PROFESSIONAL TRAINING FOR CHILD HYGIENE 295 



the microscope; that the teaching of anatomy and pathology is often 

 entirely didactic; that clinical facilities are usually inadequate and in 

 many cases practically lacking altogether; that many are squalid, 

 " reeking with commercialism," and '' without a redeeming feature of 

 any kind." Such has been the making of a large numerical majority 

 of our physicians. Additional comment would be superfluous. 



But what of those physicians whose medical training, as such, is 

 above reproach ? It would be unjust to confound them with the average 

 practitioner who is ignorant alike of the principles of medical science 

 and of child hygiene. Nevertheless, it must be said no less emphatically 

 that the ideal equipment for the school health officer is vastly different 

 from that required for the successful practise of medicine. The 

 physician is " long " on certain qualifications of little value to the 

 school health supervisor and as much " short " on others extremely im- 

 portant. When he enters the school he leaves his obstetrics and his 

 pharmacology behind. On the other hand, he needs to know a great 

 deal about such questions as those propounded in the first half of this 

 article, the solution of many of which is in no way made easier by the 

 best medical equipment. As a matter of fact and common sense, if the 

 work of the school health officer is to remain confined to the hasty and 

 superficial kind of examination usually given by the " medical in- 

 spector," then we had better forego the luxury of physicians and 

 employ trained nurses instead. After a few months apprenticeship 

 the nurse could make the usual tests of sight, hearing, etc., as well as 

 the physicians are making them. Already in some of the large cities 

 (San Francisco and Oakland, for example) nurses are actually doing, 

 under supervision, practically all the routine work of examinations. 

 As for the ordinary tests of vision, the teacher of average intelligence 

 can make them as successfully as the physician wlio is not also oculist. 

 A considerable number of the best oculists in the country have officially 

 taken this stand.^ The point is not that the work should be narrowed 

 to what the teacher can do, but rather that it should be extended 

 beyond the functions of the physician. 



The physician, after all, is only a physician, which is as much as to 

 say that he is not a hygienist in point of view. He has learned some- 

 thing of the science and art of discovering and curing disease. At best 

 .he has also learned a little of the general principles of preventive 

 medicine, but of the many special relations of preventive medicine to 

 the school he knows extremely little. He is ignorant of the technical 

 aspects of education, of child psychology, of the psychology of mental 

 deficiency, and of a host of common developmental abnormalities. If 

 he knows anything of mental hygiene and psycho-prophylaxis it is not 

 to the credit of his medical school, for not a half dozen in the country 

 have yet taken any account of the late epoch-making developments in 



='See Gulick and Ayres, "Medical Inspection of Schools," pp. 105-6. 



