SCHOOL CLINICS 505 



percentage of defects treated in children of parents in better circum- 

 stances and of an average higher level of education is not materially 

 different, if at times not smaller, than in children of the poorer sections 

 of the city : in this connection it must be noted that the per cent, of chil- 

 dren with defects other than teeth was much lower in the well-to-do 

 section than in any of the three other sections; (second) that full and 

 harmonious cooperation between the teaching staff and the medical corps 

 is an element of extreme import in the efficacy of the work. In some 

 instances, especially in cases of defects with reference to which a great 

 deal of popular education has been undertaken, it is evidently possible to 

 attain one hundred per cent, of treatments when the cooperation of the 

 principal and teachers is genuine and wholeheaited; (third) that the 

 proximity to the school of a well-equipped and efficient dispensary tends 

 to increase the usefulness and efficiency of the work of the medical 

 school inspectors; (fourth) that in the case of children's ailments, 

 parents, even of the poorer classes, resort in fifty per cent, of cases to the 

 services of private physicians; (fifth) that over thirty per cent, of 

 reported treatments of school children by private physic'ans and dis- 

 pensaries do not result in cure or improvement; and (sixth) that teeth 

 are of all the largest and most neglected class of children's defects. 



Should a comprehensive study on the lines suggested in this paper 

 bear out the above cited conclusions a thorough revision of the underly- 

 ing theory and methods of our medical school inspection should be 

 undertaken and serious attention given to the institution and organiza- 

 tion of school clinics where efficient, competent and prompt work would 

 be done. 



School clinics are being tried in various parts of the country and 

 abroad. In New York City we have dental, nose and throat, and con- 

 tagious eye diseases clinics for children, maintained by the Department 

 of Health. The number of these clinics is small and their location is not 

 planned to meet the peculiar needs of certain sections. The only thera- 

 peutic work done in schools of New York City is by nurses who treat 

 minor skin and eye troubles like scabies, ringworm, favus, impetigo and 

 conjunctivitis. This measure alone has decreased the number of school 

 exclusions from 57,665 children in 1903 to 3,361 in 1911, but what is 

 more important than mere school attendance, it has effected positive 

 cure in thousands of cases. 



It is my personal opinion and belief that school clinics, if adopted 

 on a broader scale, should be established if not in every school, then in 

 schools centrally located, so that children from other schools in the 

 vicinity could easily reach them. The clinic districts should not be made 

 too large, that the evils of overcrowding may be avoided and the children 

 not subjected to waiting long and many hours. The treatment in school 

 clinics for those who need it and are unable for one reason or another to 



