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 SCHOOL AND INDUSTRIAL HYGIENE. By D. R LINCOLN, M. D., of 
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SCHOOL AND INDUSTRIAL 
 
 HYGIENE. 
 
 BY 
 
 D. F. LINCOLN, M.D., 
 
 Chairman Department of Health, Social Science Association. 
 
 PHILADELPHIA: 
 P. BLAKISTON, SON & CO., 
 
 No. 1012 WALNUT STREET. 
 1896. 
 
COPYRIGHT. 
 
 PRESLEY BLAKISTON. 
 1880. 
 
CONTENTS. 
 
 i. SCHOOL HYGIENE. 
 
 CHAPTER. PAGE 
 
 I. GENERAL REMARKS 7 
 
 II. EMOTIONAL AND MENTAL STRAIN . . 14 
 
 III. FOOD AND SLEEP 19 
 
 IV. BODILY GROWTH 24 
 
 V. AMOUNT OF STUDY 28 
 
 VI. EXERCISE 34 
 
 VII. CARE OF THE EYES 48 
 
 VIII. SCHOOL-DESKS AND SEATS . . . .64 
 IX. A MODEL SCHOOL-ROOM . . . .79 
 X. VENTILATION AND HEATING . . .85 
 XI. SITE, DRAINAGE, ETC 94 
 
VI CONTENTS. 
 
 CHAPTER. 
 
 XII. PRIVATE SCHOOLS 
 
 XIII. COLLEGES 102 
 
 XIV. CONTAGIOUS DISEASE 105 
 
 PART II. INDUSTRIAL HYGIENE. 
 
 I. INJURIOUS EFFECTS OF INHALING DUSTY 
 
 AND POISONOUS SUBSTANCES . . . 107 
 
 II. INJURIES FROM ATMOSPHERIC CHANGES . 120 
 
 III. INJURIES FROM OVER-USE OF CERTAIN OR- 
 GANS 127 
 
 IV. INJURIES FROM ACCIDENTS . . . -133 
 V. REGULATION OF HOURS OF LABOR . .136 
 
 VI. DURATION OF LIFE IN VARIOUS OCCUPA- 
 TIONS 142 
 
 NOTE 145 
 
 INDEX 146 
 
School and Industrial Hygiene. 
 
 PART I. 
 SCHOOL HYGIENE. 
 
 CHAPTER I. 
 
 GENERAL REMARKS. 
 
 THE period at which we live is witnessing great 
 changes in the theory and practice of education, 
 from the lowest to the highest grades. The nature 
 of the child's mind has been studied, his powers 
 gauged, and his growth measured by a Pestalozzi, a 
 Froebel, a Combe, a Chadwick, a Bowditch. Every- 
 body knows that children do not like to sit still long 
 at a time ; that their minds easily wander ; that they 
 have an instinctive dislike to certain studies. This 
 restlessness of mind and body, this dislike to certain 
 mental foods, were regarded by the old masters as 
 simply undesirable elements in character, to be 
 curbed and chained, and overcome by force of dis* 
 
 7 
 
8 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 cipline. The modern tendency is in a very different 
 direction ; it studies the natural behavior of chil- 
 dren, and deduces from multiplied observations cer- 
 tain laws regarding their natural powers and apti- 
 tudes, to which all educational processes are subor- 
 dinated. 
 
 To some extent the old masters were right \ curbs 
 have their use, and " old-fashioned" hard work ought 
 not to be forgotten. Nor is the newer education free 
 from grave faults of its own ; or let us rather say, 
 that right principles are not yet fully adopted by all. 
 A great many teachers have found that emulation is 
 a more than effectual substitute for the rod. This is 
 one of the most characteristic of modern improve- 
 ments ; but its potency has no sooner been discov- 
 ered than it is abused, and many a promising child, 
 within the past thirty years, has wrecked his physi- 
 cal endurance for life, or has permanently enfeebled 
 his mind by excess of study performed under the spur 
 of emulation or an unregulated sense of duty. 
 
 No theory of education is satisfactory thst does 
 not claim the whole child. The State must leave a 
 great many things to the parents in education ; but 
 it is her duty to attend to such things as parents can- 
 not be made to attend to. Religion is a thing which 
 the State does not try to teach, assuming that parents 
 and churches can more safely attend to it ; but mo- 
 rality must be taught at school. All schools assume 
 
GENERAL REMARKS. 9 
 
 the immorality of falsehood and brutality, and the 
 paramount obligation to perform school-tasks. It 
 would be easy to take classes of ignorant, poor chil- 
 dren, before they reach the age of street ruffians 
 (which so many become after leaving the public 
 school), and not only to show them, but to convince 
 them of the necessity for truth, peaceable behavior, 
 and respect for law, and of the necessary connection 
 between duty or work performed and the prosperity 
 of one and all.* In our public schools, I think this 
 is hardly attempted. And yet, setting aside the 
 moral, and assuming the sanitarian, ground as our 
 sole basis, it is assuredly true that these branches of 
 morals, and others that might be named, as punctu- 
 ality, cleanliness, politeness, and faithfulness to en- 
 gagements, are not things which can be neglected. 
 
 Again : the food and sleep of the child are mainly 
 beyond the control of public schools. They are not 
 wholly so, however; and it is a teacher's duty to 
 discourage working in improper hours. Still more 
 imperatively is it his duty to regulate the child's 
 needs in school-time, to see if he is faint from want 
 of food, to encourage and teach good habits, and to 
 give opportunity for bodily exercise. 
 
 No lower aim should content the child's teacher 
 than that of improving all his faculties and powers 
 
 * For admirable illustrations of this kind of teaching, see 
 George Combe's " Education," edited by Wm. Jolly, 1879. 
 
IO SCHOOL AND INDUSTRIAL HYGIENE. 
 
 bodily, mental, and moral. The teacher should feel 
 his obligation to his school a patriotic one, as 
 did the Athenian office-holder, who swore, " o/wo 
 TtapaScj^tj'," to transmit the city over which he ruled 
 better than when it was put into his hands ; better in 
 all respects. 
 
 It is my strong conviction that this can be done 
 by the public or the State to a greater extent than is 
 now accomplished. 
 
 The word " culture " is as badly abused to-day as 
 the word " sentiment " was a century ago. For vast 
 numbers of our people, the pursuit of culture resolves 
 itself into the reading of books and the looking at 
 pictures and bric-a-brac for the purpose of talking 
 about them. We can easily widen this notion. The 
 culture (or development) of children certainly means 
 something better than this. But how much wider 
 and better ? It is preposterous to educate all children 
 in all branches of knowledge. We are already trying 
 to do too much in that direction ; but it is equally 
 preposterous to omit from culture the development of 
 physical endurance, moral soundness, and a good 
 practical judgment. In the case of myriads of poor 
 children who leave school at the ages of ten or 
 twelve, the opportunities for doing this are indeed 
 limited and are made so by our absurd practice of 
 making excessively large classes ; but the State should 
 never lose from mind the object of training these 
 
GENERAL REMARKS. II 
 
 children up to men and women. As regards those 
 whose education is superior and protracted, there is 
 a full opportunity for developing power and self-con- 
 trol. How do we give a young man power to fight his 
 way in the world ? We put him into a school which 
 teaches only the brain, and only a corner of that. 
 When he is thirty years old, he will, assuredly, not 
 be groaning that his tutors gave him but too imperfect 
 an acquaintance with the Greek lyrists, or Visigothic 
 numismatology; he will probably be wondering (if 
 he is an active American) whether it pays to know 
 all that ; and at forty he will have discovered that 
 the one thing which does pay in this life is life itself; 
 that vital force and endurance and a good digestion 
 are what are needed, as much as anything from books, 
 to insure success in life. The President of Harvard 
 College states this more strongly still. 
 
 The element of self-control and guidance, in cul- 
 ture, is quite as much a moral as an intellectual one. 
 The boy is taught how to control his hand in writing 
 or playing, his voice in speaking or singing, his 
 organ of language in writing theses. He is not so 
 taught in regard to the use of his moral faculties, his 
 affections, emotions, and passions ; nor is he s-hown 
 how a want of self-control, whether in the form of 
 caprice, indolence, good-nature, affection, or ambi- 
 tion, or even when veiled under the aspect of duty, 
 may take away the half of the value of his talents 
 
12 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 and knowledge. Perhaps these remarks would be 
 more forcible if applied to girls and young women, 
 in whom self-restraint is not commonly thought a 
 necessity, and the feelings naturally take the place of 
 reflection. 
 
 All that can be said against over-study must be re- 
 versed when we speak of moderate and rational study. 
 Overwork ought not to be allowed, on the one hand ; 
 and on the other, indolence must not be permitted. 
 It is little to say that study ought not to be allowed 
 to injure the health. We may say much more : it is 
 capable of improving health ; and for many persons 
 it is an indispensable means of health. A child who 
 has been kept at suitable tasks unconsciously misses 
 them when they come to an end. Civilized and 
 reading beings (I assume that a civilized, awakened, 
 informed, and interested mind is a desideratum !) must 
 have something for the mind to work upon, or they 
 fret themselves with ennui. Much study may be a 
 weariness to the flesh ; it may give dyspepsia by being 
 allowed to encroach on physical duties ; but when a 
 person has learned to hold the proper proportion be- 
 tween these two, there is nothing that he finds more 
 conducive to peace, satisfaction, and comfort. This 
 pleasant result always follows when one has accom- 
 plished work which he is fitted for ; and to deny an 
 individual his intellectual exercise is as truly a dam- 
 age to the body as is the deprivation of physical ex- 
 
GENERAL REMARKS. 13 
 
 ercise. For want of accustomed mental stimulus and 
 work, many a man (it is an old story) has found that 
 his retirement from active business was his death- 
 warrant. 
 
 School-life, however, seems to have some injurious 
 effects on the health and growth of some children. 
 Very often it is not the school that injures a child, 
 but the fact that the child is living in a city and has 
 no place to run out-of-doors. Very often it is not 
 study at all that hurts, but study in hot or close or 
 badly-lighted rooms ; or study may be in excess of 
 the powers of the system. Such points as these will 
 receive our present attention. 
 
 2 
 
CHAPTER II. 
 
 EMOTIONAL AND MENTAL STRAIN. 
 
 "C MOTIONAL STRAIN. Teachers are fully aware 
 !_/ that this is a fluctuating factor in each child, de- 
 pendent on the weather, fatigue, excitement, and 
 other circumstances. 
 
 Of these circumstances, those which affect the 
 equilibrium of power are among the most import- 
 ant. There is a large class of irregular mental or 
 emotional states which are unfavorable to the com- 
 plete health and steady activity of the mind. The so- 
 called depressing emotions timidity, despondency, 
 anxiety, and discontent often interfere with the 
 mental health, producing actual and very marked 
 lowering of the powers of execution. No scholar 
 ought to be allowed to remain under the influence of 
 them. It is the teacher's place to find out the cause, 
 and remove it if possible. In a certain number of 
 cases, they may be due to unkindness or neglect com- 
 ing from the teacher or the playmates. A neglect to 
 award merited praise either wounds or hardens the 
 one who feels the injustice. Again, all these de- 
 
EMOTIONAL AND MENTAL STRAIN. 15 
 
 pressed states may be simply a sign of over-work, 
 want of exercise, bad air, want of sleep or food, 
 etc. 
 
 A child must not be spared all that is irksome. 
 Quite the contrary of this, the performance of irk- 
 some duty is one of the best lessons taught in school. 
 But it is undesirable that he should feel the, object 
 of his study a worthless one, or should find his best 
 efforts unsuccessful. I venture to suggest that, in 
 these respects, the teacher needs as much of our 
 sympathy as the scholar. Too much drudgery is 
 laid upon her in correcting exercises, looking over 
 examination books and papers, making up averages 
 of marks, weekly and monthly reports, and other 
 "school statistics." It is hard and unsatisfactory to 
 have to give hours of the time needed for mental re- 
 freshment to the production of a few numerical re- 
 sults, which are probably destined to lie idle on a 
 shelf. 
 
 Mental Strain. There is a great deal of harm 
 done by excessive urging or over-driving of children 
 in school, as the reader must be aware. Yet, on the 
 other hand, there are many scholars whose natures 
 need this urging, and are not properly developed with- 
 out it. If a given degree of "pressure" seems to 
 the teacher's judgment moderate, how shall it be 
 decided to be excessive by persons who are not wit- 
 nesses ? Who is a better judge than the teacher of 
 
l6 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 what constitutes a fair amount of work ? In reply, it 
 should be said that a parent knows more about a 
 child, in the generality of cases, than a teacher.* 
 It is a parent's eye that can best see when the child 
 is "unlike himself;" and the parent is justified in 
 feeling anxiety whenever the child loses sleep and 
 the desire for food and play. 
 
 The means by which children are urged are well 
 known, consisting of credits, rank, prizes, public ex- 
 hibitions, and the moral influence of a teacher of 
 strenuous disposition. It will not do to condemn 
 all of these at once, for they have arguments in their 
 favor. But, as a general thing, the giving of prizes, 
 or at least public displays upon the stage, may safely 
 be forbidden in the case of girls as useless, if not 
 harmful. Their nervous system responds too quickly 
 to such stimuli. 
 
 If there be novels which do harm " by giving false 
 views of life," are there not schools for girls which 
 do precisely the same thing, by the excessive im- 
 portance which they allow the pupils to attach to a 
 paltry gift, or, far worse, to success in beating 
 rivals ? 
 
 The scholar's future health cannot but be bene- 
 fited by an effort to conquer indolence ; but to re- 
 turn to our chief point children ought in some cases 
 
 * Especially if the child be one among fifty-six, who remain 
 only five months with one teacher. 
 
EMOTIONAL AND MENTAL STRAIN. I/ 
 
 to be allowed to seem indolent, for reasons elsewhere 
 indicated ; and it is palpably unsafe to subject all 
 scholars to an equal pressure. 
 
 "Over-driven" children will often study late and 
 sleep poorly ; they then rise late, dress in haste, and 
 rush for school in dread of a mark for tardiness, often 
 not pausing to sit down at the breakfast-table. They 
 thus enter on the day's work with an exhausted and 
 irritable system, which does not have a chance during 
 the forenoon so taken up is it with school-thoughts 
 to remember its need for repair and rest. The lunch- 
 eon-basket probably contains food suited to attract 
 a jaded system and to produce dyspepsia cake and 
 pie and doughnuts. The child finishes the school- 
 tasks, and goes home with an armful of books and an 
 aching head in need of food and rest and pjay, but 
 hardly aware of either, and intent simply on learning 
 the next day's lessons. There is no recovery from 
 this strain, for the lessons are not learned until bed- 
 time, when the experience of the day before is re- 
 peated, and so on day after day until the fixed term 
 expires. 
 
 This over-work is unfortunately apt to occur at the 
 very time of the year when the system is least able to 
 bear it. The " exhibition's," the closing examina- 
 tions, and the stress of the struggle for prizes, come 
 in the months of April, May, and June, when the 
 body craves fresh air and the eyes long for green 
 2* B 
 
1 8 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 fields ; when, too, the powers of the system begin to 
 flag from the withdrawal of the stimulus of cold, 
 which has kept them strung up to a higher pitch all 
 the winter. This constitutes a very serious objection 
 to the present system of school-exhibitions. It is 
 needless to say that teachers are not exempt from this 
 strain. 
 
CHAPTER III. 
 
 FOOD AND SLEEP. 
 
 THIS is the place to finish what needs to be said 
 regarding food and sleep. 
 
 The logical connection is quite obvious. Study is 
 a consuming of certain materials contained in the 
 brain and the blood ; food and sleep are the means 
 by which this loss is made good, and the mind placed 
 in a fit condition to resume work. The system of a 
 child who is studying to excess is becoming exhausted ; 
 it loses its powers in various directions ; the muscu- 
 lar endurance may be enfeebled ; the digestion is very 
 apt to fail ; appetite for food is lost, with the power 
 to digest food ; and sleep is very apt to be poor. It 
 is pretty safe to say that a child who eats and sleeps 
 well is not much over-driven. There is a natural 
 antagonism between active study and active digestion. 
 A nourishing meal indisposes a healthy person to ac- 
 tive mental exertion ; and, vice versa, active study or 
 mental excitement takes away appetite, or at least 
 enfeebles the digestive power for a time. What we 
 say of hard study is equally true of hard play. After 
 
 19 
 
2O SCHOOL AND INDUSTRIAL HYGIENE. 
 
 hard study or play there should be an interval for 
 relaxation or cooling-down before a meal is eaten. 
 Nothing could be more injudicious than a programme 
 which allows only one hour for dinner, following a 
 forenoon of study, and followed by an afternoon of 
 study. If it be thought desirable for young adults to 
 make the day as full as possible, it will be much better 
 to have an intermission of two hours at noon-time. 
 And persons not adults should always obey a rule 
 which places an hour's interval between dinner and 
 study, and at least half an hour between breakfast 
 or tea and study. All the meals must be nourishing, 
 and stimulants, such as tea, or coffee in particular, 
 should form no part of them. If the proper amount 
 of sleep is had, there is very little time for study in 
 the evening. The child should sleep ten hours at 
 the age of twelve years; nine hours at the age of 
 fourteen or fifteen ; and eight hours at the age of 
 seventeen or eighteen. It is not necessary that he 
 should indulge in the habit (salutary for many adults) 
 of taking a nap after meals. 
 
 At the "Smith College, " at Northampton, Mass., 
 the young ladies are expected to be in bed at ten 
 o'clock, and are strongly advised not to rise before 
 six o'clock. The students are of the usual "college 
 age," say from eighteen to twenty-one. 
 
 Study or exercise before breakfast is not generally 
 to be allowed ; it will do harm to many children. 
 
FOOD AND SLEEP. 21 
 
 Excessively long intervals between meals are of 
 course to be avoided, or to be broken by solid lunch- 
 eons. If the above amount of sleep be allowed, 
 there will not be time for more than three regular 
 meals and a lunch. 
 
 Late dinners are apt to interfere with children's 
 sleep ; if, for instance, the family meal is from six to 
 seven, and the children go to bed from eight to nine. 
 A hearty, comfortable dinner about the noon-time is 
 much better. It is perfectly true that the afternoon 
 session is likely to be rather a sleepy one ; this should 
 induce the judicious teacher to shorten the session, 
 and to prefer manual tasks (writing, drawing, etc.) 
 rather than those that call for thought. Afternoon 
 lessons add very little to the child's stock of knowledge. 
 
 Is there an antagonism between food and study ? 
 Is the mind paralyzed by the contact with the gross 
 material aliment? If it be so, why not make the 
 practical inference, and reduce the amount of food in 
 order to study better ? This proposition, insane as 
 it looks to one who understands the physiological law 
 of our living, is no doubt seriously acted upon by 
 many ambitious scholars. To such I would say 
 though with small hope of being heard that it is no 
 disgrace to the mind that it is attached to a body. 
 Its Creator has willed it so, and for this life it must be 
 so. To give a body insufficient food, and to exact 
 a full task from the brain, is slow suicide. The nour- 
 
22 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 ishment goes to the brain, while the rest of the body 
 grows puny, and the foundation of slow diseases, 
 such as consumption, is often laid. True, there have 
 been men and women with whom sedentary habits 
 and a spare diet have agreed perfectly ; but with most 
 men and women the result is dyspepsia, melancholy, 
 and a tendency to consumption or insanity ; and as 
 to children, or persons under twenty, a sedentary life 
 with spare diet is a pure absurdity. There are telling 
 maxims, indeed, insisting that we should rescue hours 
 from the night and add them to our lives, and com- 
 paring sleep to death : 
 
 " Stulte, quid est somnus, gelidse nisi mortis imago ?" 
 
 but, before you acknowledge their force, go and look 
 at the sleep of a healthy child. If you are alarmed 
 at being drowsy after eating, recollect that the bright- 
 est fire is dulled for a little while after fuel is put on. 
 
 In connection with institutions for large boys and 
 girls, ' * colleges, ' ' as they are sometimes called, it 
 may be desirable to establish a cheap lunch-counter, 
 which furnishes an inducement to eat solid and whole- 
 some food rather than a stale mess brought from 
 homes at great distances. 
 
 Americans, in general, eat a great deal of trash. 
 They are brought up to it. The subject is rather a 
 wide one, but it may be of service to indicate what 
 is not trash : A plenty of roast and less of boiled 
 
FOOD AND SLEEP. 2$ 
 
 meat; a few soups made secundum artem; a fair va- 
 riety of plain vegetables; an occasional treat of the 
 best fruit, with abundant supplies of apples ; good 
 bread of more than one sort ; a daily and abundant 
 ration of the simplest and most strengthening food, 
 such as oatmeal or Indian-meal mush, with milk; 
 and, for drinks, water, milk, coffee which contains as 
 little of the original bean as possible, tea that is not 
 too strong, or diluted cocoa. Such a dietary, without 
 the compounds commonly used for dessert, but aided 
 by fresh air, sunlight, and plenty of play, makes 
 healthy children. Fish and eggs and milk are also 
 necessary, but should not be eaten under the impres- 
 sion that they "make brain." 
 
 The boarding-schools of our country have a great 
 opportunity for implanting habits of simple and whole- 
 some living. If such schools furnish unwholesome 
 diet, they do it in imitation of the ordinary habits 
 of society. In a well-conducted school, on the other , 
 hand, where enough of the best and simplest is 
 given, it is not uncommon for pupils to come from 
 the indulgences of home and holidays dyspeptic and 
 flabby, and to become brighter and stronger as soon 
 as they are subjected to the regimen of school. 
 
CHAPTER IV. 
 
 BODILY GROWTH. 
 
 IF youth be a formative period, whose product is 
 simply the adult person, then, surely, that period 
 when formation is most rapid, when a new being 
 par excellence is developing, deserves the greatest 
 respect and care. In the case of boys, growth goes 
 on at a nearly uniform rate until manhood. Girls, 
 however, concentrate a great deal of growth in a 
 few years. They are shorter and weigh less than 
 boys until the age of eleven or twelve, when they 
 , suddenly shoot beyond them, and, for about three 
 years, continue decidedly taller and heavier, after 
 which they resume the former relative position.* It 
 would seem reasonable to suppose that girls at this 
 age are less capable of mental application than boys; 
 for it is a general rule of Nature, that when a great 
 demand is made on the system by one set of func- 
 tions others must remain in comparative abeyance, 
 
 * Prof. H. P. Bowditch, in " Eighth Annual Report of Mas- 
 sachusetts State Board of Health." 
 
 24 
 
BODILY GROWTH. 2$ 
 
 and that when growth is very rapid, mental action is 
 proportionally less so. If girls are often found 
 quicker and brighter than boys at this age, it may, 
 nevertheless, be questioned whether it is right to 
 allow them to come in competition with boys ; for 
 pluck and vivacity are not, necessarily, evidence of 
 power. 
 
 After this age that is, about fourteen and fifteen, 
 in most cases comes the time when girls are under- 
 going a change which affects the whole system in a 
 different way from mere rapidity of growth, a change 
 which, if effected quietly and normally, may be said 
 to have laid the foundation of the happiness and 
 health of an entire life. At this period, if at no 
 other, a girl should be protected from the excitement 
 of "society" and late hours, and should receive the 
 support and steadying which regular habits of study 
 impart. It is a more directly practical thing to say 
 that she ought to be treated with leniency at certain 
 times ; her work should be lightened, her errors ex- 
 cused, her inattention or unreadiness overlooked, and 
 absence from school allowed if requested. 
 
 Many young girls have grown up to be strong and 
 useful women, and have never been aware that their 
 mental powers were less under control than those of 
 boys of their own age, their school-fellows, or that 
 there was any physical'necessity for their studying less 
 than, or differently from, their brothers. Especially 
 3 
 
26 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 is this true of country girls brought up without the 
 excitements of society. 
 
 The late Dr. E. H. Clarke, of Boston, was of the 
 opinion that our system of public school education 
 was ruining the health .of vast numbers of young 
 women, by compelling them to study to excess, par- 
 ticularly at the monthly period. His opinion was 
 vigorously stated in a little book, published a few 
 years since, entitled " Sex in Education," Equally 
 vigorous counter-statements were made in the books 
 called "Sex and Education," "No Sex in Educa- 
 tion," "The Education of American Girls," and 
 in other places ; and quite a salutary storm arose, 
 which has resulted, it may be hoped, in leaving the 
 public impressed with the importance of the subject, 
 if nothing more. 
 
 I would here refer the reader to two of the follow- 
 ing chapters that on Amount of Study and that on 
 Exercise. It seems to me fair to say that the growing 
 girl would not generally suffer from her studies if 
 they were restricted within the limits hereafter sug- 
 gested, and if her physical development were cared 
 for properly. A healthy girl such as nine out of 
 ten ought to be need not suffer in health from reg- 
 ular attendance on school for three or four or five 
 hours a day, if she is protected from "society" and 
 given a fair chance to grow strong. The harm is 
 done when a girl goes to the theatre or concert, and 
 
BODILY GROWTH. 2*J 
 
 appears the next morning in school with a worn and 
 tired look and two great circles around her eyes. 
 The harm, indeed, is done long before, when she 
 first comes to live in a city where public parks are 
 thought unsafe for her to walk in, and where play in 
 the open air (except for "children" that is, very 
 small girls) is an impossible or a forbidden thing. 
 It begins with that substitution of artificial for natu- 
 ral enjoyments, of society and its excitements for 
 sports, of adult for childish interests, which is char- 
 acteristic of city life. Many such girls are thought 
 to be overworked if they lose their color, while study- 
 ing four or five hours a day, at the age of fifteen. 
 
CHAPTER V. 
 
 AMOUNT OF STUDY . 
 
 "T^XCESS of mental application is any amount 
 JI^ which interferes with the vegetative functions, 
 /. e. } anything which, by its intensity or long continu- 
 ance, or by any peculiarity of its own, interferes with 
 digestion, sleep, nutrition, repair, or development. 
 
 As the reader is perfectly aware, the cell-structure 
 called brain is in need of constant repair, equally 
 with other structures; and this repair is effected by 
 processes termed " vegetative." 
 
 Muscles, stomach, and brain equally require vege- 
 tative activity in order to keep them in condition; 
 and each may suffer from over-activity without im- 
 pairing the health of the others. But, in general, 
 overwork of one tells disadvantageous^ upon all, 
 and an unsound or overburdened mind is apt to act 
 like a burden upon the body. 
 
 The amount of work to be assigned must be de- 
 termined empirically, and we have no right to say of 
 a given person, in advance of experience, that he is 
 capable of doing a certain amount of work. But we 
 
 28 
 
AMOUNT OF STUDY. 2Q 
 
 can, as the result of experience, give an approximate 
 statement of the amount which is suitable to the av- 
 erage person at a given age. 
 
 As has been said before, children can be aroused 
 by modern methods to a great spontaneous activity 
 of mind, which contrasts strongly with the listless 
 and reluctant attention of old-fashioned schools. 
 The effect is obtained by adapting the instruction to 
 the child's capacity and nature. The kindergarten 
 system is one of the most striking instances of this. 
 I do not mention it either for praise or blame, but 
 simply in order to point out the fact that, under the 
 most favorable circumstances cheerfulness, pleasant 
 and varied tasks, sympathy, and wholesome surround- 
 ings a child at the kindergarten age has not the 
 power to bear more than two or three hours of these 
 tasks in a day consistently with health. If pursued 
 longer, the work becomes too exciting. 
 
 The late Mr. Edwin Chadwick, of England, is the 
 chief authority for a definite statement of the num- 
 ber of hours that a child should be allowed to do 
 school-work. His statements are based on long and 
 patient observation, and numerous inquiries made of 
 teachers whose attention was especially called to the 
 point ; and I do not think that any one has seriously 
 attempted to refute his views, which were published 
 a number of years ago. 
 
 In the first place, he points out the obvious inabil- 
 3* 
 
30 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 ity of the little child to pay attention for a length of 
 time consecutively. The mind, like the body, must 
 be in a continual change ; the efforts made must re- 
 semble play in spontaneity, rapidity, and variety. 
 Sedentary occupation is an enforced necessity with 
 most adults, to some extent ; but it is always to be 
 considered as involving possible danger, and for a 
 little child is almost out of the question. His brain 
 is imperfectly developed ; the power of attention is 
 perfect, but incapable of sustained efforts ; the mind 
 refuses to work long in one direction, as the body re- 
 fuses to stand or sit still. There are certain classes 
 of work which are utterly beyond his power ; and yet 
 there is no doubt at all that a little child learns as 
 much, if not more, in a year as an adult student. 
 But he learns it in his own way, and it is not book 
 knowledge. 
 
 Let the adult reader try to attend to a new subject ; 
 let him take, for example, a treatise on metaphysics, 
 or anatomy, or vital statistics, or a " Student's Gib- 
 bon/' or some other work which demands close at- 
 tention ; let the work be unfamiliar, not beyond his 
 comprehension, not too interesting, and let him see 
 how soon his mind begins to flag in the effort to 
 master the text, as if it were a lesson to be recited. 
 He will find, perhaps, at the end of an hour, not that 
 the subject is merely uninteresting, but that his mind 
 does not take hold of it as sharply as when he began ; 
 
AMOUNT OF STUDY. 31 
 
 perhaps, if he is " tough/' he can stand two hours. 
 This, by the way, is quite a different thing from an 
 irresponsible, leisurely reading of the brilliant narra- 
 tion of a Parkman or a Froude. 
 
 If an adult can apply himself to the acquisition of 
 knowledge in one direction for only one hour (and 
 how much longer can an audience listen to a lecture?), 
 the child can evidently do very much less. At the age 
 of from five to seven he can attend to one subject a 
 single lesson for fifteen minutes ; a child from seven 
 to ten years of age, about twenty minutes ; from ten to 
 twelve years, about twenty- five minutes ; from twelve 
 to sixteen or eighteen years, about thirty minutes. 
 (Chad wick.) 
 
 The total of daily work corresponds with the limits 
 of a single effort. Ten hours' work is a maximum 
 average for young men ; and there is a regular grad- 
 ation from this down to two and a half or three hours 
 for children under seven. 
 
 The most vigorous and healthy young men are se- 
 lected for West Point, and they are severely win- 
 nowed by the work required of them. They are 
 excluded from dissipation and general society ; their 
 active bodily exercise, their regular diet and sleep, 
 and the healthful climate of the place, leave nothing 
 to be desired. They have ten hours a day for the six 
 cold months ; in summer much less. In our colleges, 
 where the students are not picked for their physique, 
 
32 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 the average actual work (study and recitation) among 
 those who are faithful to their work will not probably 
 exceed eight or nine hours, as far as my observation 
 goes. 
 
 In high-schools, during the period of rapid growth 
 and sexual development, a lower figure must be as- 
 sumed ; and it seems certain that five hours, or, under 
 the most favorable circumstances, six, are all that 
 should be required. The ages usually range from 
 twelve to seventeen. 
 
 Below the age of twelve years, four hours are prob- 
 ably sufficient ; below ten years, three or three and a 
 half; below seven years, two and a half or three 
 hours. 
 
 In England a very large number of children (over 
 100,000, at my latest information) are sent to school 
 on the so-called half-time plan. This plan is the 
 result of an attempt by the Government to suppress 
 the evils of juvenile labor in manufactories. The 
 children attend school about three hours a day during 
 the school-year, and those hours are taken out of 
 their factory-time. It is found that children thus 
 taught make as good progress as those who attend 
 school six hours a day. This result is probably a 
 mixed one, due, partly, to the beneficial effects of 
 change of occupation, and partly to the fact that six 
 hours are clearly beyond the limit of profitable men- 
 tal exertion. Something must also be ascribed to the 
 
AMOUNT OF STUDY. 33 
 
 regularity of attendance in half-time schools, which 
 is enforced under the penalty of exclusion from the 
 factory.* 
 
 At what age should a child be sent to school? 
 The kindergarten does not injure a child of four 
 years unless carried to the point of over-excitement, 
 which, I believe, is not often done. The common 
 primary school, however, is decidedly objectionable. 
 It takes very young children (six years of age), and 
 compels them to remain twice as long as is good for 
 them. By great ingenuity and vivacity, a teacher 
 can keep them going upon various studies for three 
 hours. This is all that is reasonably possible, yet 
 the children are expected to come back for a second 
 session in the afternoon. A school conducted by set 
 lessons and recitations a mimic grammar-school, in 
 fact should not receive children under seven or 
 eight years of age. 
 
 * See Reports of the Massachusetts Bureau of Labor for 
 
 1871, 1875, and l8 7 8 - 
 
 C 
 
CHAPTER VI. 
 
 EXERCISE. 
 
 IN spite of all that may be justly said of the value 
 of intellectual pursuits in promoting health, it 
 remains true that a great many brain-workers are 
 exposed to a serious danger. The effects of unre- 
 lieved work with the mind are not always easy to 
 trace. In the case of teachers, the system gets so 
 gradually used to a low tone of physical life that one 
 forgets the sensation of health, loses a standard for 
 self- comparison, and does not become aware that 
 ground is really lost until matters are already serious. 
 To a person in vigorous health, with strong muscles, 
 who feels his temper and digestion giving way under 
 the influence of teaching, heavy gymnastics or field- 
 sports of an active sort may be recommended. To 
 the less vigorous or muscular person, and to most 
 women who teach, a daily walk of from half an hour 
 to two hours is necessary. It should be taken in 
 company ; care should be left at home ; new scenes 
 sought, and the object should be less to get fatigue 
 by great exertions than to give the mind an oppor- 
 
 34 
 
EXERCISE. 35 
 
 tunity to take a view of life which school-work does 
 not give. One chief benefit of walking is that it 
 breaks up trains of thought. 
 
 It is certainly worth while for women to cultivate 
 muscularity, if they can do so with safety. A great 
 many could walk five miles a day, and be the better 
 for it ; others could not : and the way to find out is 
 by trying. Beginning with two miles, one may grad- 
 ually work up to five in the course of five weeks. 
 Perhaps it may be necessary to restrict the amount ; 
 but this must be learned by trial. 
 
 Some persons, especially teachers, ought to enjoy 
 almost absolute rest on Sundays. Few are really 
 aware of the value of the Sabbath as a physical agent 
 of health. The teacher should so use it as to get a 
 sense of renewed life every Monday, and, unless in 
 most vigorous health, should certainly not teach jn 
 the Sunday-school. 
 
 It is difficult to state with accuracy the precise 
 time when the frame of the body takes a permanent 
 form j it certainly varies in different cases ; but it is 
 plain enough that there is a great difference between 
 the years before twenty and those after. The re- 
 quirements of a growing body, it cannot be too often 
 repeated, are very different from those of an adult 
 body. We urge gymnastics upon the adult in order 
 to preserve the constitution ; upon the child, in order 
 to form it. Circumstances often forbid the systematic 
 
36 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 pursuit of gymnastics by adults ; children have, or 
 should have, no engagements or occupations to inter- 
 fere with it. 
 
 The benefits of gymnastics are of several sorts. 
 Children are not to practise them chiefly for the sake 
 of gaining great strength. They are to be used as a 
 means of conferring grace of movement and the out- 
 lines which indicate health and endurance; of en- 
 larging the chest, thereby giving free play to the act 
 of breathing and the motion of the heart ; of strength- 
 ening the latter organ by degrees ; of fortifying the 
 muscular walls of the abdomen against rupture and 
 the joints against accident; of confirming the habit 
 of liberal consumption and ready assimilation of food 
 (though play is better for this object). All these are 
 best attained by the use of few and light apparatus ; 
 at least, in the commencement. 
 
 The word "calisthenics" implies the imparting 
 of strength and beauty. There is a proverb that 
 " beauty is but skin deep;" a very superficial view, 
 indeed. Beauty of form is not skin deep ; it depends 
 on the bony frame, on the development of muscles 
 over the bones, and on the fatty layer over the mus- 
 cles. A straight back may be said to be an element 
 of beauty ; round shoulders and a twisted spine are 
 an element of the opposite quality, beyond a doubt. 
 
 It is well known to physicians that a large number 
 of young girls in cities have a perceptible tendency 
 
EXERCISE. 37 
 
 to distortion of the spine at the growing period of 
 life. The case is certainly aggravated by confine- 
 ment in school, by want of muscular exercise, and by 
 improper positions in study. Boys do not exhibit 
 this tendency to so marked an extent; but it is a 
 thing to be constantly looked after in the case of 
 girls. 
 
 "In a school of 731 pupils at Neufchatel, 62 cases 
 of deviation of the spinal column were observed 
 among 350 boys, and 156 cases among 381 girls. 
 These results are further stated not to differ materi- 
 ally from those of examinations made in German 
 schools. According to Adams, in 83 per cent, of 
 782 pupils (649 cases), in which this deviation oc- 
 curred, it was towards the right probably in conse- 
 quence of writing at unsuitable desks. According to 
 Eulenberg, in 92 per cent. (276) of 300 cases, the 
 curvature was also to the right. It is true that these 
 curvatures are not always associated with public 
 health, since they sometimes occur in a slight degree 
 to the strong and well ; and it is true, also, that they 
 may arise under influences not peculiar to school-life, 
 such as the preponderating use of one or the other 
 arm for any purpose. There can be but little doubt, 
 however, that to the habit of writing at unsuitable 
 desks belongs the largest share of blame. 
 
 "In the statistics which I have given, the spinal 
 curvatures were found to occur with much greater 
 4 
 
38 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 frequency among girls than among boys, partly due, 
 no doubt, to the fact that they play fewer active 
 games, and are, in general, more restrained in their 
 movements. In a brief report of a recent meeting 
 at Berlin, of some of the highest authorities of Ger- 
 many, called together to consider the entire subject 
 of the school education of girls, I find a notice of 
 an address by Herr Raaz, principal of a school in 
 Berlin, in which he speaks of the common occur- 
 rence of these spinal curvatures in his school, and 
 says that he has found the use of gymnastics to be 
 powerful in preventing them."* 
 
 Children should have several hours of play every 
 day in the open air, when possible. Vigorous and 
 spontaneous action of this sort is better than gymnas- 
 tics for the general run of children ; and if girls 
 were allowed by social feelings to play as boys do, 
 they would cease to be so subject to spinal deformi- 
 ties. 
 
 But a certain proportion of children are not suited 
 by indiscriminate play. They have a tendency to 
 distortion of the spine, which is easily brought out 
 by many forms of sport. 
 
 Any exclusive use of one side of the body is there- 
 fore dangerous. Base-ball is a vigorous and useful 
 sport ; but it is occasionally the cause of lateral dis- 
 
 * James J. Putnam, M.D. " Gymnastics for Schools," in the 
 American Journal of Social Science, No. VIII., 1876. 
 
EXERCISE. 39 
 
 tortion, owing to the excessive use of the right arm 
 and hand. Bowling would seem likely to have the 
 same tendency. Croquet is a very distorting game, 
 unless both hands are used alternately, or one as much 
 as the other, to strike the ball. 
 
 The position of a woman on horseback is one 
 which is apt to cause a "corkscrew" twist of the 
 spine. And the common games of running and 
 tossing, which do children so much good, are not so 
 directly adapted to prevent or cure spinal deformity, 
 or to make a girl full-chested and symmetrical, as is 
 a course of gymnastic training under the charge of a 
 competent person. 
 
 Evidently, if we accomplish this greater object of 
 correcting the weak points in the frame of a child, 
 we gain at the same time those benefits improved 
 appetite, complexion, sleep, mental briskness for 
 which adult gymnasts so much prize their art. As 
 for play, when can the girls in a city boarding* 
 school, for example, play? Certainly not while on 
 their daily walk, two by two, in the paved streets. 
 
 " To establish a department for physical training 
 demands but little change in the present school sys- 
 tem, since almost any school-room may be trans- 
 formed almost instantly into a gymnasium, no appa- 
 ratus being required for the lower grades, and only a 
 few light implements carried in the hands for the 
 more advanced pupils, and each scholar needing only 
 
4O SCHOOL AND INDUSTRIAL HYGIENE. 
 
 space enough upon the floor for a step in each direc- 
 tion, and room to straighten the arms in front and at 
 the sides. Of the pupils the requirement is slight, 
 being merely that the dress shall be short enough to 
 leave the feet unencumbered, loose enough to admit 
 of a full inhalation without feeling the clothes at the 
 waist or across the chest, and large enough to permit 
 the free play of every muscle in the body. For this 
 no special costume would be required, except in the 
 highest grades. Music is a great addition to the ex- 
 ercise, but not a necessity. But the great difficulty, 
 and, in fact, the only serious one, is the dearth of reg- 
 ularly trained teachers of gymnastics, who are not 
 only fully prepared for the work, but who are enthu- 
 siastic in the cause, and able to impart their informa- 
 tion to others. This arises from the low standard of 
 physical culture admitted by public opinion. Let it 
 once be required, that those who teach this branch 
 shall of necessity be regularly trained, and there will 
 be a supply of good teachers in a marvellously short 
 time."* 
 
 "In Sweden, the celebrated system of Ling is an 
 obligatory study in all public schools, three to six 
 hours a week being devoted to it, subject to the ad- 
 vice of a physician, who is appointed to examine each 
 scholar at the beginning of the school term. For the 
 
 * Quoted by Dr. Putnam from a letter received from a teacher 
 of gymnastics in a "girls, normal-school." 
 
EXERCISE. 41 
 
 education of teachers there is a great central institute 
 at Stockholm ; and the graduates from the normal- 
 schools must moreover have passed a special exami- 
 nation in this branch. A large part of the instruc- 
 tion is in the so-called 'free exercises,' including 
 proper methods of sitting, standing, lying, walking, 
 running, jumping, as well as exercises in concert, 
 games, etc. The aim of these free exercises is to 
 call into action in turn the greater part of the volun- 
 tary muscles of the body ; and with an intelligent, 
 earnest teacher to direct them, there is no end to the 
 modifications and combinations that can be made, 
 calling for precision and strict attention and skill on 
 the part of the pupils." \Ibid J\ 
 
 The city of Frankfort-on-the-Main is an illustra- 
 tion of what may be done by an enlightened commu- 
 nity, led by far-seeing hygienic genius. Gymnastic 
 exercises were first introduced there nearly seventy 
 years ago ; but the progress has been very slow in- 
 deed, and it was only a few years ago that the regu- 
 lar practice of such exercises, under trained teachers, 
 was made obligatory upon the public-school children 
 in that city. Most of the twenty-five schools already 
 possess a " turn-halle," and others are building. The 
 new halls are to be from 20 to 25 meters long (66 
 83 feet), 9 or 10 meters wide, and 5 5.6 meters high 
 (about 17 18 feet); they are all well furnished with 
 4* 
 
42 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 apparatus ; that used by girls differs somewhat from 
 that used by boys. 
 
 There were 12,101 children in the public schools 
 in 1878, of whom 10,844 attended schools where 
 gymnasiums existed and exercise was obligatory. A 
 medical certificate of disqualification is required of 
 those who are excused ; the number wholly excused 
 amounted to two and a half per cent. The scholars 
 exercise two hours every week. They are always un- 
 der the charge of teachers specially qualified for the 
 work by instruction received in gymnastic normal- 
 schools, and in classes taught by the inspector of 
 gymnastics. These teachers are not ignorant men, 
 nor "pure specialists" of gymnastics; they are all 
 regularly qualified teachers of the literary branches, 
 and the hours during which they are engaged in teach- 
 ing gymnastics are counted in with the twenty-six 
 required weekly hours, just as so many hours of Latin 
 or music would be counted. One hundred and four- 
 teen teachers are thus employed, performing an amount 
 of duty equivalent to \^ full time of seventeen teachers ; 
 which may be estimated as costing the city 46,270 
 marks, or about one dollar for each child. The value 
 of this exercise to the teachers is as great as to the 
 pupils. 
 
 It is thought desirable that the number of weekly 
 hours should be increased. Another recommenda- 
 tion is made by the authority from whom I quote 
 
EXERCISE. 43 
 
 this account,* to the effect that the city should pro- 
 vide public places for children to play in, both for 
 sanitary and moral reasons a recommendation which 
 is as important in America as in Germany. 
 
 It is interesting to remark that the youngest chil- 
 dren use chiefly free-hand exercises; that the boys 
 take the fixed apparatus by degrees, and at last use 
 them chiefly; while the girls, who in the middle 
 classes use fixed apparatus like the boys, in the upper 
 classes return, for the most part, to the use of lighter 
 instruments, suitable for young children. 
 
 Public sentiment is not at present favorable to such 
 thorough-going work in America. To the crowds of 
 men and women in our large cities who were born in 
 the country, and remember its free and natural sports, 
 its days spent in the open air with the beasts* fowls, 
 and fishes, a course in gymnastics will seem but a 
 tame thing. Those city men who have been forced 
 to use a gymnasium for their health, have not gener- 
 ally a very cheerful impression of the place. In fact, 
 the actual substitute, in our cities, for that immensely 
 popular German institution, the Turn-Verein, is the 
 volunteer militia company, which gratifies the love 
 of exercise, the social instinct, and the love of rule, 
 order, and co-operation in a very similar way. 
 
 A gymnastic class in a school should consist of the 
 
 * G. Danneberg : Das Stadtische Schulturnen zu Frankfurt 
 
 a. M. 
 
44 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 scholars in one room, or any suitable fixed number ; 
 their teacher should have precisely equal authority 
 with their class-teacher (in Amherst College, the 
 teacher is a Professor and member of the Faculty) ; 
 and the exercises should be controlled as those of a 
 soldier are not with the same stiffness, but with 
 constant care lest the boys injure themselves by am- 
 bitious efforts. 
 
 Even in Frankfort, the present complete system 
 has only been introduced in the most gradual man- 
 ner. If it is ever made a part of the American sys- 
 tem, and I cannot see why it should not ultimately 
 be, the same way must be followed. I would sug- 
 gest, as a stepping-stone, the introduction of a very 
 thorough gymnastic training in our normal-schools. 
 In three years, a young woman cannot only much 
 improve her own constitution, but can become im- 
 pressed, from experience, with the value of gymnas- 
 tics. The great difficulty to be overcome is the fact 
 that few teachers really know what physical exercise 
 can do for a person ; what elasticity and smoothness 
 of temper ; what power of continued attention and 
 work it is capable of imparting. 
 
 Girls really need gymnastics more than boys, in 
 cities, owing to the very great restraint placed on 
 their freedom, and the improper modes of dressing 
 which still prevail. One of the readiest ways to per- 
 suade young women to dress rationally is to make 
 
EXERCISE. 45 
 
 them feel by contrast the comfort of living in bodily 
 freedom, as must be done, for the time, at least, by 
 those who practise gymnastics. 
 
 Would it be too great a luxury for a democratic 
 community to indulge in, if all children were in- 
 spected by the quick and practiced eye of a medical 
 expert, once a year, especially during the ages of 
 rapid growth? and if the results of such examinations 
 were made known to the teachers of gymnastics for 
 their guidance? In every hundred children, there 
 are always some who are tending to special deformity. 
 It would be very easy, in most cases, to prevent this 
 by suitable exercises, performed with very cheap ap- 
 paratus, for a short time, every other day. Other 
 children are weakly, and should have special exemp- 
 tions. 
 
 The adoption of special teachers in gymnastics is 
 strongly to be urged. It is too much to expect of 
 the literary instructors that they shall always be 
 strong enough to perform the severe duties of in- 
 structing in gymnastics three times a week. Such 
 duties are much more toilsome for the teacher than 
 for the pupil. There are plenty of most valuable 
 instructors who could not bear the additional strain. 
 But as regards calisthenics of a very light description, 
 performed daily once or twice, for relaxation more 
 than for development, the ordinary -teacher is per- 
 
46 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 fectly competent to perform and teach them. I will 
 give a specimen of the latter to illustrate : 
 
 " Body erect, heels, together, feet at angle of 60, 
 chin not protruding, eyes front, hands closed, knuc- 
 kles touching shoulders as nearly as possible, elbows 
 touching sides with exactness. 
 
 " Right \\a.\\&down, up, down, up; left hand down, 
 up, down, up; right down; right up and left down; 
 right down and left up; right up; both down, up, 
 down, up (16 movements). 
 
 " The same alternation may be applied to forward 
 movements resembling a boxer's blows, and to lateral 
 and upward movements. This series is one of the most 
 elementary, and when learned so that the whole class 
 does it with prompt uniformity and in good time, 
 the music, if possible, of a piano or drum, a slight- 
 ly harder series may be undertaken. This course will 
 bring into use, by degrees, all the chief muscles in 
 bending and twisting the trunk, limbs, and neck." 
 
 Military drill is an excellent thing in general ; it 
 should, however, be restricted to the stronger boys. 
 Small and weak fellows are easily injured by carrying 
 a musket for a long distance. My friend, Dr, Buck- 
 minster Brown, has mentioned to me one or two 
 cases in which he believed congestion or inflamma- 
 tion of the membranes of the spinal cord at the 
 level of the shoulders to have been thus caused. 
 
 In a long session, there should be a pause at the 
 
EXERCISE. 47 
 
 close of every hour, in which the scholars should be 
 allowed to go out of doors. 
 
 A short session of three hours may require only 
 one pause, which should, however, be of twenty or 
 thirty minutes, in the case of children. 
 
 Clothing should at all times be easy and allow full 
 inspiration by chest or abdomen, without any sense 
 of pressure ; the feeling should be nearly the same as 
 when no clothes are worn. The so-called " dress 
 reform" for women effects this by making most of 
 the weight depend from the shoulders. 
 
 One of the chief faults of feminine attire -the 
 pinching of the waist where the skirts are fastened 
 is imitated by boys with a leather strap. It is dan- 
 gerous to exercise with a tight strap or string around 
 the middle. 
 
 The feet are often neglected. Children (old enough 
 to "study philosophy") will come to school in thin, 
 wet shoes from simple negligence, or because they 
 have "lost" their rubbers. They should be sent 
 home by the teacher for dry shoes and stockings. 
 On very wet days it would not be amiss for the pupils 
 to bring at least a dry pair of stockings to school 
 with them. This is especially important for older 
 girls. 
 
CHAPTER VII. 
 
 CARE OF THE EYES. 
 
 THERE is no hygienic point where the teacher 
 can render more distinct service than in rela- 
 tion to the eyes of his scholars. The functions of 
 this organ are so dependent for their perfection 
 upon a thoroughly sound condition of health, that 
 a complete account of their relations would bring us 
 in contact with most points of hygiene. But, of all 
 public servants, the teacher ought to be best informed 
 of the dangers, and best able to assist the child in 
 avoiding them. 
 
 In the valuable little treatise on the " Care of the 
 Eyes," by Mr. Brudenell Carter, we find these words, 
 which may be laid to heart : 
 
 "It is very worthy of note that, in the experience 
 of ophthalmic surgeons, it is exceptional to meet with 
 a child suffering from defective vision who has not, 
 before the defect was discovered, been repeatedly 
 and systematically punished by teachers or school- 
 masters for supposed obstinacy or stupidity. The 
 very reverse of this practice is what ought to obtain, 
 
 48 
 
CARE OF THE EYES. 49 
 
 and apparent obstinacy or stupidity should lead, from 
 the first, to the question, 'Can you see perfectly?' ' 
 
 It may be added that deafness, due to causes easily 
 removed if taken in time, is often misunderstood in 
 the same deplorable way. Deafness, however, cannot 
 be considered a " school disease " in the same sense in 
 which many diseases of the eye are such. Both the 
 eye and the ear, however, are peculiarly the instru- 
 ments of school-education, and a teacher who is ig- 
 norant of their essential construction and laws knows 
 not the tools of his trade. 
 
 There is one affection which is so common, and so 
 directly dependent (in many cases) on school-life, 
 that it may well occupy our first attention. I refer 
 to short-sight, near-si to ht, or myopia. 
 
 A child with normal eyes ought to be able to read 
 this page, in a good light, at the distance of forty 
 inches, and at all intervening distances down to four 
 inches : this is a very moderate test for young eyes. 
 Any child who cannot read it as far as fifteen inches 
 off should have his eyes examined by a competent 
 oculist. No disease is more certain to increase if 
 neglected, and none is better understood by scientific 
 experts, and r..ore susceptible of exact statement and 
 ready correction. 
 
 The near-sighted eye is 0ne which has too great a 
 diameter from front to rear, so that the retina which 
 lies at the rear is beyond the point at which pencils 
 5 D 
 
5O SCHOOL AND INDUSTRIAL HYGIENE. 
 
 of rays from far objects are focalized. This condi- 
 tion is illustrated by the following diagram from Dr. 
 Harlan's Health Primer, in this series, on "Eye- 
 sight, and How to Care for It," in which the whole 
 
 lines represent the outline of the normal eye with 
 the lens, and rays of light from a distant object com- 
 ing to a focus on the retina; while the dotted lines 
 represent a near-sighted eye, with rays from a very 
 near object coming to a focus. In near-sightedness, 
 rays from distant objects may be represented by the 
 whole white lines, which are focalized before reach- 
 ing the retina, giving a diffused image, in which each 
 point of the object is seen as a larger blurred point 
 and each line as a wider blurred line. 
 
 This defect is irremediable when it exists as an 
 anatomical fault ; but very much may be done to 
 prevent its increase when discovered, especially in 
 children. It must be remembered that some chil- 
 dren are looked upon as near-sighted because they 
 have the habit of holding their work too close to 
 
CARE OF THE EYES. 5 1 
 
 their eyes. This habit may arise from the very oppo- 
 site cause, namely, far-sight ; it may originate in 
 sheer indolence, a faulty desk or seat, or poor light, 
 and may be continued merely as a habit. And the 
 degree of near-sight is easily over-estimated by those 
 not able to apply the scientific tests of the professed 
 oculist ; for in many cases there exists a temporary 
 exaggeration of near-sight, due to the strain entailed 
 by the effort to read or see fine objects, which easily 
 passes away with change of occupation. 
 
 In order to prevent, we must first understand some- 
 thing of the causes of this complaint. 
 
 There is a strong tendency for the malformation, 
 once developed, to be transmitted to children. In 
 all probability, near-sight begins, in many children, 
 at a very early age ; but in most cases a great deal 
 can still be done to prevent its increase. 
 
 It is believed that an eye which is predisposed to 
 near-sight has naturally a more yielding and delicate 
 envelope, which, under the influence of close appli- 
 cation to near vision, yields to the compression which 
 that act necessarily causes (and causes, also, in a 
 sound eye) ; and as the yielding occurs chiefly at the 
 rear of the eyeball, that portion is very gradually 
 pushed back, and the whole globe becomes elongated. 
 
 This tendency to yield may exist as the result of 
 three causes : first, as an inheritance from near-sighted 
 parents ; second, as a characteristic of weakly, flabby 
 
52 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 children, with tissues which do not resist pressure 
 well ; and, third, as a general characteristic of child- 
 hood, when all the tissues are soft. 
 
 Of prevention, as applied to the first of these causes, 
 I will not speak; but the second is at once suggestive 
 of the great importance of preserving strong and 
 lusty health for the sake of the eyes ; and as to the 
 third, it affords a hint that childhood is not, perhaps, 
 a suitable time for close application with the eyes. 
 
 Robust and active children are less likely, on the 
 whole, to be affected, both because their tastes lead 
 them into the open air rather than to books, and be- 
 cause they generally possess a tougher fibre. Any- 
 thing which depresses vitality is capable of weakening 
 the power of vision. Bad air in school-rooms is cer- 
 tainly capable of causing bad eyes ; it provokes the 
 general condition of listlessness and languid function 
 which predisposes to near-sight and other diseases of 
 the eye. Fresh air in the school-room is absolutely 
 necessary for this reason. Delicate health, dyspepsia; 
 catarrhal, and other weaknesses may be considered as 
 aiding the tendency to near-sight. Convalescence 
 from acute fevers, as measles, is often associated with 
 a weakness of the eyes which should forbid their use 
 for a time. Diphtheria not seldom causes a paralysis 
 of sight, which should be very carefully looked after 
 both by teacher and doctor, and all use be prohibited 
 until complete recovery ensues. 
 
CARE OF THE EYES. 53 
 
 It is a false and mischievous view that considers 
 the near-sighted eye a strong eye. Such an eye is 
 " strong" only in respect to minute objects, while, 
 for almost all the pleasures and duties of life, it is a 
 half-blind eye. There is, too, a tendency, happily 
 seldom realized, to destroy sight by separation of the 
 retina from the outer coats of the eye a painless 
 process, but frightful to contemplate as the possible, 
 and in fact the logical, termination (so to speak) of 
 near-sightedness. 
 
 The mechanical pressure exercised in the act of 
 looking at near objects by the muscles used in fixing 
 the globe has been mentioned. The distention which 
 this pressure tends to produce is quickly recovered 
 from if the eye is rested often ; its effects are exag- 
 gerated by the excessive fineness of the objects looked 
 at (as in embroidering, and small maps and type), by 
 poor light, by fatigue, by sleepiness, by an over- 
 heated room, or cold feet ; by tight clothing around 
 the neck, by the effect of a recent hearty meal, or by 
 protracted use of the eyes ; and, in general, by any- 
 thing which causes congestion of the eyes. The eyes 
 are decidedly better able to bear fatigue in the fore- 
 noon than in the afternoon. The position of the 
 body is important ; stooping forwards should be pro- 
 hibited, and the eyes not allowed to approach nearer 
 than fifteen inches in general to the book or slate. 
 The proper shape and proportion of a desk which 
 
54 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 * 
 will facilitate the fulfilment of these requisitions will 
 
 be described hereafter, as well as the proper arrange- 
 ments for lighting a room. 
 
 The reader is referred to Dr. Harlan's work in this 
 series for a fuller account of " How to Care for the 
 Eyesight ' ' than can be given here. A few remarks, 
 however, are here quoted : 
 
 "It is well in reading to interrupt the strain of 
 continuous gaze upon the page, and rest the eyes, by 
 looking into the distance occasionally, even if only 
 for a few seconds. In studying, or in reading any- 
 thing that requires thought, this is likely to be done 
 unconsciously; the natural condition in close thought 
 is rest of everything except the brain. 
 
 " As distant vision represents rest for the eyes, and 
 near vision represents exertion, care should be taken, 
 in reading, not unnecessarily to increase this exertion 
 by holding the book too close. The book should not 
 be held nearer to the eyes than is necessary to make 
 the print appear perfectly sharp and distinct, and no 
 print should be read continuously that cannot be seen 
 clearly at about eighteen inches. 
 
 " Without any optical or other discoverable reason, 
 or, perhaps, merely in consequence of a careless and 
 lounging way of sitting, young people often acquire 
 the vicious habit of reading with the book held close 
 to the eyes a habit which, if examination of the 
 eyes proves it to be nothing more, should be strictly 
 
CARE OF THE EYES. 55 
 
 discouraged. It is very important, however, to de- 
 termine positively that there is no physical cause for 
 the habit, and to remember that true short-sight de- 
 pends upon the form of the eyeball, which no amount 
 of discipline can alter. Great injustice is often done 
 to children by accusing them of obstinacy or inat- 
 tention, when they are the subjects of physical defects 
 of sight or hearing. Those with a high degree of 
 long-sight are particularly liable to be misunderstood ; 
 for, though they can see distant objects better than 
 near ones, they sometimes hold the book close to the 
 eyes to make the print appear larger, and thus par- 
 tially compensate for their dimness of sight. Chil- 
 dren with astigmatism often appear stupid or inatten- 
 tive, because there is in this defect what the subjects 
 of it sometimes aptly call ' slow sight ; ' that is, they 
 do not recognize a word quickly on first sight, but 
 ' it seems to come to them afterwards.' Astigmatism 
 is that condition in. which all lines running in a given 
 direction look blurred as all the upright or all the 
 horizontal, etc. 
 
 " In reading while lying down, it is hardly possible 
 to hold the book in a favorable position, and the ex- 
 ternal muscles of the eye are strained. In addition 
 to this, when the head is on a level with the body, 
 instead of erect, there is a tendency to an excess of 
 blood in the eyes. 
 
 " It is not well to persist in reading when overcome 
 
56 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 with sleep, as there is a constant tendency for the 
 muscles of accommodation to relax, and of the eyes 
 to diverge, and they have to be forced back to their 
 work by an effort of the will. The effect of this is 
 soon shown in a congestion of the blood-vessels of 
 the conjunctiva [white of the eye]." 
 
 This is the place to speak of the excessively bad 
 and trying character of the letters on many maps 
 used in schools. Some most excellent works, as re- 
 gards thoroughness and execution, are absolutely in- 
 tolerable on account of the fineness of the engraving. 
 Other maps, printed from old and worn plates, are 
 sold, which it would require the microscope of an 
 expert to decipher. Maps for children ought to con- 
 tain few data; geography should be largely taught by 
 wall-maps and outline maps; and long search for 
 places, too often hidden like " the needle in the hay- 
 stack/' should be discouraged. 
 
 Greek letters are not harder to read than a clear 
 manuscript, if they are well printed. There is an 
 old Greek type which is very trying, however. Lex- 
 icons are an indispensable part of a classical educa- 
 tion, and the utmost care should be given to clearness 
 of type. 
 
 The most agreeable tint for paper is either a cream 
 color, like that of this page, or a pale blue (which is 
 commonly taken for clear white), produced by adding 
 a pigment. The practice of calendering the sheets, 
 
CARE OF THE EYES. 57 
 
 to give a gloss, is altogether improper, for it causes 
 them to throw a dazzling reflection in many lights. 
 
 It should be remembered that drawing, when the 
 eyes have frequently to look from the page to a dis- 
 tant object, may be quite fatiguing. Drawing maps 
 on a small scale must be forbidden ; no names, for 
 instance, should be inserted in a smaller handwriting 
 than that which is usual. A large handwriting for 
 ordinary purposes should be taught. Fine embroid- 
 ery and lace-work are notoriously destructive to the 
 eyes. As an illustration of the effect of too close 
 work with the eyes, I will mention a recent minute 
 edition of Dante's Divine Comedy, which occupies 
 a volume measuring 2 by \- inches. The type is so 
 minute that it had to be destroyed after use, owing to 
 the impossibility of distributing it ; and several work- 
 men had to stop working on it on account of the 
 injury it caused. 
 
 Pale ink and greasy slates are trying to the eyes. 
 Some other points will be mentioned hereafter. 
 
 The connection of near-sight with school-life and 
 work has received a great deal of attention within 
 the past twenty years. Statistics were first published 
 by Cohn, of Breslau, who examined the eyes of 
 10,060 school-children, and found that of this num- 
 ber 1004 were near-sighted. Since then many ex- 
 aminations of smaller numbers of children have been 
 made in Germany, Russia, Switzerland, and America, 
 
58 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 with strikingly similar results. It seems to be a uni- 
 form fact, that the youngest classes have the fewest 
 near-sighted children and the oldest the most. In 
 Konigsberg, the difference was found to be as nearly 
 six to one. In New York, the difference was nearly 
 as eight to one.* It may be a matter for congratu- 
 
 * Statistics by Drs. E. G. Loring and R. H. Derby, the ages 
 ranging from 6 to 21 years. Percentages in the lowest classes, 
 3.50; in the highest, 26.78, near-sighted per hundred. 
 
 Other American observations give the following results : 
 
 Cincinnati, 630 students : District schools, 10; Intermediate, 
 14; Normal and High, 16, near-sighted persons in 100. 
 
 Brooklyn Polytechnic, 300 students : Academic Department, 
 10 per cent. ; Collegiate Department, 28 per cent. 
 
 New York College, 549 students : Introductory class, 29 ; 
 Freshman, 40; Sophomore, 35 ; Junior, 53; Senior, 37 per cent. 
 
 Buffalo public schools, 1003 pupils: the percentage of near- 
 sightedness increased from 5 at seven years of age to 26 at 
 eighteen years. It was further ascertained that one of every 
 four graduates of the Buffalo High-School was near-sighted. 
 
 Dayton (Ohio) public schools, 765 pupils : near-sighted, 18.96 
 per cent. 
 
 In Amherst College, as has been shown by the very careful 
 examination recently made by Dr. Hasket Derby, the percent- 
 age of normal eyes, on entering, is 50.8; on graduating, 36. 
 The percentage of far-sight on entering is 5 ; on graduating, 
 13.2; that of near-sight on entering, 44.2; on graduating, 50.8. 
 Amherst students have the reputation of working well at their 
 books, and they are certainly not a puny or unwholesome set. 
 They are rather largely country boys. This refers to the class 
 graduating in 1879. 
 
 The statement for the class of 1880 (which I owe to the kind- 
 
CARE OF THE EYES. , 59 
 
 lation that we have in America fewer actual cases of 
 near-sight, perhaps one-half as many as in Germany; 
 but it would seem that the tendency of near-sight to 
 increase rapidly as school- life advances is quite as 
 marked here as there. 
 
 It is really a serious question whether the attain- 
 ment of high culture is necessarily attended by my- 
 opia in a large percentage of persons. The German 
 nation is a spectacled nation : it has not lost its mil- 
 itary qualities nor its intellectual preponderance in 
 certain directions ; but who likes to think of a uni- 
 versal use of glasses for ordinary vision by children 
 and adults alike? And yet, if it were possible to 
 send the whole nation to school up to the age of 
 eighteen (in their way), this result w r ould seem likely 
 to follow. Perhaps among the drilled and orderly 
 masses of Germany, where the boys (little old men) 
 never throw stones or steal apples, the disadvantage 
 
 ness of Dr. Derby, as it is not published) is to the effect that 
 near-sight developed from previous normal sight in 7 per cent, 
 of the whole class increased in amount in 3j/ per cent., and re- 
 mained unchanged in 22.8 per cent. This is favorable, as com- 
 pared with other statistics. Perhaps the mere fact of attention 
 being paid to the subject has increased the care of the students; 
 doubtless the gymnastic exercises have had a good effect. 
 
 These statistics, except the first and last, are quoted from the re- 
 port of Dr. Conklin, of Dayton, upon the " Effect of School-Life 
 upon the Eyesight," printed by the School Board, 1880. They 
 are not very extensive, but they should dispel the idea that near- 
 sightedness will take care of itself in America. 
 
60 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 of partial blindness is not so great as it would be 
 here; yet who wants a near-sighted policeman, or 
 sailor, or stage-driver, or a spectacled actor or singer? 
 The effect of near-sight upon the character has not 
 been studied. We would add, for the thoughtful 
 consideration of parents, these words from Mr. Car- 
 ter's book : 
 
 "It will be manifest, on reflection, that the mat- 
 ters which are lost by the short-sighted, as by the 
 partially deaf, make up a very large proportion of 
 the pleasures of existence. I am accustomed, on 
 this ground, strongly to urge upon parents the neces- 
 sity of correcting myopia in their children ; and I 
 am sure that a visual horizon limited to ten or even 
 twenty inches, with no distinct perception of objects 
 at a greater distance, has a marked tendency to pro- 
 duce habits of introspection and reverie, and of in- 
 attention to outward things, which may lay the foun- 
 dation of grave defects of character." 
 
 Homer was, assuredly, the possessor of a good 
 pair of eyes at least, in his youth ! 
 
 If near-sight is at all connected with compulsory 
 and protracted education, that is, with the methods 
 by which modern civilization is supported, it be- 
 comes a national question of a grave character, 
 whether the connection is a necessary one, or whether 
 means for preventing its growth are not feasible. 
 These means do exist, and it is our duty to urge 
 their adoption. 
 
CARE OF THE EYES. 6 1 
 
 Children are incapable, for physical reasons, of 
 enduring long protracted effort. This is true not 
 only of the mind, but of the eye, and for very 
 tangible reasons. Their tissues are soft, bones, 
 tendons, muscles, and skin alike,. and yield readily 
 to pressure. Now, no fact is better known than that 
 near-sightedness is increased by the yielding of the 
 fibrous coats of the eye under the pressure of the act 
 of reading ; and it is equally well known that child- 
 hood is, par excellence, the period when near-sight- 
 edness commences. Nature forbids the young child's 
 brain to be used for a single task more than fifteen 
 minutes or so ; and to this fact, now understood by 
 most teachers, should be added that the child's eye 
 will not bear anything like the continuous strain that 
 an adult's will bear. 
 
 Children differ greatly in this respect, no doubt ; 
 but the State should not exact tasks which are likely 
 to injure even a small proportion of the whole. 
 
 A school for young children should present a very 
 different aspect from that offered by an academy. 
 The eyes should frequently wander. If academic 
 tasks are given, the evidence of momentary fatigue 
 and inattention should not be interdicted. If the 
 school is held in the afternoon, in summer, what can 
 prevent an occasional nap ? (It may be remarked, 
 by the way, that no one should read while sleepy, or 
 just after waking.) A rational regimen for children 
 6 
 
62 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 should include vigorous play, or mechanical or agri- 
 cultural instruction, for a considerable part of the 
 day, with very limited hours of study. The latter 
 must be interrupted, for the youngest children every 
 quarter of an hour, by a change of position, stand- 
 ing, walking about, and by change of study ; for 
 older children the intervals may be less frequent; but 
 until maturity is nearly reached (say until the age of 
 sixteen), it is best to have a complete break at the end 
 of every hour for a few minutes at least, with enforced 
 cessation of eye-work. 
 
 If it be proved, as it has been over and over again 
 in England, Germany, and America, that children 
 under twelve learn as much in three hours a day as in 
 five, there would seem to be no excuse whatever for 
 the cruel custom of confining them for the present 
 period, with the consequent (we may fairly say the 
 consequent) inevitable injury to the eyesight of many. 
 Parents are not to be blamed for desiring that their 
 children shall gain knowledge rapidly ; but it is to be 
 feared that it will be long before they practically as- 
 sent to the truth of the proposition, that young chil- 
 dren become tired after three hours of study, and that 
 
 Three hours of good work are better than five hours 
 of poor work. 
 
 Children not infrequently have far-sighted eyes, 
 which are not fitted for continuous work upon near 
 objects, and which, of course, cannot be made fit by 
 
CARE OF THE EYES. 63 
 
 any effort of the will. This defect is very liable to 
 be neglected. It often causes headaches, which may 
 easily be attributed to a difficulty of the brain. 
 Convergent squinting is very liable to be the result 
 of neglected far-sight in children. The remedy for 
 far-sight is very. simple indeed, consisting in the use 
 of convex glasses. It is utterly useless to spend time 
 on other methods ; either the child must give up 
 study, and all work requiring the inspection of near 
 objects, or he must wear glasses constantly for such 
 work. 
 
 When near-sight is considerable, glasses should be 
 worn "as a. part of the eye." If it is very consid- 
 erable, two pairs must be used one for far objects, 
 the other, much weaker, for use in writing and read- 
 ing. It is certain that any degree of near-sight 
 which compels the child to stoop to work at ordinary 
 well-made desks is productive of congestion and 
 strain in continued study, which is highly prejudicial 
 to sight ; this injury may be avoided easily, comfort- 
 ably, and safely by the use of weak glasses. 
 
 It is proper to warn teachers of the contagious na- 
 ture of certain cases of conjunctivitis (inflammation 
 of the outer covering of the eyeball, ophthalmia), 
 and of inflammation of the edge of the lids. A 
 physician is the proper judge of such cases. 
 
 All spectacles or eye-glasses should be selected by 
 an oculist, /. e. , a physician trained to the special 
 care of the eyes, and never by a mere optician. 
 
CHAPTER VIII. 
 
 SCHOOL-DESKS AND SEATS. 
 
 AMONG the prominent causes of deformity of 
 the spine and of near-sight among scholars, is 
 the disproportion or otherwise bad construction of 
 these necessary pieces of furniture. 
 
 "To bad positions in writing, drawing, at the 
 piano, etc., also while standing during recitations 
 (upon one foot) ; to carrying weights, heavy books, 
 for example, more on one arm than the other; to 
 too much exercise of one arm, while the other is 
 comparatively idle, can undoubtedly be traced the 
 majority of these curvatures (/. <?., rotato-lateral cur- 
 vature of the spine). But it is not malposition alone 
 that causes the trouble. It is likewise due to long 
 continuance in one position, which at first may be a 
 good one, but which, if continued for a considerable 
 length of time, becomes changed, from simple fatigue 
 of a certain set of muscles, into a bad one. These 
 relax ; sometimes one muscle or set of muscles gives 
 way ; sometimes another set. The burden of support 
 is consequently thrown, to a great extent, upon the 
 
 64 
 
SCHOOL-DESKS AND SEATS. 65 
 
 ligaments which bind the vertebra together. These, 
 in a young person, are soft ; their elasticity is soon 
 overcome, and they are stretched. The chain of 
 bones of which the spine is composed yields. The 
 muscles and ligaments no longer do their work, and 
 the superincumbent weight of the head and shoulders 
 bends the chain, or perhaps the preponderance of 
 other muscles, not so easily fatigued, disturbs the 
 equilibrium, and a curve is the result. This curve 
 may commence in the dorsal region, between the 
 shoulders, or it may begin in the loins." * 
 
 Such a curve is easily straightened at first, but 
 becomes a " fixed fact " after a while, owing to a 
 permanent change in shape assumed by the vertebrae 
 under the influence of continued pressure. 
 
 The faults in school-desks and seats which tend to 
 produce deformity and defects of sight are the fol- 
 lowing : 
 
 1. Desk too low, causing a forward stoop, with 
 tendency to congestion of the head and formation or 
 increase of near-sight. 
 
 2. Desk too high, causing undue elevation of one 
 shoulder, usually the right, with tendency to spinal 
 curvature. 
 
 * Buckminster Brown, M. D. : " Influence of the Prevailing 
 Methods of Education on the Production of Deformity in Young 
 Persons," etc. Lecture delivered before the American Social 
 Science Association, Department of Health, 1879. 
 6* E 
 
66 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 3. Desk too far from the seat, with stoop of the 
 body, injuring the eyes. Both here and in No. i 
 there is danger of injuring the health by compression 
 of the abdomen and chest ; dyspepsia, small chests, 
 round shoulders. 
 
 4. Flat desk-lid, interfering with freedom in writ- 
 ing, disadvantageous as respects receiving the light, 
 and compelling the child to hold up his book in order 
 to see. 
 
 As to seats, we have : 
 
 5. Seat too high, so that the feet are not supported, 
 and the legs grow weary. 
 
 6. Insufficient support for the back, causing fatigue 
 and improper attitudes, and consequent tendency for 
 the spine to yield and take a side-curve. 
 
 7. Seat not hollowed suitably, causing pain and 
 restlessness. 
 
 8. Well-proportioned desk and seat, not adapted 
 to the age of the child using them. 
 
 In general, discomfort is an indirect cause of 
 deformity, as it invariably leads a child to take 
 improper positions. 
 
 Let us now consider the construction of good seats 
 in detail, making allowance for differences of opinion 
 among authorities. A medical friend of the writer's, 
 who has long and carefully studied the question, and 
 has children of his own in school, concludes that 
 desks ought to be abolished, and arm-chairs substi- 
 
SCHOOL-DESKS AND SEATS. 6j 
 
 tuted. This opinion is only an individual one, how- 
 ever, and we shall assume the necessity of desks. 
 
 The desks used for American public schools are 
 usually fairly good, though there are glaring excep- 
 tions. The newer models usually give a separate seat 
 for each child, which is desirable in the interests of 
 discipline and cleanliness ; and as regards shape and 
 proportion many are praiseworthy. The chairs are 
 commonly made comfortable by a slight backward 
 tilt of the back-piece, and a corresponding upward 
 tilt of the front of the seat-piece. The scholar can 
 thus find perfect support in reading when desired. 
 
 Liebreich considers that " the back ought to be 
 straight, and consist of a piece of wood only three 
 inches broad ; " " not high, and not slanting back- 
 wards;" "the top to be one inch lower than the 
 edge of the table for boys, and one inch higher than 
 the edge of the table for girls." 
 
 The national characteristics are shown in this dif- 
 ference. The American seat is thoroughly easy to 
 lean back in ; the German seat is suited to keep the 
 child in an erect, semi-military attitude, with right 
 angles at the knees and hips ; and, in point of fact, 
 it does keep him so, by the help of discipline. 
 
 What are the requirements of a good seat and 
 desk? 
 
 First, it may be said, it is necessary that they 
 should not tend to produce deformity of the spine. 
 
68 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 It should be remembered, however, that a child is 
 not, or ought not to be, kept sitting very long at a 
 time fifty minutes at the most. He does not re- 
 quire a chair to lean against continuously, but for 
 occasional support by way of change. To quote an 
 expression of Professor Henry J. Bigelow's (Harvard), 
 11 Rest against a well-made chair-back at will, change 
 of posture and variety of movement at will, seem 
 to me the best prophylactic against curvature." 
 Whether a perpendicular back or a tilted back is 
 used is not essential ; either kind, if rightly made, 
 is comfortable. 
 
 Second, an upright position in writing is indis- 
 pensable ; yet it is extremely rarely seen. The seat 
 must at least not interfere with such a position. The 
 desk-lid must not project so far as to touch the 
 stomach ; but that fault is hardly likely to occur. 
 
 The German plan of an upright back probably 
 assists in forming the habit of sitting erect, and is on 
 this account desirable. It seems to me perfectly 
 suitable for all children who have not a commencing 
 curvature of the spine. If the latter condition ex- 
 ists, or if there is a tendency to it, a slightly inclined 
 seat is better, as giving more perfect rest or relaxa- 
 tion. Not that such relaxation should be maintained 
 throughout the time of study, but it should be per- 
 mitted at the scholar's will. 
 
 The child who is sitting erect, with the knees at 
 
SCHOOL-DESKS AND SEATS. 69 
 
 right angles, the back against an upright support, and 
 the wrists on the table, is well balanced. The posi- 
 tion is comfortable, not because of the amount of 
 support given, but because the support is well placed. 
 It is suited to a well and vigorous person, although it 
 does not give so much rest to the over-fatigued body 
 as a tilted seat does. 
 
 If the light is bad, children cannot be prevented 
 from stooping. 
 
 Near-sighted children should be placed in the best 
 light, and, if the defect is marked, should have weak 
 glasses to read or write with. 
 
 If the desk and seat are suitably proportioned, the 
 former will be only from six to ten and a quarter inches 
 higher than the latter; and the book will be from 
 fifteen to eighteen inches distant from the eyes of a; 
 scholar sitting upright. Near-sight is not uncommon 
 to an extent which makes it uncomfortable or impos- 
 sible to read at those distances. It is thought by 
 modern ophthalmologists, in such cases, much safer 
 to give a pair of weak glasses than to permit a child 
 to get the habit of stooping forward, which, of itself 
 tends to increase near-sight. 
 
 The most luxurious position in writing is one in 
 which the back is well supported, with a lean back- 
 ward, and the desk-lid comes pretty well forward, in 
 fact, within three or four inches of the stomach. 
 Desks have been constructed with this object; but 
 
7O SCHOOL AND INDUSTRIAL HYGIENE. 
 
 scholars will not write leaning back. The posture 
 may be enjoyed for a time, but it interferes with 
 other work; it is interrupted by reaching to dip the 
 pen, to get books, etc., and the support at the back 
 is soon abandoned for the more congenial one af- 
 forded by the elbows resting upon the desk. 
 
 It is an excellent thing if the lid of the desk can 
 be made in two pieces, hinged together, so that the 
 piece next the scholar can be raised to an angle of 
 40 or 45, and form a book-rest. 
 
 It seems to me difficult to maintain an absolute 
 statement regarding the proper shape of seats. The 
 reader sees that there are good arguments both for 
 the tilted and the straight seat. There is good au- 
 thority for saying that the back should be fully 
 supported in a slightly tilted posture in writing; but, 
 in view of the necessity in after life of writing in the 
 erect position, it would seem that the child should at 
 least be taught to do it so. 
 
 The child may take any position he likes, provided 
 he does not keep it long. The more he varies his pos- 
 ture from moment to moment the safer he is. But he 
 does not usually vary it much in writing; he gets one 
 or two favorite bad positions, and only varies them in 
 degree. It is excessively hard to change such habits 
 when once formed. The primary school is the place 
 to form the child in this respect. It is, however, 
 unnatural for a young child to sit long in one posture. 
 
SCHOOL-DESKS AND SEATS. J\ 
 
 A primary class must be allowed to write a few min- 
 utes only at a time ; by frequent breaks a good deal 
 of writing may be finally performed. 
 
 With these precautions, classes of young children 
 may be drilled in the art N of sitting up in a cor- 
 rect form. In writing, it is safest to sit squarely 
 facing the desk (for sidelong attitudes engender the 
 corkscrew, spiral curve of the spine). The upper 
 part of the trunk must be straight, the head bowed 
 as little as possible ; " the shoulder-blades, both of 
 the same height, are, together with the upper arm, 
 freely suspended on the ribs, and in no way support- 
 ing the body ; both elbows on a level with each other, 
 and almost perpendicular under the shoulder-joint, 
 without any support ; only the hands and part of the 
 fore-arm resting on the table. " [Liebreich.] If lean- 
 ing against the back of a chair in writing, some sup- 
 port is naturally given to the elbow from behind. 
 
 A child who is expected to write more than half an 
 hour must have a full support for the back, at least as 
 high as the shoulders. 
 
 The same is true of piano- practising. There must 
 be a back-rest and a foot-rest also ; the latter is easily 
 supplied by a hassock or foot-stool. 
 
 The point where support for the back is most 
 needed, for work of moderate duration, is the sacrum, 
 or bone on which the spinal column rests. This bone 
 is curved, and the support given by the curve at the 
 
/2 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 back of a saddle is exactly what should be found in a 
 good seat. For weakly children, a support for the 
 whole back is also necessary. 
 
 For protracted work, also, unusual support may be 
 said to be necessary. But there should be no pro- 
 tracted work without breaks. 
 
 The seat must be large enough to support the thighs 
 for nearly their whole length. 
 
 A "carved" seat, /. e., with a saucer-like hollow 
 of elongated shape to sit in, saves much of the pain 
 which comes from sitting on flat boards. 
 
 Settees are decidedly uncomfortable and unsuitable. 
 They do not encourage sitting erect, for the backs are 
 much tilted ; they do not support the bottom of the 
 body properly, and the whole weight tends to slide for- 
 ward ; they are not suitably carved, and press directly 
 on the tuberosities, or bones that are sat upon. 
 
 A foot-rest should be provided for several reasons. 
 
 The term "distance" is technically used by the 
 Germans to express the distance between the edge of 
 the chair and the perpendicular line dropped from 
 the edge of the desk. Authorities differ, even in 
 Germany, as to what the distance should be; but the 
 most approved opinion seems to be that it should 
 equal zero (the plumb-line grazing the seat), or a 
 minus quantity (the line falling on the seat). Lieb- 
 reich directs that it shall be zero for writing, and five 
 inches for reading, which is unobjectionable, as his 
 
SCHOOL-DESKS AND SEATS. 73 
 
 desk has a hinged lid which turns up, and assumes an 
 angle of 40 for reading. He remarks that 
 
 "If the child has to read a book placed on the 
 table at too great a distance, it sits on the edge of 
 the seat, a very unhealthy and fatiguing position. It 
 rests the body on the two arms, and, if the difference 
 between the [height of the] desk and seat is too great, 
 the chest is supported by the projecting shoulders, 
 instead of the shoulders resting on the thorax. Soon 
 this position becomes too fatiguing ; the head, bent 
 forward, becomes too heavy, and must be supported 
 by one or both hands at the temples, or by the chin 
 resting upon both arms. Thus every possible modifi- 
 cation of the two positions immortalized by Raphael, 
 in the two angels at the feet of the Sixtine Madonna, 
 is adopted by the children ; but while the angels look 
 into the far ether, our children stare into a book, 
 which, in one of these positions, is only two or three 
 inches from the eye ; and, in the other, sideways from, 
 the head, and therefore at an unequal distance from 
 the two eyes. 
 
 " It is still worse when writing; with desks and 
 seats of the ordinary form, only one arm rests on the 
 table this is generally the right, while the left 
 hangs so that the elbow approaches the left knee, 
 and only the tips of the fingers hold the book on the 
 table. The edge of the book is no longer parallel 
 with the rim of the table, but slanting, or even per- 
 7 
 
74 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 pendicular to it. If we observe the position which 
 the upper part of the body assumes, we find that the 
 lumbar vertebrae bend forward, those of the chest 
 towards the left, and those of the neck forward, with 
 an inclination to the right ; at the same time, the 
 lower part of the shoulder-blade stands too far off 
 from the ribs, and is elevated too much towards the 
 right, and the shoulder-joint is raised and pushed 
 forward. To be in such a position for several hours 
 of the day, at a time when the youthful body is 
 rapidly developing, must naturally produce bad re- 
 sults." The author then speaks of spinal curvature 
 as thus caused, and adds that "the period of the 
 development of spinal curvature and short-sighted- 
 ness coincides exactly ; and they seem to form a 
 circulus vitiosus, in so far as short-sightedness pro- 
 duces curvature, and curvature favors short-sighted- 
 ness ; while evidently the same bad arrangements are 
 at the foundation of both these anomalies." 
 
 The edge of the desk should be of such a height 
 that, as the child sits upright and lets the arms fall 
 freely, the elbows are about an inch lower than the 
 edge. For girls, the desk may be one-half or three- 
 quarters of an inch higher than this. 
 
 It is a very common fault to furnish school-rooms 
 with desks of only one size. The diversity of height 
 among children, differing even only by two or three 
 years, is such that three sizes ought to be kept in 
 
SCHOOL-DESKS AND SEATS. 
 
 75 
 
 each class of a " graded school; " and in a school 
 of mixed ages, a larger number. To satisfy all re- 
 quirements, eight sizes are needed, as indicated in 
 the accompanying table, which is quoted from Var- 
 
 Varrentrapp's school-desk and seat, as used by the youngest 
 classes. 
 
 This is adapted to all ages by changing the seat only. The 
 dotted lines of the seat give the position and dimensions which 
 are suitable for the older scholars, who can dispense with the 
 foot-rest. The distances i (36.4 centimeters) and h i (5.2 cen- 
 timeters) remain the same for all children ; the " difference," 
 ip, is slightly increased for the older ones. 
 
76 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 
 
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SCHOOL- DESKS AND SEATS. // 
 
 rentrapp. The table is especially valuable as giving 
 the correct heights for the chair and the desk-lid, 
 which are the chief factors (see columns 3, 4, 5). 
 The edge of the lid overhangs the seat by about two 
 inches. If the height of the chair is reckoned from 
 the foot-rest, the latter is supposed to be directly 
 under the knees. The chair-seat is, in fact, much 
 higher than is common in our schools, which en- 
 courages the habit of keeping the knees at right 
 angles. 
 
 A rest may properly be placed under the desk. 
 The figure represents a desk which raises the scholar 
 a good deal (without interfering with comfort), the 
 object of which seems to be to facilitate the master's 
 inspection of the writing. 
 
 To complete this account, it is necessary to describe 
 the mode recommended by Liebreich.* 
 
 1. One and the same size and model of desk 
 should be used for children and grown-up persons of 
 both sexes. 
 
 2. The adaptation to the height of each child 
 should be effected by varying the height of the seat 
 and the foot-board. 
 
 3. The edge of the table is always to be perpen- 
 dicular to that of the seat. 
 
 * " School Life in its Influence on Sight ; " a lecture delivered 
 before the college of preceptors at the House of the Society of 
 Arts, July 13, 1872. London, 1872. 
 
 7* 
 
78 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 4. No seat is to be without a back, and the top of 
 this is always to be one inch lower than the edge of 
 the table for boys, and one inch higher than the edge 
 of the table for girls. 
 
 5. In all classes where the boys change places, the 
 height of the seat is to be regulated in proportion to 
 the average height of the pupils. 
 
 6. In all girls' schools, in all those boys' schools 
 where the children do not change places, in boarding- 
 schools, and in private school-rooms, the seat of each 
 child should be accurately regulated in proportion to 
 its height. This is effected by a chair, the seat of 
 which can be raised and lowered by means of a screw, 
 while at the same time the back is brought forward 
 in proportion. 
 
 The present writer would say that it seems to him 
 very desirable to select seats that suit individuals, and 
 allow them to retain such seats, instead of shifting at 
 the monthly or weekly change of rank. There is 
 also, in some cases, much advantage in placing the 
 near-sighted, the partially deaf, or the unruly near 
 the front. 
 
CHAPTER IX. 
 
 A MODEL SCHOOL-ROOM. 
 
 T TNDER this heading, I wish to state a number of 
 \U points which have various bearings on the health 
 of scholars and teachers in an ordinary class-room. 
 
 Shape. For reasons which will appear, a parallel- 
 ogram is desirable, with the teacher's platform and 
 desk at one end. This form is better for acoustic 
 reasons than a square ; and it gives the teacher better 
 command over the pupils than if the desk is in the 
 middle of one long side. 
 
 Length. The limit of distance at which large, 
 clear writing on the blackboard is easily seen (with 
 letters 2| inches in height) is about thirty feet. There 
 should be a space between the rear row of desks and 
 the wall, which may add two or three feet. The 
 length of the room should, however, in no case ex- 
 ceed forty feet (Erismann), and is limited by Var- 
 rentrapp, wez, and others, to nine or ten meters (30 
 to 33 feet). 
 
 Width. This is restricted by the fact that all the 
 windows are supposed to be placed on one of the 
 
 79 
 
8O SCHOOL AND INDUSTRIAL HYGIENE. 
 
 long sides of the room ; and that these windows will 
 not light up a room effectively if its depth exceeds a 
 certain ratio to the height of the window. This ratio 
 is commonly set as 3 to 2 ; so that if a window-head 
 is fourteen feet above the floor (which is rarely the 
 case), the light will penetrate effectively to a distance 
 of twenty-one feet. Again, allow three feet for the 
 width of the passage beyond the farthest desk, and 
 twenty-four feet is seen to be the extreme allowable 
 width; or, if the window is 13^ feet high, about 
 twenty-three feet. 
 
 Height. This is limited to thirteen or fourteen 
 feet, by practical considerations, such as the expense 
 of building and heating. 
 
 Windows. The direction from which light comes 
 to the desk of a scholar is of great importance. It 
 is universally agreed that for general purposes that 
 which comes from the left is best. Almost all au- 
 thorities of scientific weight order that this be made 
 the rule, and, in fact, the Germans generally forbid 
 the use of windows upon any other side of the room. 
 It may be said that light from the right hand is as 
 useful to read by as that from the left. This is true ; 
 but in writing, such a light is very annoying. And 
 a combination of lights from the right and left throws 
 a double set of shadows, which is also trying to the 
 eyes. The same may be said of a combination of 
 light from the left and rear. 
 
 The worst light, in general, is that from directly 
 
A MODEL SCHOOL-ROOM. 8 1 
 
 in front of the scholar. It pains the eye, if intense. 
 If moderate in amount, it still inflicts an unconscious 
 strain on the retina, by throwing on it an illumination 
 which would be healthful if the eye were not at work 
 on small objects, but which is a needless tax on the 
 endurance of the laboring organ. Practically, any 
 one may prove that it is much harder to read with 
 the book held towards a window than with the book 
 held away. This difficulty is felt by the scholar, who 
 tries to remedy it in his own way. 
 
 Sometimes he holds the book closer to his eyes, 
 which aids in developing near-sightedness. Some- 
 times he twists his body around so as to receive 
 the light on his book in the natural way, and this, 
 if allowed, may contribute to " one-sidedness " or 
 crookedness of figure. 
 
 Windows in the rear, fronting the teacher, are very 
 annoying to the teacher, and considerably lessen the 
 power of watching the scholars ; while for the scholars 
 they are exceedingly bad, as they throw the shadow 
 of the person on the desk or book. 
 
 The most agreeable light to write by is one which 
 comes from a pretty high point, and strikes the page 
 at a wide angle. An ordinary window will not give 
 such a light, but may still be found very suitable if 
 placed on the left of the scholars. 
 
 Light entering horizontally has hardly any value 
 for a student who has to use a flat desk. The ex- 
 F 
 
82 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 periment may easily be made by any one. Hence, 
 the lower panes of windows are of little use as admit- 
 ting light for study. The upper parts are by far the 
 most important, because they throw light to the op- 
 posite side of the room, and also light up the ceiling, 
 which in reality is a principal source of light. By 
 the use of iron beams, the window-heads may be 
 brought within a few inches of the ceiling. 
 
 The reader will easily see the objections to a semi- 
 circular arrangement of the seats in a room (as is often 
 the case in primary schools). It is not an advantage 
 to the teacher to have to turn her head to the right and 
 the left, as must be done if her chair is near the imagin- 
 ary centre. Nor can such a group of seats be fairly 
 lighted without throwing light directly in the faces 
 of some of the scholars, not to speak of the teacher. 
 
 The size of the windows, taken collectively, should 
 equal at least one-sixth of the floor-space, and ought 
 generally to be more. In the best American schools, 
 it is very much more. 
 
 Shades. The best protection against a hot sun is 
 furnished by Italian canvas screens. Common cloth 
 shades, with rollers, are good ; they had better be 
 rolled at the bottom. Shades with slats are better. 
 
 White daylight, the unaltered light of white clouds, 
 or the clear sky is better than colored light to work 
 by; hence, there is no advantage in tinting the ceil- 
 ing, or in giving it any other than a clear-white color. 
 But the walls at which the inmates of the room must 
 
A MODEL SCHOOL-ROOM. 83 
 
 be frequently looking, and which cast side-lights into 
 the eyes at most times, may be tinted of a bluish, or 
 semi-violet, or neutral hue. 
 
 The blackboards should be so placed as to receive 
 a good light. If put between windows, this is not 
 the case, and the eye is fatigued by the bright light 
 at the side. 
 
 Polished, brilliant, dazzling surfaces, or light-col- 
 ored surfaces on which the sun is shining, should 
 never catch the eye while at work. The floor should 
 be dark and without polish. The sun's rays should 
 never fall on the scholar's work. 
 
 Artificial light has to be used in some cases. It 
 should be given by powerful burners at a considerable 
 distance from the pupils. Ground-glass is bad for 
 shades. Ground or ribbed glass is bad for windows. 
 
 Gas-light is a very good illuminator when the gas 
 is good. But there is a great deal of an injurious 
 substance given off in burning, chiefly consisting of 
 sulphurous acid, which ought always to be got rid of 
 by a special ventilating-cap and flue applied to the 
 gas-flame, so arranged as to lead the spoiled air 
 straight to the house-chimney before it can mingle with 
 the air of the room. The tube may be so managed 
 as to have a powerful ventilating action on the at- 
 mosphere of the room, also. 
 
 Decoration. The sun is the best decorator, and 
 should be let in when this is consistent with other 
 points. Flowers, plants, colored prints, light and 
 
84 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 pretty wood for desks, give an impression of great 
 cheerfulness, which it is very desirable to maintain 
 in the interests of health. The lower part of the 
 wall may be wainscoted, to preserve it and facilitate 
 cleaning. Wall-paper should not be used ; the walls 
 should be finished with a material -that can be cleaned 
 or else whitewashed. 
 
 Architectural ornament is the last thing to be 
 thought of in a school-house, which should be built, 
 first and foremost, to do its work well as we build 
 a locomotive-engine. "Architecture," /'. e., con- 
 siderations of external appearance, may be considered 
 a foe to the health of school-children when it is 
 allowed to absorb school-funds to the neglect of 
 essential internal parts. The use of flanking projec- 
 tions, buttresses, pointed arches, or other features 
 which cut off portions of light, is to be condemned 
 entirely; the exterior appearance of a school-house 
 must necessarily be rather plain in certain respects. 
 
 Closets. The children's outer clothing and um- 
 brellas should not be kept in the class-room, to pollute 
 the air with their steaming exhalations. A closet 
 must be provided with space enough for each child's 
 clothing to hang free of the next one's; and the 
 closet should be warmed, lighted, and ventilated. 
 Its position will naturally be near the class-room in 
 ordinary cases. 
 
 The floor should be of hard, close-grained wood, 
 of a kind which will not easily splinter. 
 
CHAPTER X. 
 
 VENTILATION AND HEATING. 
 
 IT is impossible to do justice to either of these 
 subjects separately. The air breathed must be 
 warmed for a large part of the year. The warmed 
 air must be got rid of by ventilating apparatus, which, 
 again, is often in close relation with that for heating. 
 The annual bills for heating and for ventilation de- 
 pend equally on the price of coal. In practice it is 
 found that, unless planned to work together, the 
 "system" of ventilation often contradicts the "sys- 
 tem" of heating, and vice versa. Need we speak of 
 careless masons, carpenters, and tinsmiths, who ren- 
 der the best plans of the sanitary engineer void and 
 of none effect ? 
 
 In a word : All heating apparatus, with trifling ex- 
 ceptions, ought to be apparatus for supplying fresh 
 air. It is impossible to consider the problem of in- 
 troducing air without considering that of discharging 
 it. It is absurd to hire one man to get the air into a 
 room, and another to get it out. And yet this is 
 practically done in assigning contracts. 
 
 8 85 
 
86 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 It is not necessary that the same party should do 
 all the work, but that the different parties should be 
 controlled by one authority. 
 
 Quality of the Air. It is well to have the inlet of 
 the air-duct for a furnace protected from the more 
 violent winds. It is very desirable to place it at 
 a sufficient height (say ten or twelve feet) from the 
 ground, in order to avoid low-lying strata of polluted 
 air. The neighborhood of privies is certainly not a 
 desirable one ; yet even this circumstance may exist, 
 as was recently the case in a school in one of the 
 large northern cities, with most disagreeable results. 
 
 The furnace ought not to leak gas. As a rule, the 
 draught is constantly inward towards the fire and 
 smoke, so that, even if there are small cracks in the 
 furnace or flue, there is no discharge of gas. It is 
 unsafe to have a valve in the flue above the furnace. 
 Some valves are expressly made so as to shut only 
 half-way, or to leave half of the flue always open ; 
 but it is better to regulate the draught, if necessary, 
 by dampers to the inlet of air under the fire-pot. 
 
 A large furnace is best, one large enough never 
 to need to be made red-hot. Slow combustion is 
 economical ; but, much more than that, it seems to 
 supply an air which has not been "killed" or 
 " burnt/ 1 A little very hot air is known by expe- 
 rience to be distressing, when a large supply of air 
 heated only to about 90 is perfectly pleasant. The 
 
VENTILATION AND HEATING. 8/ 
 
 discomfort is due to the want of fresh air; partly, 
 also, it may be, to a chemical action of the red-hot 
 iron on the air, or the transit of carbonic oxide. 
 
 The addition of a liberal amount of water by 
 evaporation, in dry, cold weather, is a necessity. At 
 least, some people are very unpleasantly affected by 
 air that is not so treated. Nevertheless, there are 
 hospital-wards (as in the City Hospital at Boston) 
 heated by the simple introduction of abundant sup- 
 plies of fresh air that is simply warmed, and not made 
 moist ; and the result seems eminently satisfactory. 
 
 " Indirect radiation " is a term used for those cases 
 where air is heated at a central point and conveyed 
 in pipes to the rooms. "Direct radiation " is the 
 use of radiators in the rooms ; it generally implies 
 the absence of means for introducing fresh air, and 
 as such is objectionable, unless for heating entries or 
 very exposed points. 
 
 Apparatus for heating by steam or by hot water are 
 generally to be praised. The great point to attend 
 to is, that the air be not heated in excess. 
 
 Stoves have several objectionable pomts. In the 
 first place, they overheat a part of the room, and 
 leave other parts cold. This is obviated in a degree 
 by a screen. But a still more important objection to 
 most stoves is the want of a method for introducing 
 fresh air. Almost any ordinary stove can be altered, 
 however, at moderate expense, so as to give a large 
 
88 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 supply of fresh warmed air. The "fire on the 
 hearth" is an example of the way it is done. A 
 cylindrical metal screen may be placed around the 
 stove ; it should reach to the floor, and rise as high 
 as the stove. Under the floor a pipe is to be led 
 from the space enclosed by this screen to the outer 
 air ; the pipe passes through the house-wall, and may 
 have a valve at any convenient place. This converts 
 the stove into what is commonly called (when placed 
 in a cellar) a "portable furnace" with "hot-air 
 box." The fresh air enters the room over the top of 
 the screen. This plan removes the objections which 
 attach to air-tight stoves. 
 
 Further use may be made of the stove-funnel by 
 causing it to warm another tube which serves for ven- 
 tilation only. Thus, the smoke- funnel may be en- 
 closed in a larger pipe, which is not closed either 
 above or below, but, starting at a proper point in the 
 room, rises with the funnel through the roof, and 
 discharges its own quantum of impure air sucked 
 from the room. 
 
 If the chimney-place is bricked up, a hole may be 
 knocked in the brick-work, or at a higher point in 
 the chimney. 
 
 A fire in a fireplace in an ordinary city house 
 may be supposed to exhaust enough air from a room 
 to make it wholesome for ten persons. If several 
 gas-jets are burning, this is no longer true ; for a gas- 
 jet of the ordinary kind spoils as much air as two or 
 
HEATING AND VENTILATION. 89 
 
 three persons. Of course, an open fire is but a par- 
 tial means of ventilation for a large school-room, 
 besides being very wasteful of fuel. 
 
 The requirements for good ventilation in a school 
 are, that the air shall be furnished in a fresh volume 
 of from 40 to 100 cubic meters (1400 to 3500 cubic 
 feet) hourly to each scholar. If the room is spacious, 
 there may be 300 cubic feet of space per scholar, so 
 that the whole air-contents of the room are required 
 to be evacuated from five to twelve times an hour ! 
 while, if the room is of moderate size, say 200 cubic 
 feet per head, the change must go on faster the en- 
 tire contents must be changed once every 8J minutes ! 
 And this can be done, and is done, without causing 
 a draught. But we can see at once, that if the room 
 is crowded, and the air is wholly changed once mfour 
 minutes to correspond, the draught will be great. A 
 closely-packed room is not well ventilated for just 
 this reason; the inmates cannot bear the draught. A 
 certain amount of "elbow-room " must be given, or 
 the air-currents will not be borne. There should be, 
 therefore, about fifteen square feet of floor-space for 
 each inmate of the room, or from fifteen to twenty. 
 
 These considerations lead directly to a fact which, 
 though it stares us in the face, is seldom fully compre- 
 hended ; that fact is, the expensiveness of ventilation. 
 
 Every house requires a considerable amount of heat 
 to keep its walls warm. Let the house and contained 
 8* 
 
gO SCHOOL AND INDUSTRIAL HYGIENE. 
 
 air be raised to 70, and let the supply of heat from 
 the furnace be cut off, the whole amount will pass 
 away through the walls in a day or two. This is 
 a necessary waste ; or at least it can only be dimin- 
 ished by furring and thickening the walls and by 
 doubling the windows. But to extract every eight 
 minutes a school-houseful of freshly heated air, and 
 send it up over the ridge-pole, would seem extreme 
 folly to any one unacquainted with the facts and the 
 necessities of the case. This is not the place to ex- 
 plain these necessities ; suffice it to say that the school- 
 house is a peculiar place, a very closely packed place, 
 and subject to those peculiar morbid influences which 
 attend the close packing of human beings, and which 
 are so distinctly proved to exist, that the death-rates 
 of different cities are high or low in proportion to 
 the number of people dwelling on the square acre. 
 Fortunately, we have it in our power, by the judicious 
 arrangement of flues and the liberal use of coal, to 
 render these school-rooms as wholesome as the aver- 
 age dwelling-house. I do not say that this is gen- 
 erally accomplished, for it is not, even in enlightened 
 cities. 
 
 In a large school, with a thousand or more pupils 
 (though it is certainly undesirable to have even as 
 many as a thousand), a system of flues leading to a 
 heated chimney is often used to carry off bad air. If 
 the draught in this chimney could be maintained by 
 
HEATING AND VENTILATION. gl 
 
 a little steam-engine and fan, an economy in fuel 
 could doubtless by made, and the experiment should 
 be tried in some school where there are already steam- 
 boilers. 
 
 The janitor, under proper oversight, may be made 
 to feel the importance of his duties, and the impro- 
 priety of those customary negligences by which he 
 saves himself trouble and lessens the amount of coal 
 burned. If he be found incapable of taking a proper 
 pride in his duty, he should be replaced by another. 
 
 One point is seldom conceded by this class of men. 
 The cellar air is their native element, and they sel- 
 dom realize that it is an impure element. They do 
 not practically know that cellar air is generally un- 
 suitable for the supply of the furnace air-box. If 
 not prevented, they will at times close the outer orifice 
 of the duct, and open a slide which admits the cellar 
 air into the furnace box. It can rarely be safe to do 
 this. 
 
 There are certain contrivances for letting fresh air 
 enter a room unwarmed without striking the scholars. 
 One of the best and simplest is to place a narrow 
 piece of wood under the lower sash. The effect is to 
 leave a narrow opening between the sashes, which 
 admits air in an upward direction. 
 
 Another plan is to use a wider board, and pierce it 
 with one or two wide pipes bent at right angles and 
 provided with valves ; this, also, throws the wind 
 
92 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 upward. This is called the " Maine " ventilator. 
 Sometimes it is modified by covering the inlet with 
 tin, perforated with fine holes. The object of doing 
 this is to prevent the inflow of a great volume of air 
 in the form of a draught ; but it really shuts out about 
 three-quarters of the air. Then there is a contrivance 
 for letting air enter through a sifter of. cloth, in the 
 upward direction ; but the cloth can easily be per- 
 ceived to lessen the ventilating effect most essentially. 
 A better method for sifting the air (because simpler 
 and cheaper) consists in simply tacking very thin 
 flannel to a mosquito-frame, in the place of gauze, 
 and inserting the frame as .is usually done. If it is 
 thought desirable, both sides of the frame may be 
 thus covered. The plan is "found effectual. 
 
 Dr. Keen, the editor of this series, " tacks or pins 
 a piece of cloth or newspaper across the lower ten or 
 twelve inches of the window-frame and to the win- 
 dow-sill ; then raises the lower sash one inch to six 
 inches, according to the weather. By this means, 
 the draught is made to pass in the upward direction, 
 both from between the two sashes and from the open- 
 ing beneath the lower sash." * 
 
 These inlets for fresh air, however, will not always 
 let air pass. On a "close day," when there is no 
 wind, even wide-open windows will not sufficiently 
 ventilate a room full of people. If windows are 
 
 * See " Winter and its Dangers," Health Primer in this series, 
 by Dr. Osgood, in which these various plans are illustrated. 
 
HEATING AND VENTILATION. 93 
 
 placed on two sides of a room, ventilation is much 
 more likely to do good ; if on opposite sides, all the 
 better ; but in school-rooms there is an objection to 
 this plan, owing to the interference of the light. The 
 true value of these window arrangements seems to me 
 to depend on the existence of a chimney or other 
 similar draught-compeller in the room. If air is 
 sucked out by the flue, air will readily enter by even 
 small openings in windows; but if not, a window 
 opened a foot or two will often have but little effect. 
 
 Temperature. It maybe proper here to call atten- 
 tion to the disturbing effect which excessive heat has 
 on the circulation in the brain, especially when the 
 air at the floor is cold and the air at the level of the 
 head is hot. A temperature of sixty-five is agreeable 
 to healthy children, if they have an occasional chance 
 to stir themselves, and if their clothes are dry. Sev- 
 enty should not be exceeded ; and it is desirable that 
 no two parts of the room should differ more than two 
 degrees (2 Fah.). 
 
 Wet clothing must not be allowed to remain on the 
 scholar's person. This must be an imperative rule, 
 enforced by the teacher's personal attention. 
 
 It is hardly necessary to mention colds in the 
 throat, head, and lungs as favored by such neglect. 
 It is, however, easily forgotten that catarrhal affec- 
 tions of the eye and ear, producing impaired sight 
 and hearing, and menstrual irregularity, are also 
 liable to be caused or aggravated by such neglect. 
 
CHAPTER XL 
 
 SITE, DRAINAGE, ETC. 
 
 SITE OF HOUSE. This should be as healthy as 
 possible. The character of the sub-soil should 
 be known, in order that proper precautions may be 
 taken against dampness, if clay, hard-pan, or rock 
 forms an obstacle to natural drainage. 
 
 Some protection from the north winds is desirable ; 
 but the bottom of a valley, or low-lying ground, is 
 generally objectionable. 
 
 The plan should be such that the sun may enter 
 every room of the house in the winter as well as 
 summer. 
 
 The lot ought to include play-grounds in the city; 
 at the least, there should be space enough about the 
 house to allow sufficient light to enter the windows. 
 This requires a considerable outlay for land, which 
 seems to be regarded as superfluous in some large 
 cities. In the recent competition between plans for 
 model schools, at New York, this point was forced 
 upon the notice of the committee of award. In their 
 report, they claim that a public school building in a 
 
 94 
 
SITE, DRAINAGE, ETC. 95 
 
 large and densely populated city should not occupy 
 more than half the lot; and that, further, "at least 
 two adjoining sides of the building should be freely 
 exposed to light and air ; for which purpose they 
 should be not less than sixty feet distant from any 
 opposite building." 
 
 The terms of competition in this case were, that 
 the house should accommodate eight hundred chil- 
 dren, and should be built on a lot one hundred feet 
 square, facing north, enclosed by buildings of average 
 city height on the other three sides. As a result of 
 the competition, it appears to the committee that 
 such a house cannot probably be built on such a lot 
 consistently with the requirements of health. The 
 children can be provided for, but the light will prob- 
 ably be defective in many rooms even with the best 
 arrangement. 
 
 Height of House. One of the points to be aimed 
 at in the sanitary reform of schools is a reduction in 
 the height of buildings. A strict system of drill 
 may prove the surest precaution against accident in 
 case of fire, and deserves to be kept up. But there 
 are many children particularly girls who ought not 
 to be required to ascend many stairs. In the course 
 of a forenoon, several lessons may have to be recited 
 in different parts of the house, with going up and 
 down ; and the recess or recesses are, or ought to be, 
 taken in the school-yard. Decided injury from exer- 
 
96 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 tion of this sort occurs; in occasional cases ; and it is 
 a disadvantage to any girl to be placed so high that 
 she is unwilling to take the trouble to go out of doors 
 at recess. 
 
 Sewerage. It is doubtful whether privy accommo- 
 dations, or water-closets, for a large school, can safely 
 be placed in the cellar. There will pretty surely be 
 a nuisance of greater or less extent, which is much 
 more serious than if it existed on an upper story, or 
 in a yard, since the air of cellars must rise more or 
 less into the house. If the plan be tried, let all pre- 
 cautions be taken : if water-closets are used, they 
 should not be of the pan variety, but rather hopper- 
 closets, or some form made entirely of earthenware, 
 and should provide a rapid, abundant discharge of 
 water; if urinals, they should contain no wood-work 
 in any place which can be reached by spattering, and 
 should be made of impervious stone or glass not 
 metal. A long trough of masonry, kept partly full 
 of water, is a good substitute for water- closets. Some 
 closets should be placed on the different stories, in 
 any case. It is far the best if the whole can be put 
 in a tower, semi-detached and accessible from every 
 story of the main building. 
 
 A correspondent from a distant city writes as fol- 
 lows : " From considerable observation and inspec- 
 tion of the public schools, I am sure that the water- 
 closets, on the boys' side at least, are as filthy as they 
 
SITE, DRAINAGE, ETC. 97 
 
 can be ; so filthy, in fact, that no decent boy can or 
 will use them." This state of things is familiar to 
 me as a reminiscence of childhood ; at present my 
 observation, confined to the city of Boston, points to 
 a very great improvement, seconded in many cases 
 by the very anxious care of the masters. But in 
 many cases there is a truly shocking state of things,* 
 descending in one case, reported by a correspondent, 
 to the use of a common waterless privy in the second 
 story of a school, while in country places there are 
 numberless cases of shameful neglect. The old-fash- 
 ioned plan, which allowed all the excrement to lie in 
 a heap on the surface of the soil, is by no means the 
 worst of all these. Where earth is plenty and waste 
 land near by, there is no excuse for not "sanitating" 
 the privy by throwing in a layer of fresh dry loam once 
 in a week or two so as to cover up everything, and 
 removing all the contents together, and burying them, 
 every two or three weeks at longest. This plan, if 
 faithfully pursued, will almost entirely destroy odor. 
 9 G 
 
CHAPTER XII. 
 
 PRIVATE SCHOOLS. 
 
 A FEW points may be added of special application 
 to boarding-schools and private day-schools. 
 
 Both classes of schools are very .often held in com- 
 mon dwelling-houses, very slightly changed by adding 
 an L, or something of the sort. 
 
 Dwelling-rooms and parlors are very often not pro- 
 vided with windows sufficient to light them well for 
 school purposes. They are, unfortunately, often not 
 provided with fireplaces an unpardonable fault. 
 
 As regards light, much may be done to improve 
 matters by using light colors for walls ; by whitening 
 the ceiling ; by cutting down trees in front, and re- 
 moving drapery-curtains within. 
 
 A room with ten or a dozen pupils may be made 
 comfortable (as regards the freshness of the air) by 
 an open fireplace. For a larger number there are 
 needed special arrangements for ventilation, such as 
 openings in the flues at ten feet from the floor and at 
 the floor ; or tin tubes, heated by one or two gas- 
 jets, acting as flues. 
 
 98 
 
PRIVATE SCHOOLS. 99 
 
 It is, of course, desirable not to let more than two 
 pupils sleep in one ordinary room. A great deal of 
 crowding, however, of a very reprehensible sort, may 
 be found in boarding-schools. Under ordinary cir- 
 cumstances, 1000 cubic feet of space should be allowed 
 for one person to sleep in. 
 
 The purity of the air depends on many external 
 circumstances. A house with many windows, on a 
 corner lot, with free exposure to wind and sun, and 
 not very solidly finished in the wood- work, is likely 
 to have much more and better air than one in a nar- 
 row street, with the rear built around. Old houses 
 are often musty ; I will not say incurably so, but their 
 atmosphere is commonly tolerated rather than that 
 trouble should be taken. 
 
 Dormitories should be strictly supervised. A 
 teacher should regulate, or oversee, the admission of 
 air by windows at night. A good dormitory for boys 
 may be made of a long room, with a row of small 
 compartments on each side, each containing a bed 
 and a window ; the partitions, not permanent but 
 screens, not exceeding six feet in height, and the 
 doors consisting of curtains. Ventilation by open 
 windows at the ends may be safely practised in the 
 case of healthy young folks. 
 
 Supervision should be exercised, also, in the inter- 
 ests of morality. Licentious practices are certain to 
 be introduced, unless this is done. A late distin- 
 
IOO SCHOOL AND INDUSTRIAL HYGIENE. 
 
 guished hygienist assured me, that in a boarding- 
 school which he attended, he was sure that all the 
 boys but one or two were guilty of such practices ; 
 and he added that this was not an exceptional 
 school. But a very great deal can be done, by mas- 
 ters who are themselves of pure lives, in checking 
 such tendencies. Teachers, and especially parents, 
 can do incalculable good by suitable explanations to 
 pupils of say twelve years and upwards, who sin far 
 oftener from ignorance than from vice. 
 
 Perhaps less needs to be said in regard to girls ; 
 but it is well known that vicious persons occasionally 
 enter the best establishments, and that the love of 
 imitation misleads even those whose behavior and 
 general intentions are good. 
 
 It may be superfluous to say that girls at a board- 
 ing-school need that kind of care which mothers 
 should give. It may be safe to let steady young 
 women of sixteen or upwards go to large colleges for 
 girls ; but younger girls, in my opinion, ought not to 
 be placed in large schools away from home. The 
 tranquillity, the absence of exciting influences, or at 
 least their absence during a greater part of the day, 
 which prevail in a well-ordered house, are necessary 
 at that age, if ever, in laying the foundations of a 
 firm and steady nervous system. The constant 
 presence of scores or hundreds of other girls, some 
 critical, some vindictive, some too demonstratively 
 
PRIVATE SCHOOLS. IOI 
 
 friendly, is a strain upon the nervous system of r 
 child. 
 
 Children ought to have some hours in the day in 
 which to do exactly what they like, inventing their 
 own amusement, and laughing as loud as they will. 
 
 Boys should have a good gymnasium, and, in 
 the country, place and means for out-door games. 
 Girls should be obliged to have proper shoes (heels 
 not over half an inch high), and should be let out (or 
 led out, if necessary,) to walk twice a day; they 
 ought to learn the habit of walking while at school. 
 
 Music is a fatiguing occupation ; if the scholar is 
 fond of it, it is not less an exertion, and should not 
 be carried far (say not over an hour a day of prac- 
 tice) without a corresponding reduction of study. 
 Arid no prolonged practice should be allowed without 
 suitable breaks, in accordance with general principles 
 which have been fully explained. 
 
CHAPTER XIII. 
 
 COLLEGES. 
 
 IT may be questioned whether college students should 
 be included in a work on "school ' ' hygiene. They 
 are, however, very largely under age and in the grow- 
 ing period. The average age at entrance in the best 
 colleges is about nineteen. In the Amherst statistics 
 it appears that during the four college years they 
 grow in height 1.3 inches and in weight n.i pounds. 
 The two lower classes, at least, are of the age which 
 breaks down in military life. They are unformed, 
 unconsolidated, and none know better than the au- 
 thorities of colleges how ductile their minds are in 
 certain directions not laid down in the curriculum of 
 study. 
 
 The inference from these remarks is plain : the 
 students must not be left to themselves in physical 
 matters. The younger classes, at least, should be 
 compelled to attend regular exercises in gymnastics 
 under the charge of some respected person. The 
 title and position of professor may confer that re- 
 spect, or distinction as an athlete and an ingenious 
 
COLLEGES. IO3 
 
 inventor of apparatus may give it ; but a mere prize- 
 fighter or trapezist is not likely to do well. He should 
 be chosen with the same care as a professor in Chinese. 
 
 The exercises required of a whole class must, nec- 
 essarily, be such as fall far within the capacity of 
 some. They should include a brisk run, free-hand 
 exercises, and exercise with wooden dumb-bells or 
 light clubs. The class is divided into sections, each 
 under the lead of a student. There is no reason why 
 a hundred or more should not exercise at once in 
 this way, with the assistance of music. Thirty or 
 forty minutes a day is sufficient for the purposes of 
 health for most students. Those whose larger mus- 
 cular development craves more work should be put 
 into special classes or allowed to use all kinds of 
 apparatus, but always under the general control of 
 the teacher. There will be students who could be 
 trusted with instructing classes, but most of them 
 have a propensity to lame themselves, and get dis- 
 couraged over the hardest apparatus the moment they 
 first enter the gymnasium ; and, in short, nine-tenths 
 of them are no more fit to be trusted alone than little 
 boys are with firearms. 
 
 The use of the gymnasium is a necessity for those 
 who intend to do boating. The latter exercise, as 
 performed in swift shells, has very little tendency to 
 develop the chest. It brings a great and sudden 
 strain on the heart and lungs, which is very likely to 
 
IO4 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 be injurious in either of two cases : first, if the boy's 
 frame is below a certain minimum of development ; 
 and, second, if, being of fair natural growth, he is 
 not specially trained to chest -power the capacity of 
 the lungs and heart to receive a double amount of 
 air and blood in a given time,. The pulse of oars- 
 men after a race beats at twice the normal rate, and 
 a long and careful training alone can make such a 
 strain safe. If boating is to be encouraged, and I 
 believe it should be, a gymnasium is a necessity. 
 
 It is a great benefit to the students to have good, 
 substantial "commons " provided for them. This is 
 done at Harvard in a very satisfactory manner and at 
 exceedingly cheap rates. Many students injure their 
 health by "boarding themselves" in their own rooms, 
 and this class especially need such a public provision. 
 
 In regard to the structure of college dormitories, 
 it would be well to place them running north and 
 south, so that the sun shall enter every window. For 
 further remarks on the site of buildings, see Chap- 
 ter XL 
 
 The public have been recently excited at the fatal 
 epidemic in Princeton College. There is nothing at 
 all new in such an event ; and if instructive, it is so 
 only in one point, namely, that filth generates disease 
 in seminaries of learning as readily as in New York 
 tenement-houses. 
 
CHAPTER XIV. 
 
 CONTAGIOUS DISEASE. 
 
 IF a person residing in a school is attacked by small- 
 pox, varioloid, scariet-fever, measles, diphtheria, 
 or any contagious disease of "the eye or skin, such 
 person should at once be removed or absolutely 
 isolated. It should be left to the judgment of the 
 physician to decide whether such isolation shall be 
 considered sufficient to permit the other scholars to 
 remain. Such may be thought the case if the school 
 is in the country and has a separate building for an 
 hospital. It may be thought safe for day-scholars to 
 come (e. g., to the rooms in the lowest story, while 
 the patient is in the top of the house) \ but, in gen- 
 eral, prudence will lead to a suspension. 
 
 After recovery, thorough disinfection of the room 
 used by the patient is accomplished by burning two 
 pounds of sulphur. Previous to doing this, all bed- 
 ding is exposed as much as possible by spreading it 
 on chairs, etc. ; and the windows and doors are 
 closed tightly. The wood-work in the room, of all 
 sorts, is then to be sponged repeatedly with solutions 
 of chlorinated soda or carbolic acid. 
 
 105 
 
IO6 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 In the case of public schools, the following rules 
 are suggested : * 
 
 "A certificate of vaccination to be required of every 
 child entering the public schools. 
 
 "Physicians to be required, under penalties, to re- 
 port to local boards of health all cases of dangerous 
 infectious diseases observed by them ; the board to 
 inform principals of schools. 
 
 " The existence of any case of such diseases in a 
 house to exclude the inmates from attendance at 
 schools for a sufficient length of time, the propriety 
 of re-adrnission being certified to by a competent 
 physician. 
 
 "Disinfection of premises and clothing by the 
 board of health in every house where the above dis- 
 eases have prevailed. 
 
 " Medical authority to be designated, for the purpose 
 of advising teachers and pupils, and pointing out to 
 the school committee matters in regard to which their 
 authority might be used to improve the sanitary con- 
 dition of schools." 
 
 * See " Massachusetts State Board of Health Report," 1878, 
 page 252. 
 
PART II. 
 INDUSTRIAL HYGIENE. 
 
 CHAPTER I. 
 
 INJURIOUS EFFECTS OF INHALING DUSTY AND 
 POISONOUS SUBSTANCES. 
 
 IN the present brief sketch an attempt will be made 
 to present some of the principal injuries which are 
 inflicted on workmen in various trades by the noxious 
 character of their work. Some remarks will also be 
 made upon the number of hours of labor in occupa- 
 tions which are not of themselves especially un- 
 healthy; upon accidents from machinery; and, in 
 conclusion, upon the " expectation of life" in differ- 
 ent employments. 
 
 The present chapter has to deal with a large num- 
 ber of trades, and many striking facts. 
 
 Among those which have excited most sympathy 
 and which in truth are adapted to do so are those 
 relating to the deadly effects of certain kinds of dust 
 upon the lungs. The form of consumption which is 
 
 107 
 
IO8 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 thus produced is apt to begin gradually ; though in 
 some trades the artisan is affected in a few days. It 
 is not exactly what is known as tuberculous consump- 
 tion, for it is said that it is not hereditary, and that 
 workmen who are suffering in its early stages are pretty 
 sure to recover if they change their employment for 
 a healthful one. There are a great many kinds of 
 dust inhaled, and the effects are not all alike .in the 
 different trades ; but, in general, there is a certain 
 set of symptoms. 
 
 In "grinders' asthma," for example, there is first 
 an irritant, hacking, dry cough, with a scanty expec- 
 toration of whitish, stringy mucus, from simple irri- 
 tation of the interior of the lungs. This trouble in- 
 creases in time, and the man becomes weaker, loses 
 his breath easily, and breathes with less vigor; he 
 perhaps begins to spit a little blood. If he leaves 
 his dangerous trade at this point, he will probably 
 recover ; if not, he passes into a third stage, where 
 the tissue of the lungs breaks down in spots and is 
 expectorated, leaving cavities; he then surfers from 
 the usual symptoms of consumption, viz. : hectic 
 fever, night sweats, loss of sleep, emaciation, and 
 great difficulty of breathing. 
 
 The effect of certain occupations in producing 
 consumption may be estimated by the statement that, 
 while among butchers, tanners, glovers, coopers, and 
 brewers only from 7.9 to 11.2 in 100 have consump- 
 
INJURIOUS INHALATION. IOQ 
 
 tion, brush-makers have 49. i, file-cutters 62.2, needle- 
 polishers 69.6, and flint-workers 80, in 100. These 
 figures represent European experience, and are taken 
 from a large number of workmen of all classes enter- 
 ing a large public hospital in Berlin. Expressed in 
 words, they signify that while consumption is, unfor- 
 tunately, a common disease, and may be expected to 
 destroy ten per cent, of the population (more or less), 
 there are certain trades so terribly noxious by the 
 production of irritating dust, that those who work at 
 them have consumption from five to eight times as 
 frequently as is usual in other trades. 
 
 It is fortunately the case that great relief can be 
 given by mechanical appliances for carrying off the 
 dust formed in the process of grinding. The stone 
 is boxed in and connected with a flue, which rapidly 
 exhausts the air and its dusty contents from the sur- 
 face of the stone. Several stones can be connected 
 with one common flue in this way. The draught is 
 produced by a fan driven by a small engine of eight 
 or ten horse-power. 
 
 Articles which can be ground wet, as knife-blades, 
 scissors, etc., do not produce this trouble to such an 
 extent ; but the artisan is liable to rheumatism and 
 pneumonia from the wetting of his clothes. 
 
 Certain articles must be ground dry, owing to the 
 necessity of carefully avoiding rust in the finishing 
 process, as in the case of pins and needles. The 
 10 
 
IIO SCHOOL AND INDUSTRIAL HYGIENE. 
 
 more extended use of machinery, however, in grind- 
 ing, has of late done away with most of the injury 
 from this form of dust. 
 
 File-cutters are still exposed to injury from inhala- 
 tion of particles. You know that machinery is used 
 to make files; but a better article is turned out by 
 hand. 
 
 Stone-cutters, especially cutters of mill-stones, suf- 
 fer greatly from this kind of consumption ; and so do 
 potters. In grinding the materials for earthenware 
 and porcelain and glass, a great deal of the most in- 
 jurious dust escapes. 
 
 In preparing cotton for use in the mill by beating 
 and carding, a vast amount of dust is generated ; but 
 a proper arrangement of draughts ought to remove 
 the danger of inhalation. 
 
 The breathing of coal-dust in the process of mining 
 changes the color of the entire lung in a few years to 
 jet-black. This blackening of the lung is not con- 
 fined to colliers, however, for it is always found in 
 post-mortem observations of adults, to some extent, 
 in patches of lung-tissue, and seems not to produce, 
 ordinarily, any kind of disturbance. There seems, 
 however, to be no doubt that, when in excess, it may 
 injure a miner's lung, or, at all events, may aggravate 
 other diseases. Provision is commonly made for 
 ventilating mines, which affords considerable relief 
 to this evil. 
 
INJURIOUS INHALATION. HI 
 
 The chief poisonous substances used in the arts 
 and inhaled in the form of dust are arsenic, mercury, 
 and lead. 
 
 In the present state of popular knowledge, little 
 need be said of the effects of arsenic in wall-papers. 
 It is quite generally known that almost all shades of 
 color are producible by arsenical preparations, and 
 that such are actually among the most popular for 
 producing the favorite neutral tints of the day, 
 green paper being scarcely more dangerous than any 
 other. It is not the workmen, however, but the cus- 
 tomers, who seem to surfer from contact with the 
 arsenical colors ; at most, they have certain cuta- 
 neous eruptions and ulcerations. 
 
 It is said to be very hard to bring foreign paper- 
 makers to terms on the subject of arsenic. There are 
 importers who faithfully try to prevent the use of such 
 arsenical pigments ; and it would be just to second 
 their efforts by legislative action forbidding the use 
 of arsenical wall-papers altogether. But it will not 
 be found an easy task to overcome the indifference 
 of public men to mere considerations of health. 
 Very few persons die of this sort of poisoning, it is 
 true. Instead of dying, the unhappy victim (who is 
 usually unaware of the existence of such a cause) only 
 drags out years of wretched invalidism ; and, at last, 
 if removed from the injurious influence, is only ruined 
 in health for the rest of life. 
 
112 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 The symptoms of poisoning from arsenical wall- 
 paper are quite various. They include soreness of 
 the eyes, catarrh of the nose, throat, and lungs, dys- 
 pepsia and bowel-complaints, eruptions on the skin, 
 and great general depression and debility. It is often 
 noticed that the sufferer is much worse in the morn- 
 ing, after a night spent in the poisonous room. The 
 danger is greatest when the colors can easily be 
 brushed off, and is least when they are protected by 
 a glazing. But it is impossible to say when danger 
 begins ; and no arsenic should be allowed. 
 
 A variety of the papers used for kindergartens 
 has been found to be highly charged with arsenic. 
 There is a green, very popular for this purpose, which 
 almost betrays itself. Can it be necessary to insist 
 that children of the age of four years should not be 
 allowed to handle freely so dangerous a substance ? 
 
 It is perfectly true that many escape. The same is 
 true of all contagions and poisons, from yellow fever 
 to the lead contained in drinking water. It is neces- 
 sary to take such measures as will protect those who 
 are susceptible, who are likely to be among the most 
 valuable members of the community. Before wall- 
 papers are purchased, it would be well to have them 
 examined for arsenic. Any chemist, or indeed any 
 intelligent doctor, can easily detect them by Reinsch's 
 test, at least. 
 
 An eruption of the legs, painful if not dangerous, 
 
INJURIO US INHALA TION. 1 1 3 
 
 has been known to be produced by wearing stock- 
 ings dyed red with coralline, a substance which may 
 contain arsenic. 
 
 Artificial-flower makers are exposed to the poison 
 of arsenite of copper or the arsenite and acetate 
 of copper Scheele's and Schweinfurth green; they 
 inhale it, and receive it by contact with the skin. The 
 effects are, characteristically, enfeeblement of the 
 muscular force, especially of the limbs ; also a loss 
 of appetite, palpitation, pain in the stomach, diar- 
 rhoea, and constant headache. 
 
 Mercury is used by hatters to remove hair from 
 skins. A solution is applied to the skin, and, after 
 drying in a chamber, the hair is got rid of by beating or 
 brushing, which liberates a great deal of some mer- 
 curial compounds. The effects upon the health are 
 those of chronic poisoning, of which one of the most 
 prominent is that nervous complaint called mercurial 
 trembling. 
 
 Mirrors are silvered with an amalgam of mercury 
 and tinfoil, which when heated parts with the mercury 
 in the form of vapor. The process is so very inju- 
 rious that in a certain French manufactory the work- 
 men worked only six hours in a day, and only on two 
 or three days in a week. The remedy for the trouble 
 consists in abolishing mercury and coating mirrors 
 with silver. A palliative has been found, consisting 
 in the sprinkling of ammonia on the floors. 
 10* H 
 
114 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 In fire-gilding, mercury and gold in the form of a 
 paste are applied to the surface, and the mercury vol- 
 atilized by heat ; this gives a much more solid and 
 enduring surface than electro-plating, and the danger- 
 ous steps of the operation can now be conducted in 
 closed boxes. 
 
 Both mercury and arsenic are driven off by heat 
 in the process of roasting certain ores. Mercury 
 seems to be very much the more dangerous to the health, 
 causing sore mouth, loss of teeth, general debility, or 
 "cachexia," acute pains, sleeplessness, spasm and 
 tremor, and paralysis of the muscles, and intellectual 
 feebleness, besides some symptoms resembling those 
 of syphilis, eruptions, swellings over the shin-bone, 
 and glandular enlargement, with deep ulcers of the 
 mouth and nose. Altogether, the occupation of those 
 who are forced to inhale mercury is one of the very 
 worst. 
 
 Lead is a very common poison one of the most 
 common. Its poisonous effects are felt by workers in 
 lead-mines, by painters, by those who grind and pol- 
 ish flint glass containing lead, by enamellers, and to 
 some extent by type-founders and printers. Those 
 suffer most who have to do with the process of dry- 
 grinding colors. The "body" which lead gives is 
 so much thicker than that of zinc that the latter does 
 not supersede it. You may have seen cases of the 
 colic which occurs in lead-poisoning. There is an- 
 
INJURIOUS INHALATION. 115 
 
 other symptom which is more disabling, consisting in 
 a palsy of the muscles, usually beginning with those 
 which enable a person to open his fingers and throw 
 the hand back, so that subjects of this palsy go about 
 with their wrists drooping like those of a kangaroo 
 or a begging dog. In fact, it is popularly called 
 " wrist-drop." 
 
 But there are a great many other substances which 
 produce poisonous or other deleterious emanations. 
 
 There are the irritating vapors of ammonia, chlo- 
 rine, and several acids sulphurous, hyponitric, nitric, 
 hydrochloric, and hydrofluoric acids. 
 
 Etching produces fumes of hyponitric acid when 
 done upon metal, and of hydrofluoric acid when done 
 upon glass. Both acids are corrosive ; the latter is 
 excessively so, and affects the eyes, the air-passages, 
 and the hands. 
 
 Bleaching produces fumes of chlorine gas, which is 
 not injurious in small amounts ; nor is the sulphur- 
 ous vapor from straw-hat bleaching of much con- 
 sequence. 
 
 The manufacture of various chemicals is injurious 
 to workmen. 
 
 Those who make sulphate of quinia are liable to 
 an eruption which resembles eczema, not compro- 
 mising life or health, but in some cases preventing 
 workmen from continuing at the trade. 
 
 The manufacture of potassium bichromate disen- 
 
Il6 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 gages caustic vapors, which destroy the mucous mem- 
 brane of the nose and produce rapid-eating ulcers 
 of the skin. 
 
 One of the most terrible of diseases is produced by 
 inhaling the fumes of phosphorus in the process of 
 making matches a necrosis or death of portions of 
 the upper and lower jaw-bones. A surgical operation 
 is required for the removal of such dead bone. It is, 
 fortunately, often successful, at least as to life; but 
 an infinitely*better method is the preventive one. 
 
 In addition to this, the fumes of phosphorus pro- 
 duce catarrhs of the lungs and stomach in almost all 
 the workmen ; they lose appetite and become pale, 
 and weak, and thin. There are several precautions 
 which should be observed, but the chief one is the 
 substitution of a kind of phosphorus the amorphous 
 which is not poisonous when swallowed, and does 
 not give off vapors, as common phosphorus does, at 
 the ordinary temperature of the air. 
 
 Women suffer more than men from several of the 
 poisons we have named. They not only lose their 
 health more readily, from a greater susceptibility to 
 morbid influences of certain kinds, but their sexual 
 system is very liable to be injured. " They are much 
 more susceptible than men to the influence of mercu- 
 rial vapors, and those who are poisoned abort fre- 
 quently, and even the children that are born to them 
 are apt to be weak, sickly things, and die early." 
 
INJURIOUS INHALATION. 
 
 The infants of female operatives in certain branches 
 of china-making are almost all scrofulous, with an 
 enormous mortality. Lead affects women more read- 
 ily and more seriously than men. They suffer from 
 excessive flowing at the monthly period, and have 
 frequent abortions. With regard to workers in to- 
 bacco, it is stated by Tracy, of New York, that they 
 have very small families ; quite the reverse of what is 
 usually the case with working-people. He found 
 only four hundred and sixty-five children in three 
 hundred and twenty-five families. It is not certain 
 what the cause of this peculiar condition may be; but 
 it is quite probably due in large measure to a prema- 
 ture commencement of work, and to an influence 
 which tobacco has in checking the sexual develop- 
 ment of young girls. 
 
 Tobacco is such an interesting subject that it is 
 hard to avoid saying more. It will be safest, how- 
 ever, to say but little, for we know that the whole 
 subject of tobacco is to some extent an open one. It 
 is hard to prove that the drug is injurious to health in 
 the case of most adult persons who chew or smoke 
 it, or of most operatives ; but there are some who are 
 seriously, if not permanently, injured by it ; and it is 
 certainly desirable to keep young persons under six- 
 teen from its use. 
 
 The chief practical points, in the prevention of dis- 
 ease arising from dust, whether poisonous or not, are : 
 
Il8 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 1. Removal of dust by ventilators, mechanical fans, 
 etc. This is enjoined by the English law of 1878. 
 
 2. Wet-grinding, grinding in close vessels, etc., is 
 sometimes practicable. 
 
 3. The wearing of masks over the face, composed 
 of wire-gauze, wire frames covered with tarletan, res- 
 pirators of carded cotton, etc. ; but these are hot and 
 irksome. 
 
 4. If working with poisonous substances, the work- 
 men should wash the exposed parts face, hands, 
 hair, beard on leaving work, especially before eat- 
 ing, and should never eat in the work-room. After 
 work, they should change their outer clothes, and a 
 daily bath is very desirable in some occupations. To 
 protect from lead and other dusty poisons, a linen 
 suit, frequently washed, may be worn. 
 
 The effects of certain poisons on the female sex and 
 on children are so injurious that special laws are re- 
 quired to restrict their employment in manufactures 
 where poisons are used. The restrictions of the Eng- 
 lish Factory Act of 1878 are as follows: 
 
 No woman, or person under sixteen, shall take 
 meals in any part of glass-works in which the mate- 
 rials are mixed, or where flint-glass is made, or where 
 grinding, polishing, or cutting is carried on ; or in 
 any part of lucifer-match works in which any manu- 
 facturing process or handicraft (except that of cutting 
 the wood) is usually carried on ; or in the dippers' 
 
INJURIOUS INHALATION. IIQ 
 
 room, dippers' drying-room, or china scouring-room, 
 in any earthenware works. 
 
 There is absolute exclusion from labor in the fol- 
 lowing cases : girls under sixteen, not allowed to be 
 employed in an establishment where bricks or tiles 
 (not ornamental tiles) are made or finished, or salt is 
 made or finished. No child under fourteen to be em- 
 ployed in a part of the building where dry-grinding 
 in the metal trade, or the dipping of lucifer-matches, 
 is carried on ; under eleven years, all metal grinding 
 is forbidden, and fustian cutting. Persons under six- 
 teen are forbidden to work at silvering mirrors by the 
 mercurial process, or at making white-lead. Children 
 under fourteen and girls under fifteen are excluded 
 from parts where the process of melting or annealing 
 glass is carried on. 
 
CHAPTER II. 
 
 INJURIES FROM ATMOSPHERIC CHANGES. 
 
 THE unquestionable benefit which free exposure to 
 the air in all weathers confers is subject to cer- 
 tain drawbacks. It is not necessary to consider sun- 
 stroke, in the case of day-laborers, nor accidents by 
 falling from roofs, or from railroad collisions, as 
 forming an element in "industrial hygiene;" but 
 there are certain causes which affect the health per- 
 manently, as bronchitis and pneumonia ; and to this 
 may be added a liability to paralysis of the facial 
 nerve, which is especially the possession of drivers of 
 carts, etc. 
 
 Bronchitis and rheumatism are common enough 
 also among those whose trade exposes them to great 
 heat, as blacksmiths, stokers on steamships, forge- 
 men, puddlers, glass-blowers, dyers, and washer- 
 women. It is, in fact, neither heat nor cold that 
 causes the trouble, but excessively rapid transitions 
 from heat to cold. 
 
 The trade of baker is apt to be very unhealthy, 
 owing to the confined, close, dark, overheated quar- 
 
ATMOSPHERIC CHANGES. 121 
 
 ters in which it is carried on; also the night- work, 
 and occasional excess of work. 
 
 There is a peculiar and interesting class of disease 
 which attacks those who work in diving-bells or cais- 
 sons. It is caused by the excess of atmospheric press- 
 ure which exists under water, which may equal several 
 times that to which men are exposed on land. The 
 symptoms do not, however, attack the laborer on going 
 down, but rather on leaving work. The case, in fact, 
 is parallel to that of the aeronaut when he rises in 
 his balloon, or the climber of mountain peaks. The 
 symptoms, dependent upon the removal of pressure, 
 are as follows : Extreme pain ; sometimes nausea and 
 vomiting ; sometimes paralysis ; sometimes headache 
 and dizziness. They are frequently associated with 
 a sudden rush of blood to the brain and spinal cord. 
 The precautions to be observed are quite interesting. 
 It is recommended that only wiry men be selected for 
 the work ; that their time of labor be shortened in 
 proportion to the pressure ; that they take all possi- 
 ble care of themselves, never going to work on an 
 empty stomach, eating meat and drinking coffee, and, 
 when coming out of the caisson, taking time to do it 
 gradually, passing into an intermediate atmosphere 
 first, and resting an hour afterwards. 
 
 Miners. The health of a miner is exposed to 
 special causes of injury. In addition to the danger 
 of being blown up, or knocked down by falling 
 ii 
 
122 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 stones, he is* constantly at work in the presence of 
 great masses of minerals which generate noxious 
 gases, not to mention the effluvia which arise from 
 his own person, the flame of his candle, and the burn- 
 ing of powder. To this is added, in many cases, an 
 excessive heat, often a steaming, sultry heat, or else 
 a continual cloud of dust proceeding from the coal or 
 rock under the blows of his pick. And if we further 
 consider the confined position in which he often 
 works, the excessive exertion, the exposure to draught, 
 and the total deprivation of sunlight, we shall be 
 ready to admit that his life is an unnatural one, and 
 full of singular risk. 
 
 But man can adapt himself to almost anything. 
 With proper precautions, it is said that the life of a 
 miner is almost as safe, and his health quite as good, 
 as those of other classes in general ; better, in fact, 
 than those of his own family. If this be so, it is ' 
 certainly a great triumph of the hygienic art. 
 
 The precautions to be taken relate first and fore- 
 most to ventilation. 
 
 "Fire-damp" is a name given to light carburetted 
 hydrogen, which is given off abundantly in the car- 
 boniferous strata and in enormous quantities from the 
 Pennsylvania gas-wells. In the English coal-mines 
 it is much more abundant than it is at present with 
 us. When mixed with seven or eight times its own 
 volume of common air, it is highly explosive. After 
 
ATMOSPHERIC CHANGES. 123 
 
 an explosion, the passages are filled with the irrespira- 
 ble mixture of nitrogen, carbonic acid, and the vapor 
 of water, resulting from its combustion. 
 
 " Choke-damp, " or "black-damp," is a name for 
 carbonic acid, a common product of most combus- 
 tions, and of respiration. It abounds in badly-ven- 
 tilated mines. Nitrogen is not a poison, by itself. 
 Carbonic oxide, however, is one of the most danger- 
 ous of poisons, and so is sulphuretted hydrogen when 
 present in any considerable quantity. Both the latter 
 are called "white-damp." 
 
 The heated flue, as a means of exhausting air from 
 mines, has obvious dangers in coal-mines ; and its 
 special disadvantage lies in the variations which dif- 
 ferent atmospheric conditions produce in its working. 
 
 The steam- fan, driven by a small engine, may be 
 used either for drawing air from the mouth of a mine 
 or for forcing it in through tubes to the places where 
 it is most needed. It is, altogether, the best means 
 of ventilating mines. 
 
 Another reason for supplying abundance of fresh 
 air to mines is furnished by the great heat which is 
 found under ground. In the Cornish mines, the tem- 
 perature is said to increase regularly about one degree 
 Fahrenheit in every fifty feet in the upper parts, and 
 one in every eighty-five feet in the lower parts ; and 
 this is, with local exceptions, nearly the rate at which 
 the temperature rises in other mines. Some of the 
 
124 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 exceptions, however, are very remarkable. The deep 
 levels of the mines on the Comstock Lode in Nevada 
 have temperatures varying from 105 to 130 Fah. ; 
 and this excessive heat is mitigated by blowing upon 
 the men fresh air at 90 or 95, which seems to be 
 most conducive to comfort. The men, under these 
 circumstances, work with great vigor, but have to be 
 frequently relieved. 
 
 This great heat is said to be very productive of 
 heart-disease. There is no doubt that this effect is 
 intensified by excessive barometric pressure and by 
 dampness of the air, preventing evaporation from the 
 body. It is affirmed that the system in use at the 
 Comstock is so thorough as to do away with most of 
 the danger from all of these sources. 
 
 To spare the men a needless and wasteful expen- 
 diture of bodily force, it has been found best to use 
 cages worked by engines to raise and lower those who 
 are going to or from work. 
 
 The excessive quantity of coal-dust which chokes 
 the air of badly-ventilated mines has been previously 
 alluded to as affecting the lungs. But there are other 
 causes of pulmonary trouble, quite obvious in their 
 nature, such as sudden changes from heat to cold, 
 and deliberately sitting down in draughts to cool off 
 after working in the high temperatures mentioned. 
 On the whole, the principal diseases are miners' asth- 
 ma, consumption, and rheumatism, and, among those 
 
ATMOSPHERIC CHANGES. 12$ 
 
 who have worked long in badly-ventilated places, 
 dyspepsia, tremors, vertigo, and other troubles arising 
 from blood-poisoning. 
 
 As regards accidents, they are due to a great many 
 various causes ; but more than one-half of them, in 
 the Pennsylvania coal-mines, are caused by falls of 
 rock, coal, or slate. It is the opinion of good judges 
 that a very large number of these casualties could be 
 avoided by sufficient timbering of the roofs and sides. 
 One and a quarter in every hundred, or 12 J men in 
 every 1000 employed in these mines, are killed or 
 wounded every year by accidents \ and it seems that 
 here is a distinct and obvious field for a humane reform, 
 either by legislation or by private effort. 
 
 Soldiers and Sailors, In most of the European 
 services great numbers of the men used to die of con- 
 sumption and allied diseases, and fevers, probably 
 chiefly typhoid. This lamentable result was not in 
 the least due, however, to exposure to weather, but to 
 what may be called a contrary condition the want of 
 fresh air in barracks. In certain of the best English 
 regiments the losses were from one-third more to twice 
 as great as among men of the same age in civil life. 
 The fearful loss of life from disease in the Crimea is 
 well known and it is from that time that the reforms 
 date which have brought down the total rates of death 
 from disease to one-half of what they were. The 
 
126 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 present allowance in England is 600 cubic feet of 
 space to each man in barracks. 
 
 The ills of sailors are, to a very great extent, caused 
 by want of fresh air, dirt, and dampness. It is com- 
 monly forgotten that, by washing down the deck fre- 
 quently, a source of disease is introduced which is at 
 least as dangerous, and in feverish localities ten times 
 more dangerous than simple dry dirt. Good ventila- 
 tion and scrubbing and drying are the cure for the 
 chief of the curable ills of ship-life. 
 
CHAPTER III. 
 
 INJURIES FROM OVER-USE OF CERTAIN ORGANS. 
 
 IT is as true of the mind as it is of the body, that no 
 one part can be exclusively used without injury to 
 the individual considered as a whole. In the broadest 
 possible division of our being, neither "mind" nor 
 "body" has a right to exclusive cultivation; and 
 such exercise is never in the interest of the best phys- 
 ical health. The same is true if .we subdivide the 
 faculties of body and mind. There are many ways 
 in which the mind is exercised in daily life : book- 
 study, concentration of attention on discourse, mem- 
 orizing, reproducing, extemporary discourse; atten- 
 tion to great single questions in business, and to mul- 
 titudes of petty ones ; ciphering and copying by the 
 day, and the vivid, sudden, mortal collisions of the 
 street. None of these can properly be kept up to the 
 exclusion of the others, unless there is a strong pre- 
 disposition and fitness on the part of the individual : 
 they should alternate with one another, for most per- 
 sons are incapable of sustaining continued strain in one 
 of these points. We say that "worry" kills a man; 
 
 127 
 
128 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 but in saying so we mean simply that the mental ex- 
 citement upon one subject, which is perfectly health- 
 ful if continued for a few hours, becomes tyrannical 
 and destructive if kept up for whole days. A man 
 may be worried into illness by incessant, quiet cipher- 
 ing as well as by attendance at the Brokers' Board. 
 
 The care of the mental health has been sufficiently 
 treated of in another of this series of Primers.* It 
 is my purpose here briefly to mention some muscular 
 affections which are caused by monotonous and ex- 
 cessive work. 
 
 The robust activity of the blacksmith and carpen- 
 ter do not exempt them from the general law. They 
 are liable to a disease termed "hammer-palsy," af- 
 fecting the muscles which are overworked. 
 
 A painful and very unfortunate affection sometimes 
 attacks those who write a good deal. The premoni- 
 tion is given sometimes by pain in the muscles em- 
 ployed in holding the pen. There is apt to be a 
 nervous condition of the system, a tendency to 
 anxiety ; but this is not always the case. As seen in 
 its typical form, the disease presents no token of its 
 existence until the person affected begins to perform 
 one special act, as, in the present instance, the act of 
 writing. There may be great muscular vigor, and 
 complete control of all the faculties and motions 
 
 * " Brain- Work and Overwork," by H. C. Wood, M.D. 
 
OVER -USE OF ORGANS. I2Q 
 
 except one ; but as soon as the patient undertakes to 
 grasp the pen and write, he finds his fingers in a state 
 of cramp ; they pinch the pen excessively, or they fly 
 back from the pen, making it impossible to hold it. 
 It is very desirable that this should be recognized in 
 an early stage, as it is a malady somewhat difficult of 
 cure, and absolutely disabling as respects clerical 
 work. Some reader may thank me for saying that 
 electricity has been applied of late with good success 
 to the treatment of Writer's Cramp or Palsy. 
 
 The affection here described is not confined, how- 
 ever, to writers, but affects also pianists, violinists, 
 engravers, seamstresses, telegraph-operators, tailors, 
 type-setters, and many other classes who use one set 
 of muscles almost exclusively. 
 
 The theory has been put forward that writer's cramp 
 is caused by an electric current generated in a metallic 
 pen, or by the contact of pen and holder. This can- 
 not be admitted. The disease is fundamentally the 
 same, whether caused by work with the pen or on 
 catgut or ivory. But a steel-pen may be found inju- 
 rious, and can be replaced by gold or quill ; or a 
 large pen-holder may be used, made of cork, of the 
 size and shape of a large cigar, which is felt by many 
 to be a great comfort in writing. A departure from 
 the prescribed mode of holding the pen, and placing 
 it between the forefinger and the middle finger, may 
 also be a relief. Dr. Frank Woodbury, of Philadel- 
 I 
 
I3O- SCHOOL AND INDUSTRIAL HYGIENE. 
 
 phia, has lately invented an ingenious pen-holder to 
 prevent writer's cramp, by regulating the pressure at 
 which the pen is used by a slight spring. But if the 
 disease has developed itself, no such palliation is of 
 any avail ; and if the sufferer learns to write with the 
 left hand, as has been done, the left hand also is liable 
 to be attacked. The temporary use of the "type- 
 writing machine " will often prove a great boon, per- 
 mitting a continuation of work while resting the af- 
 fected muscles. 
 
 The effect of using sewing-machines is sometimes 
 injurious. It is not worth while to mention any 
 special effects. The muscular exertion, however, is 
 of a monotonous character, and may produce mus- 
 cular fatigue which is prejudicial to the general 
 health. It has been known to cause neuralgia of the 
 foot and leg. In general, the use of the machine two 
 or three hours a day is probably beneficial to most 
 women ; but a whole day's work, if the machine is 
 run by the feet of the worker, is far too severe, and 
 steam-power had better be used. Much has also been 
 done by applying the principle of alternate effort, by 
 a treadle which is moved both by the downward and 
 the upward movement of the feet, and employs both 
 feet at once or one at a time, at will. Many will 
 find relief by alternate basting and sewing each for 
 twenty to thirty minutes. 
 
 Steam-power has been applied with success to run- 
 
OVER -USE OF ORGANS. 131 
 
 ning sewing-machines. I am told by the head of a 
 large manufactory of ladies' dresses that the machines 
 do one-third more work than when run by the foot ; 
 and that the girls will work for less wages when steam- 
 power is used. 
 
 Those who use the voice a great deal in public 
 speaking and singing are apt to suffer from the strain. 
 The most common affection is follicular pharyngitis, 
 or "clergyman's sore-throat." Much of this trouble 
 is unnecessary, strictly speaking, or could be remedied 
 if the right steps could be taken. The voice ought 
 not to be used for continued and difficult efforts, un- 
 less the possessor is in good health and strength. It 
 ought not to be used in the crude, ignorant, and even 
 unintentionally "affected" manner which is often 
 heard, and which fatigues the throat without need. 
 The services of a competent teacher in elocution are 
 to be desired, not so much for rhetorical purposes as 
 for training in the right way to work with the vocal 
 organs. And by way of support, a little gymnastics, 
 for developing the chest, shoulders, and abdomen, 
 may properly accompany the process of developing 
 the voice, in some cases. 
 
 This is a fit place for a brief mention of the inju- 
 rious effects of protracted labor in one position. 
 Shoemakers and tailors, owing to their constrained 
 attitudes, and the bad air of their shops, become 
 dyspeptic, anaemic, and consumptive, and do a great 
 
132 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 deal more thinking than is good for them. The 
 sedentary life of literary people and clerks is apt to 
 affect them similarly. 
 
 Persons who stand all day at their work, as sales- 
 people and hair-dressers, are apt to have pains in the 
 soles of their feet, which may sometimes be relieved 
 by a well-shaped steel-shank to the shoe. Varicose 
 veins of the lower limbs, and uterine irregularities, 
 are also caused by standing. It is a truly inhuman 
 thing to require girls and women to remain on their 
 feet all day, without regard to the presence or absence 
 of customers an inhumanity that we are glad to 
 believe is diminishing. 
 
A 
 
 CHAPTER IV. 
 
 INJURIES FROM ACCIDENTS. 
 
 VERY considerable number of accidents are 
 caused every year by machinery used in manu- 
 facture. In England, in 1875, 2 -6 persons in every 
 1000 factory-hands were injured in this way. In the 
 United States there were 420 reported deaths caused 
 by machinery in 1870, and the number of injuries 
 was of course very much greater. 
 
 The English Factory Act appoints inspectors, who 
 must not be interested in or connected with factories 
 in any other way, and who are invested with the 
 necessary powers for carrying the act into effect. 
 
 Some of .the provisions of the act are here given, 
 from an abstract published in Professor William Wat- 
 son's paper in the Journal of Social Science, No. XI. 
 
 Certain portions of a mill, as hoists, fly-wheels, 
 wheel-races, mill-gearing, vats, etc., are required to 
 be fenced, and whenever the machinery, by reason of 
 its character or situation, is, in the opinion of the 
 inspector, likely to cause accidents to the work- 
 people, he is to serve on the occupier a notice 
 
 12 133 
 
134 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 requiring him to fence the part of the machinery 
 which he deems to be dangerous. The occupier 
 may, by serving a requisition on the inspector within 
 seven days of the receipt of the notice, refer the mat- 
 ter to arbitration. 
 
 A child (under fourteen) is not allowed to clean 
 any part of the machinery of a factory while in mo- 
 tion. A young person (from fourteen to eighteen) or 
 woman (over eighteen) is not allowed to clean such 
 part of the machinery as is mill-gearing, while the 
 same is in motion. A child, young person, or woman 
 is not allowed to walk between the fixed and travers- 
 ing part of any self-acting machine while the same is 
 in motion. 
 
 Accidents causing death, or disabling the person 
 more than forty-eight hours, must be reported to the 
 inspector and visiting surgeon by the occupier of the 
 factory or workshop. The surgeon is to examine at 
 once the nature and cause of the accident, and report 
 to the inspector within twenty-four hours. 
 
 Neglect to keep a factory or workshop in conformity 
 with the act is punishable by a fine not exceeding 
 ;io; and the court (of summary jurisdiction) may 
 inflict a fine, not exceeding ^100, for the benefit of 
 the injured person or his family, or otherwise, in case 
 of death or injury in consequence of neglect to fence 
 machinery as required. 
 
 Professor Watson, in the same paper, gives a very 
 
INJURIES FROM ACCIDENTS. 135 
 
 interesting account c^f an Association for the Preven- 
 tion of Factory Accidents, existing at Mulhouse, in 
 Alsace. It consists of twenty-four members, com- 
 prising mill-owners, superintendents, manufacturing 
 engineers, foremen, and workmen chosen by the In- 
 dustrial Society of the city, with the aid of the work- 
 men. The Association offers arbitration, in cases of 
 claims for damage, and uses various means for spread- 
 ing a knowledge of the dangers and their remedies. 
 At the Paris Exposition of 1878, they exhibited twen- 
 ty-seven examples of contrivances adapted to prevent 
 very severe accidents such as commonly occur, 
 especially from belts, shafts, pulleys, wheels, and 
 circular-saws. It would be well if our employers of 
 labor in large manufacturing centres, such as Phila- 
 delphia, Fall River, Lowell, etc., would imitate this 
 humane example. 
 
 Railway accidents may be properly mentioned in 
 this place, for they affect the employes in vastly 
 greater proportion than the passengers. For instance, 
 in France, from 1854 to 1869, the number of travellers 
 killed and wounded on railroads was 2,832 ; but that 
 of employes was 11,908. If we consider how few 
 men are required to run a train carrying hundreds of 
 passengers, we cannot help being struck with the 
 great disproportion. 
 
CHAPTER V. 
 
 REGULATION OF HOURS OF LABOR. 
 
 THE application of machinery and steam-power to 
 the manufacturing arts has made England the 
 richest country in the world. But this wealth was 
 attained, at first, at a cost of human suffering and 
 death which makes a sad page in history ; a page 
 which, fortunately, has not been paralleled in our 
 country. No system of labor has existed here, upon 
 a large scale, by which a boy of eight years could be 
 carried daily to work for sixteen hours in a mill, with 
 half an hour for meals. We have not seen large 
 numbers of little children beginning a full day's 
 work at six years of age ; nor have we frequently 
 seen the consequent distortions and deformities 
 known in England as the "factory-leg," due to 
 standing an excessive length of time. No large 
 numbers of women here work all day, leaving little 
 infants in the charge of baby-farmers. 
 
 It is useless to expect that these things will always 
 go right of themselves. The absence of legislation 
 on hours of labor, for the protection of women and 
 
 136 
 
REGULATION OF HOURS OF LABOR. 137 
 
 children especially, is excusable in some of our States, 
 on the ground of the subordinate nature of the in- 
 dustry. But the want of uniformity which is seen in 
 the laws of States which have attempted statutory 
 regulation is a little startling, and obliges us to infer 
 that American views are not so definite on some prac- 
 tical points as they might be. 
 
 From a communication sent me by Dr. Roger S. 
 Tracy, of the New York Board of Health, I compile 
 the following statements, which will give a nearly 
 complete idea of what has been done hitherto. Dr. 
 Tracy examined the statistics of the twenty-eight 
 principal States, and found the following: 
 
 Factories. Labor forbidden to children under 10 
 in Massachusetts and New Jersey ; under 1 2 in Rhode 
 Island and Wisconsin ; under 13 in Pennsylvania. 
 
 Coal-mines. Labor forbidden to children under 
 12 in Pennsylvania; to children under 12 and all 
 women in Illinois, and under 14 in Colorado. 
 
 Factories. Over ten hours' work daily forbidden 
 to children under 14 in Michigan ; 15, in Connecti- 
 cut; 16, in Maine and Maryland; 18, and all women, 
 in Ohio. 
 
 Factories. Over eight hours' daily work forbid- 
 den to all under 18, and to all women, in Wisconsin. 
 
 Educational requirements are made in eight of the 
 twenty-eight States. The strictest are those of Wis- 
 
138 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 cousin, where children are not to be employed while 
 the public schools are in session. 
 
 This is about all that has been done in our country 
 for the protection of women and children from ex- 
 cessive and improper labor. There are laws relating 
 to the employment of children in fourteen of the 
 twenty-eight States ; but a large number of the laws 
 relate to educational and not to sanitary points. 
 
 It is certainly a singular discrepancy that, in Mas- 
 sachusetts, parents are allowed to send a child of ten 
 years old to work ten hours in a factory, while in 
 Wisconsin only eight hours of labor are allowed at 
 the age of twelve to eighteen. 
 
 The English legislation has been thorough and en- 
 lightened, showing upon the part of its authors a 
 degree of humanity, painstaking, and intelligence 
 which go far to atone for previous sins of neglect. 
 Its provisions are as follows : 
 
 Children under 10 shall not be employed in any 
 factory or workshop. 
 
 A medical certificate is required, in the case of all 
 persons under 16, of the fitness of such persons for 
 employment in the factory specified. The employer 
 procures this certificate, and is responsible for proving 
 the age. The Government Inspector may require a 
 certificate, if a person under 16 seems to him unfit, 
 and may forbid his working again until recertified 
 by the certifying surgeon. The examination is made 
 
REGULATION OF HOURS OF LABOR. 139 
 
 at the factory. Refusal to give a certificate must be 
 accompanied by written reasons. 
 
 Persons under 14 shall not be employed on Sunday 
 in workshops or factories. Christmas, Good Friday, 
 and eight half-holidays besides, are given. 
 
 Children are employed (under 14) under one of 
 two plans : (a) in alternate sets, morning and after- 
 noon ; (^) on alternate days. The morning work ends 
 at i, or at dinner if earlier. The afternoon work 
 begins at i, or after dinner if later. The day is 12 
 hours long, viz. : from 6 to 6, or 7 to 7, for children, 
 \oung persons, and women, with ij hours for meals. 
 On Saturday the day ends at 2 o'clock. 
 
 Children must not be employed more than five 
 hours continuously without a meal (half-hour). All 
 must eat at the same hour (children, young persons 
 under 18, and women), and never where work is 
 going on. 
 
 Every child under 14 in a factory or workshop 
 must attend a school, either on the alternate off-days 
 or on the half-days when off work. If he fails to 
 attend in any week, he shall not recommence work 
 the next week until he has made up his absence from 
 school. The employer obtains certificate of attend- 
 ance. 
 
 The parent selects the school. Proficiency in the 
 elementary studies, which satisfies a certain standard 
 
I4O SCHOOL AND INDUSTRIAL HYGIENE. 
 
 fixed by Government, enables a child at 13 to work 
 as if over 14, as a " young person." 
 
 The school is authorized to collect its fees from the 
 occupier of the factory, to a certain extent, the 
 amount to be deducted from the child's wages. 
 
 It is not in my power to say whether the health of 
 the rising generation is suffering from overwork or 
 confinement in factories in our States. There is not 
 much evidence to prove it. The investigation pub- 
 lished in the Massachusetts State Board of Health 
 Report for 1871 is not at all alarming in its results. 
 It found that " the correspondence in death-rates be- 
 tween the factory population and the whole popula- 
 tion, at the same ages, was so remarkably close as to 
 leave but little to be said M (page 422). 
 
 There is in modern labor a tendency to aggregate 
 persons and resources in great masses, which pro- 
 duces town-life, large enterprises, and great factories. 
 In many ways this is to be deplored ; but it is right 
 to see the bright side also. The old system of inde- 
 pendent workshops, where the weaver or other me- 
 chanical toiler spent all the time he could possibly 
 give in small, crowded shops, often in his own room, 
 in narrow and nasty quarters at the best, has given 
 way to the system of large shops, which are run for a 
 much smaller number of hours, are far better lighted 
 and warmed and aired, and, what is perhaps the root 
 of the whole matter, are much more accessible to the 
 
REGULATION OF HOURS OF LABOR. 14! 
 
 control of public opinion and to legislative inspec- 
 tion. It is in the large shops that you find the large 
 brains at the counting-desk men who can under- 
 stand sanitary needs, and are not hampered by the 
 petty necessity of domestic economy which weighs 
 down the solitary workman. It is the large establish- 
 ments that take the trouble to answer questions upon 
 sanitary matters addressed to them by the State au- 
 thorities. 
 
CHAPTER VI. 
 
 DURATION OF LIFE IN VARIOUS OCCUPATIONS. 
 
 AS everybody would like to know that he has a 
 prospect of long life, everybody has a. certain 
 curiosity in regard to the statements of science con- 
 cerning the effect of his own work on the duration 
 of life. There are a good many facts going the 
 rounds, and if taken with allowances for the circum- 
 stances, these facts are valuable. But there is so 
 great a contradiction between the statements of dif- 
 ferent authors, that the most meagre statements are, 
 perhaps, the safest. 
 
 From Hirt's tables I select a typical trade or two to 
 represent each period of life, dividing life into periods 
 of five years. My selection is, of course, arbitrary. 
 
 Among the operatives who die on the average be- 
 fore the age of 40 years, I find porcelain-turners, 
 stone-cutters, and female mirror-makers. 
 
 Under 45, goldsmiths, lead and quicksilver miners. 
 
 Under 50, cabinet-makers and operatives in cotton- 
 mills not very wholesome, and not particularly 
 hurtful occupations. 
 
 Under 55, to my surprise, come some trades which 
 I should have put much lower. Needle-polishers are 
 
 142 
 
DURATION OF LIFE. 143 
 
 said to average 50, file-cutters 54, engravers 54.6, 
 and so forth. It is possible that a good many classes 
 fall in here simply because it is rather a medium age 
 at which to die, independently of other circumstances. 
 
 Under 60 years (also a good medium age, on the 
 favorable side,) we find blacksmiths, butchers and car- 
 penters, machinists and turners, the watchmaker who 
 measures our life for us, and the grave-digger who 
 takes our measure for the last time. 
 
 Under 65, it is interesting to find set down the 
 classes of tanners, dyers, gas-men, catgut makers, and 
 bone-boilers trades which may remind us that long 
 life is not to be attained by shirking disagreeable or 
 offensive tasks. 
 
 Above 65, only three trades are mentioned. 
 
 In England, the rates of mortality among different 
 classes have been estimated by Dr. Farr, who states 
 that the shortest lives are found among earthenware- 
 makers, tailors, needle-makers, makers of files and 
 saws, veterinary surgeons and farriers, railway em- 
 ployes, coachmen and cabmen, commercial clerks, 
 butchers, publicans, innkeepers. A good deal of this 
 mortality is due to habits of excessive drinking and 
 exposure to the weather. 
 
 Physicians and surgeons, chemists and druggists, 
 mercers and drapers, hair-dressers, barbers, wig-mak- 
 ers, and hatters, miners, and some others, have a high, 
 but not an excessively high, rate of mortality. Carv- 
 ers and gilders suffer less than they did ; and manu- 
 
144 SCHOOL AND INDUSTRIAL HYGIENE. 
 
 facturers of wool, silk, and cotton no longer experience 
 an exceptionally high mortality, owing to the zealous 
 efforts made by Lord Shaftesbury and his enlightened 
 colleagues in promoting sanitary legislation. 
 
 Among the healthy classes may be named carpen- 
 ters, wheelwrights, and workers in wood generally ; 
 shoemakers, grocers, publishers, and booksellers. 
 
 Among the healthiest and longest-lived are the 
 agricultural classes, game-keepers, barristers, and the 
 clerical profession. But solicitors and Catholic priests 
 in middle and later life form exceptions. 
 
 Metal workers, in the aggregate, do not experience 
 the average rate of mortality under 45, but after this 
 age the case is reversed ; miners have a still higher 
 rate, and both classes have a much higher rate than 
 agricultural laborers. 
 
 From the " Massachusetts Registration Reports" I 
 will quote the following statement of the average age 
 at death of nine general classes of men, the average 
 of all classes and occupations being 50.94 years : 
 
 Average Age at Death. 
 
 I. Cultivators of the earth . . . 65.13 
 II. Active mechanics abroad . . 52.62 
 
 III. Professional men .... 50.81 
 
 IV. Merchants, financiers, agents, etc. . 49.22 
 V. Active mechanics in shops . . 47-92 
 
 VI. Laborers, no special trades . . 47 .24 
 
 VII. Employed on the ocean . . . 46.09 
 
 VIII. Inactive mechanics in shops . . 43-64 
 
 IX. Factors laboring abroad . . . 35-42 
 
NOTE. 
 
 THE following works on gymnastics may be named 
 as useful : 
 
 Manual of Gymnastic Exercises, arranged on Hygienic Prin- 
 ciples and adapted to music. By E. H. BARLOW. Amherst, 
 Mass., 1866. 
 
 Manual of Gymnastic Exercises for Schools and Families. By 
 SAMUEL W. MASON. Boston, 1863. 
 
 Handbook of the Movement Cure for Prevention of Spinal 
 Deformities. By M. ROTH. 
 
 Bow to Get Strong, and How to Keep so. By WILLIAM 
 BLAIKIE. 
 
 Training in Theory and Practice. By ARCHIBALD MACLAREN. 
 13 K 145 
 
INDEX. 
 
 PAGE 
 
 ABORTION caused by mercurial 
 
 poisoning 116 
 
 from lead poisoning 117 
 
 Accidents I 33~ I 35 
 
 legislation to prevent. 133, 134 
 
 precautions 134, 135 
 
 on railways 135 
 
 in mines 125 
 
 Adams's statistics of distorted 
 
 spines 37 
 
 Afternoon schools 61,62 
 
 study 21 
 
 Age, as determining capacity for 
 
 study 31, 32 
 
 Air, quality of supply for furnace 86 
 
 overheated 86, 87 
 
 from cellars 91 
 
 See Ventilation. 
 
 American desks and seats for 
 
 schools 67 
 
 factory and mining legisla- 
 tion 137 
 
 Amherst College gymnastics 44 
 
 statistics of near-sight 58 
 
 Anxiety injurious to health 14 
 
 Apparatus for gymnastics 36 
 
 Appetite, failure of, sign of over- 
 study 
 
 PAGE 
 
 Atmospheric changes, injury 
 from 120-126, 143 
 
 Attention, power of, at different 
 ages 30 
 
 BACK, support for 68, 78 
 
 Bakers 120 
 
 Base-ball, when injurious 38 
 
 Bigelow, H. J., on chairs 68 
 
 Blackboards, position 83 
 
 Black-damp 123 
 
 Bleaching 115 
 
 Boarding-schools, some good ef- 
 fects on health 23 
 
 See pages 98-101. 
 
 for girls 100 
 
 Application, capacity for contin- 
 uous mental, at different ages.. 30 
 
 See Study. 
 
 Architectural ornament subordi- 
 nate to hygienic requisites 84 
 
 Arsenic in wall-paper in, 112 
 
 chronic poisoning, symp- 
 toms 
 
 in kindergarten paper 
 
 in stockings 
 
 in artificial flowers 
 
 in certain ores 
 
 Astigmatism mistaken for short- 
 sight 
 
 Boards of Health, duty in conta- 
 gious diseases in schools 100 
 
 Bodily development, when com- 
 plete 35 
 
 growth 24-27 
 
 Book-rest 70 
 
 Bowling, when injurious 39 
 
 Boys, rate of growth 24 
 
 Brain, constant repair of. 28 
 
 Breakfast neglected by children.. 17 
 
 study before 20 
 
 Bronchitis 120 
 
 Brooklyn, statistics of near-sight 58 
 Brown, Buckminster, injury 
 
 caused by military drill 46 
 
 on origin of spinal de- 
 formity 64 
 
 Buffalo, statistics of near-sight... 58 
 
 CAISSON disease 121 
 
 Calisthenics 36 
 
 specimen of 46 
 
 Carbonic oxide from furnace 87 
 
 Carter, Brudenell, on care of eyes 48 
 
 146 
 
INDEX. 
 
 PAGE 
 
 Carter, Brudenell, on near-sight. 60 
 
 Catarrhs 93 
 
 Cellar air 91 
 
 water-closets in 96 
 
 Chadwick, Edwin, on hours of 
 
 study 29-31 
 
 Chair-back, main use 68 
 
 Children, mental characteristics 
 
 7, 29, 30, 31 
 
 requirements in exercise 35 
 
 bodily peculiarities 61 
 
 sickliness owing to mothers' 
 
 trade 116, 117 
 
 legal restrictions on labor... 
 
 119, 134-137, 140 
 
 See Ages. 
 
 China-makers, scrofulous chil- 
 dren 117 
 
 Choke-damp 123 
 
 Cincinnati, statistics of near- 
 sight 58 
 
 City life, injurious to health of 
 
 children 27 
 
 Clarke, E. H., on sex in educa- 
 tion 26 
 
 Clergyman's sore throat 131 
 
 Closets for scholars' clothing 84 
 
 Clothing 40, 44, 47, 93 
 
 Coal-dust inhaled no 
 
 Cohn's statistics of near-sight 57 
 
 Colleges. 102-104 
 
 for girls 100 
 
 study in 32 
 
 Color of walls 83 
 
 Commons at college 104 
 
 Competition between girls and 
 
 boys 25 
 
 Comstock lode 124 
 
 Congestion as a cause of near- 
 sight 53 
 
 Conjunctivitis 63 
 
 Conklin, effect of school-life on 
 
 eyesight 59 
 
 Consumption caused by inhaling 
 
 dust 107-110 
 
 among miners 124 
 
 soldiers 125 
 
 Contagious diseases 105, 106 
 
 of eyes 63 
 
 Coralline 113 
 
 Cotton-mills, dust no 
 
 Croquet, how injurious 39 
 
 Cubic space required in school- 
 room -. 80 
 
 FACE 
 
 Cubic space for dormitories 99 
 
 in barracks 126 
 
 Culture, its true scope _ 10 
 
 Curvature. See Spinal. 
 
 DAMPERS of furnace 86 
 
 Danneberg on gymnastics, at 
 
 Frankfort 43 
 
 Dayton, Ohio, statistics of near- 
 sight 58 
 
 Deafness often misunderstood by 
 
 teachers 49 
 
 Decoration of school-room 83 
 
 Deformities from factory-work... 136 
 
 See Spinal. 
 
 Derby, Hasket, statistics of near- 
 sight 58 
 
 Desks, faulty construction.... 65, 66 
 
 height of. 74 
 
 assorted sizes 74 
 
 Development. See Growth. 
 
 Diet of school-children 17 
 
 See Food, Commons. 
 
 Dinner, time for 21 
 
 Discomfort as a cause of deform- 
 
 ity.. 
 
 66 
 
 Discontent, effect on health 14 
 
 Disinfection 105 
 
 Distance for reading, etc. 49, 53, 54 
 
 Diving-bells 121 
 
 Dormitories in schools 99 
 
 i coll 
 
 eges.. 
 
 104 
 
 Drawing 57 
 
 bad position in 64 
 
 Dress for gymnastics 40, 44 
 
 See Clothing. 
 
 Drill of scholars 95 
 
 Drudgery of schools 15 
 
 Drunkenness, mortality from 143 
 
 Duration of continued mental ap- 
 plication 31 
 
 of life in various occupa- 
 tions 142-144 
 
 Dust, poisonous 111-119 
 
 prevention of 109, no, 117, 118 
 
 Duty, unregulated sense of 8, n 
 
 training of sense of. 9 
 
 EARTHENWARE makers no, 143 
 
 Education, principles and theo- 
 ries of. 7, 13 
 
 claims the whole child 8, 10 
 
148 
 
 INDEX. 
 
 PAGE 
 
 Education should include morals 
 
 and health 9, 10 
 
 should develop power, en- 
 durance, self-control n 
 
 should develop spontaneity 29 
 
 See Study. 
 
 Educational legislation 137-139 
 
 See Half-time. 
 
 Elbows en desk 70 
 
 Embroidery 57 
 
 Emotional strain upon pupils 14 
 
 Emulation, its power 8 
 
 injury from 8 
 
 methods of arousing it 16 
 
 Enamellers 114 
 
 England, half-time system 32 
 
 disease among factory -hands 136 
 
 English Factory Act of 1878 
 
 118, 119, 133, 138-140 
 
 Engravers 129 
 
 Equilibrium of mental powers, 
 
 when disturbed 14 
 
 Erismann on size of school-room.. 79 
 
 Etching 115 
 
 Eulenberg's statistics of distort- 
 ed spines 37 
 
 Evaporation of water 87 
 
 Examinations of schools 17 
 
 Excess of study defined 28 
 
 Exercise, physical 34~47 
 
 adapted to different temper- 
 aments 34 
 
 by walking 34, 35 
 
 byplay 38 
 
 J. J. Putnam on 38 
 
 by military drill 46 
 
 See Walking, Gymnastics, etc. 
 
 Exhibitions of schools 16, 17 
 
 Explosion of gas 122 
 
 Eyes of young children allowed 
 
 to wander 61 
 
 care of. 48-63 
 
 ignorance of teachers about 48 
 
 Brudenell Carter on care of. 48 
 
 near-sighted 48, et seq. 
 
 distance from book... 49, 53, 54 
 
 effect of general weakness 
 
 of disease upon 52 
 
 See Near-sight, Weakness, 
 
 Far-sight. 
 
 FACTORIES, English.., 136 
 
 American 137 
 
 PAGE 
 Factories, health of operatives... 140 
 
 Farr on life statistics 143 
 
 Far-sight 62 
 
 simulating near-sight 51, 55 
 
 Fatigue not the prime object of 
 
 exercise 34 
 
 Fevers, prevention of spread 105 
 
 Field-sports 34 
 
 File-cutters no, 143 
 
 Fire-damp 122 
 
 Fire on the hearth, principles of 88 
 Fireplace, aid to ventilation.. 88, 98 
 
 See Open Fire. 
 
 Floor of school-room 84 
 
 Follicular pharyngitis 131 
 
 Food 19, 23 
 
 trashy 22 
 
 litable 
 
 deficient supply 22 
 
 See Commons, Meals. 
 
 Frankfort, public school gymnas- 
 tics 41-44 
 
 Furnace, supply of air to 86 
 
 valves 86 
 
 should be large 86 
 
 dampers 86 
 
 producing carbonic acid... .. 87 
 
 - water for 87 
 
 Furniture for schools. See Desks 
 and Seats. 
 
 GAS-LIGHT, ventilation of. 87 
 
 Gas. See Explosion. 
 
 German school-seats 67, 68 
 
 Gilders 114 
 
 Girls, rate of growth 24 
 
 competition with boys 25 
 
 about age of 14 and 15, spe- 
 cial care of. 25, 26 
 
 injured by " society" 26 
 
 choice of gymnastics for 43 
 
 should not have to climb 
 
 many stairs 95 
 
 Glasses should be worn by some 
 
 children 60, 63 
 
 to be selected by physicians 
 
 only 63 
 
 when to be worn by children 69 
 
 Glass-makers no, 114 
 
 Grinders' asthma 108 
 
 Grinding, wet and dry 109 
 
 glass 114 
 
 colors 114 
 
INDEX. 
 
 149 
 
 PAGE 
 
 Ground glass 83 
 
 Growth of body 24, 27, 35 
 
 Gymnastics, Ling's system of..... 41 
 
 for girls 43 
 
 in Amherst College 44 
 
 in normal schools 44 
 
 in colleges 102, 104 
 
 precautions in 103 
 
 teacher for 103 
 
 for boating-men 103 
 
 HABITS of health taught in 
 
 school 9 
 
 Hair-dressers 132 
 
 Half-time system of education 
 
 in England 32, 62, 139 
 
 Hammer-palsy 128 
 
 Harlan, diagram to illustrate 
 
 near-sight 50 
 
 Hatters 113 
 
 Health, laws of, taught in 
 
 schools 9 
 
 Heart-disease in miners 124 
 
 Heat of mines 123 
 
 Heating. See Ventilation. 
 
 High-schools, study in 32 
 
 Hirt's life-statistics 142 
 
 Holidays in factories 139 
 
 Horseback exercise sometimes 
 
 39 
 
 IMMORALITY in schools 99 
 
 Inhalation of dusty and poison- 
 ous substances 107, 119 
 
 Ink, pale, bad for eyes 57 
 
 Inspection of schools by medical 
 
 authority 45, 106 
 
 Irksome tasks 15 
 
 JANITOR'S duties 91 
 
 Juvenile labor on half-time sys- 
 tem 32 
 
 KEEN, W. W., ventilation 92 
 
 Kindergartens 29, 35 
 
 green papers 112 
 
 Konigsberg, statistics of near- 
 sight 58 
 
 PAGE 
 
 LEAD-POISONING 114, 115 
 
 Lead, effects on women 117 
 
 Legislation. See English Fac- 
 tory Act, Restrictions, Women, 
 Children, Education. 
 
 Length of life 142 
 
 Liebreich, construction of desks 
 
 and seats 67, 77 
 
 on spinal curvature 74 
 
 Life, duration of. 142, 144 
 
 Light, defective, causes stooping 69 
 horizontal useless in read- 
 ing 81 
 
 what constitutes good 82 
 
 dazzling eyes at work 83 
 
 direct rays of sun 83 
 
 artificial 83 
 
 - in private house 
 
 - See Windows, Shades. 
 
 -sight 58 
 
 Lot, size of, for school 94, 95 
 
 Lunch for children in school 22 
 
 Lungs affected by inhaling dust, 
 
 107, no 
 
 MAINE ventilation 92 
 
 Maps 56,57 
 
 Masks to protect from dust 118 
 
 Massachusetts Registration Re- 
 port on average age at death.. 144 
 
 State Board of Health on 
 
 prevention of spread of conta- 
 gion in schools 106 
 
 State Board of Health on 
 
 health of operatives 140 
 
 Matches 116 
 
 Meals, interval between study 
 
 and 20 
 
 intervals between 21 
 
 sleepiness after 21, 22 
 
 in factories 139 
 
 Medical inspection of schools, 
 
 45, 106 
 
 Mental application, excess de- 
 fined 28 
 
 characteristics of children... 7 
 
 depression a symptom of 
 
 over-study 15 
 
 See Study. 
 
 Mercury, effect on hatters 113 
 
 mirror-makers 113 
 
ISO 
 
 INDEX. 
 
 PAGE 
 
 Mercury, effect of on gilders 114 
 
 symptoms of chronic poison- 
 ing 114 
 
 effect on women 116 
 
 Military drill in schools 46 
 
 Miners 121, 125, 143 
 
 Mirror-makers 113 
 
 Morality taught in schools 8, 9 
 
 Mulhouse, Association for the 
 Prevention of Factory Acci- 
 dents 135 
 
 Muscles, affections caused by 
 
 over-work 128 
 
 Music, practice 101 
 
 Myopia. See Near-sight. 
 
 NEAR-SIGHT defined 49 
 
 tends to increase 49 
 
 diagram 50 
 
 prevention of increase... 50, 52 
 
 things mistaken for it.... 51, 54 
 
 causes of. 51, 53 
 
 inheritance of. 51 
 
 pathology of 51 
 
 favored by weakliness 52 
 
 bad air 52 
 
 is not strong-sight 53 
 
 dangerous tendency of. 53 
 
 Harlan on 54 
 
 caused by fine work, etc 57 
 
 statistics 57, 59 
 
 .increasing 59 
 
 effect on character 60 
 
 what is lost by it 60 
 
 should be corrected by 
 
 glasses in children 60 
 
 as related to compulsory 
 
 education 59, 60 
 
 related to spinal curvature.. 74 
 
 Necrosis from phosphorus 116 
 
 Nervous system injuredinschools 
 
 14, 18, 100 
 Neufchatel, statistics of distorted 
 
 spine 37 
 
 Neuralgia from use of sewing- 
 machine 130 
 
 New York, statistics of near- 
 sight 58 
 
 Nitrogen in mines 123 
 
 OPHTHALMIA 63 
 
 Over-study, signs of, 16, 19 
 
 PAGE 
 
 Over-study described 17 
 
 defined 28 
 
 Over-use of organs 127-132 
 
 PAINTERS 1 14 
 
 Paper, tint of .'. ...... 56 
 
 Paris Exposition of 1878, con- 
 trivances to prevent accidents. 135 
 
 Phosphorus 116 
 
 Pianists 129 
 
 Piano, bad position at 64 
 
 Play, city children deprived of.. 
 
 27, 38, 39 
 
 advantages of. 38 
 
 when injurious 38, 39 
 
 when inferior to gymnastics 39 
 
 recommended 101 
 
 Play-grounds 43, 94 
 
 Pneumonia 109 
 
 Poisons and dust, effect of in- 
 haling 107-119 
 
 Porcelain-makers no 
 
 Position in reading 55 
 
 sitting 67-69 
 
 faulty in writing, etc., as re- 
 lated to spinal curvature 64, 73, 74 
 
 in writing 68, 70 
 
 should be frequently varied. 70 
 
 Potassium bichromate 115 
 
 Primary schools 32 
 
 Principles of education 7-13 
 
 Print, bad 56 
 
 Printers 114 
 
 Private schools 98-101 
 
 Prizes to school-children 16 
 
 Professions, duration of life in 142-144 
 Putnam, J. J., on gymnastics 38, 40 
 
 RADIATION 87 
 
 Recesses in school 47, 62 
 
 Reading, position in 55 
 
 while sleepy 56 
 
 Regulation of hours of labor 136-141 
 Religion not taught by the State 8 
 Repair of brain and other organs 28 
 
 Rest of eyes during study 54 
 
 Restrictions on labor of women 
 
 and children 118, 119, 134, 137, 139 
 Rheumatism 109, 120, 124 
 
 SABBATH ~ 35 
 
INDEX. 
 
 PAGE 
 ... 126 
 ... 132 
 ... 113 
 
 94,95 
 
 Sailors 
 
 Sales-people 
 
 Scheele's green , 
 
 School-house, site 
 
 height 
 
 School-room, a model 79-84 
 
 shape, dimensions 79, 80 
 
 Schweinfurt green 113 
 
 Seamstresses 129 
 
 Seats and desks 64-78 
 
 faulty construction 65,66 
 
 principles of construction 66-78 
 
 Liebreich's 67, 77 
 
 German 67 
 
 table of dimensions 76 
 
 Varrentrapp's model 75 
 
 should not be ranged in semi- 
 circle 82 
 
 Sedentary life 131, 132 
 
 Sewerage of schools 96 
 
 Sewing-machines 130 
 
 Sex in education 26 
 
 Shades to windows 82 
 
 Shaftesbury, Lord, legislation.... 144 
 
 Shoemakers 131 
 
 Short-sight. See Near-sight. 
 
 Singers 131 
 
 Slates 57 
 
 Sleep, loss of, a sign of over- 
 study 16, 19 
 
 Sleepiness after meals 21, 22 
 
 should forbid reading 56 
 
 "Slow sight" 55 
 
 Society, injurious effect on school 
 
 girls 26 
 
 Soldiers 125 
 
 Speakers 131 
 
 Spectacles. See Glasses. 
 
 Spinal distortion in girls 36, 38 
 
 at Neufchatel, etc 37 
 
 prevented by gymnastics.... 38 
 
 Buckminster Brown on ori- 
 gin of. 64 
 
 related to bad position in 
 
 reading and writing 64 
 
 connected with school-seats 68 
 
 Liebreich on 74 
 
 Standing at work 132 
 
 State, duty of, in education 8-10 
 
 Statistics of schools 15 
 
 of spinal deformity 37 
 
 of near-sight 57~59 
 
 of consumption from inhal- 
 ing dust 108, 109 
 
 PAGE 
 
 Statistics of accidents 133 
 
 of length of life 142-144 
 
 of health of factory-hands... 140 
 
 Hirt's 142 
 
 - Farr's i 
 
 Steam-fan 91 
 
 heating 87 
 
 Stone-cutters no 
 
 Stoves 87, 88 
 
 Strain, emotional, upon pupils... 14 
 
 mental 15 
 
 Study before breakfast 20 
 
 in the afternoon 21 
 
 antagonism between study 
 
 and meals 21, 22 
 
 interval between study and 
 
 meals 20 
 
 amount of. 28-33 
 
 excess. See Over-study 28 
 
 modern methods 29 
 
 in kindergartens 29, 33 
 
 Chadwick on 29, 31 
 
 - wholesome 12 
 
 capacity for, at different 
 
 ages 29-32 
 
 maximum average 31 
 
 at West Point 31 
 
 - in colleges.. 
 
 in high-schools 32 
 
 by the half-time system 32 
 
 in kindergartens 33 
 
 in primary schools 33 
 
 with occasional rest of eyes.. 54 
 
 recesses in 62 
 
 See Education, Girls, Men- 
 tal. 
 Sulphate of quinia, manufacture 
 
 of. 115 
 
 Sulphuretted hydrogen 123 
 
 Sulphurous acid produced by 
 
 burning gas 83 
 
 Sunlight in rooms 83 
 
 inschools 94 
 
 TAILORS 129, 131 
 
 Teachers, walking exercise 35 
 
 Sabbath rest for 35 
 
 of gymnastics, dearth of. 40 
 
 in London 41 
 
 in Frankfort 42 
 
 special requirements 
 
 for 45 
 
 for colleges 103 
 
152 
 
 INDEX. 
 
 PAGE 
 
 Telegraph operators 129 
 
 Temperature of room 93 
 
 Theories of education 7-13 
 
 Tinting of walls 83 
 
 Tobacco 117 
 
 Trades, duration of life in... 142-144 
 
 Type 56, 57 
 
 Type-founders 114 
 
 Type-setters 129 
 
 Type-writing machine 130 
 
 URINALS for schools 96 
 
 VALVES forfurnace 86 
 
 Varicose veins 132 
 
 Varrentrapp on size of school- 
 room 79 
 
 Ventilation and heating 85-93 
 
 of closets 84 
 
 quality of air 86 
 
 by furnaces 86 
 
 by radiation 87 
 
 by steam and hot water 87 
 
 by stoves 87 
 
 auxiliary use of stove-funnel 88 
 
 by fireplace 88 
 
 amount required 89 
 
 expense of. 90 
 
 by fan 90 
 
 by windows 91, 92 
 
 in private schools 98 
 
 of workshops 109, 118 
 
 of mines 123, 124 
 
 Violinists 129 
 
 WALKING 34 
 
 for women 34, 35 
 
 PAGB 
 
 Walking for scholars 101 
 
 for teachers 34 
 
 Wall-papers 84 
 
 Walls, tint of. 83 
 
 Washing, to protect from dust... 118 
 
 Water-closets for schools 96 
 
 Water-supply for furnaces 87 
 
 Water, heating by 87 
 
 Watson, Wm., on accidents 133 
 
 Weakness of eyes after fevers.... 52 
 
 West Point, study at 31 
 
 White-damp 123 
 
 Windows 80-82 
 
 should be on one side of room 80 
 
 illuminating power 80 
 
 - position.. 
 
 elevation 81 
 
 collective size 82 
 
 shades , 82 
 
 ventilation by 91 
 
 in private houses 98 
 
 Women, exercise for 34, 35 
 
 special susceptibility to poi- 
 son 116-118 
 
 legal restraint on labor 
 
 118, 134, 137-139 
 
 standing in shops 132 
 
 Woodbury's pen-holder 129 
 
 Work, proper amount of mental . 16 
 
 Worry of mind 123 
 
 Wrist-drop 115 
 
 Writer's cramp 128, 129 
 
 Writing as connected with 
 
 crooked spine 37 
 
 large hand 57 
 
 position in 64, 68, 70 
 
 See Desks. 
 
 ZWEZ on size of school-room 79 
 
 THE END. 
 
CATALOGUE No. 5. NOVEMBER, 1895. 
 
 BOOKS M NURSES. 
 
 FOR NURSES AND ALL ENGAGED 
 IN ATTENDANCE UPON THE SICK, 
 OR THE CARE OF CHILDREN. 
 
 Dealing exclusively in books on medicine 
 and collateral subjects, we are able to give special 
 attention to supplying books for nurses. We have 
 a large stock of works on Nursing, Hygiene, 
 Popular Medicine, etc., Temperature Charts, etc. 
 
 Catalogues of Books on Medicine, Dentistry, 
 Pharmacy, Chemistry, etc., free, upon application. 
 
 Special attention given to orders to be forwarded 
 to a distance, by mail or express. Upon receipt of 
 the price, any book will be delivered, free, to any 
 address. Money should be forwarded by Post- 
 Office Order, Draft, or Registered Letter. 
 
 P. BLAKISTON, SON & Co., 
 
 1012 WALNUT STREET, PHILADELPHIA. 
 
 J8* The prices as given in this catalogue are net. 
 No discount can be allowed retail purchasers. 
 
THE 
 
 HYGIENE OF THE NURSERY 
 
 INCLUDING THE GENERAL REGIMEN AND FEEDING OF INFANTS 
 
 AND CHILDREN AND THE DOMESTIC MANAGEMENT 
 
 OF THE ORDINARY EMERGENCIES OF 
 
 EARLY LIFE. 
 
 BY LOUIS STARR, M.D., 
 
 Clinical Professor of Diseases of Children in the Hospital of the University 
 of Pennsylvania; Physician to the Children's Hospital, Phila. 
 
 FOURTH EDITION. ENLARGED AND IMPROVED. 
 
 WITH TWENTY-FIVE ILLUSTRATIONS. 
 i2mo. 280 Pages. Cloth, $1.00. 
 
 ^* This book contains very complete directions for the proper 
 feeding of infants: 1st, From the maternal breast. 2d. By wet- 
 nurse, including rules for choosing the woman. 3d, Artificial 
 Feeding. This part of the subject is elaborated carefully, so as to 
 include everything of importance, and will be found of great service 
 to the monthly nurse. General and specific rules for feeding are 
 given, and Diet Lists from the first week up to the eighteenth 
 month, with various recipes for artificial foods, peptonized milk, etc. 
 Directions for the sterilization of milk, substitutes for milk, prepara- 
 tion of food for both well and sick children, nutritious enemata. 
 etc., and the general management of the Nursery. 
 
 " Dr. Starr's experience as Clinical Professor of Diseases of Children in the 
 University Hospital and as physician to the Children's Hospital, with his 
 eminence in private practice among juvenile patients, is ample warranty for the 
 satisfaction and instruction to be found in this book. The dedication " To my 
 Little Patients," shows the sympathy with which the writer enters upon the 
 important discussion. The volume is entirely in the modern lines of preventive 
 medicine more important in the nursery than at any other time of life ; because 
 constitution building is going on then and there. In this admirable treatise, so 
 clearly written that no mother need be deterred by fear of medical terms from 
 making its teaching her own, Dr. Starr carries out the highest ideal of the 
 modern physician, so to regulate the lives of his professional clients that the 
 occasions are less frequent when he need be called in to act for serious compli- 
 cations. * * * * With the numerous good treatises on the subject that 
 Philadelphia publications include, this intelligent work is the most distinguished, 
 as it is also the latest work on complete Hygiene of the Nursery." The Led- 
 ger, Philadelphia. 
 
HUMPHREY'S 
 
 MANUAL OF NURSING. 
 
 MEDICAL AND SURGICAL. 
 
 A complete Text-Book for Nurses, including General Anatomy 
 and Physiology, Management of the Sick-Room, Appliances used 
 in Sick-Room, Antiseptic Treatment, Bandaging, Cooking for 
 Invalids, etc., etc. 
 
 Thirteenth Edition. With 79 Illustrations. 
 
 BY LAWRENCE HUMPHREY, M.A., M.D. 
 
 12MO. CLOTH. PRICE $1.00. 
 
 ST. JOSEPH'S HOSPITAL, 
 
 SEVENTEENTH AND GIRARD AVENUE, 
 
 PHILADELPHIA, March 15, 1893. 
 Messrs. P. Blakhton, Son <5r Co. : 
 
 Please send us six more copies of Manual of Nursing, by Humphrey. We 
 do not know of any book that more completely meets the requirements of a 
 Training Class than Dr. Humphrey's able Lectures, for they are at once clear, 
 concise, and thoroughly practical. SISTERS OF CHARITY. 
 
 From British Medical Journal, London. 
 
 " Nursing literature is expanding, and, what is more to the purpose, it shows 
 manifold signs of improvement with its growth. In the fullest sense, Dr. 
 Humphrey's book is a distinct advance on all previous manuals. It is, in point 
 of fact, a concise treatise on medicine and surgery for the beginner, incorporat- 
 ing with the text the management of childbed and the hygiene of the sick-room. 
 Its value is greatly enhanced by copious wood-cuts and diagrams of the bones 
 and internal organs, by many illustrations of the art of bandaging, by tempera- 
 ture charts indicative of the course of some of the most characteristic diseases, 
 and by a goodly array of sick-room appliances, with which every nurse should 
 
 endeavor to become acquainted The systematic arrangement of 
 
 subjects adopted by the author is excellent." 
 
 THE BEST GENERAL TEXT-BOOK. 
 
NURSING IN 
 
 ABDOMINAL SURGERY 
 
 AND 
 
 DISEASES OF WOMEN. 
 
 A Series of Lectures Delivered to the Pupils of the Training School 
 
 for Nurses Connected with the Woman's Hospital of 
 
 Philadelphia, comprising their Regular Course 
 
 of Instruction on such Topics. 
 
 BY ANNA M. FULLERTON, M.D., 
 
 Physician-in- Charge of and Obstetrician and Gynecologist to the Woman's 
 Hospital of Philadelphia, etc. 
 
 SECOND EDITION, REVISED. 
 12mo. 300 Pages. 70 Illustrations. Cloth, $1.50. 
 
 immediate success of Dr. Fuller-ton's "Handbook of 
 Obstetric Nursing," a fourth edition of which has just been pub- 
 lished, has encouraged her to prepare this manual on another and 
 very important branch of the science and art of nursing. Dr. 
 Fullerton has demonstrated that she not only knows what to say, 
 but that she has the happy faculty of saying it in a plain, practical 
 style that interests as well as instructs. 
 
 SYNOPSIS OF CONTENTS. The Surgical Nurse The Germ Theory 
 of Disease Asepsis and Antisepsis Abdominal Section The Pre- 
 paration of the Room The Preparation of Sponges Sterilization 
 of Instruments, etc. Preparation of the Patient Preparation of 
 Operator and Assistants The Nurse's Duties During Operation 
 The Nurse's Duties After Operation and During Convalescence 
 Management of Complications The Pelvic Organs in Women 
 Diseases of Women General Nursing in Pelvic Diseases Pre- 
 parations for Gynaecological Examinations Preparation for Gynae- 
 cological Operations Preparation of Patient, Operator and Assist- 
 ants Duties of Nurse During Operation Special Nursing in 
 Gynaecological Operations Diet for the Sick Supporting Treat- 
 ment of Abdominal Sections Index. 
 
A HANDBOOK 
 
 OBSTETRIC^ NURSING. 
 
 Comprising the Course of Instruction in Obstetric Nursing 
 
 given to the Pupils of the Training School for Nurses 
 
 connected with the Woman's Hospital of Philadelphia. 
 
 BY ANNA M. FULLERTON, M.D., 
 
 Demonstrator of^ Obstetrics in the Woman' s Medical College of Pennsyl- 
 vania; Physician-in-Charge and Obstetrician and Gynecologist to the 
 Woman's Hospital of Philadelphia, and Superintendent of the 
 Nurse Training School of the Woman' s Hospital of Philadelphia. 
 
 40 Illustrations, 12mo. Handsome Cloth, $1,00, 
 
 FO UR TH EDITION RE VISED. 
 
 SYNOPSIS OF CONTENTS. The Pelvis and Genital Organs 
 Signs of Pregnancy Management of Pregnancy Accidents of 
 Pregnancy Germs and Antisepsis Application of Antisepsis to 
 Confinement Nursing Preparations for the Labor Signs of 
 Approaching Labor and the Process of Labor Duties of the Nurse 
 during Labor Accidents and Emergencies of Labor Care of the 
 New-born Infant Management of the Lying-in Characteristics of 
 Infancy in Health and Disease The Ailments of Early Infancy 
 Index. 
 
 " It is a book that I have recommended since I first saw it, and we are using 
 it for our nurses at the N. Y. Infirmary, where we have a branch of our School, 
 our nurses going there for instruction in obstetrics." MRS. L. W. QUINTARD, 
 Supt. Connecticut Training School for Nurses, New Haven, Conn. 
 
 " It is the most modern and complete book I have ever read for the care of 
 obstetrical patients. I shall take pleasure in recommending it to this school for 
 study." E. L. WARR, Supt. Training School for Nurses, City Hospital, St. 
 Louis, Mo. 
 
 " I have looked it over and read it with care, and think it is the best book I 
 have ever seen on the subject. It is practical, with plain instructions, nothing 
 superfluous. A good book for nurses and teachers of nurses." Miss ANNA 
 G. CLEMENT, Supt. of Nurses, The Henry W. Bishop Memorial Training 
 School for Nurses, Pittsfield, Mass. 
 
 " I consider the book excellent in every particular. Would recommend it to 
 every nurse, whether she did obstetrical nursing or not " GERTRUDE MONT- 
 FORT, Supt. of Nurses, New England Hospital for Women and Children^ 
 Boston, Mass. 
 
 " What is to be learned in a maternity training school is the way to nurse as a 
 profession. * * * Can recommend it as a valuable manual." Front the Amer- 
 ican Journal of Medical Sciences. 
 
BOOKS ON NURSING. 
 
 VOSWINKEL. Surgical Nursing, a Manual for 
 Nurses and Students, including Complete Chapters 
 on Bandaging, Dressings, Splints, etc. By BERTHA 
 M. VOSWINKEL, Graduate of the Episcopal Hospital, 
 Philadelphia; Nurse in Charge of Children's Hos- 
 pital, Columbus, Ohio. With in Illustrations. 121110. 
 1 68 pages. Cloth, $1.00 
 
 SHAWE. Notes for Visiting Nurses, and all 
 
 those Interested in the Working and Organization of 
 District, Visiting, or Parochial Nurse Societies. By 
 ROSALIND GILLETTE SHAWE, District Nurse for the 
 Brooklyn Red Cross Society. With an Appendix 
 explaining the Organization and Workings of various 
 Visiting and District Nurse Societies, by HELEN C. 
 JENKS, of Philadelphia. i2mo. Cloth, $1.00 
 
 CULLINGWORTH. A Manual of Nursing, 
 Medical and Surgical. By CHARLES J. CUL- 
 LINGWORTH, M.D., Physician to St. Mary's Hospital, 
 Manchester, England. Third Edition. With 18 
 Illustrations. i2mo. Cloth, .75 
 
 BY THE SAME AUTHOR. 
 
 A Manual for Monthly Nurses. Third Edi- 
 tion. 32mo. Cloth, .40 
 
 " This small volume is written as a supplement to the author's well-known 
 work on nursing. It treats only of the conditions of pregnancy and labor. It 
 is clear in its statements, and will prove of great value to those whose duty it 
 is to care for women during and after confinement." N. Y. Medical Journal. 
 
 DOMVILLE. Manual for Nurses and Others 
 Engaged in Attending to the Sick. By ED. J. DOM- 
 VILLE, M.D. Seventh Edition. With Directions for 
 Bandaging, Preparing and Administering Enemata, 
 Fomentations, Poultices, Baths, etc., Recipes for 
 Sick-room Cookery, Tables of Weights, and a Com- 
 plete Glossary of Medical Terms. Cloth, . 75 
 
BOOKS ON NURSING. 
 
 CANFIELD. The Hygiene of the Sick-Room. 
 
 A Book for Nurses and Others, being a Brief Consid- 
 eration of Asepsis, Disinfection, Bacteriology, Im- 
 munity, Heating and Ventilation, and Kindred Sub- 
 jects, for the use of Nurses and Other Intelligent 
 Women. By WM. BUCKINGHAM CANFIELD, A.M., 
 M.D., Lecturer on Clinical Medicine, and Chief of 
 Chest Clinic, University of Maryland, Visiting Phy- 
 sician to Bay View Hospital, etc. i2mo. 247 pages. 
 Handsome Cloth Binding, $1.25 
 
 ** This book is the outcome of a series of lectures delivered by 
 Dr. Canfield at the University of Maryland Training School for 
 Nurses. It contains much valuable information not included in the 
 regular text-books, but which of necessity the nurse should be ac- 
 quainted with. 
 
 " We recommend it to the attention, not only of sick-nurses, but also all other 
 persons, of either sex, who desire a knowledge of the behavior of disease, as it 
 concerns infection ; and the manner in which foulness, either of wounded sur- 
 faces, or of the sick-room, or of the dwelling-house, may be prevented. 
 
 " Each disease is taken up in turn (typhoid fever, consumption, diphtheria, 
 etc.) and the methods of management of the discharges, etc , are described in 
 detail. The formulae for the preparation of disinfecting solutions, for clothing, 
 utensils, privies, etc., are clearly set forth; such details as one may search his 
 library in vain for are here given in a compact form. 
 
 " The prevention of blindness in infants receives full attention. Ventilation 
 is duly considered, and a chapter is given to the thoughtful discussion of immu- 
 nity and protection from disease. The book closes with some remarks upon 
 the diet of the sick-room. We congratulate Dr. Canfield on his work. It is 
 well worth the moderate price." Maryland Medical Journal. 
 
 GRAPHIC CLINICAL CHART. Designed by 
 J. P. CROZER GRIFFITH, M.D. The purpose of this 
 chart is to give, in the most concise form, a complete 
 record of pulse, respiration, and temperature of the 
 patient. Its simplicity and the ease with which it is 
 kept commend it to nurses, and the clearness of the 
 design makes plain at a glance the full history of the 
 case. Price, in packets 0^50, .50 
 
BOOKS ON MASSAGE. 
 
 KLEEN. Handbook of Massage. Cloth, $2.25 
 By DR. KLEEN, of Stockholm and Carlsbad. Translated 
 by EDWARD M. HARTWELL, A.M. M.D., Director of Physi- 
 cal Education, Boston Public Schools, late of Johns Hop- 
 kins University, Baltimore. With an introduction by S. 
 WEIR MITCHELL, M.D., of Philadelphia. Illustrated by a 
 series of Handsome Engravings, made from fine Pen-and- 
 ink Drawings after original photographs made for the pur- 
 pose. *jf* This is the American Edition of "Kleen's Hand- 
 book," which is well known among teachers and experts 
 as the most comprehensive and perfect on the subject. 
 Several changes and additions have been made at the 
 author's suggestion, notably among the latter the set of 
 illustrations made from photographs taken by him for this 
 edition. No pains have been spared to make this the best 
 of standard works upon massage. 
 
 MURRELL. Massotherapeutics. Fourth Edi- 
 tion. Or Massage as a Mode of Treatment. By WM. 
 MURRELL, M.D., F.R.C.P., Lecturer on Pharmacology and 
 Therapeutics at Westminster Hospital, Examiner at Uni- 
 versity of Edinburgh, Physician to Royal Hospital for Dis- 
 eases of the Chest. Fifth Edition. Revised and Enlarged. 
 Illustrated. I2mo. Cloth, 1.25 
 
 " Dr. Murrell particularly dwells on the importance of discrimination in the 
 selection of cases and on the special qualifications of a competent manipulator. 
 In a word, this essay may be said to convey in a short space most of the infor- 
 mation that is at present available in regard to this popular therapeutic agent. " 
 Front the London Practitioner. 
 
OSTROM ON MASSAGE. 
 
 JUST READY. THIRD EDITION. 
 
 Massage and the Original Swedish Move- 
 ments. Illustrated. And Their Application to 
 Various Diseases of the Body. A Manual for Students, 
 Nurses, and Physicians. By KURRE W. OSTROM, 
 from the Royal University of Upsala, Sweden ; In- 
 structor in Massage and Swedish Movements in the 
 Hospital of the University of Pennsylvania and in 
 the Philadelphia Polyclinic and College for Graduates 
 in Medicine, etc. Illustrated by ninety-three ex- 
 planatory Wood Engravings. Third Edition, Revised 
 and Enlarged. i2mo. Cloth, $1.00 
 
 " Mr. Ostrom presents to the English public this excellent, systematic manual, 
 showing, by illustrations, the various movements and the mode of application to 
 all parts of the body. The writer tells for what diseases such movements are 
 indicated, with some remarks on the physiology of the movement treatment." 
 From The Philadelphia Public Ledger. 
 
 " In this volume the author gives an excellent description of the methods of 
 massage and Swedish movement, together with their applicability to various 
 diseased conditions of the body. The methods are rapidly becoming popular- 
 ized in our own country, and the perusal of such a book as Mr. Ostrom has 
 written will be of great advantage to physicians, for whose use it is mainly in- 
 tended." From the Journal of the American Medical Association. 
 
 " .... Our author has performed a useful service in publishing this 
 brief and clearly written manual, and we can recommend it to all who wish to 
 gain a knowledge of a method of procedure which is daily finding more favor 
 in professional circles. The price of the volume should also insure it a wide 
 circulation." From the Edinburgh Medical Journal. 
 
 " The descriptions are clear, and so well supplemented by the illustrations, 
 that anyone with this book, and a subject on which to practice, could undoubt- 
 edly become proficient in the art of massage. An excellent feature is the simple 
 classification of the manipulations adopted by the author, which makes the 
 whole subject much easier to grasp." From the Medical Nevus , Philadelphia. 
 
ANATOMY AND PHYSIOLOGY. 
 
 POTTER'S Anatomy. Fifth Edition. 117 
 Illustrations and 16 Lithograph Plates. A 
 
 Compend of Human Anatomy. By SAML. O. L. 
 POTTER, M.A., M.D., M.R.C.P. (LOND.), Professor of 
 the Practice of Medicine, Cooper Medical College, 
 San Francisco. i2mo. Cloth, .80 
 
 " This is, in its way, a wonderful little book, comprising within its pages a 
 more or less complete account of every part of the human body, not even omit- 
 ting the histology of the tissues and organs." Edinburgh Medical Journal. 
 
 " Contains many useful hints and aids to memory not found in ordinary 
 works/' Canada Lancet. 
 
 " The arrangement is well calculated to facilitate accurate memorizing, and 
 the illustrations are clear and good." North Carolina Medical Journal. 
 
 BRUBAKER'S Physiology. Seventh Edition, 
 Enlarged and Improved. Illustrated. A Com- 
 pend of Physiology, including Embryology. By 
 A. P. BRUBAKER, M.D., Demonstrator of Physiology 
 at Jefferson Medical College ; Professor of Physiology, 
 Pennsylvania College of Dental Surgery, Philadelphia. 
 28 Illustrations. i2mo. Cloth, .80 
 
 w This is an admirable compend of physiology, including enough of anatomy 
 to fit it especially for the use of students of medicine. It has been prepared by 
 one who is fully fitted by his work as Demonstrator in the Jefferson Medical 
 College, and as Professor of Physiology in the Pennsylvania College of Dental 
 Surgery, and by his experience as quiz-master, to compile such a book, and it 
 has proved its utility by the acceptance it has already found. Its style is 
 clear and distinct, its teachings are sound, and it is well suited to the 
 purpose for which it is intended." Medical and Surgical Reporter. 
 
 MATERIA MEDICA AND THERAPEUTICS. 
 
 POTTER'S Materia Medica, Therapeutics, 
 and Prescription Writing. Sixth Edition. 
 
 Compend of Materia Medica, Therapeutics, and Pre- 
 scription Writing. With special reference to the Phy- 
 siological Action of Drugs. By SAMUEL O. L. POTTER, 
 M.A., M.D., M.R.C.P. (LOND.), late A. A. Surgeon, 
 U. S. Army ; Professor of the Practice of Medicine, 
 Cooper Medical College, San Francisco. 121110. 
 
 Cloth, .80 
 
BOOKS FOR NURSES. 
 
 HORWITZ'S Surgery. Minor Surgery and 
 Bandaging. Fifth Edition. 167 Illustrations. 
 
 A Compend of Surgery, including Minor Surgery, 
 Amputations, Fractures, Dislocations, Surgical Dis- 
 eases, Antiseptic Rules, Formulae, etc. , with Differen- 
 tial Diagnosis and Treatment, and a Complete Section 
 on Bandaging. By ORVILLE HORWITZ, B.S., M.D., 
 Professor of Genito-Urinary Diseases ; late Demonstra- 
 tor of Surgery, Jefferson Medical College, etc. Fifth 
 Edition. 324 pages. 121110. Cloth, .80 
 
 *#* The new Section on Bandaging and Surgical Dress- 
 ings consists of 34 Pages and 40 Illustrations. Every 
 Bandage of any importance is Figured. 
 
 WYTHE'S Dose and Symptom Book. The 
 
 Physician's Pocket Dose and Symptom Book. Con- 
 taining the Doses and Uses of all the Principal 
 Articles of the Materia Medica, and Officinal Prepa- 
 rations. By JOSEPH WYTHE, A.M., M.D. Seventeenth 
 Edition; revised and rewritten, containing Tables of 
 Weights and Measures, Rules for Proportioning the 
 Doses of Medicines, Hints on Treatment, etc. 
 Cloth, .75; Leather, with Tucks and Pocket, $1.00 
 
 WESTLAND. The Wife and Mother. A 
 
 Medical Guide to the Care of her Health and the 
 Management of her Children. By ALBERT WEST- 
 LAND, M.D. 121110. Illustrated. Cloth, $1.50 
 
 From the Philadelphia Medical News. 
 
 " A noticeable point about this little volume is the commendable absence of 
 technical terms, as the author plainly states that it is for the use of ' women who 
 are desirous of fulfilling their proper duties of wives and mothers.' Too often, 
 in works of this class, the readers for whom they are intended are confused and 
 led astray by the multiplicity of words and phrases meant rather for the prac- 
 titioner than the mother. . . . Altogether the books fulfills the objects for 
 which it was written, and will materially assist the young married woman in 
 the intelligent performance of new duties." 
 
 From the Nurse, Boston. 
 
 " The style is easy and fascinating. It should be in the hands of every nurse 
 and married women." 
 
NEW EDITION. 
 
 ACCIDENTS AND EMERGENCIES. 
 
 A Manual for the treatment of Surgical and other Injuries, 
 Poisoning and various Domestic Emergencies, in the absence of the 
 Physician. 
 
 By CHARLES W. DULLES, M.D., 
 
 Surgeon to the Out- Door Department of the University and Presbyterian 
 Hospitals, Philadelphia. 
 
 Fourth Edition, Enlarged. New Illustrations. 12mo. 
 ILLUSTRATED. 
 
 . Cloth, $1.00 
 
 SHORT LIST OF CONTENTS. 
 
 Preliminary Remarks. 
 Obstructions to Respiration. 
 Foreign Bodies in the Eye, Nose and 
 
 Ear. 
 
 Fits or Seizures. 
 Injuries to the Brain. 
 Effects of Heat. 
 Effects of Cold. 
 Sprains. 
 Dislocations. 
 Fractures. 
 Wounds of all kinds, including the 
 
 bites of Dogs, Cats, Snakes, Insects, 
 
 etc. 
 Railroad and Machinery Accidents. 
 
 Hemorrhage Bleeding. 
 
 Special Hemorrhages. 
 
 Transportation of the Injured. 
 
 Poisons and their Antidotes. 
 
 Domestic Emergencies, includes Chol- 
 era Morbus, Vomiting, Diarrhoea, 
 Nervous Attacks, Earache, Tooth- 
 ache, Asthmatic Attacks, Croup, 
 etc., etc. 
 
 Signs of Death. 
 
 Supplies for Emergencies. 
 
 The Surgical and Medicine Case, 
 their contents and use, Bandaging, 
 Poultices, etc. 
 
 Index. 
 
 *#* This book should be in the possession of every head of a 
 family, Nurse, Manufacturer, Police Lieutenant, Sea Captain, Hos- 
 pital Steward, School Teacher, Druggist, etc. etc. 
 
 " Several attempts have been made to prepare a volume which would serve 
 as a handy manual for reference in the time of need, in the absence of a doctor, 
 but none have succeeded better than the present little work. It should be in the 
 hands of all officers charged with the public conveyance of passengers, to be 
 read, in preparation for emergencies, and afterward to serve as a book of refer- 
 ence." North Carolina Medical Journal. 
 
 *' This little manual contains simple directions for the preliminary treatment 
 of accidents to all parts of the body and of such diseases as persons are suddenly 
 seized with. Without profuseness or an unintelligible vocabulary, it contains in 
 a small space a deal of useful information." New York World. 
 
 " This is a revised and enlarged edition, with new illustrations, of the manual, 
 explaining the treatment of surgical and other injuries in the absence of the phy- 
 sician. The simple and practical suggestions of this little book should be known 
 to every one. Accidents are constantly occurring, and a knowledge of what 
 should be done in an emergency is very valuable. Such a handbook should be 
 in every home, placed where it can always be found readily. Boston Journal 
 of Education. 
 
" I may say that Dr. E. P. Davis' Manual has proved useful to me 
 in teaching obstetrics by its clearness and its many practical sugges- 
 tions. "MARION E. SMITH, Chief Nurse Philadelphia Hospital. 
 
 DAVIS. Manual of Practical Obstetrics. By 
 
 EDWARD P. DAVIS, A.M., M. T \, Clinical Lecturer on Obstet- 
 rics in the Jefferson Medical College, Professor of Obstetrics 
 and Diseases of Children in the Philadelphia Polyclinic, 
 Visiting Obstetrician to the Philadelphia Hospital. Second 
 Edition, Enlarged. 351 pages; 150 illustrations, several 
 of which are colored. Cloth, $2.00 
 
 *' I have carefully reviewed the * Manual of Obstetrics ' by Dr. E. P. Davis. 
 
 " It is full, accurate, concise, and gracefully and clearly written. It is a most 
 excellent Manual of the art it teaches." Prof. J. Snydam Knox, Rush 
 Medical College, 2227 Calumet Avenue, Chicago. 
 
 " I have read it with interest, and consider it one of the best works on the sub- 
 ject for the use of students and practitioners. " Dr. James P. Boyd, Albany 
 Medical College, Albany, N. Y. 
 
 " I am so well pleased with the work that I have recommended it to my class. " 
 Dr. A . L. Breysacher, Medical Department A.I. U., Little Rock, A rk. 
 
 " I have completed my examination of it, and want to say that I think it is 
 the biggest little work on the subject it has been my privilege to look over. It 
 is surely a complete work, devoid of theory, replete with practice. I heartily 
 commend it as a manual. " Dr.J. R. Rathmell, Chattanooga Medical College, 
 Tenn. 
 
 " I would say that in style and character it is abreast with the most modern 
 and approved methods and thought upon the subject, that for brevity it is clear, 
 systematic, and concise, very suitable for the busy student during the session at 
 college, and for the busy practitioner as well. It gives the essentials, and I shall 
 take pleasure in recommending it to my students. " Dr. M. R. Mitchell, Kan- 
 sas Medical College , Topeka, Kan. 
 
 " It is especially clear and pleasing in style and the subject matter is well 
 chosen. It is a good text-book. " Dr. Clara Marshall, Philadelphia. 
 
 " It is concise and accurate, and I cordially recommend it as admirably suited 
 to the convenience of the medical student and busy practitioner. " Dr. De 
 Laskie Miller, Rush Medical College, Chicago, III. 
 
 " I consider it a very good book. " Prof. A. F. A. King, National Medical 
 College, Columbian University, Washington, D. C. 
 
 " I consider it a valuable work, especially for the recent graduates who are 
 entering upon the practice of obstetrics and pursuing post-graduate studies. 
 
 " I keep my copy where I can read it, and consult its pages almost daily, and 
 generally find what I want in a few lines." Dr. P. C. Clayberg, American 
 Medical College, St. Louis, Mo. 
 
 " The book appears to me to meet the purposes for which it is written and to 
 be a valuable addition to the library of the busy practitioner. " Prof. Randolph 
 Wins low, University of Maryland, Baltimore, Md. 
 
 "I am well pleased with the 'Manual of Obstetrics' by Dr. E. P. Davis, 
 and can recommend the work to the profession." Prof. C. A. Pauly, Pulte 
 Medical College, Cincinnati, O. 
 
 " The book is a most excellent one. After careful investigation, I have no 
 hesitation in cordially recommending it to anybody in need of a small manual." 
 Dr. M. D. Mann, Buffalo, N. Y. 
 
THE 
 
 AMERICAN HEALTH PRIMERS. 
 
 EDITED BY W. W. KEEN, M.D., 
 
 Professor of Surgery in the Jefferson Medical College, Fellow of the College 
 of Physicians of Philadelphia, etc. 
 
 12 Vols. 32mo. Attractive Cloth Binding, each 40 Cents. 
 
 This Series of HEALTH PRJMERS is prepared to diffuse as widely and 
 cheaply as possible, among all classes, a knowledge of the elementary facts of 
 Preventive Medicine. They are intended incidentally to assist in curing dis- 
 eases, and to teach people how to form correct habits of living, and take care 
 of themselves, their children, employees, etc. 
 
 I. HEARING AND HOW TO KEEP IT. With Illustrations. By CHAS. 
 
 H. BURNETT, M.D., of Philadelphia, Aurist to the Presbyterian Hospital. 
 
 II. LONG LIFE AND HOW TO REACH IT. By J. G. RICHARDSON, M.D., 
 of Philadelphia, late Professor of Hygiene in the University of Pennsyl- 
 vania. 
 
 HI. THE SUMMER AND ITS DISEASES. By JAMES C. WILSON, M.D., 
 of Philadelphia, Professor of the Practice of Medicine, Jefferson Medical 
 College. 
 
 IV. EYESIGHT AND HOW TO CARE FOR IT. With Illustrations. By 
 GEORGE C. HARLAN, M.D., of Philadelphia, Surgeon to the Wills (Eye) 
 Hospital. 
 
 V. THE THROAT AND ThE VOICE. With Illustrations. By J. SOLIS 
 COHEN, M.D., of Philadelj hia, Lecturer on Diseases of the Throat in Jef- 
 ferson Medical College, an< I on the Voice in the National School of Oratory. 
 
 VI. THE WINTER AND ITS DANGERS. By HAMILTON OSGOOD, M.D., 
 of Boston, Editorial Staff Boston Medical and Surgical Journal. 
 
 VII. THE MOUTH AND THE TEETH. With Illustrations. By J. W. 
 WHITE, M.D., D.D.S., of Philadelphia, Editor of the Dental Cosmos. 
 
 VIII. BRAIN WORK AND OVERWORK. By H. C. WOOD, JR., M.D., of 
 Philadelphia, Clinical Professor of Nervous Diseases in the University of 
 Pennsylvania. 
 
 IX. OUR HOMES. With Illustrations. By HENRY HARTSHORNB, M.D , 
 of Philadelphia, formerly Professor of Hygiene in the University of Penn- 
 sylvania. 
 
 X. THE SKIN IN HEALTH AND DISEASE. With Illustrations. By 
 L. D. BULKLEY, M.D., of New York, Physician to the Skin Department 
 of the New York Hospital. 
 
 XL SEA AIR AND SEA BATHING. With Illustrations. By JOHN H. 
 PACKARD, M.D., of Philadelphia, Surgeon to the Pennsylvania Hospital. 
 
 XII. SCHOOL AND INDUSTRIAL HYGIENE. By D. F. LINCOLN, M.D., 
 of Boston, Mass., Chairman Department of Health, American Social 
 Science Association. 
 
 u The series of 'American Health Primers ' deserves hearty commendation. 
 These handbooks of practical suggestions are prepared by men whose profes- 
 sional competence is beyond question, and, for the most part, by those who 
 have made the subject treated the study of their lives." New York Sun. 
 
 *#* Each Volume 50 Cents, in Attractive Cloth Binding. 
 
BYFORD'S 
 MANUAL OF GYNECOLOGY 
 
 Two Hundred and Thirty-four Illustrations. 
 
 By HENRY T. BYFORD, M.D., Professor of Gynecology 
 and Clinical Gynecology in the College of Physicians 
 and Surgeons of Chicago ; Professor of Clinical Gyne- 
 cology in Woman's Medical School of Northwestern 
 University, etc. 
 
 12mo. 488 Pages. Cloth, $2.50. 
 
 Though prepared more especially for medical stu- 
 dents and young physicians, this book has many 
 points that recommend it to the nurse who wants 
 to thoroughly understand the important details of 
 gynecological nursing. 
 
 The chapters in Part One on gynecological tech- 
 nique and the principles of gynecological treat- 
 ment are more minute in detail than is usual in 
 such books, special attention being given to the 
 duties of the nurse, to aseptic and antiseptic mat- 
 ters, instruments, etc., etc. A series of eight illus- 
 trations showing the various postures in which the 
 patient is placed for examination or operating will 
 prove exceedingly useful. 
 
GOULD'S POCKET MEDICAL LEXICON. 
 
 12,000 MEDICAL WORDS 
 
 PRONOUNCED AND DEFINED. 
 
 A Pronouncing Lexicon of Medical "Words Specially Adapted for 
 Nurses, Including Many Useful Tables and a Dose List. 
 
 BY GEORGE M. GOULD, M.D., 
 
 Author of "An Illustrated Dictionary of Medicine, Biology, and Allied 
 Sciences " " The Student ' s Medical Dictionary," etc. 
 
 Pocket Size. 317 Pages. Gilt Edges, Full Morocco. 
 Price $1.00 ; with a Thumb Index, $1.25. 
 
 OVER 45,000 COPIES OF GOULD'S DICTIONARIES 
 HAVE BEEN SOLD. 
 
 "Gould's Dictionary, Pocket Edition, is the most complete and convenient I 
 have seen." Marion E. Smith, Head Nurse, Philadelphia Hospital, Phila. 
 
 " The Pocket Dictionary is a little gem." L. J. Gross, Head Nurse, Buffalo 
 General Hospital. 
 
 " I have examined Gould's Dictionary, and consider it the best dictionary in 
 a small compass that I have seen. The price, too, is most reasonable I shall 
 recommend it to all our nurses." F. Htitcheson, Head Nurse, Flower Mission 
 Training School for Nurses, Indianapolis, Ind. 
 
 " I shall certainly have the nurses each send for a copy of the dictionary. It 
 is just what they need, and is a nice size to carry." Harriet Sutherland, Head 
 Nurse, Margaret Pillsbury Hospital, Concord, N. H. 
 
 -8=- Every nurse should have a copy of this little book in order 
 to intelligently pursue her studies and to thoroughly understand 
 the physician's directions. It furnishes a vast amount of informa 
 tion not to be obtained in the regular text-books.