APPENDIX I 



Care must be taken to see that all combs and brushes are thoroughly 

 cleansed, and to prevent children wearing each others' hats, caps, etc. 



Children with ringworm should not be allowed to attend school. 



Impetigo. A disease characterized by few or many large or small 

 flat or elevated pustules or festers upon the skin. The condition is often 

 secondary to irritation or itching diseases of the skin (hives, lice, itch), 

 and scratching starts up a pus infection. 



The disease most often appears upon the face, neck, and hands, 

 less often upon the body and scalp. The size of the spots varies very 

 much, and they often run together to form on the face large superficial 

 sores, covered with thick, dirty, yellowish or brownish crusts. 



The disease is contagious, and often spread by towels and things 

 handled. 



Children having impetigo should not be allowed to attend school 

 until all sores are healed and the skin is smooth. 



DISEASES OF THE BONES AND JOINTS 



All noticeable lameness, whether sudden or continued, may indicate 

 serious joint trouble, or may be due to improper shoes. These cases, 

 as well as curvatures of the spine, as indicated by habitual faulty postures 

 at the desk or in walking, should be referred for medical inspection. 



Spinal curvature should be suspected when one shoulder is habitu- 

 ally raised or dropped, or when the child leans to the side, or shows per- 

 sistent round shoulders. 



Complaints of persistent "growing pains" or "rheumatism" may 

 be the earliest signs of serious disease of the joints. 



SOME GENERAL SYMPTOMS OF DISEASE IN CHILDREN WHICH TEACHER 

 SHOULD NOTICE, AND ON ACCOUNT OF WHICH THE CHILDREN 

 SHOULD BE REFERRED TO THE SCHOOL PHYSICIAN 



Emaciation. This is a manifestation of many chronic diseases, 

 and may point especially to tuberculosis. 



Pallor. Pallor usually indicates anemia. Pallor in young girls 

 usually means chlorosis, a form of anemia peculiar to girls at about 

 the age of puberty. It is usually associated with shortness of breath; 

 the general condition otherwise usually appears good. Pallor may 

 also be a manifestation of disease of the kidneys; this is almost invariably 

 the case if it is associated with puifmess of the face. 



Puffiness of the Face. This, especially if it is about the eyes, points 

 to disease of the kidneys; it may, however, merely indicate nasal ob- 

 struction. 



