198 TRANSACTIONS OF THE CANADIAN INSTITUTE. [Vou. VIII. 
and known to the teachers, there were ten per cent., which were as fol- 
lows : 
alg Nature of Additional Defect. 
; oas 
3 Sa. 3 Z 
6 ra] Paes 3 
a ° 55x ; ; a 
SCHOOLS. = A 8, Z g a g g F: sf 3 
a) 3 HS we Gs) aI @ $ 5 
: Z wad Ee 2) 2 5 
3 S 6h.A 0 ze o a ri 
Zz Z Z Q Qa Ay = =| 
Blinds: Sczteeoek eeiee 10 254 39 Le 8 3 21 7 
Weal cesta teeth et 12 560 57 4 Ae 7 12 34 
Mentally Defective.... 67 3,471 464 18 43 177 LH 226 
Physically Defective.... 12 657 15 a Ae ee 15 Sie 
It will thus be seen that the work in the metropolis has been moving 
along on scientific lines in a manner quite typical of English thorough- 
ness. 
Coming closer home, it is found that the cities of New York, Phila- 
delphia, Chicago and Boston, have begun the good work, the latter city 
leading in the initiation of the same, it being the first city in the world 
to establish a daily system of medical inspection. The work was not begun 
without some effort on the part of the health authorities, and persisted 
in for nearly four years. 
The work was begun in 1894, on the occasion of an outbreak of 
diphtheria, and has been continued ever since under the control of the 
Board of Health. At present the staff of medical inspectors numbers 
50, one for each district, who is paid an annual salary of $200, making 
a daily visit to each of the four schools in his district, with an average 
attendance of 1,400. The method pursued in this city is as follows : 
The teacher sends to a separate room the children who either appear 
ill, complain of symptoms, or whose parents request it. The medical 
inspector on his daily round examines these children, keeping a record 
of each case; and if found to be ill, the child is sent home with a note 
advising parents as to course of action to be taken. If the case is a con- 
tagious one, he notifies the medical health officer, and with this his duties 
end. If the parents are poor, one of the staff of nurses takes charge of 
the case. Before the child is permitted to return, however, an examina- 
tion is made by the inspector. An indication of the extent of the work 
may be obtained from the fact that in the year 1899, the teachers refused 
17,449 pupils, of whom 2,583 or 14.08 per cent. were sent home. Four 
hundred and sixty-eight or 18 per cent. were suffering from acute in- 
fectious diseases and diseases of the throat, mouth, chest or skin. 
The work as at present in force in New York City, is fully set forth 
