,,clevel& ,,education ,,survey          
,,heal? ,,"w ,,9     ,,! ,,public       
,,s*ools      ,,leon>d ,p4 ,,ayres      
,,&     ,,may ,,ayres                   
,illu/ration3 ,,cfs       ,,! ,,survey  
,,committee ,,( ,,!     ,,clevel&       
,,f\ndation     ,,clevel&  ,,ohio       
#aiae       ,,copyright1 #aiae1 ,,by    
,,! ,,survey ,,committee ,,( ,,!        
,,clevel& ,,f\ndation       ,,wm,f4     
,,fell ,,co,,pr9t]s     ,,philadelphia  
,,! ,,survey ,,committee ,,( ,,!        
,,clevel& ,,f\ndation      ,*>les ,e4   
,adams1 ,*airman     ,?omas ,g4         
,fitzsimons     ,myrta ,l4 ,jones       
,bascom ,little     ,victor ,w4 ,s9c]e  
,ar?ur ,d4 ,baldw91 ,secret>y     ,james
 ,r4 ,g>field1 ,c\nsel     ,all5 ,t4    
,burns1 ,director      ,,! ,,educational
 ,,survey     ,leon>d ,p4 ,ayres1       
,director  ,illu/ration3 ,team "w betwe5
 physician & nurse 9 ,clevel&4          
,,=eword   ,?is report on ,heal? ,"w 9 !
 ,public ,s*ools is "o ( ! #be sections 
( ! report ( ! ,educational ,survey (   

,clevel& conduct$ by ! ,survey          
,committee ( ! ,clevel& ,f\ndation 9    
#aiae4 ,tw5ty-?ree ( ^! sections w be   
publi%$ z sep>ate monographs4 ,9        
addition !re w be a l>g] volume giv+ a  
summ>y ( ! f9d+s & recomm5dations relat+
 to ! regul> "w ( ! public s*ools1 & a  
second simil> volume giv+ ! summ>y ( ^? 
sections relat+ to indu/rial education4 
,copies ( all ^! publications may be    
obta9$ f ! ,clevel& ,f\ndation4 ,!y may 
also be obta9$ f ! ,division (          
,education ( ! ,russell ,sage           
,f\ndation1 ,new ,york ,city4 ,a        
complete li/ w be f\nd 9 ! back ( ?is   
volume1 toge!r ) prices4                
,,table ,,( ,,cont5ts                   
,,page     ,=eword                      
#e     ,li/ ( ,illu/rations & ,diagrams 
#i     ,! ,argum5t = ,m$ical ,inspection
                              #aa       
,heal? & ,s*ool ,progress               
#ac     ,exam9ations = ,physical        
,defects                                
#ad     ,objections to ,m$ical          

,inspection                             
#af     ,h[ ! ,"w ,/>t$                 
#ah     ,! ,pres5t ,sy/em               
#bj     ,! ,s*ool ,nurse                
#ba     ,clevel&'s ,disp5s>ies          
#bd     ,d5tal ,cl9ics                  
#bh     ,eye ,cl9ics                    
#cj     ,co-op]ation ( ,college = ,b>b]s
                              #cb     ,!
 ,m$ical ,inspection ,/aff              
#cb     ,! ,plan ( ,conc5trat+ ,int]e/s 
#cd     ,uni=m ,proc$ure                
#cg     ,vacc9ation                     
#ci     ,future ,developm5t             
#dc     ,t5 ,types ( ,heal? ,"w         
#df     ,heal? & ,education & ,bus9ess  
#dh     ,summ>y                         
#ed                          ,,li/ ,,(  
,,illu/rations                          
,,fac+                                  
,,page      ,team "w betwe5 physician & 
nurse 9 ,clevel&4  ,frontispiece        
,tony's tonsils ne$ att5tion            
#ag     ,ei!r doctor or nurse visits e  
s*ool e day             #bj             

,clevel&'s disp5s>ies are well equipp$  
#be     ,! equipm5t ( ! ,m>ion ,s*ool   
d5tal cl9ic co/ ab\t #gjj #bh     ,! eye
 cl9ic is adv]tis$ by its lov+ fri5ds   
#ca     ,vacc9at$ *ildr5 at ,hodge      
,s*ool--#ej1jjj m are         unvacc9at$
                                        
#ci     ,%[] ba?s in/all$ 9 an old      
build+ 9 a cr[d$ section   #dd          
,,diagrams      ,numb] ( *ildr5 giv5    
physical exam9ations ea* ye> =          
five s*ool ye>s & numb] f\nd to h       
physical defects  #bf      ,p] c5t (    
physical defects correct$ ea* ye> = five
         s*ool ye>s                     
#cf     ,,heal? ,,"w ,,9 ,,! ,,public   
,,s*ools   ,clevel& employs #af         
physicians1 "o oculi/1 & #bg nurses to  
take *>ge ( ! heal? ( h] s*ool *ildr54  
,! city sp5ds #cf1jjj a ye> on sal>ies &
 supplies = ^! p4 ,!re are #hf s*ool    
disp5s>ies & cl9ics4 ,clevel& is mak+   
?is heavy inve/m5t because %e f9ds x    
pays4     ,,! ,,argum5t ,,= ,,m$ical    
,,inspection   ,m$ical inspection is an 

ext5sion ( ! activities ( ! s*ool 9 :i* 
! educator & ! physician jo9 h&s to     
insure = ea* *ild su* conditions ( heal?
 & vitality z w be/ enable him to take  
full advantage ( ! free education (f]$  
by ! /ate4 ,its object is to bett] heal?
 conditions among s*ool *ildr51 safegu>d
 !m f disease1 & r5d] !m heal?i]1       
happi]1 & m vigor\s4 ,x is f\nd$ ^u a   
recognition ( ! intimate relation%ip    
betwe5 ! physical & m5tal conditions ( !
 *ildr51 & ! consequ5t dep5d5ce (       
education on heal? conditions4  ,9      
,clevel&1 ! value ( m$ical inspection 0 
recogniz$ :ile ! movem5t 0 /ill 9 its   
infancy 9 ,am]ica4 ,"h1 z else:]e1 ?is  
sudd5 recognition ( ! imp]ative         
necessity = safegu>d+ ! physical welf>e 
( s*ool *ildr5 grew out ( ! discov]y t  
compulsory education "u mod]n city      
conditions meant compulsory disease4  ,!
 /ate1 to provide = its own protection1 
has decre$ t all *ildr5 mu/ att5d s*ool1
 & has put 9 motion ! all-p[]ful b      
indiscrim9at+ ag5cy ( compulsory        

education1 :i* ga!rs 9 ! ri* & ! poor1 !
 bright & ! dull1 ! heal?y & ! sick4 ,! 
object 0 to insure t ^! *ildr5 %\ld h   
s\nd m9ds4 ,"o ( ! un=ese5 results 0 to 
insure t !y %\ld h uns\nd bodies4       
,m$ical inspection is ! device creat$ to
 rem$y ?is condition4 ,its object is    
prev5tion & cure4  ,ev] s9ce its        
e/abli%m5t ! good results ( m$ical      
inspection h be5 evid5t4 ,epidemics h   
be5 *eck$ or avoid$4 ,improvem5ts h be5 
not$ 9 ! cleanl9ess & neatness ( !      
*ildr54 ,tea*]s & p>5ts h come to "k t  
"u ! new sy/em x is safe = *ildr5 to    
cont9ue 9 s*ool 9 times ( ?reat5$ or    
actual epidemic4     ,,heal? ,,& ,,s*ool
 ,,progress   ,b m$ical inspection does 
n conf9e itself to deal+ ) contagi\s    
disease4 ,its aid has be5 invok$ to help
 ! *ild :o is backw>d 9 8 s*ool /udies4 
,) ! rec5t ext5sions 9 ! l5g? ( ! s*ool 
t]m & ! increase 9 ! numb] ( ye>s (     
s*ool+ dem&$ ( ! *ild1 has come a great 
advance 9 ! /&>ds ( ! "w requir$4 ,:5 ! 
/&>ds 7 l[1 ! "w 0 n beyond ! capacity (

 ev5 ! weak] *ildr52 b ) close grad+1   
full] c\rses1 high] /&>ds1 & con/antly m
 insi/5t dem&s = intellectual atta9m5t1 
conditions h *ang$4 ,pupils h be5 unable
 to keep up ) _! classes4 ,! t]ms       
backw>d1 ret>d$1 & exceptional1 z appli$
 to s*ool *ildr51 h be5 add$ to !       
vocabul>ies ( educators4  ,s*ool m5     
discov]$ t ! drag-net ( compulsory      
education 0 br++ into s*ool hundr$s (   
*ildr5 :o 7 unable to keep /ep ) _!     
companions1 & because ?is int]f]$ ) !   
ord]ly adm9i/ration ( ! s*ool sy/em1 !y 
began to ask :y ! *ildr5 7 backw>d4  ,! 
s*ool physicians help$ to f9d ! answ] :5
 !y %[$ t hundr$s ( ^! *ildr5 7 backw>d 
simply because ( removable physical     
defects4 ,& !n came ! next great =w>d   
/ep1 ! realization t *ildr5 are n       
dull>ds ?r\gh ! w ( an inscrutable      
,provid5ce1 b r ?r\gh ! law ( cause &   
effect4     ,,exam9ations ,,= ,,physical
 ,,defects   ,?is l$ to an ext5sion ( ! 
scope ( m$ical inspection to include !  
physical exam9ation ( s*ool *ildr5 ) !  

aim ( discov]+ :e!r or n !y 7 suff]+ f  
su* defects z w\ld h&icap _! educational
 progress & prev5t !m f receiv+ ! full  
b5efit ( ! free education furni%$ by !  
/ate4 ,?is "w 0 9 its infancy five ye>s 
ago1 b today ,clevel& has a ?or\gh &    
compreh5sive sy/em ( physical exam9ation
 ( its s*ool *ildr54  ,surpris+ numb]s (
 *ildr5 h be5 f\nd :o1 ?r\gh defective  
eyesight1 h be5 s]i\sly h&icapp$ 9 _!   
s*ool "w4 ,_m are f\nd to h defective   
he>+4 ,o!r conditions are f\nd :i* h a  
great & =m]ly unrecogniz$ influ5ce on ! 
welf>e1 happ9ess1 & m5tal vigor ( !     
*ild4 ,att5tion has be5 direct$ to !    
real significance ( ad5oids & enl>g$    
tonsils1 ( swoll5 gl&s & c>i\s tee?4    
,tea*]s & p>5ts h come to realize t !   
problem ( ! pupil ) defective eyesight  
may be q z important to ! community z t 
( ! pupil :o has "s contagi\s disease4  
,if a *ild :o is unable to see di/9ctly 
is plac$ 9 a s*ool :]e physical defects 
are unrecogniz$ & disreg>d$1 heada*es1  
eye/ra91 & failure foll[ all 8 ef=ts at 

/udy4 ,he _c see ! blackbo>ds & *>ts2   
pr9t$ books are indi/9ct or are se5 only
 ) mu* ef=t1 ev]y?+ is blurr$4 ,nei!r he
 nor 8 tea*] kn[s :at is ! matt]1 b he  
soon f9ds x impossible to keep pace ) 8 
companions1 &1 becom+ disc\rag$1 he     
falls beh9d 9 ! unequal race4  ,9 no    
bett] plight is ! *ild suff]+ f enl>g$  
tonsils & ad5oids1 :i* prev5t prop]     
nasal brea?+ & compel him to keep 8 m\? 
op5 9 ord] to brea!4 ,p]haps "o ( 8     
tr\bles is deafness4 ,he is soon        
consid]$ /upid4 ,?is impression is      
/r5g!n$ by 8 poor progress 9 s*ool4     
,?r\gh no fault ( 8 own he is doom$ to  
failure4 ,he neglects 8 /udies1 hates 8 
s*ool1 leaves long be=e he has complet$ 
! c\rse1 & is well />t$ on ! road to an 
ineffici5t & despond5t life4  ,public   
s*ools are a public tru/4 ,:5 ! p>5t    
deliv]s 8 *ild to _! c>e he has a "r to 
insi/ t ! *ild "u ! sup]vision ( ! s*ool
 au?orities %all be safe f h>m & %all be
 h&$ back to him 9 at lea/ z good       
condition z :5 x ent]$ s*ool4 ,ev5 if ! 

p>5t does n insi/ ^u x1 ! *ild himself  
has a "r to claim protection4 ,! *ild   
has a claim ^u ! /ate & ! /ate a claim  
^u ! *ild :i* dem&s recognition4        
,education )\t heal? is useless4 ,x w\ld
 be bett] to sacrifice ! education if1 9
 ord] to atta9 x1 ! *ild mu/ lay d[n 8  
good heal? z a price4 ,education mu/    
compreh5d ! :ole man & ! :ole man is    
built fundam5tally on :at he is         
physically4     ,,objections ,,to       
,,m$ical ,,inspection   ,! objection t !
 s*ool has no "r to p]mit or require    
m$ical inspection ( ! *ildr5 w n be>    
close scrut9y or logical analysis4 ,!   
au?ority :i* has ! "r to compel         
att5dance at s*ool has ! add$ duty (    
insi/+ t no h>m %all come to ^? :o g    
!re4 ,! ex]cise ( ! p[] to en=ce s*ool  
att5dance is dang]\s if x is n          
accompani$ by an appreciation ( ! duty (
 see+ to x t ! assembl+ ( pupils br+s to
 ! individual no physical detrim5t4     
,illu/ration3 ,tony's tonsils ne$       
att5tion4  ,nor are ! s*ools1 9 assum+ !

 m$ical ov]sight ( ! pupils1 trespass+  
^u ! doma9 ( private rights &           
initiative4 ,"u m$ical inspection1 :at  
is done = ! p>5t is to tell him ( ! ne$s
 ( 8 *ild1 ( :i* he might o!rwise h be5 
9 ignorance4 ,x leaves to ! p>5t ! duty 
( meet+ ^? ne$s4 ,x leaves him ) a l>g] 
responsibility ?an be=e4 ,x is difficult
 to f9d a logical basis = ! argum5t t ! 
s*ool has n ! "r to in=m ! p>5ts (      
defects pres5t 9 ! *ild1 & to advise z  
to rem$ial measures :i* %\ld be tak5 to 
remove !m4  ,! ju/ification ( ! /ate 9  
assum+ ! function ( education & 9 mak+ t
 education compulsory is to insure its  
own pres]vation & effici5cy4 ,:e!r or n 
x is successful w dep5d on ! degree to  
:i* its individual memb]s are           
spiritually prep>$ = mod]n co-op]ation4 
,b ! well-be+ ( a /ate is z mu* dep5d5t 
^u ! /r5g?1 heal?1 & productive capacity
 ( its memb]s z x is ^u _! k &          
intellig5ce4 ,9 ord] t x may insure !   
effici5cy ( its citiz5s1 ! /ate1 ?r\gh  
its compulsory education enactm5ts1     

requires its y\? to pursue c]ta9 /udies 
:i* exp]i5ce has prov$ necess>y to      
secure t effici5cy4 ,individual         
effici5cy1 h[ev]1 re/s n alone on       
education or intellig5ce1 b is equally  
dep5d5t on physical heal? & vigor4      
,h5ce1 if ! /ate may make m&atory tra9+ 
9 intellig5ce1 x may also comm& tra9+ to
 secure physical s\ndness & capacity4   
,heal? is ! f\ndation on :i* re/s !     
happ9ess ( a p & ! p[] ( a nation4      
,,h[ ,,! ,,"w ,,/>t$   ,! fir/ "w ( ?is 
k9d 9 ,clevel& is describ$ 9 ,sup]9t5d5t
 ,jones' report = #aijj4 ,9 t ye> !     
s*ools became greatly int]e/$ 9 ! "q (  
defective vision4 ,te/s 7 made by tea*]s
 9 diff]5t grades1 & z a result ov]     
#b1jjj *ildr5 7 giv5 treatm5t4  ,9      
#aijf1 an agreem5t 0 rea*$ ) ! ,bo>d (  
,heal?1 s t ea* alt]nate day a heal?    
inspector communicat$ ) ! pr9cipal ( e  
s*ool4 ,tea*]s 7 w>n$ to be on ! al]t = 
symptoms ( illness1 & *ildr5 %[+ signs (
 measles1 :oop+ c\gh1 sc>let fev]1 or   
o!r common diseases ( *ildhood1 7       

report$ to ! pr9cipal1 & ?r\gh h] to !  
,bo>d ( ,heal?4 ,contagi\s cases 7      
exclud$ f s*ool z soon z detect$1 & a   
sy/ematic campaign />t$ aga9/ ! waves ( 
disease :i* 7 sweep+ "o aft] ano!r ?r\gh
 ! s*ools4  ,9 ! same ye> ,drs4 ,l4 ,w4 
,*ilds1 ,j4 ,h4 ,mc,henry1 ,h4 ,l4      
,san=d1 & o!r memb]s ( ! m$ical         
pr(ession volunte]$ _! s]vices z s*ool  
physicians1 to detect n only cases (    
possible contagion1 b also ! exi/5ce (  
physical defects4 ,:at 0 probably ! fir/
 s*ool disp5s>y 9 ! ,unit$ ,/ates 0 op5$
 at ! reque/ ( ,dr4 ,*ilds by ! ,bo>d ( 
,education 9 #aijg at ! ,murray ,hill   
,s*ool4 ,! value ( s*ool disp5s>ies 0 s 
imm$iately evid5t t by #aiji sev5 o!rs 7
 e/abli%$ = ! use ( ^! ?ree physicians4 
,co9cid5t ) ! disp5s>ies came ! s*ool   
nurse4 ,:5 ! fir/ nurse 0 appo9t$ at !  
,murray ,hill ,s*ool1 a rem>kable *ange 
0 obs]v$ among ! *ildr54 ,abs5ces became
 less frequ5t4 ,sk9 diseases 7 r>e4     
,*ildr5 began to take an int]e/ 9 heal? 
matt]s1 & !re 0 a m>k$ rise 9 /&>ds (   

neatness & cleanl9ess4 ,tea*]s &        
pr9cipals unit$ 9 _! dem& = m nurses1   
until )9 a ye> aft] ! movem5t />t$ !re 7
 six nurses appo9t$ by ! ,bo>d (        
,education & regul>ly employ$ 9 s*ool   
"w4 ,9 ! same ye>1 ,decemb]1 #aiji1 !   
,bo>d ( ,education =mally vot$ to       
e/abli% a ,division ( ,heal? ,sup]vision
 & ,inspection z "p ( ! regul> s*ool    
sy/em4     ,,! ,,pres5t ,,sy/em   ,z x  
is at pres5t organiz$1 ! ,division h&les
 inspection = contagi\s disease1        
inspection = physical & m5tal defects1  
foll[-up "w = ! rem$y+ ( defects1 heal? 
in/ruction1 recomm5dation ( *ildr5 to   
s*ools = ! physically & m5tally         
h&icapp$1 s*ool lun*es1 g>d5s1 &        
playgr\nds4  ,ei!r ! nurse or physician 
reports at ea* s*ool e day ( ! ye>4     
,once dur+ ! ye> ea* *ild is giv5 a     
c>eful physical exam9ation1 & fur!r     
exam9ations are made :5 !y are ne$$4    
,all s]i\s defects are report$ to p>5ts1
 & 9 cases :]e treatm5t is important1   
p>5ts are urg$ to consult ) ! s*ool     

doctor conc]n+ ! nature ( ! difficulty &
 ! be/ means ( cur+ x4 ,to supplem5t ^! 
int]views1 ! s*ool nurse sp5ds a l>ge "p
 ( h] "t 9 visit+ homes1 talk+ ) p>5ts1 
not+ conditions "u :i* *ildr5 live1 &   
mak+ sugge/ions z to home c>e4          
,illu/ration3 ,ei!r doctor or nurse     
visits e s*ool e day4  ,"s idea ( !     
complexity ( ?is "w may be ga9$ f !     
,division records = #aiad-aiae4 ,f !    
beg9n+ ( ,septemb] to ! end ( ,june--a  
p]iod ( #ch s*ool weeks--doctors &      
nurses exam9$ #gd1gbe *ildr52 gave      
private int]views to #b1edg p>5ts2 made 
#e1fge visits to disp5s>ies2 #aj1fjc    
visits to homes2 & gave #gf1bdj         
treatm5ts & dress+s4 ,9 addition1 !y    
gave #gge too?bru% drills1 & #ai1djf    
individual or class heal? talks to !    
pupils ( ! public s*ools dur+ ! ye>4    
,,! ,,s*ool ,,nurse   ,! value ( ! s*ool
 nurse is "o feature ( m$ical inspection
 ( s*ools ab\t :i* !re is no division ( 
op9ion4 ,h] s]vices h abundantly        
demon/rat$ _! utility1 & h] employm5t   

has q pass$ ! exp]im5tal /age4 ,!       
introduction ( ! tra9$ nurse into !     
s]vice ( education has be5 rapid1 & few 
s*ool innovations h met ) su* widespread
 support & en?usia/ic approval4  ,!     
reason = ?is is t ! s*ool nurse supplies
 ! motive =ce :i* makes m$ical          
inspection effective4 ,! s*ool          
physician's discov]y ( defects &        
diseases is ( little use if ! result is 
only ! ent]+ ( ! fact on ! record c>d or
 ! exclusion ( ! *ild f s*ool4 ,! notice
 s5t to p>5ts tell+ ( ! *ild's condition
 & advis+ t ! family physician be       
consult$1 repres5ts wa/$ ef=t if ! p>5ts
 fail to realize ! import ( !           
notification or if !re be no family     
physician to consult4 ,if ! physical    
exam9ation has = its only result ! ent]+
 ( words ^u record c>ds1 !n p$iculosis &
 tub]culosis are ( precisely equal      
importance4 ,! nurse avoids su*         
ineffective lo/ motions by conv]t+ !m   
into effici5t function+ ?r\gh assi/+ !  
physician 9 8 exam9ations1 p]sonally    

foll[+ up ! cases to insure rem$ial     
action1 & educat+ tea*]s1 *ildr51 &     
p>5ts 9 practical appli$ hygi5e4  ,"s   
idea ( ! "w ( ! s*ool nurses 9 ,clevel& 
may be ga9$ f ! foll[+ record ( :at "o  
nurse did dur+ "o day :ile ! survey 0 9 
progress4 ,x repres5ts a typical day's  
"w = a typical nurse & is n especially  
unusual4       #h3cj ,a4 ,m4       ,home
 call to get p]mission to take *ild to  
s*ool      headqu>t]s = m5tal           
exam9ation4       ,call$ at             
,case-,woodl& ,s*ool to exam9e *ild )   
sore      ?roat4       ,took a *ild home
 to h "m clean h] up4       ,call$ at   
,h>mon ,s*ool4       ,treat$ #aj cases (
 impetigo1 ?ree ( too?a*e1 two (        
r+worm4       ,took two *ildr5 home to  
be clean$ up4       ,inspect$ #ej       
*ildr54       ,gave heal? talk4         
,tri$ to locate a boy :o is to att5d    
p>tial bl9d class      at ,h>mon ,s*ool4
       ,f\nd boy 0 transf]r$ f ,h>mon   
,s*ool to ,m>ion      ,s*ool la/ ye>4   
,call$ at ,m>ion ,s*ool b f\nd no trace 

( boy4       ,call$ at address to :i*   
*ild 0 suppos$ to h mov$2      no su*   
numb]4       ,call$ at ,k5n>d ,s*ool to 
see if ,miss ,o',neill rememb]$      him
 at ,m>ion ,s*ool2 f\nd no trace ( him4 
,call$ at two homes 9 reg>d to enl>g$   
tonsils &      defective vision4        
#a3ae ,p4 ,m4       ,mayfl[] ,s*ool3 boy
 ) spra9$ ankle1 soak$ 9 hot      wat]1 
/rapp$ ) adhesive4       ,treat$ f\r    
cases ( impetigo1 "o cut f+]1 op5$ two  
boils4       ,conf]5ce ) "m at s*ool4   
,in/ruct$ h] 9 case ( *ild's dis*>g+ e>4
       ,inspect$ #fb *ildr54            
,call$ at two homes to secure treatm5t =
 defective tee?4       ,advis$ "m to s5d
 *ildr5 to ,m>ion ,d5tal ,cl9ic4  ,to   
sum up ! case = ! s*ool nurse3 ,%e is ! 
tea*] ( ! p>5ts1 ! pupils1 ! tea*]s1 & !
 family 9 appli$ practical hygi5e4 ,h]  
"w prev5ts loss ( "t on ! "p ( ! pupils 
& va/ly r$uces ! numb] ( exclusions =   
contagi\s diseases4 ,%e cures m9or      
ailm5ts 9 ! s*ool & cl9ic & furni%es    
effici5t aid 9 em]g5cies4 ,%e gives     

practical demon/rations 9 ! home (      
requir$ treatm5ts1 (t5 discov]+ !re !   
s\rce ( ! tr\ble1 :i*1 if undiscov]$1   
w\ld r5d] useless ! "w ( ! m$ical       
inspector 9 ! s*ool4 ,! s*ool nurse is !
 mo/ effici5t possible l9k betwe5 !     
s*ool & ! home4 ,h] "w is imm5sely      
important 9 its direct results &        
f>-rea*+ 9 its indirect influ5ces4      
,among =eign populations %e is a v pot5t
 =ce = ,am]icanization4     ,,clevel&',s
 ,,disp5s>ies   ,clevel& has #hf s*ool  
disp5s>ies1 or :at are usually t]m$     
physicians' (fices4 ,^! are rooms ab\t  
#bj feet long by #ae feet wide1 locat$ 9
 ! basem5t or on ! fir/ floor ( ! s*ool 
build+1 well light$1 & pa9t$ 9 :ite or  
light colors4 ,usually !y conta9 "o or  
two small :ite enamel tables1 sev]al    
*airs1 a wa% bas9 ) runn+ wat]1 a :ite  
enamel pail = wa/e mat]ials1 wood5      
tongue depressors1 eye *>ts1 a m$ical   
cab9et fill$ ) in/rum5ts & supplies1    
fil+ boxes1 & pr9t$ =ms4 ,9 #cg ( !     
elem5t>y s*ools1 %[] ba?s are provid$ z 

"p ( ! equipm5t ( ! build+4             
,illu/ration3 ,clevel&'s disp5s>ies are 
well equipp$4  ,clevel&'s disp5s>ies are
 ( exceptionally high grade4 ,9 e case  
light+1 v5tilation1 & equipm5t are good4
 ,_m ( ! rooms are l>ge en\gh =         
conf]5ces & hygi5e talks1 & 9 at lea/ "o
 s*ool--,ea/ ,madison--! disp5s>y is us$
 ) desirable psy*ological effect = !    
regul> meet+s ( ! ,mo!rs' ,club4 ,!     
excell5ce ( ,clevel&'s s*ool disp5s>ies 
has contribut$ 9 no small measure to !  
effici5cy ( ! m$ical s]vice1 & money    
sp5t 9 ?is way has be5 a wise inve/m5t4 
,x is probably true t ,clevel&'s        
disp5s>ies are ( bett] grade ?an ^? (   
any o!r l>ge city 9 ! ,unit$ ,/ates4    
,illu/ration3 ,columns are proportionate
 9 height to ! numb] ( *ildr5 giv5      
physical exam9ations ea* ye> = five     
s*ool ye>s4 ,portion 9 black indicates  
numb] hav+ physical defects4 ,! figures 
above ! columns %[ h[ _m ?\s&s ( *ildr5 
7 exam9$ & h[ _m f\nd defective 9 ea*   
ye>4  ,^! disp5s>ies h prov$ ( ! greate/

 value 9 r5d]+ ! physical exam9ations ( 
! *ildr5 m effective & effici5t4 ,?is "w
 is v diff]5t f t :i* relates to !      
detection ( contagi\s diseases4 ,! latt]
 is prim>ily a protective measure &     
looks ma9ly to ! imm$iate safegu>d+ ( ! 
heal? ( ! community4 ,! =m] aims at     
secur+ physical s\ndness & vitality &   
looks f> into ! future4  ,! physical    
exam9ations conduct$ 9 ^! disp5s>ies h  
%[n conclusively t a l>ge p]c5tage ( !  
,clevel& *ildr5--l ^? ( all o!r         
cities--suff] f defective vision to !   
ext5t ( requir+ an oculi/'s c>e if !y   
are to d _! "w prop]ly1 & if p]man5t    
injury to _! eyes is to be avoid$4 ,m   
?an ?is1 a consid]able proportion ( !   
*ildr5 are s s]i\sly defective 9 he>+ t 
_! s*ool "w suff]s sev]ely4 ,mo/        
important ( all1 only a small m9ority ( 
^! defects ( sight & he>+ are discov]$  
by tea*]s or kn[n to !m1 to ! p>5ts1 or 
to ! *ildr5 !mselves4 ,:5 ! *ildr5      
attempt to d _! s*ool "w :ile suff]+ f  
^! defects1 among ! results may be c\nt$

 p]man5t injury to ! eyes1 sev]e injury 
to ! n]v\s sy/em due to eye/ra91 &      
depression & disc\ragem5t1 ow+ to       
inability to see & he> cle>ly4          
,moreov]1 !re are o!r defects1 9        
p>ticul> ^? ( nose1 ?roat1 & tee?1 :i*  
are common among *ildr5 & :i* h an      
important be>+ ^u _! pres5t heal? &     
future developm5t4 ,! importance ( ^!   
defects is emphasiz$ by ! fact t1 if    
discov]$ e>ly en\gh1 !y may easily be   
rem$i$ or modifi$1 :]eas neglect leads1 
almo/ inv>iably1 to p]man5t impairm5t ( 
physical condition4 ,^! are ! reasons :y
 ,clevel&'s heavy inve/m5t 9 s*ool      
disp5s>ies is yield+ a return 9 enhanc$ 
heal?1 happ9ess1 & vigor probably       
unexcell$ by ! divid5ds f any o!r sort (
 educational exp5diture4     ,,d5tal    
,,cl9ics   ,d5tal "w = s*ool *ildr5 0   
introduc$ ab\t a ye> ago by ! ,clevel&  
,auxili>y ( ! ,national ,m\? ,hygi5e    
,association4 ,build+ space is provid$  
by ! ,bo>d ( ,education 9 f\r s*ools1   
,/an>d1 ,lawn1 ,f[l]1 & ,m>ion4 ,!      

,association furni%es equipm5t1 d5ti/s1 
& assi/ants4 ,cl9ics are op5 ?ree =5oons
 a week & are cr[d$ to capacity4        
,illu/ration3 ,! equipm5t ( ! ,m>ion    
,s*ool d5tal cl9ic co/ ab\t #gjj4  ,:5  
?is "w />t$1 x 0 frankly an exp]im5t4   
,?r\gh wise & ?\ghtful managem5t ! ,m\? 
,hygi5e ,association has %[n t d5tal    
cl9ics = s*ool *ildr5 are bo? practical 
& necess>y4 ,?is hav+ be5 demon/rat$1 ! 
"t has come :5 ! city %\ld take ov] _!  
direction4 ,clevel& %\ld no long] rely  
^u ! activity ( a private organization1 
b at an e>ly date %\ld assume full      
f9ancial & adm9i/rative responsibility =
 d5tal cl9ics 9 ! public s*ools4  ,dr4  
,william ,osl]1 ! di/+ui%$ ,engli%      
physician1 is cr$it$ ) say+1 ,if ,i 7   
ask$ to say :e!r m physical det]ioration
 0 produc$ by alcohol or by defective   
tee?1 ,i %\ld say unhesitat+ly1         
defective tee?4 ,! developm5t ( !       
movem5t = d5tal inspection ( s*ool      
*ildr5 9 ,clevel& %[s t ! educational   
sy/em has be5 awak5+ to a realization ( 

! tru? & significance ( ,dr4 ,osl]'s    
/atem5t4 ,! mo/ sali5t fact 9 !         
situation is t ! commone/ ( all physical
 defects among s*ool *ildr5 is decay$   
tee?4 ,cases ( d5tal defectiv5ess are   
frequ5tly great] 9 numb] ?an are all o!r
 sorts ( physical defects comb9$4       
,moreov]1 x is probably true t !re is no
 s+le ailm5t ( s*ool *ildr5 :i* is      
directly or indirectly responsible = s  
great an am\nt ( mis]y1 disease1 & m5tal
 & physical h&icap4 ,^! are reasons :y  
,clevel& %\ld /eadfa/ly cont9ue 9 !     
ma9t5ance & developm5t ( ! d5tal cl9ics4
     ,,eye ,,cl9ics   ,an eye cl9ic is  
ma9ta9$ by ! ,dep>tm5t ( ,m$ical        
,inspection at ! ,br[nell ,s*ool4 ,?is  
cl9ic is op5 e aft]noon dur+ ! s*ool    
ye>4 ,! me?od ( proc$ure is z foll[s3   
,dur+ ! r\t9e physical exam9ations (    
*ildr5 by ! doctors 9 ! diff]5t s*ools1 
! vision is te/$ &1 if f\nd defective1 !
 p>5ts are advis$ ( x by note4 ,! nurse 
!n foll[s up ! case & if %e f9ds t !    
p>5ts are unable to pay = an exam9ation 

by an oculi/1 %e takes ! *ild to ! s*ool
 cl9ic1 aft] hav+ obta9$ ! writt5 cons5t
 ( ! p>5t4 ,!re ! *ild is giv5 a ?or\gh 
& accurate exam9ation1 ! eyes be+ fir/  
dilat$ ) homatrop9 & ! error (          
refraction det]m9$ by means ( !         
ret9oscope4 ,! prop] glasses are ord]$ =
 ! *ild & 9 a few days he is br\ght back
 to ! cl9ic & ! frames c>efully adju/$4 
,! nurse !n keeps 9 t\* ) ! case1 see+  
to x t ! *ild we>s ! glasses1 t ! frames
 are /raight1 & t ! symptoms ( :i* !    
*ild compla9$ are reliev$4              
,illu/ration3 ,! eye cl9ic is adv]tis$  
by its lov+ fri5ds4  ,_m p>5ts are      
unable to pay an oculi/'s fee b are able
 & will+ to pay a small am\nt = glasses 
& 9 ^! cases a nom9al *>ge is made = !m4
 ,exp]i5ce has %[n t if a *>ge1 no matt]
 h[ small1 is made = ! glasses bett] c>e
 is tak5 ( !m & bett] results are       
obta9$4 ,9 "s cases !re has be5         
opposition on ! "p ( ! p>5ts to ! *ild's
 we>+ glasses1 b usually ! nurse has be5
 able to prove to !m ! necessity & has  

obta9$ _! cons5t4  ,dur+ ! s*ool ye>    
#aiad-ae1 ! total numb] ( disp5s>y      
visits 0 #a1iac4 ,9 #ffe cases ! eyes 7 
refract$ & 9 #ejj cases glasses 7       
furni%$4 ,9 ab\t #ge p] c5t ( ! cases ! 
*ildr5's symptoms are reliev$ & _!      
s*ol>%ip is improv$4 ,9 ab\t #aj p] c5t 
( ! cases ! symptoms are n reliev$4     
,ab\t five p] c5t ( ! *ildr5 refuse to  
we> ! glasses4 ,! rema9+ #aj p] c5t ( ! 
*ildr5 _c be locat$ because !y h mov$ f 
! city or be5 transf]r$ to private      
s*ools4 ,! value ( ! "w ( ! eye cl9ic is
 beyond "q4  ,!re are no o!r cl9ics 9   
connection ) ! ,clevel& public s*ool    
sy/em4 ,m5tal exam9ations are made by a 
special tea*] appo9t$ = t purpose4 ,all 
surgical cases are ref]r$ to family     
physicians or local hospitals =         
treatm5t4     ,,co-,,op]ation ,,(       
,,college ,,= ,,b>b]s   ,r an unusual =m
 ( cl9ical "w is f\nd 9 s]vice r5d]$ by 
/ud5ts ( ! ,clevel& ,college = ,b>b]s4  
,9 sev]al di/ricts an arrangem5t betwe5 
! s*ool physician & ! college provides t

 free hair cuts be furni%$ pupils at    
int]vals dur+ ! s*ool ye>4 ,! com+ ( !  
b>b] is an ev5t eag]ly greet$1 &        
pr9cipals report t z a result *ildr5 %[ 
increas$ pride 9 p]sonal appe>ance4     
,,! ,,m$ical ,,inspection ,,/aff   ,!   
organization ( ! /aff des]ves special   
comm5t4 ,! physicians employ$ are mature
 m51 graduates ( well-kn[n m$ical       
s*ools4 ,! y\nge/ m$ical inspector on ! 
/aff is #bi1 ! olde/ #df1 & ! av]age age
 ( all ! doctors is #cf4 ,!y are pick$  
m51 select$ = ! "w because ( _! skill1  
intellig5ce1 & social viewpo9t4 ,!y are 
spl5didly repres5tative ( ! m$ical      
pr(ession 9 ,clevel&4 ,!y h fairly wide 
private practices & 9 _m cases are c>ry+
 on ! s*ool "w at real f9ancial         
sacrifice because ( _! int]e/ 9 !       
problems x involves4 ,_! assi/ants are  
all regi/]$ nurses f ! ,visit+ ,nurses  
,association & di/9ctly high grade wom54
  ,m$ical inspectors receive #ajj a mon?
 dur+ ! s*ool ye>4 ,!y are requir$ to   
give ?ree & "o-half h\rs a day1 five    

days a week1 to "w 9 ! s*ools1 inclusive
 ( travel+ "t betwe5 build+s4 ,nurses   
are paid on ! s*$ule ( ! ,visit+ ,nurses
 ,association & sal>ies range f #fj to  
#hj dep5d+ ^u l5g? ( s]vice4 ,! upp]    
limit w probably be rais$ to #he 9 ! ne>
 future4 ,nurses are on duty f #h3cj to 
#d3cj e weekday except ,saturday1 :5 "w 
ends at noon4 ,nurses are regul>ly      
employ$ only dur+ ! s*ool ye>1 b two are
 reta9$ long] = s]vice 9 summ] s*ools4  
,! effici5cy ( doctors & nurses is 9 no 
small measure due to ! frequ5t in=mal   
conf]5ces ( ! /aff4 ,9 addition to _m   
small] conf]5ces1 once ea* mon? ! entire
 /aff meets--nurses z well z            
physicians--to discuss problems :i* h   
aris5 dur+ ! prec$+ weeks1 & makes plans
 = ! future4 ,^! meet+s are v in=mal2   
nurses are urg$ to take "p 9 !          
discussion1 & ! result is ! en?usia/ic  
co-op]ation ( ! entire /aff4     ,,!    
,,plan ,,( ,,conc5trat+ ,,int]e/s   ,an 
int]e/+ feature ( organization is ! plan
 :]eby ea* ye> a diff]5t s]ies (        

problems is attack$1 & ! en]gies ( !    
entire /aff direct$ along ?is l9e4 ,?us1
 #aiaj-aiaa %[s special emphasis laid ^u
 eye defects1 & ne>ly #aa1jjj *ildr5 7  
f\nd 9 ne$ ( glasses4 ,9 #aiaa-aiab1    
al?\gh ! numb] ( defects discov]$       
increas$1 ! numb] ( *ildr5 exam9$       
/rik+ly decreas$4 ,extra /udy 0 made (  
ad5oids1 gl&s1 nutrition1 & goitre4 ,!  
foll[+ ye> less emphasis 0 laid on      
discov]+ defects & ! entire /aff unit$ 9
 an ef=t t[>d correct+ ^? already not$4 
,practically e *ild 9 ! sy/em 0 exam9$4 
,at ! same "t "o memb] specializ$ on    
hunt+ = tub]culosis cases & ano!r on    
m5tal exam9ations ( backw>d *ildr54  ,9 
#aiac-aiad1 ! =ce 0 especially int]e/$ 9
 ! "q ( communicable disease & !        
proportion ( conjunctivitis1 r+ worm1   
impetigo1 scabies1 & p$iculosis discov]$
 & treat$ 0 v l>ge4 ,z a natural        
accompanim5t ( ?is activity1 ! numb] (  
home visits & s*ool treatm5ts decid$ly  
increas$4 ,9 addition1 !re 0 a notable  
rise 9 ! frequ5cy ) :i* p>5ts came to ! 

disp5s>y = conf]5ces ) ! doctor ab\t _! 
*ildr54  ,! record = #aiad-aiae %[s a   
decrease 9 ! numb] ( home visits1 :i* is
 p>tly acc\nt$ = by ! fact t ! numb] (  
disp5s>y visits made by nurses has      
practically d\bl$4 ,! numb] ( p>5t      
consultations ) doctors has increas$ by 
"o-half ! record = #aiad1 & 9 contra/ ) 
#ejj heal? talks giv5 to classes by     
nurses la/ ye>1 we h #a1bfj talks by    
physicians & #d1dca by nurses to classes
 9 #aiad-aiae4  ,?is me?od ( v>i$       
problems is unque/ionably effective 9   
promot+ gr[? & ma9ta9+ int]e/ on ! "p ( 
! /aff4 ,c>e %\ld be tak51 h[ev]1 to    
provide t )9 ea* f\r-ye> p]iod--twice   
dur+ ! eight ye>s ( s*ool life--special 
emphasis be laid ^u ! discov]y & cure ( 
ea* ( ! m important defects4 ,h[ ?is    
emphasis %\ld be di/ribut$ is a matt]   
be/ decid$ by ! /aff 9 conf]5ce4 ,x     
might be f\nd advisable to adopt a plan 
:]eby special att5tion is giv5 to tee?1 
ad5oids1 tonsils1 & gl&s 9 ! l[] grades2
 po/ure & he>t 9 ! upp] grades2 & eyes1 

he>+1 lungs1 & nutrition /raight ?r\gh !
 grades4 ,:atev] plan is adopt$ mu/ be !
 result ( /udy1 consultation1 &         
exp]im5t1 9 an endeavor to f9d ! mo/    
economical inve/m5t ( ef=t on ! "p (    
nurses & doctors 9 t]ms ( results ga9$4 
,illu/ration3 ,columns are proportionate
 9 height to ! p] c5t ( physical defects
 correct$ ea* ye> = five s*ool ye>s4    
,spee* defects are v common among       
*ildr54 ,at fir/ !y yield readily to    
treatm5t1 b if all[$ to cont9ue ?r\gh ! 
adolesc5t p]iod ! habit becomes fix$ s t
 try+ to cure x is a difficult & (t5    
fruitless task4 ,judg+ f ! exp]i5ce (   
o!r cities1 ab\t #bjj boys & #hjj girls 
9 ! ,clevel& public s*ool sy/em are     
suff]+ f "s =m ( spee* defect4 ,!re are 
few fields 9 :i* ! m$ical inspection    
dep>tm5t has su* an opportunity =       
effective "w & 9 :i* s little has be5   
done4 ,ef=t %\ld be made to locate ^!   
*ildr51 & =m !m into gr\ps = daily      
tra9+1 "u ! direction ( a tea*]         
specially prep>$ to h&le spee* cases4   

,,uni=m ,,proc$ure   ,9 ! fall ( #aiad1 
! m$ical /aff conduct$ a survey ( its   
own effici5cy4 ,a committee prep>$      
que/ions conc]n+ proc$ure1 & secur$     
answ]s f ea* memb] ( ! /aff4 ,^! answ]s 
7 comp>$ & discuss$ 9 /aff meet+s &     
uni=m rules 7 f9ally adopt$ =           
exam9ations & record+4  ,9 l9e ) ?is1 ! 
/aff some:at e>li] prep>$ rules =       
report+ defects s t all records may be  
compil$ on ! same basis4 ,?is           
/&>dization ( "w is an especially       
notewor?y feature ( ! ,clevel& sy/em1 & 
%\ld furni% valuable sugge/ions to      
m$ical inspection dep>tm5ts ( o!r       
cities4 ,a few ( ! rules adopt$ by !    
/aff w s]ve to indicate ! nature ( _!   
"w3       ,tee?--,report decay$ fir/ or 
second tee?1 & r$d5$      & inflam$     
gums4 ,d n report loose fir/ tee?4      
,tonsils--,report cases ) hi/ories (    
recurr5t      tonsilitis1 & :]e ! size (
 ! tonsils causes      difficulty (     
swall[+ or ?ick spee*4 ,d n report      
mod]ately enl>g$ tonsils ) no hi/ory (  

tonsilitis      nor evid5ce ( me*anical 
ob/ruction4       ,ad5oids--,report m\? 
brea!rs ) *>act]i/ic      ad5oid faces1 
conv9c+ y\rself z to diagnosis by hav+  
! pupil say l1 m1 n1 o1 p4 ,d n try to  
confirm !      diagnosis ( ad5oids by a 
digital exam9ation ( !      nasoph>ynx4 
,gl&s--,report g5]al gl&ul> enl>gem5t & 
c]vical      enl>gem5t ( ! lymphatic    
gl&s accompani$ by      malnutrition &  
anemia4 ,d n report submaxill>y         
enl>gem5t 9 recurr5t tonsilitis or c>i\s
 tee? or      po/-c]vical enl>gem5t 9   
p$iculosis capitis1 or 9      impetigo  
or eczema ( ! scalp4  ,z a result (     
rules su* z ^!1 a giv5 report means !   
same ?+ to e memb] ( ! /aff2 only       
important defects are /ress$2 & ! ef=t  
to rem$y !m is conc5trat$ :]e x w be mo/
 effective4 ,/ati/ics bas$ on records   
su* z ^! w be reliable & may be us$ =   
sci5tific /udy4     ,,vacc9ation        
,?irte5 ye>s ago smallpox visit$        
,clevel&4 ,twelve hundr$ & =ty-eight    
cases 7 report$4 ,!re 7 #cj cases (     

black smallpox4 ,_m ( ! pati5ts 7 bl9d$ 
or disfigur$ = life2 #bbd di$4 ,we f9d 9
 ! annual report ( ! ,bo>d ( ,heal? = t 
ye>3 ,x 0 ! smallpox we read ab\t1 t    
t]rible sc\rge :i* /ruck t]ror into !   
=m] g5]ations4 ,its contagi\s nature %[$
 itself ev]y:]e4 ,"o case1 if n promptly
 report$ to ! heal? (fice & remov$ to ! 
hospital1 w\ld inv>iably infect ! :ole  
neighborhood4 ,its sev]ity manife/$     
itself ev5 9 ! mild] cases1 :ile        
conflu5t cases1 almo/ )\t exception1    
develop$ hemorrhages dur+ ! pu/ul>      
/ate4444 ,at ! ,mayor's reque/1 a meet+ 
( physicians 0 held 444 to consid] !    
smallpox situation4444 ,vacc9ation 0    
recomm5d$ on all sides1 b ! p 7 n prone 
to get vacc9at$4444 ,:olesale vacc9ation
 0 f9ally effect$ by ! action ( ! ,s*ool
 ,c\ncil & ! help ( ! ,*amb] ( ,comm]ce4
 ,! ,s*ool ,c\ncil am5d$ ! vacc9ation   
clause1 mak+ vacc9ation a conditio s9e  
qua non = att5d+ s*ool & giv+ ! heal?   
(fic] ! :ole control ( ! matt]4 ,)\t ?is
 am5dm5t ! s*ools c\ld n h op5$ la/     

fall4 ,! situation 0 too critical4 ,) x1
 ! op5+ ( ! s*ools help$ greatly to     
ext]m9ate smallpox4 ,e s*ool1 public &  
private1 0 put 9 ! *>ge ( a             
physician4444 ,! doctors work$ ) a w1 & 
if any?+ 0 done ?or\ghly & consci5ti\sly
 9 ?is city1 x 0 ! vacc9ation ( all     
tea*]s & pupils la/ fall4444 ,?r\gh !   
influ5ce ( ! ,*amb] ( ,comm]ce !        
employ]s prevail$ on _! employees to get
 vacc9at$4 ,also to h ev]yone ( _!      
family vacc9at$4 ,! consequ5ce 0 t ! p  
got vacc9at$ by t5s ( ?\s&s4 ,m5 :o     
=m]ly spurn$ ! vacc9ator f _! door came 
n[ to 8 (fice4444 ,! city paid =        
#aie1jjj vacc9ations4  ,9 #aiaj smallpox
 aga9 broke out1 ?is "t 9 ! s\!a/]n "p (
 ! city1 & ?reat5$ to spread ov] !      
entire community4 ,) vivid memories (   
e>li] horrors1 ! disease 0 met at !     
outset ) vigor\s measures4 ,x 0 discov]$
 t 9 spite ( ! exp]i5ce ( ! ,bo>d (     
,education eight ye>s be=e1 & )\t reg>d 
to ! rule :i* provid$ t ,no tea*] or    
pupil %all att5d any s*ool )\t furni%+  

satisfactory c]tificate t he or %e has  
be5 successfully vacc9at$ or o!rwise    
protect$ f smallpox1 unvacc9at$ *ildr5  
_h be5 admitt$ to ! public s*ools       
lit]ally by ?\s&s4 ,by ! "t t #fc cases 
( smallpox _h be5 report$ ! ,bo>d (     
,heal? aga9 took matt]s into its own    
h&s1 ent]$ ! s*ools1 & vacc9at$ #ee1jjj 
s*ool *ildr54 ,equally vigor\s measures 
7 tak5 among adults & ! epidemic 0      
*eck$4  ,e ye> s9ce #aiaj !re h be5     
cases ( smallpox 9 ,clevel&4 ,! ,bo>d ( 
,heal? no long] relies ^u ! ,bo>d (     
,education to protect ! lives ( !       
community aga9/ ! sc\rge4 ,:]e #gj1jjj  
*ildr5 are ga!r$ toge!r daily = h\rs at 
a /ret*1 ! possibilities ( spread+      
disease ?r\gh\t ! city at l>ge con/itute
 a grave m5ace4 ,!re=e1 imm$iately ^u ! 
report ( a case ( smallpox1 ! ,bo>d (   
,heal? (ficials ex]cise _! "r ( entry   
into ! s*ools ( t di/rict1 & ei!r       
vacc9ate or exclude f att5dance e *ild  
:o c\ld himself become a c>ri] ( !      
disease4 ,dur+ ! pres5t ye> ov] #a1djj  

*ildr5 7 vacc9at$ 9 ?is way4  ,t        
vacc9ation prev5ts smallpox no          
intellig5t p]son acqua9t$ ) ! facts c   
d\bt4 ,an ov]:elm+ mass (               
incontrov]tible evid5ce c be f\nd 9 e   
m$ical libr>y4 ,! mortality /ati/ics (  
diff]5t c\ntries tell ! same /ory4 ,a   
s+le example %[s ! g5]al exp]i5ce3 ,9   
sev5 prov9ces ( ! ,philipp9e ,isl&s !re 
7 #f1jjj dea?s annually f smallpox      
alone4 ,9 8 #aijf report1 ,dr4 ,victor  
,g4 ,heis]1 ,director ( ,heal? 9 !      
,isl&s1 describes h[ dra/ic measures 7  
tak5 to /amp out ! disease4 ,"u 8       
direction practically ?ree million "o   
hundr$ ?\s& p]sons 7 vacc9at$4 ,! foll[+
 ye>1 in/ead ( #f1jjj dea?s f smallpox1 
!re 0 n "o4  ,= #ac ye>s ! ,bo>d (      
,education has _h ^u its books a rule   
requir+ vacc9ation z a pr]equisite to   
admission to ! s*ools4 ,t rule has nev] 
be5 adequately en=c$4 ,9 ,july1 #aiad1  
,city ,ord9ance #cbhdf-;,b 0 pass$1 "o  
section ( :i* reads3 ,no sup]9t5d5t1    
pr9cipal1 or tea*] ( any public1        

p>o*ial1 private s*ool1 or o!r          
in/itution1 nor any p>5t1 gu>dian1 or   
o!r p]son1 %all p]mit any *ild n hav+   
be5 successfully vacc9at$1 nor hav+ _h  
smallpox1 to att5d s*ool4 ,al?\gh pass$ 
a ye> ago1 t ord9ance has n yet be5     
en=c$4 ,exact figures _c be secur$1 b x 
is probable t !re are 9 ! ,clevel&      
s*ools today m ?an #ej1jjj unvacc9at$   
*ildr54 ,= ea* ( ^! ! sup]9t5d5t1       
pr9cipal1 tea*]1 & p>5t may be held     
liable to a #bjj f9e1 #fj days          
imprisonm5t1 or bo?4     ,,future       
,,developm5t   ,comp>$ ) o!r l>ge       
cities1 ,clevel& has an unusually good  
sy/em ( m$ical inspection4 ,:]e o!r     
cities are /ill /ruggl+ ) details (     
organization1 record keep+1 & ! l1      
,clevel& is ready to lead ! way into new
 & imm5sely important fields4  ,m$ical  
inspection includes f\r fields (        
endeavor3 prev5tion ( epidemics1        
discov]y & cure ( physical defects1     
provision ( heal?ful surr\nd+s1 &       
=mation ( correct habits ( ?\ght &      

action 9 reg>d to heal?4 ,! fir/ two are
 conc]n$ ) rem$y+ pres5t conditions1 &  
"h ,clevel& is do+ excell5t "w4 ,! latt]
 two provide heal? insurance = ! future4
 ,9 ^!1 ,clevel& has made a beg9n+ b    
%\ld c>ry h] ef=ts f> 9 advance ( any?+ 
n[ attempt$4  ,?irte5 ye>s ago a crusade
 0 />t$ aga9/ ! common dr9k+ cup4 ,today
 !re is n a s*ool 9 ! city :i* is n     
suppli$ ) sanit>y dr9k+ f\nta9s1 & !    
common cup is a ?+ ( ! pa/4 ,n9e ye>s   
ago individual t[els 7 suppli$ to *ildr5
 9 c]ta9 s*ools4 ,at ! pres5t "t        
individual t[els1 soap1 & hot wat] are  
available 9 e build+4 ,9 #aijf ! fir/   
%[] ba? 0 in/all$ 9 an elem5t>y s*ool4  
,n[ !re are #cg build+s s equipp$4 ,!   
w9d[s 9 "s ( ! classes = ! bl9d are made
 ( amb] t9t$ glass4 ,= ye>s !re has be5 
agitation 9 favor ( adju/able seats &   
desks1 & al?\gh conditions 9 c]ta9      
s*ools are /ill v bad1 ^! are           
exceptions1 & ! g5]al seat+ provision is
 9 accordance ) ! laws ( hygi5e4        
,illu/ration3 ,%[] ba?s in/all$ 9 an old

 build+ 9 a cr[d$ section4  ,b !        
,division ( ,m$ical ,inspection mu/ g   
f>!r ?an ?is4 ,! physician mu/ jo9 ) !  
psy*ologi/ & ! educator 9 sci5tific     
rese>* to det]m9e ! conditions be/ suit$
 to ! education ( ! *ild4 ,%all         
blackbo>ds be ( slate1 composition bo>d1
 or glass8 ,%all !y be color$ black1    
gre51 or ivory :ite8 ,is light *alk on a
 d>k gr\nd bett] or worse ?an d>k *alk  
on a light gr\nd8 ,is prismatic w9d[    
glass sup]ior to pla98 ,to :at ext5t is 
gl>e f poli%$ desks detrim5tal to       
eyesight8 ,h[ l>ge mu/ be ! type 9      
textbooks 9 ord] t "y *ildr5 may easily 
read x8 ,:at v>iations f ! pres5t s*ool 
program are necess>y 9 ord] to make     
adequate provision = *ange 9 ! use (    
diff]5t sets ( muscles1 & relief f n]ve 
/ra98  ,^! que/ions & hundr$s ( o!rs are
 fac+ educational au?orities4 ,! me?od (
 answ]+ !m affects n only ! *ildr5 ( "o 
city b ! *ildr5 ( all cities ?r\gh\t !  
c\ntry4 ,ev]y:]e s*oolm5 are on ! al]t  
to ga9 in=mation :i* w help 9 solv+ ^!  

problems4  ,9 addition to regul> "w (   
inspection & exam9ation1 ! doctors &    
nurses ( ,clevel& sp5d a great deal ( "t
 9 conf]5ces ) p>5ts1 talks ) tea*]s1   
lessons & talks to *ildr51 too?bru%     
drills1 & ! l4 ,! importance ( "w ( ?is 
k9d c h>dly be ov]e/imat$1 b x mu/ be f>
 m ?an talks at p4 ,x %\ld be ! aim ( ! 
,dep>tm5t ( ,m$ical ,inspection to      
e/abli% "r habits 9 reg>d to heal?4 ,=  
?is reason1 al?\gh bo? me?ods are       
helpful1 drill 9 ! use ( ! too?bru% is m
 effective ?an lectures on ! ne$ ( us+  
x4 ,z a result ( ! "w ( doctors &       
nurses1 ,clevel&'s *ildr51--& h] tea*]s 
z well1--%\ld n only believe 9 pl5ty (  
sleep1 b %\ld g to b$ e>ly2 n only      
disapprove ( too mu* tea & c(fee1 b h   
/r5g? to refuse :5 x is (f]$4 ,?r\gh    
classes = ! anemic & pre-tub]cul>1 !    
public s*ools help ea* ye> betwe5 two & 
?ree hundr$ *ildr54 ,?is is wor? do+1 b 
!y w r5d] a f> great] s]vice to ,clevel&
 if1 9 addition1 !y succe$ 9 giv+ to    
#hj1jjj *ildr51 s firmly t x w nev] be  

brok51 ! habit ( sleep+ w9t] & summ] )  
wide op5 w9d[s4  ,! d5ti/1 ! oculi/1 !  
physician1 %\ld come to be reg>d$1 n z  
disp5s]s ( cures nor sympa!tic li/5]s to
 hypo*ondriacs1 b z lead]s to :om       
intellig5t p g 9 ord] to =e/all         
tr\ble1--speciali/s 9 heal? r ?an       
disease4 ,lead+ its future citiz5s to =m
 "r habits ( ?9k+ & act+ 9 reg>d to     
heal? is "o ( ! greate/ educational     
s]vices :i* ! public s*ool c r5d]4      
,,t5 ,,types ,,( ,,heal? ,,"w   ,z ! "w 
9 ,clevel& develops1 x %\ld aim to      
include all ^? types ( activity :i*     
ext5d$ & v>i$ exp]i5ce has %[n to bett] 
! heal? ( s*ool *ildr51 safegu>d !m f   
disease1 & r5d] !m heal?i]1 happi]1 & m 
vigor\s4 ,among su* activities ! foll[+ 
are ( special importance3  #a4 ,m$ical  
inspection = prev5t+ ! spread (         
contagi\s disease & = ! discov]y & cure 
( rem$iable physical defects4  #b4      
,d5tal inspection = ! purpose ( secur+  
s\nd tee? among ^! s*ool *ildr54  #c4 ,!
 /eady developm5t ( ! "w ( ! s*ool      

nurses to ! end t _! co-op]ation )      
doctors1 tea*]s1 & p>5ts may            
progressively contribute t[>d improv+ ! 
heal? ( ! *ildr54  #d4 ,op5-air s*ools =
 giv+ to ! physically weak su*          
advantages ( pure air1 good food1 & w>m 
sun%9e z may enable !m to pursue _!     
/udies :ile rega9+ _! physical vigor4   
#e4 ,special classes & s*ools = !       
physically h&icapp$ & m5tally           
exceptional 9 :i* *ildr5 may receive !  
c>e & in/ruction fitt$ to _! ne$s4  #f4 
,s*ool g>d5s1 :i* s]ve z nature /udy    
laboratories1 :]e education & recreation
 g h& 9 h&1 & increas$ k is accompani$  
by increas$ bodily effici5cy4  #g4      
,s*ool playgr\nds1 :i* af=d space1      
facilities1 opportunity1 & inc5tive = ! 
expression ( play in/9cts & impulses4   
#h4 ,organiz$ a?letics1 :i* aid 9       
physical developm5t1 & af=d tra9+ 9     
al]tness1 int5se application1 vigor\s   
ex]tion1 loyalty1 ob$i5ce to law & ord]1
 self-control1 self-sacrifice1 & respect
 = ! rights ( o!rs4  #i4 ,sy/ematic     

in/ruction & practice 9 p]sonal &       
community hygi5e & sanitation4  #aj4 ,! 
progressive improvem5t ( all adjuncts ( 
bett] sanitation 9 s*ool h\ses1 su* z   
sanit>y dr9k+ cups & f\nta9s1 sy/ems (  
vacuum clean+1 improv$ sy/ems ( light+1 
heat+1 & v5tilation4     ,,heal? ,,&    
,,education ,,& ,,bus9ess   ,!re is "o  
condition 9 ! ,clevel& s*ool sy/em :i*  
rises l a mighty b>ri] aga9/ !          
possibility ( completely fulfill+ any   
su* program ( heal? education z t outl9$
 9 ! #aj planks ( ! prec$+ plat=m4 ,?is 
is ! fundam5tal fact t ! ,clevel& s*ool 
au?orities h n yet conceiv$ ( heal? "w z
 be+ an integral "p ( education4  ,9 ?is
 city ! "w ( ! ,bo>d ( ,education is    
divid$ into ?ree ma9 dep>tm5ts4 ,^! are 
! executive dep>tm5t1 ! educational     
dep>tm5t1 & ! dep>tm5t ( ! cl]k4 ,!     
executive dep>tm5t is "u ! lead]%ip ( ! 
director ( s*ools & x deals ) ! bus9ess 
activities ( ! ,bo>d4 ,! educational    
dep>tm5t is "u ! sup]9t5d5t ( s*ools &  
deals ) tea*+4  ,"u ?is organization !  

activities c>ri$ on by ! ,bo>d (        
,education mu/ be assign$ to "o or ano!r
 ( ! dep>tm5ts & ?is entails 9 mo/ cases
 arriv+ at a decision z to :e!r ! "w 9  
"q is pr$om9antly ( an educational      
nature or ( a bus9ess nature4 ,9 deal+ )
 heal? "w 9 ! public s*ools1 ! ,bo>d (  
,education r5d]$ its decision bo? ways4 
,x decid$ t provision = heal? 9         
education 0 a s]ies ( bus9ess           
transactions & s x plac$ m$ical         
inspection 9 ! executive dep>tm5t "u !  
lead]%ip ( ! director4 ,x also decid$ t 
provision = education 9 heal? 0 a tea*+ 
problem & s x plac$ physical education &
 tra9+ 9 physiology & hygi5e "u !       
direction ( ! sup]9t5d5t ( s*ools4      
,despite its decision t provision =     
heal? 9 education is a bus9ess matt]1   
:ile provision = education 9 heal? is a 
tea*+ matt]1 ! ,bo>d realiz$ t "s sort (
 unity 0 ess5tial if ! diff]5t sides ( !
 "w 7 c>ri$ =w>d effici5tly4 ,!y met ?is
 situation by employ+ a compet5t        
director ( heal? "w & giv+ him an       

(ficial dual p]sonality4 ,z ! (ficial   
held responsible = heal? 9 education1 he
 is ! director ( m$ical inspection & is 
subord9ate to ! director ( s*ools4 ,z ! 
(ficial responsible = education 9 heal?1
 he is an assi/ant sup]9t5d5t & is      
responsible to ! sup]9t5d5t ( s*ools4 ,9
 "o capacity he is appo9t$ by !         
sup]9t5d5t & receives a portion ( 8     
sal>y f educational funds4 ,9 8 o!r     
capacity he is appo9t$ by ! director (  
s*ools & paid f bus9ess appropriations4 
,z an employee ( ! educational dep>tm5t1
 he is appo9t$ = a t]m ( "o ye>1 b z an 
employee ( ! bus9ess dep>tm5t1 he is on 
! civil s]vice li/ ) an indet]m9ate     
p]iod ( employm5t4  ,9 8 educational    
capacity1 he may arrange = !            
organization ( basketball teams = ?is is
 held to be a matt] ( physical          
education1 b 9 ord] to h a basketball   
game actually play$ at any "t outside ( 
regul> s*ool h\rs1 he mu/ get !         
p]mission ( ! director1 = ?is is held to
 be a bus9ess transaction4  ,in/ruction 

9 infant hygi5e is giv5 to ! girls 9 !  
upp] grades4 ,"p ( ! tea*+ is done by ! 
regul> tea*]s1 ! re/ by ! nurses ( !    
m$ical inspection dep>tm5t4 ,:5 !       
in/ruction is giv5 by ! tea*]s1 x is    
consid]$ an educational activity & is "u
 ! sup]vision ( ! sup]9t5d5t2 :5 ! same 
class is taught by ! nurse1 x is        
consid]$ a bus9ess transaction & is "u !
 au?ority ( ! director4  ,z *ief m$ical 
inspector1 repres5t+ ! bus9ess dep>tm5t1
 ?is (ficial discov]s a feeble-m9d$ *ild
 :om he wi%es to transf] to a special   
class4 ,s9ce ! transf] ( ?is *ild is an 
educational problem1 he reports ! matt] 
to ! assi/ant sup]9t5d5t 9 *>ge ( !     
di/rict4 ,s9ce ! m$ical inspector is    
also an assi/ant sup]9t5d5t1 ^! two m5  
are co-ord9ate educational (ficials4 ,! 
assi/ant sup]9t5d5t ( ! di/rict reports 
! reque/$ transf] to ! city sup]9t5d5t  
:o deals ) ! matt] z an educational     
problem & issues an ord] to ! *ief      
m$ical inspector 9 8 capacity z assi/ant
 sup]9t5d5t 9 *>ge ( physical education 

to make ! transf]4  ,?is :ole situation1
 :i* arises f assign+ "s phases ( !     
heal? "w to ! bus9ess dep>tm5t & o!r    
phases to ! educational dep>tm5t1 has n 
giv5 rise to z _m or z s]i\s            
difficulties z might well be expect$4   
,?is relative fre$om f tr\ble & friction
 is an impressive tribute to ! unremitt+
 tactfulness ( ! (ficials mo/ directly  
conc]n$4 ,! *ief m$ical inspector is a  
conspicu\s example ( a man defy+ holy   
writ by successfully s]v+ two ma/]s4    
,heal? "w 9 ,clevel& public s*ools is on
 a high] plane ?an 9 mo/ o!r cities4    
,its pres5t accompli%m5ts h c>ri$ x     
fur!r ?an simil> "w has gone else:]e4   
,its future possibilities are unusually 
bright because ! e>ly /ages ( developm5t
 h be5 successfully pass$4 ,! "o ?+ t we
 may be sure ( is t ?is future          
developm5t w t5d t[>d an ev] clos]      
relation%ip & m intimate int]m+l+ ( !   
activities :i* make = heal? 9 education 
& ^? :i* are direct$ t[>d education 9   
heal?4 ,ea* new developm5t & ea* =w>d   

/ep r5d]s a sep>ation ( ! "w into       
educational & bus9ess activities        
progressively difficult4  ,to discov]   
decay$ tee? & to tea* *ildr5 to c>e = _!
 tee? are intimately relat$ matt]s & _! 
sep>ation is b\nd to be !oretical & n   
real4 ,to attempt to sep>ate ! te/+ (   
vision f tea*+ conc]n+ ! cons]vation (  
vision is to lose an opportunity = ! mo/
 effective sort ( in/ruction4 ,simil>ly1
 if "o scrut9izes all ( ! #aj items t h 
be5 sugge/$ z indicat+ ! heal?          
activities :i* ,clevel& %\ld cont9ue to 
develop 9 its public s*ools1 he c h>dly 
fail to appreciate ! utt] impossibility 
( successfully divid+ ! "w into c]ta9   
activities :i* %all be educational &    
c]ta9 o!r activities :i* %all be        
bus9ess4 ,soon] or lat] ! !ory t ?is c  
be done w be de/roy$ by ! logic ( ev5ts1
 = heal? "w 9 our public s*ools is      
con/antly becom+ a m intimate & integral
 "p ( ! e-day education ( all ! *ildr54 
,soon] or lat] s]i\s difficulties are   
b\nd to arise f an adm9i/ratively uns\nd

 arrangem5t 9 :i* a s*ool (ficial 9 *>ge
 ( a mo/ important division ( "w is     
responsible to two entirely indep5d5t   
*iefs4 ,! opportunities = hone/ b       
irreconcilable conflict ( views are s   
num]\s t !y w surely arise 9 "t4 ,"o    
*ief may favor vacc9ation & ! o!r be    
oppos$ to x on pr9ciple4 ,"o may deem x 
! duty ( ! s*ools to h ! doctors &      
nurses give in/ruction 9 sex hygi5e :ile
 ! o!r may be utt]ly aga9/ any?+ ( !    
sort4 ,"o may hold t ! only useful      
physical ex]cise is t ga9$ ?r\gh games &
 a?letics1 :ile ! o!r may favor =mal    
gymna/ics4 ,"o may believe 9 s*ool      
g>d5s1 & ! o!r deem !m a wa/e ( "t &    
money4 ,"o may believe t c\rses 9 infant
 hygi5e %\ld be provid$ = ! girls 9 !   
upp] gramm> grades1 :ile ! o!r may hold 
t su* in/ruction %\ld be res]v$ =       
cont9uation classes = "y wom54  ,all (  
^! are matt]s on :i* educational        
au?orities are %>ply divid$ 9 op9ion &  
!re are _m m ( ! same nature4 ,! pres5t 
director ( s*ools1 ! pres5t sup]9t5d5t (

 s*ools1 & ! pres5t *ief m$ical         
inspector h s f> work$ successfully "u !
 pres5t arrangem5t ( divid$ duties &    
responsibilities1 b a reorganization    
along s\nd] adm9i/rative l9es %\ld be   
made be=e1 in/ead ( aft]1 s]i\s tr\ble  
arises4 ,ev5tually1 if n n[1 ,clevel&   
mu/ realize t heal? "w 9 education mu/  
be plac$ "u ! direction ( ! city's      
highe/ educational (ficial :o is ! city 
sup]9t5d5t ( s*ools4     ,,summ>y   #a4 
,clevel& employs #af s*ool physicians1  
"o oculi/1 & #bg nurses4 ,x sp5ds       
#cf1jjj a ye> on sal>ies & supplies = ^!
 p1 & ma9ta9s #hf s*ool disp5s>ies &    
cl9ics4  #b4 ,?r\gh m$ical inspection1 !
 educator & ! physician jo9 h&s to      
insure = ea* *ild su* conditions ( heal?
 & vitality z w be/ enable him to take  
full advantage ( ! free education (f]$  
by ! /ate4 ,x recognizes ! intimate     
relation%ip betwe5 ! physical & m5tal   
conditions ( *ildr54 ,x realizes t      
education is dep5d5t ^u heal?4 ,x bett]s
 heal? conditions among s*ool *ildr51   

safegu>ds !m f disease1 & r5d]s !m      
heal?i]1 happi]1 & m vigor\s4  #c4 ,!   
fir/ "w ( ?is k9d 9 ,clevel& />t$ 9     
#aijj :5 te/s 7 made ( defective vision4
 ,9 #aijf ! ,heal? ,dep>tm5t provid$    
inspectors = contagi\s diseases 9 !     
s*ools4 ,9 ! same ye> inspection =      
physical defects 0 und]tak52 ! fir/     
disp5s>y 9 ! ,unit$ ,/ates 0 e/abli%$ at
 ! ,murray ,hill ,s*ool1 & s*ool nurses 
7 appo9t$4 ,9 #aiji ! ,division ( ,heal?
 ,sup]vision & ,inspection became "p ( !
 regul> s*ool sy/em4  #d4 ,! ,division  
h&les inspection = contagi\s disease1   
inspection = physical & m5tal defects1  
foll[-up "w = ! rem$y+ ( defects1 heal? 
in/ruction1 recomm5dations ( *ildr5 to  
special classes1 s*ool lun*es1 g>d5s1 & 
playgr\nds4 ,e *ild is exam9$ e ye>4    
#e4 ,clevel& has #hf disp5s>ies4 ,9 e   
case light+1 v5tilation1 & equipm5t are 
good4 ,x is probably true t ^!          
disp5s>ies are ( bett] grade ?an ^? (   
any o!r l>ge city 9 ! ,unit$ ,/ates4    
#f4 ,d5tal cl9ics are n[ conduct$ 9 f\r 

public s*ools by ! ,clevel& ,auxili>y ( 
! ,national ,m\? ,hygi5e ,association4  
,?is "w has n[ rea*$ a po9t :]e x %\ld  
be tak5 ov] & adm9i/]$ z a "p ( ! public
 s*ool sy/em4 ,! function ( a private   
organization is to exp]im5t &           
demon/rate4 ,x _c ev5tuate on a l>ge    
scale1 & x %\ld n if x c\ld4 ,! function
 ( a public organization is to ev5tuate 
on a l>ge scale4 ,x c seldom exp]im5t1 &
 x lacks fre$om & flexibility 9         
demon/ration4 ,! ,m\? ,hygi5e           
,association has exp]im5t$ & demon/rat$ 
successfully4 ,its "w %\ld n[ be assum$1
 cont9u$1 & ext5d$ by ! ,division (     
,m$ical ,inspection4  #g4 ,! eye cl9ic  
conduct$ by ! ,division at ! ,br[nell   
,s*ool is do+ excell5t "w4 ,z ! sy/em   
gr[s1 ?is cl9ic %\ld be suppli$ ) m     
work]s4 ,! ,clevel& ,college = ,b>b]s   
gives an excell5t free s]vice 9 _m ( !  
s*ools4 ,!re are no o!r cl9ics4 ,m5tal  
exam9ations are made by a special tea*] 
appo9t$ = t purpose4 ,all surgical cases
 are ref]r$ to family physicians or     

local hospitals = treatm5t4  #h4 ,m$ical
 inspectors are mature m51 graduates (  
well-kn[n m$ical s*ools1 ) a fairly wide
 private practice4 ,! s*ool nurses are  
all regi/]$ nurses4  #i4 ,! numb] (     
s*ool nurses %\ld be increas$ z rapidly 
z possible until "o nurse is provid$ on 
full "t = e #bjjj *ildr5 enroll$ 9      
s*ool4 ,?is w\ld mean ! employm5t ( #aa 
additional nurses1 increas+ ! /aff f #bg
 to #cd4 ,z ! population increases1 m   
nurses %\ld be add$4  #aj4 ,(fice       
consultations betwe5 p>5ts & physicians 
are among ! mo/ important activities ( !
 ,division & %\ld be sy/ematically      
enc\rag$4 ,to ?is end arrangem5ts %\ld  
be made :]eby def9ite h\rs = p>5t       
consultations are assign$ to ea* s*ool4 
#aa4 ,! ,division ( ,m$ical ,inspection 
has s organiz$ its "w t ! att5tion ( !  
/aff is conc5trat$ ^u a diff]5t set (   
problems ea* ye>4 ,?is me?od is         
unque/ionably effective 9 promot+ gr[? &
 ma9ta9+ ! int]e/ ( ! /aff4 ,c>e %\ld be
 tak51 h[ev]1 to provide t )9 ea*       

f\r-ye> p]iod special emphasis be laid  
^u ! discov]y & cure ( ea* ( ! m        
important defects4 ,"s plan %\ld be     
adopt$ by ! /aff :]eby ef=t may be      
conc5trat$ on discov]+ & rem$y+ defects 
at ^? ages :]e su* exp5diture ( "t &    
en]gy w secure ! l>ge/ returns4  #ab4   
,adequate provision %\ld be made = !    
correction ( spee* defects4 ,classes 9  
spee* tra9+ %\ld be e/abli%$ "u !       
direction ( a tea*] specially tra9$ 9   
?is "w4  #ac4 ,/&>dization ( "w is an   
especially notewor?y feature ( !        
,clevel& sy/em1 & %\ld furni% valuable  
sugge/ions to m$ical inspection         
dep>tm5ts ( o!r cities4 ,?r\gh ?is      
/&>dization ! same t]ms h uni=m mean+s  
:5 us$ by diff]5t memb]s ( ! /aff1 &    
con/ant /&>ds are employ$ 9 detect+ &   
record+ defects4  #ad4 ,!re are probably
 m ?an #ej1jjj unvacc9at$ *ildr5 n[ 9 ! 
,clevel& s*ools4 ,imm$iate /eps %\ld be 
tak5 to see to x t e *ild n[ 9 s*ool is 
vacc9at$1 & t no *ild is admitt$ to     
s*ool h]eaft] )\t simil> protection4    

,pr9cipals1 tea*]s1 & p>5ts %\ld be held
 responsible = violation ( ! vacc9ation 
ord9ance4  #ae4 ,! ,division ( ,m$ical  
,inspection %\ld plan /eadily to enl>ge 
its field ( activity 9 ord] to provide 9
 con/antly increas+ measure bett] work+ 
conditions 9 ! s*ools & to tra9 ! *ildr5
 into habits ( heal? t %all be          
life-long4 ,x is probable t ! heal? "w 9
 ! ,clevel& public s*ools is unsurpass$ 
by t ( any o!r city 9 ! c\ntry4 ,! city 
n[ has an opportunity to lead ! way into
 va/ly important =w>d ext5sions look+   
t[>d ! provision ( heal? insurance =    
future g5]ations4  #af4 ,"u ! pres5t    
organization1 ! (ficial 9 *>ge ( heal?  
"w is responsible to ! director ( s*ools
 9 "p ( 8 activities & to ! sup]9t5d5t 9
 ! re/ ( !m4 ,he %\ld be responsible to 
! city sup]9t5d5t alone1 = heal? "w 9 ! 
public s*ools is education & n bus9ess4 
,,clevel& ,,education ,,survey          
,,sectional ,,reports   ,^! reports c be
 secur$ f ! ,survey ,committee ( !      
,clevel& ,f\ndation1 ,clevel&1 ,ohio4   

,!y w be s5t po/paid = #be c5ts p]      
volume ) ! exception ( ,measur+ ! ,"w ( 
! ,public ,s*ools by ,judd1 ,! ,clevel& 
,s*ool ,survey by ,ayres1 & ,wage ,e>n+ 
& ,education by ,lutz4 ,^! ?ree volumes 
w be s5t = #ej c5ts ea*4 ,all ( ^!      
reports may be secur$ at ! same rates f 
! ,division ( ,education ( ! ,russell   
,sage ,f\ndation1 ,new ,york ,city4     
,*ild ,acc\nt+ 9 ! ,public              
,s*ools--,ayres4   ,educational         
,ext5sion--,p]ry4   ,education ?r\gh    
,recreation--,johnson4   ,f9anc+ !      
,public ,s*ools--,cl>k4   ,heal? ,"w 9 !
 ,public ,s*ools--,ayres4   ,h\sehold   
,arts & ,s*ool ,lun*es--,b\ghton4       
,measur+ ! ,"w ( ! ,public              
,s*ools--,judd4   ,ov]cr[d$ ,s*ools & ! 
,platoon ,plan--,h>twell4   ,s*ool      
,build+s & ,equipm5t--,ayres4   ,s*ools 
& ,classes = ,exceptional               
,*ildr5--,mit*ell4   ,s*ool             
,organization & ,adm9i/ration--,ayres4  
,! ,public ,libr>y & ! ,public ,s*ools4 
,! ,s*ool & ! ,immigrant4   ,! ,tea*+   

,/aff--,jessup4   ,:at ! ,s*ools ,tea* &
 ,might ,tea*--,bobbitt4   ,! ,clevel&  
,s*ool ,survey 7,summ>y volume7--,ayres4
         99       99       99       99  
99    ,boys & ,girls 9 ,comm]cial       
,"w--,/ev5s4   ,dep>tm5t ,/ore          
,occupations--,o',le>y4   ,dressmak+ &  
,mill9]y--,bryn]4   ,railroad & ,/reet  
,transportation--,flem+4   ,! ,build+   
,trades--,%aw4   ,! ,g>m5t              
,trades--,bryn]4   ,! ,metal            
,trades--,lutz4   ,! ,pr9t+             
,trades--,%aw4   ,wage ,e>n+ &          
,education 7,summ>y volume7--,lutz4     
,transcrib]'s ,note3  ,! foll[+         
type-writt5 mat]ial 0 atta*$ inside !   
front cov] ( ?is book & is includ$ "h = 
its hi/orical int]e/4                   
,,division ,,( ,,m$ical ,,inspection    
&                     ,,physical        
,,education                             
,,clevel&     ,dr4 ,e4 ,a4 ,pet]son     
,director    ,mr4 ,h4 ,p4 ,kimmel       
,secret>y    ,h5ry ,w4 ,lu!r            
,sup]visor ( ,physical ,tra9+    ,l\ise 

,kle9 ,mill]              ,curator (    
,s*ool ,g>d5s    ,anna ,l4 ,/anley      
,sup]visor ( ,s*ool ,nurses    ,*>lotte 
,/e9ba*              ,exam9] ( ,atypical
 ,*ildr5    ,lola ,b>n>d                
,ass't4       ,mabel ,j4 ,w9swor?       
,sup]visor ( ,s*ool ,fe$+    ,hannah    
,sp]o                     ,/5ograph]    
,,! ,,clevel& ,,f\ndation ,,survey      
,,room #be4 #fab ,,/4 ,,clair ,,ave1 ,n4
 ,e4 ,,clevel&1 ,,ohio  ,novemb] #ah1   
#aiae4  ,! next meet+ ( ! ,advisory     
,committee ( ! ,education ,survey w be 9
 ! ,assembly ,room ( ,! ,holl5d51       
,monday1 ,nov4 #bbnd1 #aiae at #ab4 ,!  
section ( ! ,survey to be consid]$ w    
describe a feature ( s*ool "w 9 :i*     
,clevel& equals any & excells mo/ cities
 ( ! c\ntry4    ,subject3 ,,heal? ,,"w  
,,9 ,,! ,,public ,,s*ools   ,speak]3    
,,leon>d ,p4 ,,ayres1                   
,director ,education ,survey4  ,y are   
invit$ to br+ any int]e/$ fri5ds & are  
urg$ to be prompt s z to give full "t = 
bo? ! lun*eon & ! discussion4  ,please  

reply on enclos$ c>d4  ,y\rs truly1 ,f4 
,f4 ,pr5tiss1 ,*airman4 ,all5 ,t4       
,burns1 ,director4  ,end ( ,transcrib]'s
 ,note