
 speed too great. Children inclined to tuberculosis may 
 develop disease of the spinal column through excessive 
 gymnastics. Lateral curvature of the spine has already 
 been referred to. Sometimes excessive exercise may be 
 followed by general weakness of health, which in middle- 
 aged people may be permanent. In following up the 
 history of certain university athletes, it was found that 
 only about six per cent suffered permanently from the 
 effects of over exercise. 
 
 The results of indiscretion by exposure to cold or wet 
 during athletic exercises must be reckoned separately. 
 Rheumatism, inflammation of the lungs, etc., may arise in 
 this way. Such attacks occur when the exposure is 
 prolonged, or when the person is overtired at the time 
 the exposure takes place. 
 
 Training. — Training is conducted under much more 
 rational conditions than formerly. Extreme regularity 
 of life is of the highest importance. Exercise must be 
 progressive and well timed. Meals must be taken to the 
 minute. The person should take a substantial breakfast, 
 a light lunch, a still lighter tea, and a substantial, but
 
 SCHOOLS AND SCHOLARS. 83 
 
 not heavy dinner, when the day's work is done. He 
 should rest after each meal. Alcohol and smoking arc 
 prohibited. Indigestible foods should be avoided ; pork, 
 veal, shell-fish, pastry, starchy foods and sugar should be 
 taken sparingly. Butter, fruit, and plain dishes may be 
 taken with impunity. Meat may be taken three times a 
 day. Drink should be taken after meals rather than with 
 them. Drink should not be limited, but only taken when 
 there is thirst. Sleep is of great importance. " Early to 
 bed and early to rise " is a good maxim, and the bed- 
 room should be freely ventilated. 
 
 Influence of Health on Efficiency of Work. — 
 Mr. Paget, M.P., divided a village school into two equal 
 divisions. In one division the scholars were kept 
 constantly at book work, in the other for half the time 
 the scholars were employed gardening, with the result 
 that the division spending all the time at book work was 
 beaten in the examination by those who had only given 
 half the time in preparing the subjects for examination. 
 The gardening kept the pupils in better bodily health, 
 with the result that they learnt better. It has been also 
 shown that underfed children are unable to work as well 
 as those obtaining sufficient food. 
 
 In mental fatigue there is either inci'eased motion of 
 the limbs, fidgetiness, or decreased movement amounting 
 to prostration. There is often fulness under the eyes, 
 and increased movements of the eye. The horizonta 
 lines on the forehead are deepened owing to action of 
 the frontal muscles, while the young student shows 
 excessive sensibility to reproof, irritablencss and temper, 
 followed by headache, loss of appetite and disturbed sleep.
 
 84 The hygiene op 
 
 Neglected Children. — The Board of Education state 
 that "it is the duty of the parents not only to send 
 their children to school, but to send them in such a state 
 of cleanliness as to prevent their being a nuisance to 
 other children." The Board did not think the refusal 
 to admit a boy in such a dirty state could be held to 
 be unreasonable. Every effort must be made by the 
 school authorities to improve the state of such children 
 before resorting to exclusion. 
 
 A general condition of dirt is the commouest cause of 
 complaint. The children are rarely washed, and their 
 clothing appears to be the remains of tawdry finery 
 begrimed in the dust and dirt of slums. It may be 
 necessary to visit the parents, and call attention to this 
 want of cleanliness, but an impression may be made 
 upon the children by pointing out the contrast that 
 exists between them and the tidier scholars. In such 
 children lice (pediculi) find a fertile breeding ground. 
 In the head louse (pediculus capitis), the eggs are de- 
 posited on the shafts of the hah-, and are small oval, semi- 
 transparent bodies, attached by a pedicle, or stem, to 
 the hair. The young are hatched in about five days. 
 The louse is semi-transparent, of a dirty white colour. 
 It has six legs, with claws for seizing the hair, and 
 prominent eyes. It is furnished with a sucker, which 
 is capable of piercing the skin and drawing blood. The 
 pediculus vestimenti, or clothes louse, is somewhat 
 larger. The eggs are deposited not on the hair of the 
 skin, but on the fibre of the clothing. 
 
 Lice may be cleared away by bathing with alcohol. 
 This has a solvent effect on the sticky material by
 
 SCHOOLS AND SCHOLARS. 85 
 
 which the eggs are attached to the hair. Various 
 preparations of mercury are also used, hut they must 
 be applied before irritation of the scalp has been caused. 
 For clothes-lice the garments must either be destroyed 
 or baked in a disinfecting oven. Under the Verminous 
 Persons' Act, 1897, local authorities can make arrange- 
 ments for cleansing such persons in a public establish- 
 ment arranged for the purpose, and pressure should be 
 put on authorities to make this provision. By the 
 irritation of pediculi, eczema is set up on the scalp, and 
 this is frequently accompanied by swelling of the super- 
 ficial glands of the neck. Eczema on the body from 
 this cause is rarely met with in the young, though 
 common amongst old people. Some children are 
 naturally more liable to be infested with these pests than 
 others ; and care should be taken to exclude affected 
 children before the parasite can be transferred to the 
 cleanly, from whom it often causes considerable trouble 
 in removal. 
 
 Scabies or Itch is caused by a minute insect called 
 the Acarus Scabiei. It is found in the soft skin of the 
 flexor surfaces of joints, but most commonly between the 
 fingers. The insect burrows under the skin and lays its 
 eggs there. The burrow is like an old pin scratch, and 
 has a dotted and beaded appearance with ragged dirty 
 edges at the opening. By inserting the point of a 
 needle along the burrow the insect can usually be with- 
 drawn for examination, as it adheres to the point. The 
 irritation of the insect causes itching, and scratching is 
 resorted to, which sets up a kind of eczema of the skin. 
 "Weak sulphur ointment smeared over the body, except
 
 86 THE HYGIENE OF 
 
 the face and scalp, just before going to bed will usually 
 effect a cure in three or four days. Close fitting 
 garments should be used to sleep in. 
 
 Ophthalmia. — This disease begins with heat, redness, 
 swelling and pain. Then there is some discharge which 
 rapidly increases in quantity and soon becomes thick and 
 purulent. The disease is highly contagious, and is very 
 liable to spread through schools. It is advisable as a 
 matter of precaution to exclude children showing any 
 signs of redness and watering of the eyes. It may be 
 only a slight cold, or it may be the beginning of measles, 
 whooping cough or German measles. Children dwelling 
 in slums, who are underfed and not cleanly kept, are 
 very liable to this disease. 
 
 Signs of Depressed Health in Children. — Pallor 
 is due to the impoverishment of the blood. The red 
 blood corpuscles are reduced in number. It is a sign of 
 imperfect discharge of the vital functions. 
 
 In children, the commonest causes are connected 
 with interference with the digestive processes. It may 
 be temporarily caused by overfeeding with unsuitable 
 foods, such as cakes, pastry, unripe fruits, etc., and 
 is quickly removed by the administration of a dose of 
 castor oil. If not properly attended to, diarrhoea may be 
 set up and the pallor becomes accentuated. Some 
 children will have a rapid rise of temperature after a 
 surfeit of unsuitable food. 
 
 Constipation is another common cause of pallor. 
 Children need to be taught to empty the bowels at 
 regular times. This is very difficult in day schools 
 as in the hurry of starting in the morning the most
 
 SCHOOLS AND SCHOLARS. 97 
 
 convenient hour is not made use of. In this case many 
 children will make a convenience at some later time of 
 day, and it will be well that such arrangement should not 
 be interfered with. In boarding schools it is most 
 important that ample w.c. accommodation should be 
 provided, and a teacher should be told off to see that the 
 scholars make the daily visit. The increased learning 
 capacity of the pupils will well repay the extra trouble, 
 for it must be remembered that all matters intended to 
 be discharged from the body if retained are liable to 
 undergo partial re-absorption, thus causing a poisoning 
 of the blood which predisposes to other ills. This cause 
 of pallor is very common in big girls about the age of 
 puberty, and should be promptly attended to. 
 
 Scrofula affecting the glands is usually accompanied 
 by pallor. Scrofula is not now considered to be the 
 same disease as consumption, though allied to it, and 
 many children whose glands enlarge and become so 
 diseased as to require removal, grow up strong and 
 healthy. 
 
 Pallor may also be caused by constricted and tight 
 fitting clothing, such as belts and corsets. Pallor due to 
 want of air and exercise is referred to elsewhere. 
 (Page 133). 
 
 IFasta'w/.— Loss of flesh follows pallor if the exciting- 
 cause be not removed. It is an accompaniment of all 
 exhausting diseases. It also may arise from local 
 affections such as the presence of worn is in the intestines, 
 abscesses arising from injuries, and occasionally from 
 over- work.
 
 88 THE HYGIENE OP 
 
 CHAPTEE VII. 
 
 -*o^oo- 
 
 Food for Children. — Nitrogenous. — Animal tissue 
 chiefly nitrogenous. — Constant oxidation; urea; uric acid. — 
 Proteids of blood ; reserve ; wasting. — Non-nitrogenous. — 
 Fats ; heat energy. — Starches ; food sparers partly take the 
 place of proteids and fats. — Diet of the poor. — Minimum 
 daily need of foodstuffs.— Fluids : after meals. — Salt ; 
 vegetable feeders. — Increase of food with exercise. —Diet 
 of children. — Proportion of nitrogenous to non-nitrogenous 
 food. — Effect of sleep on digestion. — Too great frequency 
 of meals. — Excess of food : indigestion ; increase of body 
 weight ; fat ; gout, etc. ; excess of water. — Underfeeding ; 
 starvation ; muscular twitchings ; inattention to work. 
 Clothing. — Protection ; normal temperature ; radiation 
 and conduction. — Woollen ; variable climate ; absorption 
 of moisture ; non-conducting properties of air ; effect of 
 washing on wool. — Cotton : not very absorbent ; conduction 
 of heat. — Flannelette ; inflammability. — Linen : more 
 absorbent than cotton. — Silk : good absorbent and non- 
 conductive qualities. — Tight clothing. — Bare limbs. — Feet. 
 — Damp clothes. Nervous Children. — Infancy ; early 
 symptoms ; exciting causes. — Education. — Over-pressure. — 
 Explosiveness of nervous tissue. — Results. 
 
 Food for Children. — Poods are divided into nitro- 
 genous and non-nitrogenous, mineral salts and water, 
 and food accessories such as tea, coffee, alcohol, etc. 
 The non-nitrogenous foods are sub-divided into fats, 
 carbo-hydrates, and vegetable acids. 
 
 tjri^&o&^AM IjtyDiH. — With the exception of the bones, 
 the greater part of 'the body of an animal is nitrogenous 
 matter; the liquids largely containing nitrogenous sub-
 
 SCHOOLS AND SCHOLARS. SO 
 
 stances in solution. Oxidation of the nitrogenous matter 
 (proteids or albuminoids) in the bod)- is constantly going 
 on, about 500 grains of urea and 10 grains of uric acid 
 being excreted daily by the kidneys ; these two com- 
 pounds largely consist of nitrogen. 
 
 The nitrogenous foods absorbed from the digestive 
 tract are transformed into the proteids of blood. When 
 the body is deprived of nitrogenous food, it draws upon 
 the proteids of the blood, and partly on the tissues 
 themselves. When the reserve is exhausted, the tissues 
 begin to waste. On the absorption of proteids depends 
 the working activity of the body. Muscles, nerve cells, 
 glands, etc., are dependent upon proteids for their action. 
 The chief nitrogenous foods are parts of muscle, of the 
 blood, eggs, and portions of the seeds of cereals and 
 leguminosae. 
 
 Fats. — Fat is used by most nations, but in greater 
 amount in cold climates than in hot. Fat is a source of 
 energy and heat in the body, and accumulates in the 
 body as a reserve force, easily dissimilated and very 
 combustible. In hard work more fat is wanted. Fat in 
 the body is not derived from the fat eaten, or only to a 
 limited extent, as it has been shown to be derived in part 
 from the proteids, and in part from the starchy foods. 
 
 Carbo-Hydrates or Starches.— These foods act as 
 proteid and fat sparers. Carbo-hydrates cannot alto- 
 gether take the place of proteids, but they may take the 
 place of fats. The poor consume more starches than 
 fats from motives of economy, but bow far one may 
 replace the other has not been shown. Either taken 
 excess will cause digestive troubles, 
 
 m
 
 90 THE HYGIENE OP 
 
 Table op the Minimum Daily Need op Foodstuffs {Ktinig). 
 
 CONDITION. 
 
 WEIGHT IN GRAMMES. 
 
 PROTEIDS. 
 
 PAT. 
 
 CARBO- 
 HYDRATES. 
 
 Child up to 1J years 
 
 20-36 
 
 30-45 
 
 60-90 
 
 ,, 6 to 15 ,, 
 
 70-80 
 
 37-50 
 
 250-400 
 
 Man 
 
 118 
 
 5G 
 
 500 
 
 Woman 
 
 92 
 
 44 
 
 400 
 
 Old man 
 
 100 
 
 68 
 
 350 
 
 Old woman 
 
 80 
 
 50 
 
 260 
 
 It will be seen that the proportion of fat and starch is 
 greatest in young children. 
 
 Water is essential to life. Fluids should not, however, 
 be taken with food, but after meals. 
 
 Salt {sodium chloride) is more necessary to vegetable 
 feeders, because vegetables contain salts which excite 
 an increased secretion of sodium chloride in the urine 
 of man, whereas a certain amount of salt is present 
 in flesh. It is a source of the hydrochloric acid (HC1) in 
 the gastric juice. The absence of salt in the food leads 
 to digestive troubles, the salt in the body being absorbed 
 and not being replaced 
 
 Phosphates are very important in the food, especially 
 of young and growing animals. Phosphates are not 
 absorbed readily unless sufficient salt is contained in the 
 food. Phosphates are present in fish, coarse parts of 
 meal, etc. Phosphates of calcium and magnesium are of
 
 SCHOOLS AND SCHOLARS. 91 
 
 great importance in the formation of bone, and the 
 absence of them is one cause of rickets. 
 
 Carbonates, Sulphates, and Iron are aiso necessary 
 to a proper diet, the last being an important constituent 
 of the blood. The total salts amount to about 30 grammes 
 daily. 
 
 The amount of food taken must increase with the 
 exercise ; this, of course, applies principally to proteids 
 and fat. The proportion of nitrogenous to non-nitro- 
 genous food should be about one to five, and of fat to 
 carbo-hydrates about the same (one to five). Among the 
 working classes there is always deficiency of proteids 
 and fats, and excess of carbo-hydrates owing to the 
 large proportion of bread in the food. 
 
 Diet for Children from Six to Seventeen Years of Age 
 
 (Kunig). 
 
 oz. 
 Meat (raw) 6 
 
 Bread 10£ 
 
 Potatoes ... ... ... (ji 
 
 Pat (butter or lard) ... ^ 
 
 Milk "\ 8 | 
 
 Flour 3£ 
 
 Vegetables ... ... ... <;^ 
 
 Water 20-30 
 
 Sleep diminishes digestion ; hence food should not be 
 taken just before going to bed. Pood taken too often 
 tends to diminish the activity of the digestive juices an. I 
 k f ives no rest to the alimentary tract-. 
 
 Exckss or Kood. — Excess primarily produces indiges- 
 tion. The body weight may gain chiefly by deposition 
 of fat. Excess of proteids causes disorders of the liver 
 and muscles, gout, rheumatism, etc. A diet of proteids,
 
 92 THE HYGIENE OF 
 
 with deficiency of fat and carbo-hydrates causes leanness, 
 the fat of the body being absorbed on account of the fat- 
 producing foods being reduced in quantity. Excess of 
 fats and starches tends to corpulence and dyspepsia. 
 Great excess of water leads to oxidation of the proteids 
 of the body. 
 
 Underfeeding. — A vigorous adult dies when he loses 
 two-fifths of his body weight ; children succumb sooner. 
 The child has thirst, as it requires extra water for the 
 oxidation of the proteids of its own body, this oxidation 
 being the result of their deprivation from its food. Faint- 
 ings may take place, more especially when food is 
 withheld. Pulse beats and respiration are slower. 
 There is muscular weakness, the fat is used up and 
 the child grows tall and thin. Muscular twitchings 
 or St. Vitus' s dance may be noticed, and mental weak- 
 ness may degenerate into imbecility. When the under- 
 feeding is merely comparative, the child grows thin, is 
 restless, and unable to pay proper attention to work. 
 
 Clothing. — -Clothing is primarily a protection for the 
 body against heat and cold ; more especially against cold, 
 so that the body may be maintained at 98 - 4 deg. Fah., 
 the normal temperature of the body. 
 
 Clothing must be so arranged as to prevent the 
 radiation or conduction of heat without interfering with 
 the evaporation of perspiration. (See Chapter IX.) 
 
 Woollen Materials are usually considered the most 
 suitable for general wear in such a variable climate as 
 England. Nothing chills the body more readily than 
 wind, and when there is wind and cold combined the
 
 SCHOOLS AND SCHOLARS. 93 
 
 thickest clothing should be worn. Several layers of 
 clothing are warmer than one thick garment, as air is 
 retained between the layers and acts as a non-conductor. 
 It is partly for the same reason that wool is worn. JThe 
 rounded fibi'es of which it is composed are coarse and 
 woven loosely together, so that air is retained in the 
 meshes. It is of itself also a non-conductor of heat, and 
 a great absorber of water, which is taken up in the 
 meshes and then evaporated by the heat of the body. 
 Woollen garments after frequent washing harden, and 
 the soft fibre shrinks and becomes non-absorbent. 
 Woollen garments worn in summer should be thin and 
 lightly woven. Woollen materials do not burn readily. 
 
 Cotton. — The fibre of cotton is hard, does not 
 absorb water and does not shrink when washed, but it is a 
 better conductor of heat than wool. It absorbs odours 
 readily, and has recently been prepared in a form 
 of weaving known as cellular, which allowing of layers of 
 air between the meshes makes it a non-conducting 
 form of clothing. It is cheaper than wool. Cotton is 
 made up with a mixture of wool under the uame of 
 flannelette, though the wool is often infinitesimal in 
 amount. This form of material is very combustible. 
 
 Linen. — Linen is a good conductor of heat and feels 
 cold to the touch. It absorbs water better than cotton. 
 
 Silk. — This material approaches wool in its absorptivity 
 and non-conducting capacities, but is expensive as an 
 article of clothing. 
 
 Wool is best worn next the skin, and should form the 
 chief part of the child's dress. Jn summer, cotton 
 frocks may be worn over light woollen underclothing.
 
 94 THE HYGIENE OF 
 
 Woollen stockings or socks should be worn all the yeai* 
 round, thread and silk being reserved for very special 
 occasions. Constrictions of tight clothes should be 
 avoided, as air cannot get in between the layers to 
 serve as a non-conductor of heat. Belts, garters, 
 etc., should be replaced by suspenders. Tight gloves 
 and boots may cause chilblains by impeding the 
 free circulation of the blood. Bare chests should be 
 avoided. Bare legs and arms in well fed children do not 
 seem to cause much harm. Bare feet are not often seen 
 in England, but it is probable that they would be 
 attended with less danger than is the wearing of defective 
 shoes and boots. 
 
 Children should never sit in damp clothing or damp 
 shoes and stockings, as after exercise the bodies of 
 children cool rapidly and chill may result. 
 
 Nervous Children. — Every teacher should under- 
 stand that certain children, often very intelligent, come 
 under this category, and must be very carefully treated if 
 the nervousness is to be kept in check or cured, as ill 
 advised methods will easily turn the nervous child into 
 the idiot or the lunatic. 
 
 Nervous children may be classed in indistinguishable 
 steps from the timid to the hysterical. Nervousness in 
 children may begin in early infancy. The baby does not 
 sleep quietly, it starts in its sleep, it has convulsions, and 
 suffers from fever.ishness (sudden rises of temperature) 
 without adequate cause. 
 
 Nervous children are easily excited. The visit of the 
 examiner, too hard study, even tossing up and down,
 
 SCHOOLS AND SCHOl 95 
 
 and games sometimes cause intense excitement, followed 
 by sleeplessness at nights, talking in sleep, starting up in 
 terror and walking in the sleep. The child grows pale, 
 stutters, assumes a strange expression, talks to itself, 
 and has attacks of diarrhoea frequently brought on by some 
 special excitement, such as having to repeat a lesson, 
 or being called up before the examiner. These children 
 are often of spare habit. 
 
 Amongst predisposing causes are threadworm and 
 other parasites, rheumatism, and, of course, inheritance 
 from parents — nervous, drunken, etc. For such children 
 corporal punishment should be absolutely forbidden as it 
 inevitably aggravates the disorder. 
 
 School hours and lessons should be short, with properly 
 arranged exercises in the open air which should be 
 neither slovenly and perfunctory, nor so much in the 
 nature of competition as to be exciting. When there is 
 any doubt, it is always best to be on the safe side, and 
 suppose that the child is really suffering, than to punish 
 for naughtiness what is in reality a serious defect in the 
 constitution of mind and body. 
 
 Over Pressure. — It must always be remembered that 
 in true education the child's brain is enlarged and not 
 stuffed. It is this stuffing, or cramming, which leads to 
 over pressure, and this cramming is largely the effect of 
 competition which in true education should be avoided. 
 The object of the teacher should he to develop the 
 particular characteristics of each child's brain, not to 
 assimilate every child to the pattern of some particular 
 examination. Pressure in school for nine months, and
 
 96 THE HYGIENE OF 
 
 holidays for recuperation during three is wrong in 
 principle. The education should go on continuously 
 in such a way that the old idea of school should dis- 
 appear, and the child's school days become the happiest 
 in life. Life in school should be broken up into 
 instruction, exercise, and games, and the more scientific 
 the management of exercise and games, the more 
 receptive the child will become to the instruction. 
 Regularity should be the golden rule for diet, and the 
 ordering of life. Parties, theatre-going, lectures, etc., 
 should be the exception, not the rule. 
 
 School life begins too early. It is only the exceptional 
 child who is fit to learn before the age of six, and the 
 junior classes should be more in the nature of a creche 
 than a schoolroom. The bringing of very young children 
 together creates many opportunities for the spread of 
 disease, but it also takes children very much away from 
 their homes, which are too often dirty and anything but 
 suitable for rearing men and women either mentally or 
 physically healthy. 
 
 Sir J. Crichton Browne says : — -" The brain is made up 
 of explosive material, the explosiveness of which may be 
 heightened or reduced. In states of disease such as 
 insanity or epilepsy the brain substance, or certain tracts 
 of it, are raised to a higher degree of explosiveness, as 
 gunpowder is when mixed with nitro-glycerine. In 
 states of idiocy or imbecility it is reduced to a lower 
 degree of explosiveness, as gunpowder is when mixed 
 with moistened clay, so that it only burns slowly away or 
 will not light at all." 
 
 The explosions of nervous tissue are not visible,
 
 SCHOOLS AND SCHOLARS. U7 
 
 their effects being observed after the explosion. Luckily 
 in most cases the explosions usually take place in 
 precocious children, and the symptoms have been already 
 referred to, excitability, sleeplessness, etc. It is to such 
 children that the teacher must devote most observation ; 
 amongst them may be a child who judiciously treated may 
 grow into a genius, whilst among the remainder may be 
 many bright children who can easily be coached for examina- 
 tions and scholarships. Such children may be stable in 
 character, and as long as they are in good health come to 
 no harm by hard work ; or they may be msrely excitable 
 children who are easily excited over their work, to the 
 breakdown of their bodily health, and, if care is not taken 
 in time, of then mental capacity.
 
 98 THE HYGIENE OP 
 
 CHAPTEE VIII. 
 
 ooi^^oo 
 
 Infectious Diseases. — Measles. — Premonitory symp- 
 toms ; cold in head ; spots in mouth ; rash on body. — 
 German Measles different from Measles. — Common cold ; 
 difference of symptoms. — Whooping Cough ; character 
 of cough ; sickness. — Diphtheria ; suspicious sore throat ; 
 glands of neck ; examination for the bacillus. — Anti- 
 toxin ; early application; decrease of mortality. — Scarlet 
 Fever ; sore throat ; sickness ; rash ; appearance of the 
 tongue. — Mild character. — Epidemic waves. — Effect of 
 sanitation. — Peeling. — Discharges. — Continuance of infec- 
 tion. — Kidney Disease.— Premonitory rashes. — Small- 
 pox. — Difference from Chicken Pox ; pain in back. — 
 Vaccination ; a preventive ; confers immunity against 
 Smallpox. — Re-Vaccination. — Meningitis ; sometimes 
 infectious ; tuberculous. — Ringworm ; fungus ; in scalp ; 
 on body. — Contagious Impetigo ; originating in pediculi ; 
 easily inoculated. — Chorea ; girls ; onset gradual ; move- 
 ments; loss of weight. — Ophthalmia; photophobia; redness 
 of conjunctiva ; watering ; discharges. — Acute conjunc- 
 tivitis. — Chronic conjunctivitis ; follicular conjunctivitis ; 
 trachoma. — Epilepsy ; fits ; suddenness ; drowsiness ; 
 treatment. 
 
 Infectious Diseases. — Certain infectious diseases have 
 premonitory symptoms by which they can be recognized 
 or diagnosed at an early stage before they become 
 intensely infectious. 
 
 Measles. — Measles may begin with high fever, aching 
 pains and vomiting. This subsides a little and there
 
 SCHOOLS AND SCHOLAK> '»'.» 
 
 follows cough and sneezing, and watery running from the 
 eyes with fear of light. The conjunctiva is reddened and 
 the child looks very depressed, and as if it had a very bad 
 cold. About the third day spots appear on the forehead 
 and sides of the face. The spots begin as red points 
 which are raised and feel shotty on the pressure of a 
 ringer. They form crescent-shaped groups on the body 
 which soon become irregular. The child feels worse 
 when the rash appears. Often before the rash appears 
 on the face, if the child is made to open the mouth deep 
 red spots may be seen about the back of the mouth and 
 throat. When the child appears to be suffering from 
 a severe cold the throat should be looked at, and if these 
 spots are seen the child should be sent home and the 
 parent warned. Small white spots may also be some- 
 times seen on the inside of the lips and checks four or 
 even five days before the general rash of measles appears. 
 There is nearly always a very peculiar odour about 
 children with measles. 
 
 German Measles.— This disease is very like a mild 
 attack of measles. The symptoms are similar, but not 
 so severe. The rash usually appears at the same time as 
 the water running from the eyes, but in many cases the 
 first symptom complained of is a stiff neck due to 
 enlargement of the glands of the neck, such as is seen 
 when pediculi are present in the hair. This disease is 
 very infectious, though not as dangerous in its results 
 as measles, and the patienl usuallj feels better when 
 the rash cumes out. The spots are smaller and pinker 
 than in measles. 
 
 Common Cold. — The symptoms are very similar, but
 
 100 THE HYGIENE OP 
 
 there is neither the depressed appearance noticed in 
 measles nor the fear of light (photophobia). 
 
 Whooping Cough. — This disease in its early stage is 
 very difficult to distinguish from a common cold. There 
 is frequently vomiting, puffiness round the eyes, and the 
 sputum is very thick and difficult to cough up, but 
 the fact that it is coughed up by very young children 
 should arouse suspicion, as in ordinary cough it is 
 usually swallowed. Whooping cough and measles or 
 whooping cough and German measles may attack the 
 child at the same time. 
 
 Diphtheria. — This disease frequently attacks children 
 suffering from measles. Crowing noise in the throat 
 may be a sign of deep seated diphtheria, and is a serious 
 symptom. Sore throat is always very suspicious. The 
 fever is not necessarily severe. If the tonsils are seen 
 to be enlarged and reddened with irregular whitish 
 grey patches on them it is probably diphtheria. If the 
 patches are on one side only, or if they extend to the 
 uvula or parts around the tonsils, it is a more certain 
 sign of diphtheria. The glands behind the angle of the 
 jaw are felt to be enlarged beneath the skin. It is 
 advisable that all children with sore throat should be 
 seen by a doctor before being allowed to attend school. 
 This may be difficult in elementary schools, but if the 
 teacher is at all suspicious, the Medical Officer to the 
 School Board, or the Medical Officer of Health, can be 
 called upon to decide. Many cases of diphtheria are 
 very mild, and a decision can only be arrived at by 
 examining the tbroat for the presence of the bacillus 
 Klebs-Loeffler (the bacillus of diphtheria). To effect this
 
 SCHOOLS AND SCHOLARS. 101 
 
 the medical man has a glass tube into which a cork fits 
 tightly, and into this cork a piece of wire is inserted, 
 round the end of which a little sterilised cotton wool is 
 wound. The tube merely protects this swab. To 
 examine for the bacillus the doctor takes the swab out of 
 the sterilised glass tube and passes it lightly over the 
 diseased surface of the tonsil, and then replaces it in the 
 tube, pushing the cork in tightly and sending it to 
 the laboratory to be examined. This examination 
 for the bacillus should be made before applications 
 have been used, and although the presence of the 
 bacillus confirms the diagnosis its absence does not 
 show that the disease is not diphtheria. It is only a 
 negative sign. 
 
 The infection lasts for about three weeks, but no child 
 ought to be allowed to return to school till it has been 
 proved that no diphtheria bacilli are to be found in the 
 throat or nose, nor so long as discharges continue from 
 the throat and ears. 
 
 Great importance should be laid upon early attention 
 to all cases of sore throat, as by the early use of anti- 
 toxin danger of death from this disease is almost 
 abolished. The germ of the disease grows upon the 
 tonsils, and there generates a poison which being 
 absorbed in the blood causes degenerative changes in 
 nerve tissue, etc. Anti-toxin is a preparation from the 
 serum of the blood of the horse, an animal that is 
 immune against (i.e., cannot contract) diphtheria. Horses 
 being inoculated with diphtheria, their serum heroines 
 more strongly immune against the disease, and when 
 injected into the human body it acts as an antidote to
 
 102 THE HYGIENE OP 
 
 the poison generated by the germ. The earlier the 
 antidote is administered in the case of infection, the 
 greater is the chance of recovery. Anti-toxin is harmless 
 to healthy persons. 
 
 Scarlet Fever or Scarlatina. — Sore throat is 
 present from the beginning. The whole of the back of 
 the mouth and throat has a vivid velvety red appearance. 
 One of the earliest symptoms is vomiting, and before 
 many hours the rash appears on the neck and chest. 
 The rash is bright red with little points in it which are 
 not seen in any other diseases where the skin has a red 
 flush. By passing the finger over the skin the rash 
 disappears for a moment to immediately re-appear. 
 In the early stages of the disease the tongue is covered 
 with a creamy white fur in the centre and bright at 
 the edges. It soon cleans and assumes a bright red 
 strawberry-like appearance. 
 
 At the present time this is a very mild disease, 
 only one or two cases in every hundred proving fatal, but 
 formerly there was very great mortality. Whether this 
 is due to epidemic waves, or not, is uncertain. These 
 epidemic waves occur in many diseases. For many 
 years the disease lies low, so to speak, and then 
 from causes unknown it assumes a character of 
 intenseness. 
 
 It is generally believed that the present mild form of 
 the disease is due to the better sanitary surroundings in 
 which people live at the present day. 
 
 About three weeks from the outset of the disease, 
 peeling, or desquamation, of the skin takes place, and 
 this continues till about the sixth week. Owing to the
 
 SCHOOLS AND SCHOLARS. 103 
 
 mildness of some of the attacks it often happens that 
 the first symptom notice. 1 is the peeling of the skin. 
 This takes place from all parts of the body, and 
 children may frequently b,e seen picking the flakes of 
 skin from their fingers. Th and soles are the 
 
 last parts from which skin comes off as a rule, and in 
 any doubt about infection the boots and stockings should 
 be removed. 
 
 Infection continues for about six weeks, hut no child 
 should be admitted to school till desquamation has 
 ceased. Care should also be given to discharges from the 
 nose and ears, or even from diseased glands, as infection 
 often remains whilst these discharges continue. Children 
 recovering are liable to such complaints as kidney 
 diseases, etc. It will be observed that the premonitory 
 signs of these diseases are somewhat similar, and 
 it will always be advisable, when there is any sus- 
 picion at all, that the child should be sent home 
 and not received at school again till it has been seen 
 by a doctor.' 
 
 hi addition to the rashes described, there is in manj 
 cases what is called a prodromal, or forerunning, rash, 
 usually very slight and fugitive, which should be brought 
 to the notice of the doctor when possible. 
 
 Smallpox. — Epidemics of this disease occur from lime 
 to time. In a, person who has been vaccinated the 
 disease is usually very slight, just, a, lew isolated spots 
 feeling hard, like shot beneath the skin, when pressed. 1 1 
 will nearly always he found out that- two days before 
 tin; spots appeared then' had been severe pain in the 
 small of the back. Sometimes the first signs of rash
 
 '104 THE HYGIENE OP 
 
 may appear in a form resembling measles, scarlet fever. 
 or erysipelas, on the sides, abdomen, or inner part of 
 the thighs. The true spots are usually seen on the 
 forehead, face, and wrists. The patient feels better in 
 mild cases after the spots come out. In severe 
 smallpox the patient is so ill that a doctor is always 
 called in. 
 
 Chicken Pox. — In chicken pox the spots come out in 
 crops after very slight malaise. The first crop is usually 
 on the back or chest, but not always so. The day 
 following a second crop appears, and the next day 
 perhaps a third crop. By the sixth day the spots have 
 all dried up and the child is well. 
 
 The following rules should be adhered to, unless 
 specially modified by the Medical Officer of Health : — 
 
 INFECTIOUS AND CONTAGIOUS DISEASES : 
 ISOLATION AND QUARANTINE. 
 
 N.B. — The table which folloivs has been compiled and reprinted 
 with the kind permission of the Medical Officers of Schools 
 Association, from tlie third and fourth editions of their " Code 
 of Rules for the Prevention of Infectious and Contagious Diseases 
 in Schools." Of this Code, all the more important recommendations, 
 with regard to infectious diseases, have been adopted by the Minister 
 of Public Instruction in France. 
 
 ISOLATION means the continued separation of the infectious 
 patient from the healthy until after he has ceased to be 
 infectious. 
 
 QUARANTINE means the similar separation of a possibly infected 
 person until after the termination of the period at which he 
 would (if infected) have developed characteristic signs of the 
 disease in question. 
 
 The following Table indicates the periods of Isolation and of 
 Quarantine which are generally applicable in the case of the 
 principal Infectious Diseases : —
 
 SCTIOOLS AND schoi.\i;s. 
 
 105 
 
 DISEASE. 
 
 Chicken-Pi >x. 
 
 Diphtheria. 
 
 German 
 
 Mi. \sli;s 
 (Rubella) ;\.nd 
 Epidemic 
 Ri iseola. 
 M i ■ 
 Morbilli). 
 
 Mumps. 
 
 I IPHTHALMIA. 
 RlNGWOB M 
 
 Scarlet 
 
 1'kvi.i:. 
 
 Sji IIA-Pox. 
 
 w 
 
 I loUGH. 
 
 ISOLATION 
 OF THE Patient. 
 
 Until every scab has fallen ofl 
 (the scalp should be specially 
 unined). 
 
 In no case for less than four weeks, 
 provided convalescence is com- 
 pleted, and that there is no 
 longer any sore throat, or any 
 abnormal discharge from the 
 throat, ii" >'. ears, or eyes, and 
 no albuminuria; and that bac- 
 terioscopic examination oi the 
 pharyngeal (or nasal i mucus for 
 the specific bacillus has been 
 attended with negative results: 
 this examination having been 
 made in not less than three 
 days after the discontinuance of 
 local antiseptic applications. 
 
 For not less than ten days from 
 the date of the appearance of 
 the rash. 
 
 For not h>ss than two weeks from 
 the date oi the appearance ol 
 the rai b, convalescence being 
 satisfactorily established. 
 
 For not less than three weeks from 
 the commencement, provided 
 that one clear week lias elapsed 
 since the subsidence of all 
 swelling. 
 
 See "Ophthalmia," page 100. 
 
 See " Ringworm," page 108. 
 
 For not less than sixweeks from the 
 
 date "1 the appearani I the 
 
 rash, provided that convales- 
 cence is completed, and desqua- 
 mation bas ceased, and *here is 
 no sore-throat, discharge from 
 the ear, suppurating glands or 
 , , .. matou patches. 
 
 Until evei cab bas fallen off, and 
 ill.' skin lesions have all healed. 
 
 For not less than five weeks from 
 the commencement oi the 
 whooping, provided that the 
 eh;,, , , i ■ i pa tnodic coui b 
 and the w hoopin oea ed 
 
 for at least two weeks. 
 
 QUARANTINE, 
 
 after Exposure to 
 
 Infection. 
 
 For 20 clear days. 
 For 12 clear days. 
 
 For 20 clear days. 
 
 for 16 clear daj s. 
 For 24 clear days. 
 
 For 10 clear days. 
 
 For 16 clear days. 
 For 21 dear days. 
 
 N.B. Complete Disinfection of the pet on and of the clothing 
 must be carried out at the termination of the period of Tsolationqx 
 oj Quarantine.
 
 106 THE HYGIENE OF 
 
 Vaccination. — This is the only preventive of smallpox. 
 Communication with all parts of the world is so easy 
 and so extensive that smallpox can at any time be 
 introduced into England. The disease has an average 
 incubation period of twelve to fourteen days ; that is 
 to say, twelve to fourteen days elapse from the date of 
 infection to the appearance of the spots, so that it is 
 possible for a person to be infected with smallpox in 
 America, Eussia, West Africa, or even Bombay, and not 
 develop the disease till reaching England. 
 
 The liability to contract any infectious disease depends 
 upon the absence of immunity in the individual. Some 
 persons are immune from all infectious diseases, they . 
 never catch anything; whilst others take every disease 
 to which they are exposed. 
 
 Vaccination, or Cow-pox, is a modified form of small- 
 pox, having assumed a mild type from passing through 
 the body of a calf. Vaccination confers immunity on 
 individuals for varying periods of time. Four good 
 marks on the arm will, in some instances, procure 
 immunity for life, in others to puberty, and in others 
 to school age. It is, therefore, necessary to re-vaccinate 
 at the age of about puberty, or conclusion of school life. 
 In Prussia, where this was made compulsory in 1874, there 
 is practically no smallpox at all, as the whole nation 
 has been rendered immune. It is necessary that at least 
 four good marks should be made, as one mark can only 
 procure immunity for a very short time. 
 
 Whenever cases of smallpox occur in the district, it 
 is advisable to have recourse to a third, or even fourth, 
 re-vaccination. In the recent outbreak in London no
 
 SCHOOLS AND SCHOLARS. 107 
 
 one died of smallpox who had heen re-vaccinated within 
 ten years. 
 
 The risk, in vaccination, of inoculating other diseases 
 has been grossly exaggerated. This never occurs if the 
 lymph is good and the operation is carefully performed. 
 At the worst far greater risks are daily taken by every- 
 body in railway travelling, in eating oysters, etc. 
 
 Meningitis. — This is a disease of the membranes of the 
 brain. There are several varieties; in its simple form it 
 may arise firm i exposure to the sun, or shock physical or 
 mental — and it also follows on other diseases. It ma,\ 
 begin with headache followed by delirium and stupor, or 
 there may be vomiting and convulsions to begin with; 
 but in some cases the attack is sudden and painful to 
 witness. The disease may also arise from injury with 
 fracture of the skull. 
 
 The commonest form is of tubercular origin, and in 
 these cases the onset is not so rapid. Children a 
 irritable and constantly crying, putting their hands to the 
 head and complaining of pain. There is usually constipa- 
 tion. As the disease advances the child may be quirt 
 and drowsy. There may be squint, and if the nail is 
 drawn across the skin a red mark persists for some time. 
 
 Particular observation should therefore be directed to 
 children showing any of these symptoms, and if they 
 persist beyond a day or two, medical advice should he 
 sought. Another form of meningitis occasionally occurs 
 in epidemic form. 
 
 Ringworm. — This contagious disease is common to 
 man, dog, cat, horse, etc., but is usually spread from 
 person to person by brushes, caps, and so on. It seems
 
 108 THE HYGIENE OP 
 
 to be commoner in delicate children, perhaps because the 
 skin is of finer texture. It is caused by a fungus. In 
 the scalp a round patch varying in size from a three- 
 penny bit to a crown may be found on which are lustre- 
 less, opaque, brittle, swollen, and distorted stumps 
 looking as if the hair had been nibbled off. Crusts may 
 form, or the disease may be complicated with eczema. 
 The disease may attack the smooth skin. The patches 
 are often irregularly circular with well marked margins. 
 It also affects the beard and nails. This disease is very 
 contagious and children must be excluded from school 
 whilst suffering from it. It is exceedingly difficult to 
 cure even with much care and attention. 
 
 In cases of ringworm of the head, the scalp should 
 be subjected to a careful microscopic examination in a 
 good light, and the broken off hairs carefully scrutinised 
 for signs of the ringworm fungus. 
 
 "It is sometimes considered that ringworm is cured when 
 the hair commences to grow on the affected areas, but this 
 is not necessarily true, for it frequently happens that diseased 
 broken-off hairs remain ; and the malady may thus persist 
 for months or years. It is often very difficult to detect the 
 short diseased stumps, which protrude only 'an eighth of an 
 inch or less, and it is important not to mistake closely-cut 
 healthy hairs for diseased stiunps." 
 
 Contagious Impetigo. — This disease usually occurs in 
 badly nourished children. It usually begins from the 
 irritation of pediculi (lice) in the hair. The irritation 
 induces scratching of the head, the contagion is trans- 
 ferred to the face, and from the face the disease may 
 be conveyed to other children not affected with pediculi. 
 
 Chorea, oe St. Vitus' s Dance. — This disease is more
 
 SCHOOLS AND SCHOLARS. 109 
 
 frequent amongst girls than boys. It may occur in bright, 
 well-made children, and is characterised by awkward 
 twitches and movements, whilst the child may show- 
 weakness of health and childishness of manner. The 
 onset is gradual in most cases, the fingers twitch and the 
 girl drops things in a clumsy way. The shoulders may 
 be moved up and down, and the feet shuffled about. The 
 facial muscles are never still, the eyes are constantly 
 on the move, and the mouth makes many grimaces. 
 These movements may sometimes be averted by engaging 
 the child's attention, but they soon recur. These children 
 lose weight rapidly and often complain of "growing 
 pains." The latter are due to muscular rheumatism, but 
 the joints are also sometimes found to be swollen. In 
 cases following on rheumatism or rheumatic fever there 
 may be heart disease. 
 
 Ophthalmia. — This disease is sometimes epidemic in 
 schools, more particularly resident orphan schools in 
 connection with the Poor Law. The symptoms com- 
 prise fear of light, redness of the conjunctiva, watering, 
 and later on purulent discharge and very serious evils. 
 The first cases should be immediately isolated, and the 
 towels, sponges, etc., used by the patients removed and 
 disinfected. Each child should have separate articles. 
 
 " Evexy case of acuta conjunctivitis should be isolated, 
 
 landing precise diagnosis. The latter can, in many 
 
 instances, be made with certainty only by a bacterioscopic 
 
 examination of the discharge from the conjunctiva. 
 
 " In chronic conjunctivitis, a distinction should bo mado 
 between two conditions that somewhat resemble one another, 
 namely, Follicular Conjunctivitis and Trachoma (granular 
 lids). The former is common among children of the noon i
 
 110 THE HYGIENE OP 
 
 class, and is not a serious ailment. The latter is an infectious 
 disease, always calling for prolonged isolation and special 
 treatment. If neglected, it is apt to affect the cornea, and 
 thus damage sight." 
 
 Epilepsy. — A child may occasionally be seen at school 
 in an epileptic fit. The seizure is sudden, pallor of the 
 face is followed by loss of consciousness and the patient 
 falls. The hands are clenched and the limbs stiffened, 
 the face is distorted, blue and congested. The tongue 
 may be bitten by the closure of the teeth which set rigidly, 
 and the foaming upon the mouth may then be tinged 
 with blood. The child is very drowsy after such an 
 attack and should be allowed to rest. Sometimes the 
 attacks are very mild without convulsion. This is called 
 " petit mal " by the French. These children should be 
 trained under proper conditions in country places.
 
 SCHOOLS AND SCHOLARS. Ill 
 
 CHAPTER IX. 
 
 -»Oj<*<0-&- 
 
 Warming and Ventilation (Theoretical). — Heat 
 requires a continuous supply of air. — Air for ventilation 
 warmed. —Combustion of fuel. —Carbon and Hydrogen 
 forming, witb air, carbon-dioxide and water. — Removal 
 of products of combustion. — Heat by friction. — Energy. — 
 Foot-pounds. — Thermal units. — Heat of fuels. — Amount 
 of heat for a penny. — Latent heat. — Specific heat. Dis- 
 tribution of Heat. — Conduction. — Good conductors : 
 metals. — Non-conductors : still air ; asbestos. — Radiation. 
 — Transparent media. — Polished surfaces. — Reflection. — 
 Sun-burn from snow fields. — Convection. — Movement of 
 air : warm air rises ; cold air sinks. — Hot climates ; lessened 
 convection ; punkahs. — Scents. — Convection in liquids. — 
 Good building and fuel economy. — Damp walls and fuel 
 consumption. — Moisture from gas. — Indirect ventilation. — 
 Proper inlets. Air. — Composition. — Impurity. — Weight. — 
 Low barometer. — Density decreased by rise of tempera- 
 ture. — Carbon dioxide. — Standard of organic impurity. — 
 Impurity. — Microbes. — Dust : when deposited. 
 
 Warming and ventilation are best considered together 
 The continuous production of heat requires, as a rule, a 
 continuous supply of air, so that heat is an importan/ 
 agent in ventilation. Air supplied for ventilation 
 fr< quently has to he warmed in order to avoid the 
 sensation of cold draughts. Heat for such purposes as 
 warming must nearly always be due to combustion, that 
 is to the chemical action caused by the combination of 
 the oxygen of the air with such substances as wood, coal, 
 oil, or coal gas. Those substances arc known as fuels
 
 112 THE HYGIENE 0$ 
 
 and may be solid, liquid, or gaseous, and consist chiefly 
 of the solid element — carbon, and the gaseous element, 
 hydrogen, in combination. On combustion the carbon 
 unites with a portion of the oxygen of the air to form 
 carbonic acid gas (carbon di-oxide), whilst the hydrogen 
 unites with another portion of the oxygen of the air to 
 form water. This breaking up and the re-combination 
 of carbon, hydrogen, and oxygen causes the evolution of 
 heat. 
 
 One pound of carbon in burning forms 3'7 lbs. of 
 carbonic acid gas (C0 2 ) and gives out enough heat to 
 raise 87 lbs. of water from 62 deg. F. to the boiling 
 point, 212 deg. F. One pound of hydrogen (190 cu. ft.) 
 produces 9 lbs. of water, and the heat evolved will raise 
 417 lbs. of water from 62 deg. F. to the boiling point. 
 
 In the evolution of heat it is therefore necessary to 
 bring to the fuel a constant stream of air for the supply 
 of oxygen and arrangements must also be made for 
 removing the carbonic acid and other products of 
 qombusiion. Heat may also be produced by friction. 
 If a flat mass is dragged along a horizontal table by 
 a string to which a weight (say of 100 lbs.) is attached, 
 then for every foot the 100 lb. weight falls a certain 
 quantity of heat is generated by the friction produced 
 between the table and the mass upon it. 
 
 The amount of heat thus produced is small compared 
 with the heat caused by combustion. 1 lb. of coal would 
 have to fall 2,000 miles to produce the same amount of 
 heat as would be evolved by its combustion. The falling 
 weight is said to lose energy by falling, and energy may 
 be measured in this way. The energy of bodies may take
 
 SCHOOLS AND SCHOLVK*. 
 
 113 
 
 other forms. A weight may be raised, a moving mass 
 may be stopped, or a compressed spring may resume its 
 natural shape. Thus the energy to raise 10 lb. through 
 a vertical height of 50 ft. is expressed as 500 foot-pounds ; 
 20 lbs. raised 25 ft. would show an equal amount of 
 energy expended. 
 
 Heat may be expressed in the same way, i.e., as foot- 
 pounds ; but it is found more convenient to refer to the 
 amount of heat necessary to raise 1 lb of water from 
 32 deg. to 33 deg. F. The amount of heat to raise 1 lb. 
 of water through any degree between 32 deg. and 212 deg. 
 F. (the boiling point) is practically the same, and this 
 is called the British Thermal unit. The number of 
 lb.-F. units of heat produced by 1 lb. of different kinds of 
 fuel is as follows : — 
 
 Coal ... 
 Coke ... 
 Peat ... 
 Wood ... 
 Petroleum 
 
 14,000 lbs.-F. 
 12,600 „ 
 
 9,000 
 
 7,200 „ 
 21,000 „ 
 
 The number of lb.-F. units obtained for a penny are : — 
 Coal 95,000 lbs.-P. ^ 
 
 Coke ... 150,000 
 
 Peat 45,000 „ 
 
 Wood 54,000 „ 
 
 Petroleum 21,500 
 
 The heat of combustion is as follows 
 
 1 lb. of Carbon is 
 
 1 lb. of Hydrogen is 
 
 Approximately. 
 
 13,000 F. units. 
 62,500 
 
 Willi these figures the amount of beat evolved by fuels 
 can be estimated. 
 
 Latent heat must also be taken into account. Each 
 pound of ice in melting absorbs 143 lbs.-F. units of heat
 
 114 THE HYGIENE OP 
 
 without raising the temperature of the ice, and the 
 boiling away of 1 lb. of water into steam is caused by 
 the transference of 966 lbs.-F. units of heat, but the 
 steam is of the same temperature as boiling water. 
 The heat in these cases is rendered latent, and the 
 amount used up in the fusion or evaporation of the 
 substance is referred to as latent heat. 
 
 In the same way, when water evaporates, heat becomes 
 latent, thus causing a cooling of the surrounding sub- 
 stances and the water itself. 
 
 A cold substance in moist air causes a condensation of 
 moisture and a liberation of latent heat. 
 
 Specific Heat. — This varies for different substances, 
 and means the number of units of heat required to raise 
 the temperature of 1 lb. of a substance through 1 deg. F. 
 
 Note the specific heat of the following substances : — 
 Water 1 
 
 Air (when the volume is constant) 
 
 Air (when allowed to expand) ... 
 
 Iron 
 
 Ice ... 
 
 •169 
 •238 
 •114 
 •504 
 
 Water absorbs more heat than most substances. 
 By cooling 1 lb. of steam at 212 deg. F. to 60 deg. F., 
 the latent heat being added, 1,118 lb.-F. units of heat 
 would be transferred, whereas only 36 lb.-F. units 
 would be got out of 1 lb. of air similarly treated. 
 
 Distribution of Heat. — If substances at different 
 temperatures are placed together, the temperature of the 
 different substances will gradually become uniform. 
 
 This may be effected in different ways. 
 
 1. Conduction. — In conduction the hot layers pass the 
 heat to the cooler layers in contact with them in what is
 
 SCHOOLS AND SCHOtABfi. 115 
 
 called a slope of temperature. This slope is steeper 
 whilst the differences in temperature are greater, and 
 lessens as the temperatures become equalised. But 
 conduction has little effect in heating ah-, except through 
 convection. 
 
 Most metals are good conductors, particularly copper, 
 but air would be a good non-conductor if kept still. 
 Thus flannel, cotton wool, swansdown, etc., are warm, 
 because air is retained in the meshes. This prevents the 
 escape of heat from hot bodies. Asbestos, glass, wood, 
 wool, indiarubber, fossil meal (kieselguhr), paper, etc., 
 are non-conductors. Steam boilers, pipes, etc., are fre- 
 quently packed in asbestos or coated with non-conducting 
 materials in order to retain the heat and save expendi- 
 ture of fuel. 
 
 Heating by conduction may readily be wasteful, as it 
 may pass through improperly constructed walls to the 
 cold outer air, where it is lost. 
 
 2. Badiation. — All bodies surrounded by transparent 
 substances are continually radiating heat, which may be 
 absorbed, transmitted, or reflected in the same way as 
 light. Light is, in fact, a form of radiation which is 
 visible. 
 
 The amount of heat radiated per second depends upon 
 the temperature in some way not yet understood. 
 Polished surfaces of hot substances radiate less heat 
 than dull sin-faces; good reflectors are bad radiators. 
 Good radiators are good absorbers; fcransparenl bodies 
 are bad radiators, e.g., a glass screen in front of an 
 open fire. 
 
 Badiation falling on a polished surface such as steel
 
 116 THE hYGIENE OE 
 
 is reflected ; but if the surface is dulled with lampblack, 
 the heat is absorbed. Hence the reason for polished 
 steel surfaces round an open fire, as heat is reflected 
 from the steel and not absorbed, to be afterwards 
 radiated. If the surface be dull white, the heat is 
 diffusely reflected in all directions. Thus the reflection 
 of sunlight from a snow field may cause the same effect 
 as if the surface of the snow were hot. This causes 
 sunburn in the high mountains where there is sunlight 
 on the snow. 
 
 3. Convection. — Convection refers to the currents set up 
 by the differing temperatures of portions of air caused by 
 contact with heated bodies — the hotter air rising and the 
 colder air falling. Air in contact with a hot surface is 
 heated by conduction, and then becomes specifically 
 lighter than the cooler portions. The heated air then 
 rises, being pushed upwards by the sinking of the 
 colder air. Convection currents are very complicated 
 in a closed room. The heat of the open fire crosses 
 the room in direct lines to the walls, furniture, etc., 
 without materially heating the ah' itself. The surfaces 
 of the walls and furniture absorb this radiated heat and 
 communicate it to the air by conduction, and thus form 
 other convection currents upward. Heat may be 
 reflected from polished surfaces to absorbent surfaces in 
 other parts of the room, and cause by conduction to 
 the air further convection currents 
 
 Windows being colder than the air in contact with 
 them, may cause downward convection currents, whilst 
 the sun rays falling on wall or furniture cause upward 
 convection currents. The convection of air by the
 
 SCHOOLS AND SCHOLARS. 117 
 
 draught up the chimney still further complicates the 
 currents of air. By watching the motes in a sunbeam 
 in such a room the air is shown to be in a state of 
 
 turmoil. 
 
 The human body in an atmosphere colder than itself 
 causes convection currents, thus supplying a certain 
 amount of fresh air to the body. In hot climates tins 
 convection is lessened, and the necessity for punkahs 
 and other artificial current formers is shown. 
 
 Smell is chiefly distributed by convection, and strong 
 smelling substances may be used to show the rapidity 
 of the currents of air. Smoke from a cigar will show 
 the direction of these currents. 
 
 The convection of heat in liquids is made use of in 
 warming by hot-water pipes, the currents set up in the 
 water in the pipes from the boiler to the rooms being 
 similar to those described in the air. 
 
 The cooling of a hot body surrounded by cooler ones 
 depends upon a variety of conditions. 
 
 An iron room painted dead black would be very cold 
 on a cold night and very hot in the sun's rays ; whereas 
 a house of brick (specific heat high) with a layer of air 
 between double walls, painted white on the outside, 
 with a thatched roof and double -lass windows, would 
 be warm in cold weather and cool in summer. 
 
 Economy of fuel is effected in houses properly built. 
 Only sufficient heat should go up the chimney to ensure 
 ventilation. Chimneys should be in the centre of the 
 house, so that the heat should not be lost by conduction 
 through the outside wall. Walls should be dry, as every 
 pound of water from a damp wall means the consumption
 
 118 THE HYGIENE OP 
 
 of a pound of coal in an ordinary grate. Lighting gas 
 to dry a room is not efficacious unless ventilation is 
 provided to carry off the heated air containing the 
 moisture ; otherwise it would only be redeposited 
 when the gas was turned out and the air cooled. 
 
 Walls should be thick, or double, and shutters to 
 windows will keep the house warmer at night. But if 
 the present indirect means of ventilation are closed it 
 will be necessary to provide proper inlets. 
 
 It should be remembered that though loss of heat by 
 radiation and convection helps ventilation the loss of 
 heat by conduction does not assist in any way. 
 
 Ventilation. — By ventilation is meant the replace- 
 ment of vitiated air by fresh air. Air is a mixture of 
 gases, and fresh air may be said to contain 20-96 per 
 cent, by volume of oxygen, 79 per cent, of nitrogen, and 
 •04 per cent, of carbonic acid gas, aqueous vapour 5 grains 
 to 20 grains per cubic foot of air, small traces of ozone, 
 and minute quantities of gaseous impurities. There will 
 also be solid particles in suspension derived from the 
 soil and the vegetable world. The weight of air varies 
 according to barometric pressure and temperature. The 
 lower the barometer, the less is the density or weight 
 of the air. 
 
 Barometric pressure may be lowered by ordinary 
 atmospheric changes, or by difference in altitude, as in a 
 balloon or up a mountain. Whilst pressure remains 
 equal, the density is decreased by a rise of temperature. 
 For every degree F. of rise in temperature, the volume 
 of the air is increased by - 4 -A T of its volume at 
 32 deg. F. Air may also be cooled by reduction of
 
 SCHOOLS AND SCHOLARS. 119 
 
 pressure, and use of this law is made in cooling chambers 
 where by the release of compressed air a eool atmos- 
 phere is obtained. 
 
 The carbonic acid gas in the atmosphere has been 
 shown to be -01 per cent., or four parts per 10,000 ; when 
 this is raised to six parts by the introduction of organic 
 impurities of respiration, the limit of impurity is said to 
 be reached. That this is a desirable standard is evident, 
 but sanitarians will often have to be content with a 
 larger amount of impurity. This impurity must not be 
 confused with the amount of C0 2 arising from products 
 of combustion. 
 
 In order to sufficiently dilute this added impurity, it is 
 necessary to introduce 3,000 cubic feet of fresh air for 
 each person per hour. It has been suggested that instead 
 of six parts per 10,000 as the standard of impurity, ten 
 parts sbould be adopted for towns and thirteen parts 
 for schools, with an additional test showing that there are 
 not more than twenty microbes per litre of air. 
 
 Dust is always present in air except on the tops of high 
 mountains and at sea. The solid particles vary in 
 number, but they are capable of carrying microbes and 
 assisting in the spread of diseases. Dust remains in 
 suspension from the convection of air currents. When 
 the air is still, it is deposited, or even when flowing very 
 slowly it settles on horizontal flat dry surfaces. From 
 wet surfaces there is constant evaporation in which fche 
 smaller molecules of water bombard the larger particles 
 of suspended dust which are then carried further away 
 by the current of air. A somewhat similar result follows 
 when cold air containing dust is passing over warmer.
 
 120 THE HYGIENE OF 
 
 surfaces, as the cold molecules, touching the hot surface, 
 rebound with greater force than they strike. It is to 
 this repellant action of moist and warm surfaces that 
 dust laden air passing into our bronchial tubes is driven 
 out again, with only a partial deposit of the microbe- 
 carrying dust. The reverse effect takes place if the 
 surface is cold and the air warmer. The deposit of soot 
 in a chimney and of dust on walls near hot- water pipes 
 is explained in this way. Air containing the dust or 
 soot is warm and the particles are deposited on the 
 cold wall. 
 
 Air filters should be colder than the air passing 
 through them, for the same reason. Jute cloth screens, 
 17 ft. by 4 ft. collected 2i lbs. of dust in seven weeks in 
 University College, Dundee. All conduits for air should 
 be so arranged that they can be readily cleaned.
 
 SCHOOLS AND SCHOIiABS. 121 
 
 CHAPTER X. 
 
 ooJa^O-c 
 
 Methods of Ventilating, etc.— Variation of baro- 
 metric pressure; air of differing densities; currents. — 
 Fall of barometer or rise in temperature; air heaviei , 
 volume requires larger space. — Direct impact of wind; 
 open door or window. — Wind blowing across an open- 
 ing ; release of pressure. — Up-draugbt ; cowls ; smoky 
 chimneys; steam jet. — Ventilation by fans. — Circular 
 fans.— -Natural ventilation and mechanical. — Organic 
 impurity. — Vacuum and plenum systems. — Relative ex- 
 posure. — Difficulties of ventilation in lofty buildings. — 
 Death rates in crowded tenements. — Air space per head. — 
 Air entering a room from a tube. — Natural ventilation. — 
 Outlets hi«h. — Fresh air should not cause draught. — 
 Window with bottom board. — Tobhfs ventilators. — Louvre 
 windows. — Ventilating fireplaces. — Perforated bricks. — 
 Sherringham's ventilator. ■ — Cornices. — McKinnell. — 
 Tubes over gas burners. — Size of openings. — Outlets 
 smaller than inlets. — Filtered air. — Gas lights. — In- 
 creased ventilation. — Advantages of electric glow-lamps: 
 no impurity ; no absorption of oxygen. — Chimneys — Up- 
 takes in winter, downtakes in summer. — Cubic capacity 
 per head. — Measurements of cubic capacity. — Tempera- 
 ture. — Floor space. — Board of Education recurircments too 
 low. — Cleaning schoolrooms. — Blow through. — Open fire 
 radiation — Closed stoves. — Impure gases. — Cast iron. — 
 Carbon monoxide ; danger to life. — Gas stoves. — Hot air. 
 — Hot water. — Low pressure. — High pressure. — Steam 
 pipes. — Protection to pipes. — Summary. — Effects of 
 Overcrowding. — Headache. — Thirst. — Rise of tempera- 
 ture. — Death. — Black Hole. — Tubercle bacillus : destroyed 
 by sunshine; spread by dust ; spread of infectious diseases. — 
 Sewer air. — Typhoid. — Pneumonia. — Drainage. — Straight 
 lines. — Automatic flushing. — Inspection . 
 
 Ventilation. — The displacement of foul air may bo 
 brought about in different ways. 
 
 1. Variation of Barometric Peessube and of Tim 
 perature. — This causes intermittent ventilation, air of
 
 122 THE HYGIENE OP 
 
 different densities causing currents. Thus, equilibrium 
 is disturbed, and what is known as a "bead" is formed. 
 
 (a) A fall of 1 inch of the barometer always follows 
 the abstraction of 57 cubic inches of air from every cubic 
 foot, or about J^ of its bulk. The lowering of the 
 barometer is caused by a decrease in the density or 
 weight of the air ; a given weight of air occupies a 
 larger space, i.e., a given volume of air weighs less. 
 
 (b) A rise in temperature of 1 deg. F. causes the 
 expulsion of Sh cu. in. from each cubic foot, because 
 the volume of 1 cu. ft. is increased T ± r part for the 
 rise of each degree of temperature. 
 
 2. Direct Impact of Wind upon an Opening. — This 
 is the simplest form of ventilation, and is best shown 
 when doors and windows are open and there is a 
 thorough draught. 
 
 3. Wind Blowing aceoss the Opening op a Tube, 
 Pipe, etc. — This causes a lessening of the amount of 
 pressure at the end of the tube, and a sucking action 
 is set up, which draws out the air from within. This 
 often assists the draught up a chimney, and acts in a 
 limited degree when the wind is blowm past an open 
 window or door. Cowls of various shapes are some- 
 times put on the top of ventilating pipes to increase 
 the up-take or prevent down-draught. The pressure of 
 the wind at the top of a smoky chimney is probably 
 not the only cause of down draught ; the pressure at the 
 other end of the ventilating system is partly responsible. 
 The draught in a pipe is sometimes assisted by the 
 discharge of a steam jet along the tube in the direction 
 in which the current is desired.
 
 SCHOOLS AND SCHOLARS. 123 
 
 4. Ventilation by Fans — A number of vanes are 
 attached to an axle. When the fan rotates, the particles 
 of air slip along the vanes on the tips, and leave the 
 tips at a tangent* at almost as greal a velocity as 
 that of the tips themselves. The motion of the air 
 is from the centre to the periphery. The pressure 
 at the axis is diminished. To obtain the full effect of 
 the fan, it must be enclosed in a circular box with 
 arrangement for the supply of fresh air at the axis, 
 and for delivery by a tube from the circumference. 
 
 5. Ventilation by Bellows or Blowing Machines. 
 — These are sometimes used instead of fans. It has 
 been shown that in naturally ventilated schools the 
 respiratory impurity shown as carbonic acid gas (carbon 
 dioxide) is 15 to 18 per 10,000, whereas with mechanical 
 ventilation it is only 11 to 12-5 per 10,000. 
 
 6. The Plenum and Vacuum Systems. — Eeference 
 is sometimes made to the " plenum " and to the 
 "vacuum" systems of ventilation. The practical dis- 
 tinction is that in the " plenum " system the air is 
 forced into the air conduits and escapes by chinks and 
 crevices or by special exit ventilators, whereas in the 
 "vacuum " system the foul air is drawn out and the fresh 
 air enters by chinks and crevices or suitable openings. 
 In some experiments conducted by me some years ago 
 in H.M.S. Polyphemus, a torpedo ram, with the greater 
 part of the hull under water, it was shown that the 
 "vacuum" system was much more effective, the atmo- 
 sphere of the lower deck when the men wi re a Leep 
 being much purer than when fche " plenum " system was 
 working. When the ship was under steam both systems
 
 124 THE HYGIENE OP 
 
 were kept at work, but the exhaust fans were much more 
 expensive to work when in harbour, as special engines 
 had to be kept going. 
 
 Where space is too great, difficulties may arise from 
 the imperfect circulation of the air. Persons have 
 suffered from breathing organic impurities given off by 
 a crowd in a lofty tent, when, although the air space 
 was large, there was no circulation of air from the 
 upper parts of the tent to relieve the suffering humanity 
 in the crowd. This difficulty seems to have been over- 
 come in a church in Berlin, in which the air of the dome 
 is kept at a higher temperature than the rest of the 
 church, where pure air is maintained constantly (at 
 60 deg. F.) by natural ventilation. In small tenements 
 the air is often very foul ; the greater the number of 
 rooms available, the less is the amount of impurity. 
 Children suffer most, the death rate in one-roomed 
 tenements being double what it is in four-roomed ones. 
 
 Each person should be allowed 1,000 cu. ft. of air- 
 space, and provision should .be made to renew the supply 
 three times every hour, as 1,000 cu. ft. is rendered 
 impure by the air expired from the lungs in twenty 
 minutes, and thus becomes poisonous. This amount 
 of cubic space (1,000 cu. ft.) is, however, rarely obtain- 
 able. In barracks 600 is allowed, in common lodging- 
 houses 300, and in schools the Board of Education 
 require 80 cu. ft. as a minimum. The objection to 
 change of air is usually its chilling effects. This can 
 be obviated by warming the incoming fresh air. 
 
 It must be borne in mind that ventilating shafts 
 should be straight. Every bend or angle in a tube
 
 SCHOOLS AND SCHOLARS. 125 
 
 diminishes the velocity. Angles obstruct the currents 
 more than curved bends. Air entering from a tube is 
 diffused more widely if the velocity is greater, but is 
 more unpleasantly felt than a lesser velocity, which may 
 penetrate further but less diffusively. The velocity is 
 rapidly reduced as it leaves the tube. At the orifice 
 the current is like the rapids of a river, but the stream 
 quickly assumes the character of still flowing water. 
 
 Inlets and Outlets. — Inlet ventilation causes more 
 perceptible currents around the openings than outlet 
 ventilation. In natural ventilation it is advisable to 
 arrange the outlet at the highest point, since the 
 expired air, being moist and warm, is lighter, and 
 ascends to the upper parts of the room. Fresh air 
 inlets should be arranged so as to avoid draughts. 
 This is done by many devices. The lower window 
 sash may be raised a little, so that the air enters 
 between the lower and the upper sash, and is directed 
 upwards. The air being colder and heavier than 
 the indoor air, immediately falls, but the change in 
 the direction of the current lessens the force of the 
 draught. A board maybe placed across the bottom 
 opening of the lower sash, so that air does not enter t here. 
 If the difference between the internal and external air 
 is more than 20 deg. F., a draught is felt. 
 
 Tobin's Ventilator is similar in action. An opening 
 in the wall on the floor level is connected with a tube 
 rising to a convenient height, usually aboul four or five 
 feet, where the fresh air emerges without creating much 
 draught. If the tube is made of metal, the incoming 
 air is easily warmed \>\ hot water, etc.
 
 126 THE HYGIENE OF 
 
 Louvred Panes of glass are sometimes inserted in 
 windows with similar results. 
 
 Ventilating Fireplaces have a hot-air chamber at the 
 back of the grate, through which air is conducted, and 
 then warmed before being introduced into the room. 
 
 Perforated Bricks cause little draught. 
 
 Sherringham' s Ventilator is a small vertical flap-door 
 in the wall near the ceiling, balanced by a counterpoise, 
 and hinged below so as to fall forward towards the 
 room. It is cased in at the sides, so that the current 
 is directed upward by the angle of the flap. 
 
 Ventilated Cornices have been made. The upper part 
 may be used as an outlet and the lower as an inlet, or 
 the cornices on different sides of the room may be 
 outlets or inlets. 
 
 McKinnell's Ventilator consists of a smaller tube 
 within a larger. Fresh air enters between the two 
 tubes, and is deflected by a flange upon the inner tube, 
 which acts as an outlet. The sectional area of the 
 inner or outlet tubes is the same as that of the inlet. 
 
 An opening is sometimes made from the room into 
 the chimney, back draught being prevented by lightly 
 moving flaps, which close by their own weight in the 
 absence of an upward current. Tubes over gas lights are 
 also used to cany oif vitiated air. An inner tube is 
 arranged to carry off the products of the burning gas ; this 
 passes at a suitable point into a larger tube, and the 
 vitiated air is carried away by the heat of the space 
 between the two tubes. 
 
 The size of the openings should be about 24 sq. in. 
 per head for outlet, and 48 sq. in. for inlet, but no single
 
 SCHOOLS AND SCHOLARS. 127 
 
 outlet should exceed GO sq. in. or inlet 144 sq. in. if 
 undue draught is to be avoided. 
 
 Air should be taken from suitable points free from 
 contamination of drains, smoke, etc., and, if neces- 
 sary, it may first be warmed and filtered before being 
 introduced. 
 
 When there is only one opening in a room this may 
 act both for inlet and outlet, and many ventilators will 
 act sometimes as inlets, sometimes as outlets, according 
 to the atmospheric conditions. 
 
 In winter, in rooms warmed by open fires streams of 
 warm air ascend to the ceiling from the more central 
 parts of the apartment, whilst sheets of colder air slide 
 down the walls and windows. Just as in some streams 
 warm water flows for a long distance above a colder layer, 
 so air at different temperatures does not mix as readily 
 as might be expected. 
 
 Stinking gases such as hydric sulphide (sulphuretted 
 hydrogen) if a little wanner than the air in the room, 
 though making the air slightly denser do not sink like 
 cold air, but rise and diffuse rapidly. 
 
 Gas jets burning in a room should be provided with 
 special outlets to carry off the impurities of combustion, 
 such as carbon di-oxide and sulphur dioxide, etc. It is 
 computed that 1,800 cu. ft. of fresh air should be 
 introduced for each cubic foot of gas burned. Note, 
 however, that the carbon di-oxide from gas has a less 
 relative impurity than that from the lungs. 
 
 Incandescent Electric Lamps cause no impurity and 
 absorb no oxygen, as the filament glows in a vacuum 
 within the glass bulb. The heat developed is less than
 
 128 
 
 THE HYGIENE OF 
 
 that given off by a man or a candle, and about one-tentb 
 of that from an ordinary gas jet. 
 
 In winter the chimneys if not placed in thin external 
 walls, even when fires are not lighted, are warmer than 
 other parts of the house, and they act as outlets, but 
 in summer the walls are warmed by the sun and with 
 open windows there is often a downcast from the 
 internal chimneys. A gas jet is sometimes burnt in the 
 chimney to remedy this, or an electric fan will set up a 
 draught where the current is available. The amount of 
 fresh air required per hour averages 3,000 cu. ft. per 
 person. 
 
 9,800 cu. ft. 
 
 is required 
 
 per 
 
 adult male in hard work. 
 
 4,750 „ 
 
 „ 
 
 
 „ ,, light work 
 
 3,(100 „ 
 
 „ 
 
 
 „ „ in repose. 
 
 3,000 ,, 
 
 „ 
 
 
 ,, female „ 
 
 2,000 „ 
 
 >» 
 
 
 child in repose. 
 
 Measurements of Areas. 
 
 Area of a circle = D 2 x '7854 
 
 = C* x -0796 
 Circumference of a circle = D x 3-1416 
 Diameter of a circle 
 Area of an ellipse 
 
 Area of parallelogram 
 Area of triangle ... 
 
 = C + 3-1416 
 
 = Product of the two diameters 
 
 X -7854 
 = Base x vertical height 
 = Base x half height, or height 
 
 X half base 
 
 Irregular spaces must be divided up into parallograms, tri- 
 angles, etc. The cubic capacity of a room is the area of the 
 floor space multiplied by the height. 
 
 The temperature of class rooms should be kept at from 
 60 deg. F. to 65 deg. F. In the infants' department 
 65 deg. F. is more suitable. The Board of Education 
 has made 80 cu. ft. the minimum air space per child with 
 8 sq. ft. as the minimum floor space. Under the London
 
 SCHOOLS AND SCHOLARS. 129 
 
 School Board older children have about 10 sq. ft. of floor 
 space. It is practically impossible under these conditions 
 to maintain the maximum impurity at 6 parts per 10,000 
 carbon di-oxide, and 10 parts are frequently present, 
 external air having 1 parts. Even then in a room 10 ft. 
 high it would be necessary to change the air about fifteen 
 times per horn*. In order to avoid the feeling of draught, 
 it would therefore be necessary that the incoming air 
 should be warmed. 
 
 Perflation. — The school-room should be cleared from 
 time to time, and a thorough blow through obtained by 
 opening the windows and doors, unless special artificial 
 arrangements are provided for ventilation. 
 
 Warming. — Open Grates. — With an open fire nine- 
 tenths of the heat of combustion disappears. A part is 
 carried away with the products of combustion, and a 
 part disappears by conduction through the walls, while 
 much of the fuel itself is wasted, passing up the chimney 
 in the form of soot. The heat taken by conduction to the 
 walls has very little heating effect upon the air by 
 convection currents as from the situation of the fire 
 bricks, etc., it is clear that the air heated by passing over 
 them is carried up the chimney by the strong draught. 
 The heating effect of an open fire is therefore chiefly by 
 radiation. Fire brick should enter into the construct ion 
 of the grate more than iron, .as it is a better radiato] 
 A narrowing of the chimney opening to prevent too greai 
 jcape up the chimney is one means of economising 
 heat. Air chambers behind the grates are often intro 
 duced with good effect.
 
 130 THE HYGIENE OP 
 
 Closed Stoves. — These are very economical in the 
 production of heat, but they do not remove enough 
 air. There is often a feeling that the air is burnt, 
 and there is over-dryness. Whether this latter feeling is 
 not due to gases given off from the closed stoves, and 
 especially through joints, etc., is not clearly known. 
 Carbonic oxide is found to be present when cast-iron 
 stoves are used, but not so much with wrought-iron. 
 Eed hot cast-iron reduces carbonic acid (carbon dioxide) 
 to carbonic oxide (carbon monoxide). Wrought-iron does 
 not do this so readily. 
 
 Gas Stoves. — These are convenient but expensive, 
 especially for warming large rooms. Care must be taken 
 to carry off the products of combustion which, besides 
 water vapour and carbon dioxide, include coal gas and a 
 certain amount of sulphur dioxide derived from the carbon 
 bisulphide and sulphuretted hydrogen which occur as 
 impurities. Now that water gas is being used to cheapen 
 coal gas, carbon monoxide is also liable to escape. This 
 gas being odourless may be breathed unwittingly with 
 fatal results. Heating by hot air can only be effected for 
 a short distance, as the amount of heat carried by a 
 given quantity of air is small. One of the best methods 
 is to pass the air through chambers containing 
 hot water pipes, and thence into the room to be 
 ventilated. 
 
 Hot Air Furnaces. — Heating from a central hot-air 
 furnace is sometimes unsatisfactory, unless attention is 
 paid to the details. The heating chamber should not 
 be remote, otherwise the air must be unduly heated; 
 and the furnace should be large, otherwise in cold weather
 
 SCHOOLS AND SCHOLUtS. 131 
 
 noxious gases such as carbon monoxide, etc., will be 
 produced by the great heat employed and sunt with the 
 air into the rooms. 
 
 Cool air should be mixed with the hot air as required. 
 If the hot air supply is cut off from the room, the inmates 
 breathe the impure air over and over again, unless 
 alternative openings are provided to give natural ventila- 
 tion when the artificial supply is stopped. The source 
 of air supply must be good, and the furnace-room should 
 be well supplied with fresh air. 
 
 Hot Water Pipes. — Heating by hot water pipes is 
 convenient. Air passing over hot water pipes is not 
 usually raised above 100 deg. F., even when the 
 temperature of the pipes is much higher. With low- 
 pressure there is a somewhat higher first cost on 
 account of the large size of the pipes. Heating 
 by high-pressure is less costly to initiate as the 
 pipes are' smaller. The weakest part is in the coil of 
 pipe in the fire, and there a burst w T ould be most likely to 
 occur. Such bursts do not appear to be as dangerous 
 as in low-pressure boilers. Hot water continues to 
 circulate through the pipes after the fires are put out, 
 more particularly with low-pressure systems. Heating 
 by steam pipes is used abroad but is not much 
 employed in this country; the tending to the boiler 
 must be continuous to keep a head of steam, and is 
 therefore expensive. In Perkins' System strong pipes, 
 hermetically sealed, contain a measured amounl of 
 water. This is g aerated into steam, and thus expands 
 to fill the whole system of pipes. It cainiol escape, and 
 when the fire goes out the steam condenses to water.
 
 132 THE HYGIENE OP 
 
 Hot pipes should be protected as burns may be caused 
 to young children, etc. 
 
 Summary. — Mechanical Ventilation. — Gives more 
 constant purity and is independent of weather ; schools 
 are warmer and less draughty ; equal distribution of 
 heat and fresh air ; diminution in the number of micro- 
 organisms ; first and annual cost very heavy. 
 
 Open Fires. — Cheerful, air fresher, paint work lasts 
 longer; first cost less, but upkeep more than stoves or 
 pipes ; air said to be more charged with micro-organisms 
 than with hot pipes. 
 
 Stoves. — Small first cost, but not cheerful, and often 
 cause disagreeable dryness of atmosphere. 
 
 Hot Pipes. — Less annual cost ; equal distribution of 
 heat ; first cost heavy ; high-pressure pipes cheaper than 
 low-pressure ; atmosphere purer ; air not as fresh as with 
 open fires. 
 
 Effects of Overcrowding. — The effects of foetid air 
 containing organic matter, excess of water and carbonic 
 dioxide produced by respiration are headache, heaviness, 
 inertness, and occasionally faintness or nausea. The 
 organic matter is the most poisonous, as has been shown 
 by experiments, when the watery vapour and the carbon 
 dioxide were removed. Persons kept in such an 
 atmosphere have an increased temperature, quick pulse, 
 loss of appetite, dryness of mouth and thirst. When the 
 overcrowding is very great, as in the Black Hole of 
 Calcutta, death ensues. Of 300 Austrians imprisoned 
 in a small room after the Battle of Austerlitz, 260 died.
 
 SCHOOLS AND BCHOiiAKS. 133 
 
 When people have to live in a moderately vitiated 
 atmosphere, the aeration of the hlood seems to be 
 interfered with, and the general tone of the system is 
 impaired. Person- become pale, and lose appetite, 
 strength and spirits. Such persons are more liable to 
 pulmonary complaints, and consumption is a disease fre- 
 quently occurring amongst them. This has been brought 
 to the public notice very forcibly of late years, the dis- 
 covery of the tubercle bacillus having shown the way in 
 which Consumption is spread in foul air. The tubercle 
 bacillus is destroyed by sunshine and in fresh air. It is 
 carried into the lungs on the particles of dust. It has 
 been shown how in healthy persons many germs may be 
 thrown off, but if the person into whose air tubes the 
 bacillus is introduced is suffering from poor health 
 through confinement in vitiated air, the bacillus eifects a 
 lodgment and the disease known as phthisis or con- 
 sumption contracted. The phlegm coughed up by the 
 patient dries on the floor, and being converted into dust 
 is breathed by other persons who contract the disease 
 therefrom. 
 
 Impure air also greatly facilitates the spread of 
 infectious diseases, such as typhus fever (formerly called 
 gaol fever when our prisons were badly ventilated), 
 plague, smallpox, erysipelas, scarlet fever, and measles. 
 
 Measles in particular, is greatly spread by over- 
 crowding, and this is apparent when it is remembered 
 that its great infectivity is in the earlier stages, when 
 the symptoms are similar to those of a severe cold in 
 the head. 
 
 Sickness of any kind is aggravated by treatment in
 
 134 THE HYGIENE OF 
 
 confined spaces, and many diseases have been treated 
 more successfully in the open air than even in 
 hospital. 
 
 Air rendered impure by combustion, though containing 
 considerable amounts of carbon dioxide, is not so 
 injurious as air containing carbon dioxide expired by 
 human beings. Particles of coal, sulphur dioxide, and 
 impurities of combustion have an irritating effect upon 
 the lungs. Persons confined for long in such atmo- 
 spheres suffer from headache, heaviness, and pallor. 
 
 Air rendered impure by emanations from sewers and 
 drains may be very dangerous. The clearing out of a 
 privy in a school caused violent purging, vomiting, great 
 prostration and twitching of the muscles in many of 
 the children. In small quantities these emanations may 
 cause headache, loss of appetite, and generally impaired 
 health. Sulphuretted hydrogen, sulphide of ammonia, 
 and carbon dioxide are the gases that appear to cause 
 the poisonous effects. 
 
 Amongst other diseases, typhoid fever and pneumonia 
 are often thought to be caused by sewer gas. It is 
 probable that such is the case, but direct proof is at 
 present not available. 
 
 Water-closets should be divided from the school-rooms 
 and passages by a lobby with cross ventilation. All 
 drains should run outside the buildings — not under 
 them. They should be in straight lines, and at every 
 bend a man-hole, with air-tight cover, should be provided 
 to give access for cleaning. The drain ventilators should 
 be carried up the sides of the buildings in straight lines. 
 The tops may be covered with a wire cajs to prevent
 
 SCHOOLS AND SCHOLARS. 135 
 
 access of birds, who sometimes block up unprotected 
 pipes with their nests. 
 
 It is a good plan to have a large cistern at the head 
 of the drainage system which is discharged automatically 
 
 at stated intervals. The teacher should inspect the 
 
 whole drainage system from time to time, to see that 
 everything is working property.
 
 136 THE HYGIENE OP 
 
 CHAPTEE XL 
 
 -oO^lft^O-o- 
 
 School Accidents. — First Aid of St. John's Ambulance 
 Association. — Contusions ; black eye. — Abrasions. — 
 Wounds. — Bleeding ; arterial jets ; venous bleeding. — 
 Course of blood vessels. — Tourniquets. — Haemorrhage from 
 lungs and nose. — Concussion ; unconsciousness for short 
 time; quiet. — Painting. — Fits. — Epileptic; danger of 
 injury. — Hysterical ; freedom from injury. — Stings of 
 bees, wasps, etc — Bites of animals ; binding of limb above 
 the injury, — Choking ; removal of obstruction. — Frost- 
 bite ; chilblains. — Burns and scalds ; lying down, covering 
 with rags, etc. — Corrosives ; sulphuric acid. — Poisons ; 
 emetics. — Shock and collapse ; after severe injuries. 
 — Foreign bodies in nose and ears ; not to be meddled 
 with. — Foreign bodies in eye; removal. — Electric shock. 
 — Artificial respiration. — Apparent drowning. — Broken 
 bones ; supporting the limb ; danger of wound of skin ; 
 temporary splints. — Sprains ; rest and cold. 
 
 First Aid. — Every school teacher should qualify in 
 First Aid under the St. John's Ambulance Association. 
 Under the auspices of this society there is published an 
 emergency book on card to hang on the wall, giving 
 simple directions for procedure in emergencies. Every 
 school should be provided with something of this kind. 
 In this chapter a few simple remedies are described, such 
 as any person can apply whilst skilled aid is being fetched. 
 
 Contusions. — When the skin is not broken there may 
 be rupture of small vessels beneath the skin, giving rise 
 to swelling and discoloration, as in black eye. The 
 swelling is brownish-red, becoming black, and after a 
 few days green and yellow. If there is deep-seated
 
 SCHOOLS AN'D SCHOLARS. 
 
 137 
 
 bruising, as from a sudden fall, the discoloration may 
 not appear for some days. The application of brandy, 
 etc., to the skin round a black eye may prevent dis- 
 coloration. Cold compress, ice, and evaporating lotions 
 are also useful. 
 
 Abrasion of the Skin. — Skin is often rubbed severely 
 in falls, etc. There is not exactly bleeding, but the skin 
 is reddened and raw-looking. Dirt and gravel, etc., 
 should be washed away or removed with a clean dry rag. 
 Friars' balsam or collodion may he applied, or a piece of 
 clean wet rag. Avoid sticking plaster. 
 
 Wounds. — If the flesh is torn or cut a wound is caused^ 
 If there is slow oozing of blood when the wound is 
 
 Fig. i ( at the Elbow. 
 
 cleansed, applj a clean di rag and Kind up. The blood
 
 IIS 
 
 THE HYGIENE OP 
 
 will clot and so stop further bleeding. The sides of the 
 wound may be brought together by pads kept in place by 
 a bandage. Sticking plaster should be avoided. If the 
 blood spurts from the wound with the pulse beats an 
 artery has been severed. A clean dry pad with pressure 
 by a bandage will usually stop the hoemorrhage. The 
 elevation of the wounded limb belps to lessen the 
 strength of the blood current, and where practicable, 
 flexing the limb at the joint above the wound will often 
 
 Fig. 22. — Bleeding at tlie Knee. 
 
 stop the bleeding. A pad in the bend of the elbow 
 or behind the knee will press on the main blood vessel. 
 The ankle may be secured to the thigh, or the wrist to 
 the upper arm to keep the parts fixed as shown in the 
 wood cuts. Bleeding from the palm may be controlled 
 by putting a pad on the wound and closing the fist 
 tightly, the closure being enforced by a bandage. 
 
 In venous bleeding the blood is dark purple, and wells 
 slowly out of the wound. The patient should lie down, 
 and the limb should be elevated, garters and other 
 constrictions being removed. A dry pad of lint and a 
 bandage will usually stop the bleeding.
 
 SCHOOLS AND SCHOLARS. 139 
 
 The course of the large bloodvessels of the limbs may 
 be roughly described. 
 
 The main artery of tlic arm may he felt in the armpit. 
 It passes inside and behind the biceps muscle, coming m 
 front of the flexure of the elbow joint. It then divides 
 into two branches, the radial branch being felt at the 
 wrist near the thumb. 
 
 The main artery of the thigh may be felt in front, 
 just inside the mass of the extensor muscles. It passes 
 obliquely towards the inner side of the knee and then 
 behind, where it can be felt when the knee is flexed. It 
 is not readily felt lower down. 
 
 A tourniquet for stopping the flow of blood in the 
 large artery may be made by wrapping up a round stone 
 or similar object in a handkerchief and applying this 
 over the course of the bloodvessel above the wound, i.e., 
 on the side nearer the heart. The ends of the band- 
 kerchief should then be tied round the limb and a stick 
 inserted between the knot and the limb. By turning the 
 stick round, the band is tightened and the stone is 
 pressed down on the artery. Braces, straps, etc., may 
 be used, to form the band of the tourniquet which, 
 being brought over the stone, presses it down on the 
 artery. A piece of indiarubber tubing turned several 
 times round a limb and firmly fastened makes a 
 good tourniquet. 
 
 Bleeding from the Lungs. — If bright red blood is 
 coughed up it may come from the lungs. The patienl 
 should lie perfectly quiet and he given plenty of fresh air. 
 
 Bleeding from the Nose.- This is a common 
 complaint in childhood. l>ei the child sit in a chair with
 
 140 THE HYGIENE OP 
 
 the head raised ; unfasten tight clothing at the neck and 
 apply cold compresses to the nose and nape of the neck. 
 The arms may be raised above the head. If bleeding 
 persists, syringe out the nose with cold water, and then 
 plug the nostrils with a piece of clean lint or cotton wool. 
 Give plenty of fresh air. 
 
 Concussion. — In concussion there is loss of con- 
 sciousness. This appears to be caused by the sudden 
 mecbanical shaking up of the brain substance without 
 structural injury. The unconsciousness should not 
 last many minutes unless there is structural injury. 
 Vomiting often occurs as the patient is recovering. The 
 symptoms of shock or collapse (p. 143) may be present 
 more or less. The patient should be kept perfectly 
 quiet (in bed if possible) in a darkened room, and 
 the treatment should be continued for some time after 
 recovery. The diet should be very sparing and simple. 
 
 Painting and Fits. — In fainting, the patient turns 
 pale, is restless and anxious, breaks out in a cold sweat, 
 and loses consciousness. Give access to fresh air, loosen 
 the clothing, and let the patient lie flat on the back with 
 the head low. Smack the face and hands sharply with 
 the end of a wet towel, and on returning to consciousness 
 give a little tea or coffee. 
 
 Epileptic Fits occasionally occur in school life. The 
 patient may give a scream, but not always, and fall 
 unconscious. The limbs are twitched and jerked about 
 convulsively, and the face is contorted, with, sometimes, 
 foaming from the lips. The teeth are clenched, and the 
 tongue may be bitten. Loosen clothing and remove 
 anything against which the patient might hurt
 
 SCHOOLS AND SCHOI A.KS. 141 
 
 himself. Wrap up a penknife in a handkerchief and 
 
 place between the teeth to prevent the tongue being 
 bitten. Do not restrain the movements, and allow the 
 patient to sleep after the tit. Neither food nor drink 
 should be given. 
 
 Hysterical Fits are common in young girls. The 
 patient howls and screams, kicks about, laughs and cries 
 by turns. She does not hurt herself. Flick the face 
 with a wet towel, avoiding the eyes. Send all friends 
 out of the room, and make as little fuss as possible. 
 
 Stings of Bees, Wasps, &c. — Eemove the sting, if 
 possible, bathe with hot water, and apply a little solution 
 of bicarbonate of soda or weak ammonia. 
 
 Bites from Animals. — Tie tightly a piece of string or 
 a handkerchief round the limb above the bite. Wash the 
 wound freely by putting it under the tap and allowing 
 the full pressure of the water to fall on it. The wound 
 may be sucked by a person whose mouth is free from 
 cracks or sores. 
 
 Choking. — This is caused by the blocking of the wind 
 pipe with articles of food, coins, etc. Put the forefinger 
 down to the root of the tongue boldly, and try fco hook up 
 the obstruction. Pat the back to provoke coughing, if 
 the symptoms are not very urgent. 
 
 Frostbite. — This is not very common in this country, 
 but in severe winters the tips of the ears, nose, fingers, 
 or toes may be slightly affected, exhibiting a greyish- 
 white or tallow hue. Do not apply heat, but soft snow 
 or cold water till the circulation is restored. 
 
 Chilblains are more common in girls than boys, and 
 most common when there is the debility of the patient.
 
 142 THE HYGIENE OP 
 
 When first coming on, the parts should be rubbed gently 
 with snow or some cold material. A little soap liniment 
 may then be used. The application of resin ointment 
 and cotton wool protects the part from cold. Tonics 
 and cod liver oil may be given. 
 
 Burns and Scalds. — Flannellette is very inflammable. 
 When clothing catches fire the person should lie down 
 and roll himself over and over. He should be covered 
 with rugs, blankets, etc., or a coat, if nothing better 
 is at hand. If a woman is attending to the person whose 
 clothes are alight, she should fasten her skirts tightly 
 about her to prevent them catching fire. As an 
 application, equal parts of olive oil and lime water on 
 rags is soothing, and the parts affected should be wrapped 
 up in cotton wool. A saturated solution of bicarbonate 
 of soda is also useful to relieve pain. In removing 
 stockings, underclothing, etc., care should be taken not 
 to tear the skin off where they adhere. 
 
 Corrosives. — Sulphuric acid, or vitriol, may be brought 
 into contact with the skin through explosions in the 
 chemical laboratory. The excess of the acid should 
 first be rapidly removed with cotton wool or a clean 
 dry cloth, as it is the combination of the acid with 
 water, either of the body or applied externally, which 
 causes the sudden development of heat and consequent 
 burning of the tissues. As soon as the mass of corrosive 
 liquid has been removed, the parts should be freely 
 irrigated with water. Further treatment should be the 
 same as for burns and scalds. 
 
 Poisons. — The kinds of poison most likely to be 
 swallowed by school children are fungi, berries, etc.
 
 SCHOOLS AND SCHOLARS. 143 
 
 An emetic should be given, to be followed by a dose of 
 castor oil with 15 drops of laudanum, or less for a small 
 child. To cause vomiting, tickle the hack of the throal 
 with the finger. A useful emetic is made by adding one 
 tablespoonful of mustard powder to half a pint of 
 lukewarm water. Atropine is an antidote to muscarine, 
 the poison of many fungi, and a dose of 3 to 5 drops of 
 liquor atropia may be given after the emetic has had 
 effect, if medical aid is not within easy reach. If carbolic 
 acid is taken, half an ounce of Epsom salts should be 
 given after the emetic has had effect. 
 
 Shock or Collapse. — This always occurs with severe 
 injuries. The face is pale, the surface of the body is 
 cold, the pulse being weak and irregular. Respiration 
 is feeble, the breathing being shallow. The patient is 
 only semi-conscious. Keep the head low, and cover the 
 body with warm clothing. Eub the limbs and apply hot 
 water bottles to the body and extremities. Give warm 
 drinks, and, if necessary, resort to artificial respiration. 
 
 Foreign Bodies in the Ears or Nose. — Do not 
 attempt to remove them, but send for a doctor. 
 
 Foreign Bodies in the Eye. — Try and remove the 
 substance with the corner of a handkerchief, a clean 
 feather, or a clean soft paint brush. If the eye is too 
 painful to allow this, drop in a little castor oil and 
 apply a cold compress. If a noxious fluid has got into 
 the eye, wash out with clean water. Do not rub the eye. 
 
 Electric Shocks. — The hands may be bruised and 
 there-, may be; some difficulty in letting go the wire. 
 India rubber is a non-conductor, and a tobacco pouch 
 may be used to protect the hands of fehe person assisting
 
 144 
 
 THE HYGIENE OP 
 
 the patient. In serious cases artificial respiration should 
 be resorted to. 
 
 Artificial Eespiration. — The following is the pro- 
 cedure to be followed in inducing artificial respiration : — 
 
 i. Pull the tongue forward. An assistant should hold 
 it in that position with a piece of cloth or a handker- 
 chief. This is to prevent the root of the tongue falling 
 over the windpipe. 
 
 ii. Eaise and support the shoulders with a roll of 
 clothing. Let the head lie low. 
 
 iii. Kneel down on both knees behind the patient's 
 head, and grasp his arms just below the elbows ; press 
 the bent arms firmly against the sides and front of 
 the chest (Pig. 23). 
 
 Fig. 23. — Artificial Respiration ; Expiration. 
 
 iv. Next slowly and steadily pull the arms upwards 
 and outwards over the head till the elbows almost 
 touch the ground (Fig. 24). This causes the lungs to 
 expand and the air to rush in. 
 
 v. -Jhese movements (iii. and iv.) must be repeated 
 alternately about fifteen times a minute until the patient
 
 SCHOOLS AND SCHOLAKS. 
 
 145 
 
 begins to breathe, or until hope is abandoned. Mean- 
 while, to excite respiration, smelling salts or snuff may 
 be applied to the nostrils, and hot and cold water 
 alternately may be dashed, in moderate amount, over 
 the neck and head. 
 
 Fig. 24. — Artificial Respiration ; Inspiration. 
 
 vi. When breathing is restored, the movements should 
 be so regulated as to synchronise with the respiratory 
 efforts of the patient. An assistant should then rub the 
 arms and legs from below upwards to assist circulation 
 of the blood. 
 
 vii. Remove wet clothing, cover with warm, dry 
 clothes, and apply hot-water bottles to the feet, limbs, 
 and body. 
 
 viii. (live stimulants as soon as the power of swallow- 
 ing is restored. 
 
 ix. After prolonged unconsciousness or a sudden 
 immersion the person should go to bed and remain 
 quid for some hours. 
 
 In the Apparently Drowned. Turn the patient 
 on his face, and put your finger down to the root of
 
 146 THE HYGIENE OP 
 
 his tongue, to clear out seaweed, etc. Then clasp him 
 round the waist with your arm, and allow the water 
 to drain out of his throat and lungs. Place him 
 on his back, and immediately the air passages 
 seem free of froth and water proceed to artificial 
 respiration. 
 
 Broken Bones. — Cut away the clothes from the 
 limb. Move the limb as little as possible, or the skin 
 may be punctured by the end of the broken bone. If 
 there is a wound, treat it as described before. If it 
 is necessary to move the patient, support the limb 
 both above and below the fracture, and gently place it 
 as nearly as possible in the natural position. Support 
 the limb with a temporary splint, such as an umbrella, 
 or stick, or billiard cue. Wrap these in clothing for 
 padding, and then fasten to the limb above and below 
 the fracture by a handkerchief, necktie, etc., passed 
 round the limb and the support. If the fracture is of 
 the leg, fasten the sound limb to the broken one at 
 knee and ankle. The straw cover of a wine bottle 
 serves, as a good splint and padding combined, for the 
 arm or ankle. 
 
 Sprains. — The joint should be kept at rest, cold 
 compresses being applied and the limb elevated, 
 so that blood may readily flow from the injured 
 part. 
 
 Further directions for dealing with injuries may 
 be obtained in the publications of the St. John 
 Ambulance Association (St. John's Gate, Clerkenwell, 
 London, E.C.), and in other works of a similar character. 
 The " Emergency Book " previously referred to is
 
 SCHOOLS AMD SCHOIiAES. U7 
 
 published at half-a-crown, and is to be obtained from 
 the publishers, 83, Newman Street, London, W. The 
 St. John Ambulance Association issue also an excellent 
 little work at one shilling, on " First Aid to the Injured," 
 and it is from the latter work that— by the courtesy 
 of Lord Knutsford and the Executive Committee— we 
 have been enabled to reproduce the diagrams illustrating 
 this chapter.
 
 148 
 
 THE HYGIENE OP 
 
 INDEX. 
 
 
 *^V1 
 
 PAGE. 
 
 **-»v~ 
 
 PAGE. 
 
 Abrasions of Skin 
 
 ... 137 
 
 Brain Growth 
 
 ... 57 
 
 Accidents, School ... 
 
 ... 136 
 
 Breathlessness 
 
 ... 78 
 
 Adam's Apple 
 
 37, 39 
 
 Bricks, Perforated... 
 
 ... 136 
 
 Adenoids 
 
 15, 39 
 
 Broken Bones 
 
 ... 146 
 
 Afferent Nerves 
 
 ... 18 
 
 Bronchi 
 
 ... 120 
 
 Air 
 
 118, 124 
 
 Burns 
 
 ... 142 
 
 „ Cells 
 
 ... 42 
 
 
 
 „ Composition of 
 
 ... 118 
 
 Capacity, Respiratory . 
 
 ... 42 
 
 „ Filters 
 
 120, 127 
 
 Carbo-Hydrates 
 
 ... 89 
 
 „ Hot 
 
 ... 130 
 
 Carbonates ... 
 
 ... 94 
 
 „ Outlets and Inlets 
 
 ... 125 
 
 Carbonic Dioxide, or Carbonic 
 
 ,, Space, Allowance of . 
 
 ... 124 
 
 Acid Gas ... 42, 69, 78, 
 
 112, 118, 119 
 
 Albuminoids 
 
 ... 89 
 
 Carbon Monoxide ... 
 
 ... 131 
 
 Alcohol 
 
 ... 83 
 
 Caries 
 
 11, 55 
 
 Anaemia ] 
 
 0, 86, 95, 132 
 
 Cells, Air 
 
 ... 42 
 
 Anti-toxin 
 
 ... 101 
 
 ,, Nerve 
 
 ... 18 
 
 Aqueous Humour ... 
 
 22 
 
 Cerebellum 
 
 ... 18 
 
 Arched Instep 
 
 '. ... 54 
 
 Cerebrum 
 
 ... 18 
 
 Areas — Measurements . 
 
 ... 128 
 
 Cervical Vertibrse ... 
 
 ... 43 
 
 Arms 
 
 ... 49 
 
 Chest 
 
 .. 40, 43, 70 
 
 Arterial Bleeding ... 
 
 ... 138 
 
 „ Girth 
 
 ... 40 
 
 Arteries 
 
 ... 139 
 
 ,. Movements ... 
 
 ... 38 
 
 Artificial Respiration 
 
 143, 144 
 
 Chicken-Pox 
 
 104, 105 
 
 Asphyxia 
 
 ... 55 
 
 Chilblains 
 
 94, 141 
 
 Astigmatism 
 
 ... 31 
 
 Chimney 
 
 117, 126, 128 
 
 Automatic Action of Mus< 
 
 Jles ... 68 
 
 Choking 
 
 ... 141 
 
 
 
 Chords, Vocal 
 
 ... 37 
 
 Bacilli 
 
 ... 100 
 
 Chorea 
 
 ... 108 
 
 Bare Feet 
 
 ... 93 
 
 Chorium 
 
 ... 54 
 
 Barometric Pressure 
 
 118, 121 
 
 Choroid 
 
 ... 23 
 
 Baseball and Rounders . 
 
 ... 76 
 
 Cleft Palate 
 
 ... 11 
 
 Bass Voice 
 
 ... 37 
 
 Clergymen's Sore Throat 
 
 ... 38 
 
 Baths 
 
 ... 74 
 
 Closed Stoves 
 
 ... 130 
 
 Bee, Stings from 
 
 ... Ill 
 
 Clothing 
 
 ... 92 
 
 Bellows, Ventilating 
 
 ... 123 
 
 Cold in the Head ... 
 
 . 10, 13, 99 
 
 Berries, Poisonous... 
 
 ... 143 
 
 Collapse or Shock ... 
 
 ... 143 
 
 Binocular Vision ... 
 
 ... 24 
 
 Comeliness and Exercise 
 
 ... 70 
 
 Bites 
 
 ... 141 
 
 Complexion 
 
 9 
 
 "Black Hole" 
 
 ... 132 
 
 Concussion 
 
 ... 140 
 
 .. Eye 
 
 ... 136 
 
 Condensation 
 
 ... 114 
 
 Blood Corpuscles ... 
 
 9 
 
 Conduction 
 
 ... 114 
 
 Bleeding 
 
 ... 137 
 
 Conductors, Good and Bad 
 
 ,, from Lungs 
 
 ... 139 
 
 Conjunctivitis 
 
 ... 109 
 
 „ „ Nose 
 
 ... 139 
 
 Constipation... 
 
 ... 86 
 
 Body as a Machine 
 
 ... 60 
 
 Consumption 
 
 ... 133 
 
 Bones, Broken 
 
 ... 146 
 
 Contagious Impetigo 
 
 ... 108 
 
 Boots and Shoes 
 
 53, 73 
 
 Contusion 
 
 ... 136 
 
 Bowed Legs 
 
 ... 54 
 
 Convection 
 
 ... 116 
 
 Boxing 
 
 ... 74 
 
 Convulsive Hand ... 
 
 ... 52 
 
 Brain 
 
 18, 96 
 
 Corpuscles, Blood ... 
 
 9
 
 SCHOOLS AND SCHOLARS. 
 
 149 
 
 Cord, Spinal 
 
 Cornea 
 
 Cornices, Ventilating 
 
 Corrosives 
 
 Corsets 
 
 Cotton 
 
 Cough, Whooping ... 
 Country Schools 
 
 Cowls 
 
 Cow Pox 
 
 Cramming 
 
 Cricket 
 
 Crippled Children ... 
 Crystalline Lens ... 
 Cubic Spaces 
 Curves, Spinal 
 Cycling 
 
 PAGE. 
 
 18 
 
 22 
 
 '.'.'. ..'. 126 
 
 142 
 
 38, -7 
 93 
 
 100, 105 
 41, 53, 58, 71 
 
 122 
 
 106 
 
 95 
 
 75 
 
 53 
 
 22 
 
 124, 128 
 
 44-46 
 
 74 
 
 Daily Need of Foodstuffs 
 Damp Clothes 
 
 „ Walls 
 
 Debility of System 
 
 Decay of Teeth 
 
 Depressed Health, Signs of 
 
 Desks 
 
 Diaphragm 
 
 Diet 
 
 ., Milk 
 
 Digestion 
 
 Dimensions of Head 
 
 Diphtheria 
 
 Dirt 
 
 Discharges from Ear 
 Discharges from Nose 
 Diseases, Infectious 
 
 Dorsal Vertebrae 
 
 Drains 
 
 Dress for Exercise 
 
 Drink in Exercise 
 
 Drowning 
 
 Dust 
 
 Earache 
 
 Ears 
 
 Ears, Foreign Bodies in . 
 East Winds, Exposure to. 
 Economy of Fuel ... 
 
 Eczema 
 
 Effects of Overcrowding . 
 Efferent Nerves 
 Efficiency of Work, and 
 Electric Light 
 
 ,, Shocks 
 Emergency Book ... 
 
 Emi I 
 
 Emmetropia 
 
 I inergetic Hand 
 Enlarged Joints 
 I ipidemic Waves ... 
 
 Epidermis 
 
 Epilepsy 
 
 Eustachian Tubes ... 
 Excess of Food 
 Exercise 
 
 ...17, 
 
 ... 90 
 
 ... 94 
 ... 117 
 ... 47 
 ... 55 
 ... 86 
 ... 63 
 42,67 
 ... 91 
 ... 54 
 ... 57 
 ... 10 
 100, 105 
 ... 84 
 17 
 13 
 ... 98 
 ... 43 
 ... 134 
 ... 72 
 ...83, 90 
 ... 145 
 ... 119 
 
 ... 17 
 
 ... 16 
 
 ... 112 
 
 15 
 
 ... 117 
 
 85 
 
 ... 132 
 
 18 
 
 83 
 
 127 
 
 143 
 
 146 
 
 L43 
 
 23 
 
 50 
 
 54 
 
 L02 
 
 .,1 
 
 110 
 
 16 
 
 ... 01 
 
 47, 67, 79 
 
 Health 
 
 96, mi. 
 
 12 
 
 Exercise, Effects of 
 ,, Excessive 
 Exhaust Ventilation 
 
 Expiration 
 
 Eyes 
 
 „ Flat 
 
 „ Foreign Bodies in ... 
 
 ,. Don.,' 
 
 „ Normal 
 
 ,, Overstrain of 
 
 Fainting 
 
 Fans, Ventilating 
 
 Fat 
 
 Fatigue 
 
 » Eye 
 
 ,, Mental 
 
 Feeble Hand 
 
 Feet 
 
 Fencing 
 
 Fever, Scarlet 
 
 Filtered Air 
 
 Fireplaces, Ventilating 
 
 First Aid 
 
 Fish 
 
 Fits 
 
 Flannel 
 
 Flannelette 
 
 Flat Eye 
 
 Floor Space 
 
 Flushing Drains 
 
 Fog, Exposure to 
 
 Food 
 
 „ Daily 
 
 ,, Fibrous 
 
 „ Nitrogenous 
 
 „ Patent 
 
 „ Proteids 
 
 Foodstuffs, Minimum Daily 
 
 Football 
 
 Foot Pounds 
 
 „ Tons 
 
 Foreign Bodies in the Nose, 
 
 and Eyes 
 
 Fractures 
 
 Fright, Hand in 
 
 Frostbite 
 
 Fuels 
 
 Furnaces, Hot Air 
 
 PAGE. 
 
 lis, T.I 
 
 ... 82 
 
 ... 123 
 
 ... 41 
 
 ... 20 
 
 ... 26 
 
 ... 142 
 
 ... 28 
 
 ... 23 
 
 ... 26 
 
 80, 140 
 ... 123 
 68, 89 
 ... 78 
 ... 26 
 ... 83 
 ... 52 
 ... 53 
 ... 74 
 ... 102 
 120, 127 
 ... 126 
 136, 147 
 ... 90 
 110, 140 
 ... 115 
 ... 142 
 ... 26 
 ... 129 
 ... 135 
 ... 15 
 ... 8S 
 ... 90 
 ... 56 
 ... 88 
 ... 54 
 89 
 90 
 76 
 112 
 81 
 
 Need 
 
 Ears, 
 
 143 
 146 
 ... 52 
 ... 141 
 111,117 
 ... 130 
 
 Games 67 
 
 Gas Jets 127 
 
 „ Lights, Tubes over 126 
 
 ,, Stoves L80 
 
 German Measles 99, 105 
 
 German Type 85 
 
 (Hands .. ■ 36, 87 
 
 Goli 7:i 
 
 Grates, open 120, 132 
 
 Growth 57 
 
 „ Effects "f in',1 in. -ti. hi 
 
 and E ercise on ... 62 
 
 „ of Teeth 66 
 
 „ Physical and Mental 09, 70
 
 150 
 
 THE HYGIENE OP 
 
 
 PAGE. 
 
 
 PAGE. 
 
 Gullet 
 
 .. 12 
 
 Lumbar Vertebras 
 
 ... 43 
 
 
 
 Lunatics 
 
 ... 94 
 
 Hands 
 
 49 
 
 Lungs 4] 
 
 , 68, 79, 139 
 
 ,, Blue 
 
 .. 49 
 
 
 
 „ Types of 
 
 .. 50 
 
 Machine, Body as a 
 
 ... 60 
 
 Headache 
 
 26, 134 
 
 Main Arteries 
 
 ... 139 
 
 Head, Cold in 
 
 .. 10 
 
 Mastication 
 
 ... 12 
 
 „ Measurements 
 
 .. 10 
 
 McKinnell's Ventilator ... 
 
 ... 126 
 
 Hearing 
 
 .. 16 
 
 Meals, Lessons after 
 
 ... 57 
 
 Heart 43 
 
 , 50, 69 
 
 Measles ... 86, 98, 
 
 100, 105, 133 
 
 Heat 
 
 .. Ill 
 
 ,, German ... 86, 
 
 99, 100, 105 
 
 „ Distribution of 
 
 .. 114 
 
 Measurement of Areas .. 
 
 ... 128 
 
 „ Latent 
 
 .. 113 
 
 Mechanical Ventilation .. 
 
 ... 132 
 
 „ Non-Conductors 
 
 .. 93 
 
 Medical Officer 
 
 ... 100 
 
 ,, Specific 
 
 .. 114 
 
 Meningitis 
 
 ... 107 
 
 Height of Boys and Girls 
 
 .. 58 
 
 Mental Aptitude 
 
 18, 83, 97 
 
 ,, of Seats and Desks 
 
 .. 65 
 
 Milk Diet 
 
 ... 54 
 
 Heights, Belative 
 
 .. 60 
 
 „ Teeth 
 
 ... 56 
 
 Hoarseness 
 
 .. 39 
 
 Mouth 
 
 ... 11 
 
 Home Lessons 
 
 .. 31 
 
 Movements, Imitation of 
 
 ... 59 
 
 Hot Air 
 
 .. 130 
 
 „ Involuntary.. 
 
 ... 18 
 
 ,, Pipes 
 
 .. 132 
 
 „ Nervous 
 
 ... 68 
 
 „ Water Pipes 117 
 
 ,, of Air 
 
 ... 119 
 
 Hypermetropia 
 
 .. 26 
 
 „ of Eye 
 
 ... 19 
 
 Hysteria 
 
 .. 141 
 
 ,, Spontaneous 
 
 ... 18 
 
 
 
 ,. Voluntary ... 
 
 ... 18 
 
 Idiots 
 
 94 
 
 Mumbling 
 
 ... 38 
 
 Imitation of Movements ... 
 
 .. 40 
 
 Mumps 
 
 ... 105 
 
 Impetigo, Contagious 
 
 .. 108 
 
 Muscles 
 
 47, 67, 89 
 
 Impositions 
 
 .. 31 
 
 ,, Tone of 
 
 ... 47 
 
 Impure Air 
 
 .. 124 
 
 ,, Unused 
 
 ... 48 
 
 Incandescent Electric Lamps 
 
 .. 127 
 
 Mushroom Poisoning 
 
 ... 143 
 
 Indigestion 
 
 .. 89 
 
 Myopia 
 
 ... 28 
 
 Infectious Diseases 
 
 .. 98 
 
 
 
 „ ,, Isolation 
 
 .. 104 
 
 Neck 
 
 ... 36 
 
 „ ,, Quarantine 
 
 104 
 
 Needlework 
 
 ... 67 
 
 Influence of Health on Work 
 
 .. 83 
 
 Neglected Children 
 
 ... 84 
 
 Inlets, Air 
 
 .. 125 
 
 Nerve, Afferent 
 
 ... 18 
 
 Inspiration 
 
 .. 41 
 
 „ Cells 
 
 18,96 
 
 Iron 
 
 .. 01 
 
 „ Efferent 
 
 ... 18 
 
 Isolation and Quarantine 
 
 .. 104 
 
 ,, Optic 
 
 ... 23 
 
 Itch 
 
 .. 85 
 
 Nervous, Children 
 
 ... 94 
 
 
 
 „ Hand 
 
 ... 50 
 
 Joints, Enlarged 
 
 54 
 
 ,, Movements 
 
 ... 68 
 
 Jumping 
 
 .. 75 
 
 Nitrogen after Exercise .. 
 
 ... 70 
 
 
 
 Nitrogenous Food 
 
 ... 88 
 
 Klebs-Loeffler 
 
 ... 100 
 
 Non-conductors of Heat .. 
 
 ... 93 
 
 Knock Knees 
 
 ... 53 
 
 Normal Hand 
 
 ... 51 
 
 
 
 ,, Vision 
 
 ... 23 
 
 Larynx 
 
 12,37 
 
 Nose 
 
 ... 11 
 
 Latent Heat 
 
 ... 113 
 
 „ Bleeding from 
 
 ... 139 
 
 Lateral Curvature of Spine 
 
 ... 45 
 
 „ Foreign Bodies in .. 
 
 ... 142 
 
 Legs 
 
 ... 53 
 
 Nursing 
 
 ... 46 
 
 Lens, Crystalline ... 
 
 ... 22 
 
 
 
 Lessons after Meals 
 
 ... 57 
 
 Open Grates 
 
 129, 132 
 
 ,, Home 
 
 ... 31 
 
 Openings for Ventilation .. 
 
 ... 126 
 
 „ Length of 
 
 6 ., 95 
 
 Ophthalmia 
 
 . 86, 105, 109 
 
 „ Light for 
 
 ... 63 
 
 Optic Nerve 
 
 ... 23 
 
 Lice 36, 
 
 8^ , 108 
 
 Organic Impurity in Air .. 
 
 ... 124 
 
 Light 
 
 ... 115 
 
 Outlets, Air 
 
 ... 125 
 
 Linen 
 
 ... 93 
 
 Overcrowding 
 
 ... 132 
 
 Lip Movements 
 
 59, 57 
 
 Over-pressure 
 
 ... 95 
 
 Long Eye 
 
 ... 28 
 
 Overstrain on Eye 
 
 ... 26 
 
 Louvred Windows 
 
 ... 126 
 
 ,, Mental 
 
 ... 95
 
 SCHOOLS AND SCHOLARS. 
 
 151 
 
 Overstrain, Physical 
 Oxidation of Air 
 
 Oxygen 
 
 „ Absorption 
 ,, in Exercise 
 
 PAGE. 
 
 ... 80 
 42, 112 
 ... 118 
 ... 69 
 67,72 
 
 109 
 
 11 
 
 •5,133,134 
 
 96 
 
 54 
 
 ... 36, 84, 108 
 129 
 
 126 
 
 131 
 
 90 
 
 57 
 
 ... 71, 76, 83 
 54 
 
 Pains, Growing 
 
 Palate, Cleft... 
 
 Pallor 
 
 Parties 
 Patent Foods 
 Pediculi 
 Perflation 
 Perforated Bricks 
 Perkins' System 
 Phosphates ... 
 Physical Growth 
 
 „ Training 
 Pigeon-breast 
 
 Pins ami Needles 64 
 
 Pipes, Hot Water ... 117, 131, 132 
 
 Play and Games 07 
 
 Plenum System 123 
 
 Pneumonia 134 
 
 Poison 142 
 
 Poisonous Berries 143 
 
 Poisonous Products of Exercise 
 
 68, 79 
 Pointed I ... 53, 73 
 
 Positions of Children (sitting) ... 66 
 1- ildren (si aid n I 17, 66 
 
 Pressure, Barometric ... 118, 121 
 
 Printing Types 32 
 
 Proteids 89 
 
 Pulse Beats 43 
 
 Pupil -22 
 
 Quarantine 104 
 
 Radiation 115, 129 
 
 Beading Book 29 
 
 from the Wall 29 
 
 Respiration 40 
 
 „ Artificial 144 
 
 ., through Skin ... 55 
 
 Respiratory Capacity 42 
 
 65 
 
 ,, Hand at 51 
 
 Retina 22, 2:i 
 
 Re vaccination L06 
 
 Rickets 53 
 
 Riding 73 
 
 Ringworm 105, 107 
 
 Roseola 105 
 
 Rounders 76 
 
 Rowing 74 
 
 Rubella 105 
 
 Running 73 
 
 ,, from Ears, Nose, etc. ... 103 
 
 Runs, Short and Long 79 
 
 Salt 90 
 
 Scabies 85 
 
 Scalds 142 
 
 Scarlet Fever or Scarlatina 102. LOS 
 
 School Accidents 136 
 
 Selenitic I -11 
 
 uloiis (Hands 31',, 87 
 
 ks 03 
 
 id Wind SO 
 
 Sense Stimulation 18 
 
 Sherringham's Ventilator ... 120 
 
 Shock or Collapse 143 
 
 Shooting 7:; 
 
 Shouting at Play 40,70 
 
 Silk 93 
 
 Singing 38 
 
 Skating 73 
 
 Skin 54,68 
 
 Skipping 53,73 
 
 Sleep 19, 83, 94 
 
 Smallpox 103, 105, 133 
 
 Smell 117 
 
 Smoking 
 
 .lisni 
 Soprano Voice 
 
 Sore Throat 
 
 Specific Heat 
 Speech 
 
 „ without Voice 
 Spinal Cord 
 
 ,, Curvature ... 
 
 Spine 
 
 Spontaneous Movements 
 
 Sprains 
 
 Stammering and Stuttering 
 Standing of Children 
 Starches 
 
 Stings 
 
 in Ambulance 
 
 Stoves 
 
 Straight Hand 
 
 Strain, Eye 
 
 St. Vitus's Dance ... 
 Sulphates 
 Sulphuric Acid 
 
 Sweat 
 
 Swimming 
 
 Teeth 
 
 „ Growth of ... 
 ,, Decay of 
 ,, Permanent ... 
 tperature 
 ii '' ' '■■''" 
 
 „ of Class Rooms 
 
 Tents, Ventilate 
 Tests, Hearing 
 
 ,- Sight 
 
 ,, Voice 
 
 Theatres 
 
 Thermal Unit 
 
 Thirst 
 
 Throat 
 
 ,, Sore 
 
 Tighl Corsets 
 
 Tin d Hand 
 
 Tui. m'K Ventilator 
 
 ... 83 
 
 ... 95 
 
 ... 37 
 
 ... 100 
 
 ... 114 
 
 ... 37 
 
 ... 40 
 
 ... 18 
 
 ... 45 
 43, 70 
 
 ... 18 
 
 ... 146 
 
 ... 39 
 
 ... 47 
 
 ... 89 
 
 ... 141 
 
 ... 147 
 
 130, 132 
 
 ... 51 
 
 ... 25 
 
 27, 92, 108 
 
 ... 91 
 
 ... 142 
 
 ... 55 
 
 ... 74 
 
 ... 55 
 
 56 
 
 ... 56 
 
 ... 57 
 
 . . 121 
 
 ... 74 
 
 . . 128 
 
 ... 124 
 
 ... 17 
 
 ... a r > 
 
 ... 17 
 
 ... 90 
 113 
 
 37 
 
 ... 100 
 
 88, 87 
 
 ... 51 
 
 ... 120
 
 152 
 
 THE HYGIENE OF SCHOOLS AND SCHOLARS. 
 
 
 pan i-:. 
 
 
 PAGE. 
 
 Toes, Pointed 
 
 53 
 
 Vitriol 
 
 ... 142 
 
 Tonsils, Enlarged ... 
 
 12, 76 
 
 Vocal Chords 
 
 ... 37 
 
 Tourniquet 
 
 139 
 
 Voice 
 
 ... 37 
 
 Trachea 
 
 42 
 
 „ Change of 
 
 ... 40 
 
 Training 
 
 ... 67, 80, 82 
 
 
 
 Tuberculosis 
 
 ...82,107, 133 
 
 Waist, Tight 
 
 31,87 
 
 Types, Printing 
 
 32 
 
 Walking 
 
 ... 72 
 
 Typhoid Fever 
 
 131 
 
 Walls, Damp 
 
 ... 117 
 
 Typhus Fever 
 
 133 
 
 Warming 
 
 111, 129 
 
 
 
 Wasps, Stings from 
 
 ... 141 
 
 Underfeeding 
 
 92 
 
 Wasting 
 
 87, 108 
 
 Uptakes 
 
 123 
 
 Water 
 
 ... 90 
 
 Urea 
 
 69,81 
 
 „ Hot 
 
 ... 131 
 
 Uvula 
 
 12 
 
 W.C. Accommodation 
 
 S7, 134 
 
 
 
 Weights of Scholars 
 
 ... 59 
 
 Vaccination 
 
 103, 106 
 
 Whispering 
 
 ... 40 
 
 Vacuum System ... 
 
 123 
 
 Whooping Cough 
 
 100, 105 
 
 Venous Bleeding ... 
 
 138 
 
 Wind in Exercise 
 
 ... 72 
 
 Ventilating Shafts ... 
 
 124 
 
 ,, in Ventilation 
 
 122, 129 
 
 Ventilation ... ... 8C 
 
 , 111, 118, 121 
 
 „ Second 
 
 ... 80 
 
 ,, by Bellows 
 
 123 
 
 Windows 
 
 116, 122 
 
 „ by Fans 
 
 123 
 
 Windpipe 
 
 ... 42 
 
 Verminous Persons 
 
 85 
 
 Wool 
 
 92, 115 
 
 Vertebrae 
 
 44 
 
 Work, Health and Efficiency 
 
 of 83 
 
 Vertical Writing 
 
 62 
 
 Worms 
 
 87,95 
 
 Vibration of Cords 
 
 37 
 
 Wounds 
 
 ... 137 
 
 Vision, Normal 
 
 23 
 
 Writing, Position 
 
 ... 62 
 
 Vitreous Humour ... 
 
 22 
 
 „ Vertical 
 
 ... 62 
 
 Printed by Henry Palmer & Co., London, 
 
 53 46 2
 
 This book is DUE on the last date stamped below 
 
 FEB 2 7 T961 
 
 Form L-9-15m-7,'31
 
 UNIVERSITY of CALIFORNIA 
 
 AT 
 
 L08 ANGELES 
 
 LIBRARY