Civics and Health

Part Ii. Reading the Index to Health Rights

V. MOUTH BREATHING 45

VI. CATCHING DISEASES, COLDS, DISEASED GLANDS 57

VII. EYE STRAIN 72

VIII. EAR TROUBLE, MALNUTRITION, DEFORMITIES 83

IX. DENTAL SANITATION 89

X. ABNORMALLY BRIGHT CHILDREN 104

XI. NERVOUSNESS OF TEACHER AND PUPIL 107

XII. HEALTH VALUE OF "UNBOSSED" PLAY AND PHYSICAL TRAINING 115

XIII. VITALITY TESTS AND VITAL STATISTICS 124

XIV. IS YOUR SCHOOL MANUFACTURING PHYSICAL DEFECTS? 139

XV. THE TEACHER'S HEALTH 152

Part Iii. Cooeperation in Meeting Health Obligations

XVI. EUROPEAN REMEDIES: DOING THINGS AT SCHOOL 159

XVII. AMERICAN REMEDIES: GETTING THINGS DONE 166

XVIII. COOePERATION WITH DISPENSARIES AND CHILD-SAVING AGENCIES 174

XIX. SCHOOL SURGERY AND RELIEF OBJECTIONABLE, IF AVOIDABLE 184

XX. PHYSICAL EXAMINATION FOR WORKING PAPERS 190

XXI. PERIODICAL PHYSICAL EXAMINATION AFTER SCHOOL AGE 201

XXII. HABITS OF HEALTH PROMOTE INDUSTRIAL EFFICIENCY 208

XXIII. INDUSTRIAL HYGIENE 218

XXIV. THE LAST DAYS OF TUBERCULOSIS 229

XXV. THE FIGHT FOR CLEAN MILK 252

XXVI. PREVENTIVE "HUMANIZED" MEDICINE: PHYSICIAN AND TEACHER 268

Part Iv. Official Machinery for Enforcing Health Rights

XXVII. DEPARTMENTS OF SCHOOL HYGIENE 283

XXVIII. PRESENT ORGANIZATION OF SCHOOL HYGIENE IN NEW YORK CITY 296

XXIX. OFFICIAL MACHINERY FOR ENFORCING HEALTH RIGHTS 302

XXX. SCHOOL AND HEALTH REPORTS 310

XXXI. THE PRESS 322

Part V. Alliance of Hygiene, Patriotism, and Religion

XXXII. DO-NOTHING AILMENTS 329

XXXIII. HEREDITY BUGABOOS AND HEREDITY TRUTHS 335

XXXIV. INEFFECTIVE AND EFFECTIVE WAYS OF COMBATING ALCOHOLISM 343

XXXV. IS IT PRACTICABLE IN PRESENTING TO CHILDREN THE EVILS OF ALCOHOLISM TO TELL THE TRUTH, THE WHOLE TRUTH, AND NOTHING BUT THE TRUTH? 357

XXXVI. FIGHTING TOBACCO EVILS 363

XXXVII. THE PATENT-MEDICINE EVIL 369

XXXVIII. HEALTH ADVERTISEMENTS THAT PROMOTE HEALTH 378

XXXIX. IS CLASS INSTRUCTION IN SEX HYGIENE PRACTICABLE? 384

XL. THE ELEMENT OF TRUTH IN QUACKERY; HYGIENE OF THE MIND 391

XLI. "A NATURAL LAW IS AS SACRED AS A MORAL PRINCIPLE" 398

INDEX 405

CIVICS AND HEALTH

Part I. Health Rights

CHAPTER I

HEALTH A CIVIC OBLIGATION

In forty-five states and territories the teaching of hygiene with special reference to alcohol and tobacco is made compulsory. To hygiene alone, of the score of subjects found in our modern grammar-school curriculum, is given statutory right of way for so many minutes per week, so many pages per text-book, or so many pages per chapter. For the neglect of no other study may teachers be removed from office and fined. Yet school garrets and closets are full of hygiene text-books unopened or little used, while of all subjects taught by five hundred thousand American teachers and studied by twenty million American pupils the least interesting to both teacher and pupil is that forced upon both by state legislation. To complete the paradox, this least interesting subject happens also to be the most vital to the child, to the home, to industry, to social welfare, and to education itself.

Whether the subject of hygiene is necessarily dull, whether the statutes requiring regular instruction in the laws of health are violated with impunity, whether health principles are flaunted by health practice at school,--these are questions of immediate concern to parents as a class, to employers as a class, to every pastor, every civic leader, every health officer, every taxpayer.

Interviews with teachers and principals regarding the present apathy to formal hygiene instruction have brought out the following points that merit the serious consideration of those who are struggling for higher health standards.

1. There is many a slip 'twixt the making of a law and its enforcement. If laws regarding hygiene instruction are not enforced, we should not be surprised. It has been nobody's business to see whether and how hygiene is being taught. The moral crusade spent itself in forcing compulsory laws upon the statute books of every state and territory. Making a fetish of Legislation, the advocates of anti-alcohol and anti-tobacco instruction failed to see the truth that experienced political reformers are but slowly coming to see--Legislation which does not provide machinery for its own enforcement is apt to do little good and frequently will do much harm. Machinery, however admirably adapted to the work to be done, will get out of order and become useless, or even harmful, unless constantly watched and efficiently directed. Of what possible use is it to say that state money may be withheld from any school board which fails to enforce the law regarding instruction in hygiene, if state officials never enforce the penalty? So long as the penalty is not enforced for flagrant violation, what difference does it make whether the reason is indifference, ignorance, or desire to thwart the law? Fortunately, it is easy for each one of us to learn how often and in what way the children in our community are being taught hygiene, and how the schools of our state teach and practice the laws of health. If either the spirit or the letter of the law regarding instruction in hygiene is being violated, we can measure the penalty paid in health and morals by our children and our community. We can learn whether law, text-book, curriculum, or teacher should be changed. We can insist upon discussion of the facts and upon remedies suggested by the facts.

2. Teachers give as one reason for neglecting hygiene, that they are often compelled to struggle with a curriculum which requires more than they are able to teach and more than pupils are able to learn in the time allowed. While an overcharged curriculum may explain, it surely does not justify, the violation of law and the dropping of hygiene from our school curriculum. If there is any class of citizen who should teach and practice respect for law as law, it is the teacher. Parents, school directors, county and state superintendents, university presidents, social workers, owe it not only to themselves, but to the American school-teacher, either to repeal the laws that enjoin instruction in hygiene or else so to adjust the curriculum that teachers can comply with those laws. The present situation that discredits both law and hygiene is most demoralizing to teacher, pupil, and community. Many of us might admire the man teacher who frankly says he never explains the evils of cigarettes because he himself is an inveterate smoker of cigarettes. But what must we think of the school system that shifts to such a man the right and the responsibility of deciding whether or not to explain to underfed and overstimulated children of the slums the truth regarding cigarettes? If practice and precept must be consistent, shall the man be removed, shall he change his habits, shall the law regarding instruction in hygiene be changed, or shall other provision be made for bringing child and essential facts together in a way that will not dull the child's receptivity?

3. Teachers are made to feel that while arithmetic and reading are essential, hygiene is not essential. Whatever may be the facts regarding the relative value of arithmetic and hygiene, whether or not our state legislators have made a mistake in declaring hygiene to be essential, are questions altogether too important for child and state to be left to the discretion of the individual teacher or superintendent. It is fair to the teachers who say they cannot afford to turn aside from the three R's to teach hygiene, to admit that they have not hitherto identified the teaching of hygiene with the promotion of the physical welfare of children. Teachers awake to the opportunity will sacrifice not only hygiene but any other subject for the sake of promoting children's health. They do not really believe that arithmetic is more important than health. What they mean to say is that hygiene, as taught by them, has not heretofore had an appreciable effect upon their pupils' health; that other agencies exist, outside of the school, to teach the child how to avoid certain diseases and how to observe the fundamental laws of health, whereas no other agencies exist to give the child the essentials of arithmetic, reading, and geography. "We teach (or try to teach) what our classes are examined in. If you want a subject taught, you must test a class in it and hold a teacher responsible for results, and examinations are mercilessly unhygienic, you know."

4. Teachers believe that they get better results for their children from teaching hygiene informally and indirectly than from stated formal lessons. Whether instruction should be informal or formal is merely a question of method to be determined by results. What the results are, can be determined by principals, superintendents, and students of education. It is easy to understand how at the time of a fever epidemic children could be taught as much in one week about infection, disease germs, antiseptics, value of cleanliness, etc., as in five or ten months when vivid illustration is lacking. Physicians themselves learn more from one epidemic of smallpox than from four years of book study. To make possible and to require a daily shower bath will undoubtedly do more to inculcate habits of health than repeated lessons about the skin, pores, evaporation, and discharge of impurities.

If one illustration is better than ten lessons, if an open window is worth more than all that text-books have to say about ventilation, if a seat adjusted to the child is better than an anatomical chart, this does not mean that instruction in hygiene should cease. On the contrary, it means that provision should be made for every teacher to open windows, to adjust desks, to use the experience of individual children for the education of the class. If the rank and file of teachers have not hitherto been sufficiently observant of physiological and hygienic facts, if they are unprepared from their own lives to detect or to furnish illustrations for the child, this again does not mean that the child should be denied the illustrations, but that the teacher should either have instruction and experience to incite interest and to stimulate powers of observation, or else be asked to give place to another teacher who is able to furnish such qualifications.

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