MEDICAL INSPECTION OF SCHOOLS 



the band connecting the lower surface of the tongue with the floor of the 

 mouth is found in a certain number of cases. If there is no distinct 

 ulceration, there may be a marked congestion of the band. 



As long as there is any cough, the child who has had whooping- 

 cough should be looked upon with suspicion. 



Varicella (Chicken Pox). A few black crusts scattered over the 

 bodv are evidences of an attack of chicken pox. The crusting seen in 

 impetigo must be differentiated from that of chicken pox.* 



No child should return to school until all crusts have disappeared 

 from the body, particularly from the scalp, for in this region the crusts 

 remain longer than elsewhere. 



THE EYES 



[Supplement to circular already issued f] 



There are certain children who show normal vision by the ordinary 

 tests, yet whose parents should be notified to have the eyes examined. 

 These are: (i) children who habitually hold the head too near the book 

 (less than twelve to fourteen inches) ; (2) children who frequently com- 

 plain of headaches, especially in the latter portion of school hours; (3) 

 children in whom one eye deviates even temporarily from the normal 

 position. 



It should be remembered that the following symptoms are at times 

 indicative of trouble with the eyes: (i) habitual scowling, and wrinkling 

 of the forehead when reading or writing; (2) twitching of the face; 

 (3) inattention and slowness in book studies in a child otherwise bright. 



THE EARS 



See circular of directions f for testing hearing, already in hands of 

 teachers. 



THE THROAT AND NOSE 



In all cases of acute illness the throat should be examined for the 

 presence of the eruption of scarlet fever and measles and for the exuda- 

 tion or membrane of tonsilitis and diphtheria, and a culture taken in 

 any suspected case of the latter. 



The presence of discharge from the nose should be noted, and 

 if it is thick and creamy, a culture should always be taken. In all cases 

 of severe hoarseness, with difficult breathing, diphtheria should be sus- 



* See Diseases of the Skin. 



f See pp. 45-47 for this circular. 



1 86 



