May 18, 1900.] 



SCIENCE. 



Ill 



crowding of the nursiug profession already 

 apparent. 



Leaving now the hospital, a term here 

 meant to include asylums, convalescent 

 homes and similar institutions which are 

 his particular province, and passing over 

 questions, interesting in themselves in re- 

 gard to the working relationship of medical 

 staifs and boards of managers, let us con- 

 sider other directions wherein the physician 

 finds opportunities for the acknowledgment 

 of his citizenship. 



The medical supervision of public schools, 

 of recent inauguration, demanded as a ne- 

 cessity in view of the opportunity afforded 

 for the spread of contagious diseases 

 through the medium of these aggregation 

 centers, is opening the way to a much 

 larger sociological service than was at first 

 expected of it ; for, where medical inspec- 

 tion has been fairly established, the exam- 

 iners find themselves confronted with ques- 

 tions of the proper seating of school chil- 

 dren, of the provision of school lunches, of 

 proper lighting, ventilation and sanitary ac- 

 commodations and of the detection and 

 setting aside for compensatory educational 

 advantages children whose defective sight 

 or hearing puts them below the average of 

 their fellows. 



It is in schools for the defective, however, 

 that the doctor finds his especial work, and 

 the generous provision now made for the 

 care of feeble-minded and backward chil- 

 dren, the blind, the -deaf, and latterly the 

 crippled, gives him a large opportunity for 

 elucidative study leading toward the better- 

 ment of the condition of those whose in- 

 heritance or personal misfortune have made 

 them a charge upon the community, not 

 only for assistance, but for encouragement 

 toward turning their moderate capital in 

 life to the best account. 



The distinction between lack of percep- 

 tive capacity and lack of sense- transmission 

 is frequently represented only by a thin and 



shadowy line, and the partition classifica- 

 tion of dependent and imperfect children is 

 often one of the most exacting of the moral 

 responsibilities of the doctor. 



Children who are regarded as backward, 

 or even idiotic, are sometimes found on 

 careful examination, to be merely creatures 

 shut within themselves by the closure of 

 normal channels of communication, and the 

 bringing of such children into touch, through 

 the education of their tactile sense, with the 

 human companionship which makes life 

 worth living is worth far more than all it 

 costs in time or effort. 



In such cases as these the child has vir- 

 tually no desultory memorj', all impressions 

 received come mainly through one channel 

 and the memorizing capacitj' is in propor- 

 tion to the concentration effort in reception, 

 the nervous energy of the child, moreover, 

 instead of being expended in an effort at re- 

 ception through several sense organs, is 

 limited to a distinctively volitional one, and 

 in place of being used in the elaboration of 

 different methods of expression, is devoted 

 almost solely to perception. 



The intelligence, slowly educated by an 

 expenditure of effort on the part of the child, 

 is, reactively, constantly increasing the per- 

 ceptive power, so that when, through the 

 utilization of a quickened tactile sense, new 

 forms of expression are afforded, the concen- 

 trated nervous energy bursts its bounds in 

 a flood of questions and there is no fairyland 

 imaginable which will compare in its won- 

 ders to that into which such a child is ad- 

 mitted through the educational portals of 

 the kindergarten for the blind. 



The first attempts at the education of the 

 so-called deaf mutes, but mutes only because 

 of the lack of hearing and of training, began 

 naturally through the medium of the signs 

 and gestures which these unfortunates sub- 

 stituted for the inadequate utterance of 

 which some of them were capable. While 

 succeeding in imparting a good education 



