MEDICAL INSPECTION OF SCHOOLS 



57,742, or about 8 per cent. In Cincinnati and Rochester in the 

 same year the exclusions amounted to between 3 and 4 per cent, 

 in Philadelphia and Spokane to 4 per cent of the membership. 

 In the state of Massachusetts in 1907, towns and cities having an 

 average attendance of 342,000 reported something more than 

 1 5,000 exclusions during the year. Again the percentage is 4. It 

 should be mentioned that in many cities cases of pediculosis form 

 a very large proportion of the diseases listed as communicable. 

 In New York City, where only the worst cases of this class are 

 excluded, the total exclusions in 1909-10 amounted to little more 

 than i per cent (8,884) of a total membership of 744,148. 



These facts have a direct and important bearing on the 

 question at issue. The data showing that the proportion of cases 

 requiring exclusion on account of contagious disease does not 

 exceed 4 per cent of the school membership indicate that the por- 

 tion of the work falling within the purview of the department' of 

 health is specific and limited. On the other hand, the fact that 

 all the children need medical and sanitary supervision with respect 

 to exercises, suitable seats and desks, type, paper, suitable hours 

 of study and recreation, drinking water, physical and mental 

 defects, and the like, indicates that the portion of the work which 

 legitimately forms a function of the educational authorities is 

 general in nature and almost unlimited in scope. 



By far the most important evidence bearing on the problem 

 is that drawn from the experience of American commonwealths 

 and municipalities. Medical inspection laws, or regulations 

 equivalent to laws, are now in force, as has been stated, in 19 states 

 and the District of Columbia. It is most significant that in 17 

 of these 20 cases the administration of the provisions is placed in 

 the hands of the educational authorities. In one case administra- 

 tion may be through either the department of health or the depart- 

 ment of education, and in only two cases is it entirely in the hands 

 of the health authorities. 



No less striking is the situation among American municipal 

 systems. In the early days of medical inspection practically all 

 systems were administered by local boards of health, but as 

 experience has accumulated the tide has turned until at the present 

 time only about one-quarter are under boards of health and in 



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