On large playgrounds belonging to the Park Department, as well as at the public baths, arrangements are made whereby instruction in athletics, swimming, games, and play may be carried on under school supervision, thus offering the best means to make these activities a source of better health to all the children rather than a spectacular exhibition by the few. A specific appropriation amounting to more than $50,000 annually is provided for these purposes by legislative act. This appropriation cannot be used for any other purpose.

The nursing division of the department is under the direction of one supervising nurse who has at present thirty-four assistants. The division is provided for by an additional special appropriation of $25,000 annually. Rooms are equipped at schools in each district, and each nurse has an assignment of approximately 2,700 pupils. These nurses are appointed from a certified list similar to that of other employees in the service. The following report of the first twenty nurses appointed under this department for the period September 11, 1907, to February 1, 1908, shows the work possible under this adjunct to health and efficiency:

Diseases of: Ear, 1,492 cases cared for; Eye, 6,078 cases cared for, including 3,649 suffering from defective vision; of these 1,131 were corrected by oculists; Nose, 2,602 cases, of which 1,405 had adenoids, 423 of whom had the obstruction removed; Mouth, 1,765 cases including 1,686 who had carious teeth; Throat, 1,695 cases, including 683 of hypertrophied tonsils, and 608 of tonsilitis; Skin, 10,139 cases, all of which were followed to their homes and the parent or guardian instructed how to care for the same.

In addition to the above 2,563 pupils having abrasions and wounds received 9,144 dressings; 2,034 miscellaneous affections, including 350 septic wounds, 312 suffering from renal disease, 121 having rachitis, 207 suffering from malnutrition, 227 with epilepsy, 126 with chorea, and 548 with bronchitis, anaemia, and heart disease were treated; 3,120 excluded pupils were followed to their homes; 3,293 were taken to family physicians, resulting in 3,202 being cured and returned to school at the minimum of absenteeism; 4,772 were taken to hospitals on request of parents; and 3,223 of these were cured and returned to school; 7,559 home visits were made for the purpose of instructing or advising parents concerning the children, or in order to persuade the parents to seek proper medical or surgical aid for the child. There were also 2,882 affections looked after of which there is no classification. the specific infectious diseases.

These do not include

The nurses are not permitted to visit homes of contagious diseases. The great advantage of having a nurse under the school jurisdiction who may look after the minor ailments in school life and who visits the homes of children, giving advice and assistance to mothers, and in harmonizing the fixed customs and traditions of a great alien population with our habits and standards of living is solving many vexatious problems of the past and forms a link between. the school and the home not possible by any other means. It does not seem possible to conceive a more satisfactory arrangement nor a more effective piece

of school machinery than nurses under school supervision. With a corps of medical inspectors under this same supervision, who would conduct a daily clinic in their respective school districts, there are no problems connected with the health and efficiency of school children which could not be quietly, rationally, economically, and effectually solved. Until such an organization is perfected in part or in whole, little progress can result from the efforts to promote the health and efficiency of our school children.

DISCUSSION

E. C. MOORE, superintendent of schools, Los Angeles, Cal.-A health program is needed for all schools. For years our ideal of education has been wrong. It must be not a sound mind in a sound body, but a sound mind making and keeping its body sound. The mind in control in the school, and the minds being trained there, must make and keep the bodies of the students sound. There is no other way. As Dr. Allen has put it: "When the state for its own protection compels a child to go to school it pledges itself not to injure itself by injuring the child."

Shall the board of health or the board of education undertake this work? A part of it must be done by the board of health. Combating contagious diseases falls naturally within its province. School funds should not be used for that purpose, but the best health officer is one who is present all the time and ever-watchful of the welfare of the child. That ever-present health officer is the teacher. She must in the main be the guardian of conditions to see that they are hygienic and she must develop the cardinal physical virtues of breathing, sitting, standing, and walking properly.

There are other conditions which immediately affect school work which she may detect but which she cannot of herself remedy. Some of them are caused by the schools. All of them affect school work and in the very degree in which they obtain they render school work impossible. For this reason it belongs to the schools to do all in their power to remedy them. In so doing they are treading on the well-established preserves of the physician, and the physician is apt to regard their encroachment with distrust and concern. The situation is a delicate one. A line must be drawn between what school authorities may undertake and what properly belongs to the province of the medical profession. I believe that it is a safe principle to lay down that the schools must not undertake to do what other social institutions, the home, the hospital, the clinic, the settlement, the medical profession, stand ready to do and can do perhaps better than the schools.

It may be easier to hire a surgeon to do the operative surgery that should be done to give a certain number of pupils their chance, but I am convinced that it is better to employ the agencies already existing to get the work done.

This principle would limit the medical work of the schools to inspection and even that must, it seems to me, be limited and of a superficial sort. Certain defects go uncared for because their presence is unknown. In every schoolroom some of the pupils cannot see well, cannot hear well, cannot breathe properly, have uncared-for teeth, or irregular heart action. If parents but knew of these conditions, they would in most cases see to it that they are remedied and if they will not on their own initiative, they can be persuaded or coerced to have them cared for. The program of medical inspection with which I am familiar aims to concern itself with defective eyesight, defective hearing, defective teeth, defective breathing, and defective heart action. with a director and three assistant physicians. schools co-operate. It is the duty of each class the eyesight and hearing of the pupils in her class. ing tells me that the teachers make the preliminary tests in a very satisfactory manner.

It is in the charge of a health laboratory
With this laboratory the teachers of the
teacher to test as carefully as possible
The physician in charge of eye-examin-

All the more difficult cases are sent to the laboratory for examination and all the examinations which the teachers make are under the direction of the laboratory staff. Reports of all examinations which show conditions which need care are sent to the parents with urgent recommendations that the case be taken up with a specialist or with the family physician. There is a follow-up system to see that the proper steps have been taken.

MISS SADIE AMERICAN, executive secretary, Council of Jewish Women, New York City (founder of Vacation Schools in Chicago, Ill.).-There is one point that I specially desire to emphasize. It is the necessity for providing more fully for our girls, in play, in athletics, and in vocational or industrial training. Not sufficient regard has been paid to the girls, not sufficient careful study has been given to conditions and to their needs. Those of you who have had anything to do with reformatories for girls must know the appalling number of girls between the ages of ten and sixteen who are in such institutions. It is my firm belief that many of them are there because of the insufficient provision for play, for physical activity, for amusement, if you will, for desires perfectly legitimate, but which have not been satisfied. If we properly provide for our girls the dance halls will not be filled and the well-known consequences of the dance hall may be lessened.

A second point that I desire to make is the necessity for educating the parents. A friend of mine—a teacher-recently showed me the following note: "Dear m'am. I don't want Mary to spend her time in no dancing. If I want her to jump I can make her jump myself." This is typical of the attitude of many more highly educated than was this mother whose Mary would probably have learned to dance in some less favorable place. Along the line of Dr. Gulick's paper another experience comes to my mind of an educated mother who resented her child being sent home from school with a note advising that the adenoids be removed. She felt that she knew what was good for her child and did not wish to be interfered with. We have much to do not only to secure proper medical inspection and the school nurse, but to make parents of all groups and grades understand the intent and the need and the meaning of such innovations as medical care of school children and as play.

A third point is that we need school playgrounds, no matter whether there be municipal playgrounds or park playgrounds or settlement playgrounds. We need these playgrounds out of doors next to the school if we can have them, and if not, then in the basement, or on the roof, or wherever else it is possible, for not until we learn to associate in the mind of the child the school with his play, will we have less of a truant problem. The school should be the center of the life of the child, next to the home, with which he associates his joys and his pleasures as well as his work. Alas, in the tenement districts, to many it must be instead of the home. But when he does associate the school with his play and with his work of the hand as well as of the head, the school will become the influence and the lasting influence which it should be.

And finally let me say that we have passed the theoretic stage in regard to the effect of work with the hand in addition to and in connection with work for the mind, whether we call this industrial training or vocational training or manual training.

The vacation schools of Chicago have proven that such hand work holds the children purely by their desire to come, and the police of that city testify that juvenile arrests are at least one-third less in the districts in which there are vacation schools, than they were in these districts when there were no such schools. Juvenile arrests, I say, and not juvenile crime, for there is great difference between them, and that which is called mischief in the home of the well-to-do and where there are larger spaces for play may be interference with law or ordinance and cause arrest and send a boy-yes, shove a boy-along the criminal path.

ADDRESS AT THE RECEPTION AT THE WHITE HOUSE PRESIDENT THEODORE ROOSEVELT

Gentlemen and Ladies:

[Stenographic Report]

Of all the bodies of citizens that I have received here at the White House, there is none which occupies a more important relation than yours. I am tempted to say none has come that has occupied as important a relation to the nation, because you men and women who deal with education, who represent the great American policy of education for all children, provided by the public as the prime duty of the public, bear a relation to the family, a relation to the future of our whole people, such as no other like number of individuals can bear. I own six of the children that you educate, and I am prepared to extend cordial sympathy to some of you.

Seriously, friends, it is idle for any man to talk of despairing of the future of this country, or feeling unduly alarmed about it, if he will come in contact with you here, and with the forces that you represent. Fundamentally this country is sound morally, no less than physically. Fundamentally, in its family life, and in the outside activities of its individuals, the country is better, and not worse, than it formerly was. This does not mean that we are to be excused if we fail to war against rottenness and corruption; if we fail to contend effectively with the forces of evil; and they waste their time who ask me to withhold my hand from dealing therewith. But it is worth while to smite the wrong for the very reason that we are confident that the right will ultimately prevail. You who are training the next generation are training this country as it is to be a decade or two hence; and, while your work in training the intellect is great, it is not as great as your work in training character. More than anything else, I want to see the public school turn out the boy and the girl who, when man and woman, will add to the sum of good citizenship of the nation. It is not my province, nor would it be within my capacity, to speak about your pedagogic problems. You yourselves are far better able to discuss them. But, as a layman, let me say one or two things about your work.

In the first place, I trust that, more and more, our people will see to it that the schools train toward and not away from the farm and the workshop. We have spoken a great deal about the dignity of labor in this country, but we have not acted up to our spoken words, for in our education we have tended to proceed upon the assumption that the educated man was to be educated away from and not toward labor. The great nations of mediaeval times who left such marvelous works of architecture and art behind them were able to do so because they educated alike the brain and hand of the craftsman. We, too, in our turn, must show that we understand the law which decrees that a people which loses physical address invariably deteriorates, so that our people

shall understand that the good carpenter, the good blacksmith, the good mechanic, the good farmer, really do fill the most important positions in our land, and that it is an evil thing for them and for the nation to have their sons and daughters forsake the work which, if well and efficiently performed, means more than any other work for our people as a whole. One thing that I would like to have you teach your pupils is that whether you call the money gained salary or wages does not make any real difference, and that if, by working hard with your hands, you get more than if you work with your head only, it does not atone for it to call the smaller amount salary.

The term, "dignity of labor," implies that manual labor is as dignified as mental labor; as of course it is. Indeed, the highest kind of labor is that which makes demands upon the qualities of both head and hand, of heart, brain, and body. Physical prowess, physical address, are necessities; they stand on a level with intellect, and only below character. Let us show that we regard the position of the man who works with his hands as being ordinarily and in good faith as important and dignified and as worthy of consideration as that of business men or professional men. We need to have a certain readjustment of values in this country, which must primarily come through the efforts of just you men and women here and the men and women like you thruout this land.

I would not have you preach an impossible ideal; for if you preach an ideal that is impossible you tend to make your pupils believe that no ideals are possible, and therefore, you tend to do them that worst of wrongs-to teach them to divorce preaching from practice, to divorce the ideal that they in the abstract admire from the practical good after which they strive. Teach the boy and girl that their business is to earn their own livelihood; teach the boy that he is to be the homemaker; the girl that she must ultimately be the homekeeper; that the work of the father is to be the bread-winner, and that of the mother the housekeeper; that their work is the most important work by far in all the land; that the work of the statesman, the writer, the captain of industry, and all the rest, is conditioned-first, upon the work that finds its expression in the family, that supports the family. So teach the boy that he is to be expected to earn his own livelihood; that it is a shame and scandal for him not to be self-dependent, not to be able to hold his own in the rough work of actual life. Teach the girl that so far from its being her duty to try to avoid all labor, all effort, that it should be a matter of pride to her to be as good a housewife as her mother was before her. Sometimes the kindest and most well-meaning mother, sometimes a kind and well-meaning father also, do as much damage to the children as the most thoughtless and selfish parent could, by bringing them up to feel that the goal of their attainment should be the absence of effort instead of effort well directed. We have all of us often heard some good but unwise woman say, "I have worked hard; my daughter shan't work;" the poor woman not realizing that great tho the curse of mere drudgery, of overwork, is, that it is not so great as the curse of vapid idleness;