MEDICAL INSPECTION OF SCHOOLS IN RELATION 

 TO SOCIAL EFFICIENCY. 



By Christian Frederick Louis Leipoldt, F.R.C.S., L.R.C.P. 



The medical inspection of schools presents so many interest- 

 ing points for discussion that it is difficult to select any special 

 aspect of the subject for detailed consideration without appearing 

 to lay undue stress upon the value of a component part of an all- 

 round valuable and important whole. All will admit the intrinsic 

 importance of the medical inspection of schools ; all Avill agree 

 that no branch of social, educational, or medical work is 

 strengthened by standing by itself, but only by its co-partnership 

 with correlated work ; and, finally, all of us will readily confess 

 to the creed that there is no real best where the degrees of com- 

 parison are so unequal as they are bound to l)e in any work that 

 is rudimentary and pioneering. School medical inspection is, to 

 some extent, yet in its embryonic stage. It is true it has already 

 been in working, in some countries, for more than a decade, but 

 when we consider it in relation to broad (|uestions of public health 

 and national efficiency, we find that it has hitherto been largely 

 haphazard. The Legislature has, as it were, made a junij) into 

 the middle of a ])roblem which should have been attacked on its 

 outworks. We started with the seemingly axiomatic assumption 

 that where the State imposes obligation it must hel|) those who 

 are unable to fulfil their civic duties. In a phrensy of fine altru- 

 istic philanthro])y we plunged into medical inspection and super- 

 vision of schools, with all their attendant difficulties, and added 

 communal obligations. Let us be grateful for that. One step in 

 the right direction counts far more than a parallelogrammatic 

 circumvallation of the whole objective. But siege engineers have 

 a defi.nite aim, and the laws that guide them are not fixed but 

 fluent, as Vauban showed. Above all, they have in view two 

 objects to be achieved — thoroughness and efficiency gained with 

 the minimum of energy expenditure. In England, however, to 

 cite one instance of an almost universal tendency, the State has 

 disregarded A'auban's rules, and by a cu.rious gymnastic effort, 

 highly creditable to its agility, but hardly conclusive proof of its 

 logicality, it has started progress in the middle instead of at 

 the beginning. For it seems to me to be wrong to suppose, and 

 to act on the supposition, that the State is concerned with the 

 health of the growing citizen solely when such health, or the 

 want of it, is a factor in estimating the degree to which a child 

 can respond to the educational call made upon him by an Act of 

 Parliament that prescribes school for every young citizen be- 

 tween the ages of five and fourteen. The health of the child 

 concerns the State directly, inasmuch as it is the well or ill being 

 of a unit of the community ; indirectly, because the safeguard- 

 ing of the sanity of the mass of young citizens safeguards at 

 the same time the sanity of the race, and consequently the econo- 

 mic V'.elfare of the nation. The obligation on the State is far 



