SCHOOL CLINICS 501 



recognize that our underlying principles must be altered and actual con- 

 ditions met more satisfactorily than by mere observation and noticing of 

 defects. 



Medical inspection of school children is in its infancy. Before a 

 satisfactory method will be worked out many experiments must be tried 

 out and many careful inquiries made. The present fragmentary study 

 was undertaken on behalf of the public health, hospital and budget com- 

 mittee of the New York Academy of Medicine to demonstrate a method 

 of testing the value of certain elements entering into the effectiveness of 

 our medical school work, in order to determine whether school clinics 

 are a practical necessity. Matters pertaining to the health of the school 

 children of the City of New York are confided to the care of a dual 

 authority — that of the Department of Education and the Department of 

 Health. The sanitary care of schools, the instruction in physical train- 

 ing and personal hygiene, the segregation of backward and mentally 

 defective children, are entrusted to the Department of Education; all 

 the other elements of the medical school inspection are under the control 

 of the Department of Health. 



There are instances where the work of the two departments overlaps ; 

 there are instances where the two departments collide. There are oppor- 

 tunities for mutual dissatisfaction and irritation, which at times engen- 

 der ill-feeling and refusal to cooperate on the part of individuals. We 

 shall eventually come to the point, it seems to me, when we shall have to 

 decide on some definite policy of procedure, which will eliminate any 

 possibility of friction. We should like, therefore, to know precisely to 

 what extent the full and complete cooperation of the teaching staff with 

 the medical corps is to be counted on as a factor in bringing the efficiency 

 of our school medical work to the highest possible pitch. Then, we have 

 a great many dispensaries in the City of New York, varying in size and 

 efficiency. The knowledge of the extent to which the proximity of a 

 large and well-equipped dispensary affects our problem is also essential 

 before a definite policy is adopted. Thirdly, we harbor within our city 

 limits population composed of various races, of various degrees of intelli- 

 gence and education and differing in economic status. We should like 

 to know to what extent these factors enter into our problem. 



Eecognizing the importance of these elements, we have selected four 

 schools in the Borough of Manhattan : One on the lower east side, in a 

 section whose population is composed almost entirely of Russian, Aus- 

 trian and other Jews, and where the cooperation of the school authori- 

 ties with the health officers is known to be excellent. Then, another 

 school amidst a mixed population — foreign to a great extent, where the 

 interest of the principal in the work of the health department's officials 

 was known to be slight. A third school was selected, again in a Jewish 

 quarter, but in another section of the city, near a large and efficient dis- 



