COPYRIGHT DEPOSIT astoerssitie educational jHonograptyss EDITED BY HENRY SUZZALLO PRESIDENT OF THE UNIVERSITY OF WASHINGTON, SEATTLE THE TEACHING OF HYGIENE IN THE GRADES BY Jf MACE ANDRESS, Ph.D. Head of the department of psychology, boston normal school formerly head of the department of psychology and hygiene, state normal school, worcester, mass. HOUGHTON MIFFLIN COMPANY BOSTON, NEW YORK AND CHICAGO <$fre ttfaetfifce pte0 Cambridge COPYRIGHT, 1918, BY J. MACE ANDRESS ALL RIGHTS RESERVED id Wot fcibersibe $re*£ CAMBRIDGE . MASSACHUSETTS U . S . A FEB 19 1918 ©CI.A481733 A*-0. I To W. H. BURNHAM PIONEER IN HEALTH EDUCATION • CONTENTS Editor's Introduction vii Preface xi I. The Fundamental Importance of Hygiene^-— in the Curriculum i II. The Status of the Teaching of Hygiene . 12 III. The Goals of Instruction .... 26 IV. Suggestions on Method 39 V. Important Problems and their Solution . 86 VI. The Teaching of Hygiene in the Rural Schools 150 Bibliography 165 Selected List of Best Reference Books for Teachers 172 Outline 175 EDITOR'S INTRODUCTION The impotency of mere knowledge is gradually being recognized by the schoolmaster. Long he has believed in the magical influence of informa- tion about human conduct. Centuries of unchang- ing pedagogical tradition bear witness to his faith in the omnipotence of facts. Now, somewhat sud- denly, this sublime confidence in pure, or rather isolated, intellectual training, is disturbed by lay critic and psychological skeptic. As long as theory and practice were the sep- arate responsibilities of two different classes of people, the dependence of each on the other could not be fully perceived, and in consequence the assumed self-sufficiency of each was safe from destruction. It is precisely because contempo- raneous intellectuality has assumed practical aims, and because practical work has sought an efficiency that requires scientific aid, that we are now no longer content in education to worship pure learnedness. When learning ceases to be worshiped exclusively for its own sake and comes to gain the sanction of the actual service it may vii EDITOR'S INTRODUCTION render to human living, it is necessarily sub- jected to criticism it has not known before. As a product of this criticism, two striking changes occur in the intellectual discipline of our schools. First, the intellectual content of the school curric- ula is chosen on a different basis — a practical one. It includes elements previously omitted and omits those before included. Second, the intel- lectual activity is dealt with under conditions approximating normality. It begins in proper motivation and ends in expression to a degree unknown in traditional schools. Cognition is related to its emotional backgrounds and to its functional terminus. More useful subject-mat- ter assimilated under natural psychological con- ditions, rather than isolated information arti- ficially acquired, is the characteristic demand of every modernized course of study. The critics have had their way. Certain new practical ambitions of the public schools have revealed the weakness of educa- tional formalism more readily than some of its ancient functions. The teaching of language and literature has been slow to respond to reform, whereas the attempts to teach morals, art, civics, and health have been sensitive. Theirs was a practical purpose, and they were bound to viii EDITOR'S INTRODUCTION be checked by somewhat concrete social results. Mere information about goodness, beauty, and personal efficiency is too fragmentary not to be noted. Perhaps our inevitable disappointment as to the results of book learning in the field of health education has been most startling. Health is more tangible than morals or aesthetics, hence we have recognized the need of a change in peda- gogical procedure. This change we are now ob- taining. The memorization of the names of all the bones of the body has passed. Gone, too, is our old reliance on remembered descriptions of the old textbook physiology. Even rules for daily hygienic behavior seem not to be so highly valued as before. They, too, have failed to cover the gap between knowing and doing. The pedagogical faith is now pinned to action properly motivated, functionally explained, and much practiced. Health education is based on a regimen rather than on a textbook. It concerns every moment of the child's daily life rather than a study period or recitation spent at a school desk. This new training in hygiene reveals itself most characteristically in the reformed teaching of progressive teachers in the elementary school grades. Its plan and its method should be known to all teachers of young children. To aid in this ix EDITOR'S INTRODUCTION purpose we present the following monograph. It is a guide to the useful and effective teaching of hygiene. It indicates, with practical social surveys as a basis, the hygiene which has the most frequent and crucial value in daily life. It gives a hundred estimates of the worth of subject- matter, and a thousand suggestions as to right methods of teaching. Finally it includes references to further stores of wisdom too expansive to be given here, and too detailed to interest the teacher just beginning to think on the problem. PREFACE The purpose of this book is to give teachers and school administrators some practical suggestions on the teaching of hygiene in the grades. The word " hygiene " is here given a broader interpre- tation than giving instruction to children in a formal lesson a few minutes every day or week; it refers to those influences brought to bear on the children by the teacher, both incidental' and systematic, to conserve and improve their health. An effort has been made to emphasize the fol- lowing points: (i) the value of health to the individual and society; (2) the relative impor- tance of hygiene in the curriculum ; (3) the present unsatisfactory status of the teaching of hygiene; (4) the specific goals of the teaching of hygiene; (5) effective methods of teaching; (6) the appli- cation of these methods to the most significant problems of teaching; (7) the special health problems of both city and rural schools and their solution; and (8) definite references to the best literature for teachers and pupils. Many of the ideas herein presented have ap- xi PREFACE peared in articles by the writer published in the Elementary School Teacher, Educational Standards, The Rural School Teacher, The American Journal of School Hygiene, and in a chapter in Educational Hygiene (Charles Scribners' Sons), edited by L. W. Rapeer. This chapter is entitled "The Teaching of Hygiene in Elementary Schools." Special thanks are due Miss Laura S. Plummer, Dr. W. H. Burnham, and my wife, who read the manuscript and gave helpful suggestions, also to Mr. Arthur Kallom, who assisted in the reading of the proof. J. Mace Andress Boston Normal School December, igiy THE TEACHING OF HYGIENE IN THE GRADES THE FUNDAMENTAL IMPORTANCE OF HYGIENE IN THE CURRICULUM Hygiene is an applied science of practical value having as its objects the conservation and im- provement of man's health and the lengthening of human life. That health is of fundamental im- portance in life and education, taking precedence over all other values, is the thesis of this chapter. i. The value of health It is a common experience that loss of health and life leads to keen mental and physical anguish. If hygiene can alleviate this suffering in the slight- est degree, its position in the elementary-school curriculum is abundantly justified, but it may do more ; for preventable illness or postponable death is always a distinct economic waste. It is possi- ble within reasonable limits to estimate this eco- nomic waste and so put a monetary value on a i THE TEACHING OF HYGIENE practical kind of hygiene. It is not assumed here that money is a thing of greatest worth, but, since the discomfort and pain associated with illness are well understood and are quite immeasurable, let us pass to a consideration of the economic value of health and long life, topics which are often but vaguely comprehended. We may best approach these topics by re- viewing briefly our national losses due to a lack of applied hygiene. According to Dr. Irving Fisher (25), the newborn child has a net worth of $90. Since a child must be fed, clothed, housed, and educated up to at least the age of fourteen, or, in the case of one who learns a profession, until twenty or twenty-five, before there is any appreciable return on the investment so that the individual becomes self-supporting and economi- cally productive, the vital value of the child steadily increases every year after birth. At the age of twenty a human life represents $4000. There comes a time, of course, later in life, when the investment has been partially returned and when one's productive power wanes, that the economic value decreases. Dr. Fisher estimates that the average economic loss through prevent- able death is $1700. Since 42 per cent of the 1,500,000 deaths are preventable or postponable, 2 IMPORTANCE OF HYGIENE there is an annual loss to the Nation each year of approximately one billion dollars. When we con- sider that one third of the deaths due to typhoid and one fifth of those caused by tuberculosis occur at a time when our young people are in high schools and colleges, a period representing the maximum investment of society for the pre- paration of the individual for future usefulness, we get a good idea of some of the havoc that is wrought. Preventable sickness, not resulting in death, also represents a tremendous financial loss. The cost of caring for the sick — nurses, medicine, medical attendance, etc. — and the loss of wages amount to probably another billion of dollars. The share of the American workman in these losses is enormous. According to the estimate of the American Association for Labor Legislation (7) the industrial workers in the United States lose each year because of illness about 284,000,000 days, involving a loss to industry and in wages and medical cost amounting to $772,857,000. It is estimated that one third of this loss is prevent- able. It must not be assumed, of course, that these losses are purely individual, that he who is sick pays his own bills alone. These wastes gnaw at 3 THE TEACHING OF HYGIENE the very vitals of society. The workman who falls sick not only sustains individual losses, but he tends to cripple industry and increase the cost of the manufactured article to the consumer. Sickness and death inevitably entail social hard- ship. For example, the English Royal Commis- sion on Poverty states that 55 to 60 per cent of the poverty of Great Britain is due to illness. Dr. Baird (8) says the report of the Charity Organization of New York City seems to con- firm the report of this commission. The cruel blight of poverty not only closes the door of op- portunity to the individual, but places a heavy burden upon society. A family left destitute must often be supported by public or private charity. Children are often denied proper food, shelter, clothing, and sanitary surroundings, and are usually forced to leave school early to seek em- ployment. As a result their usefulness to society is greatly diminished. Every individual who is not dependent upon society for his livelihood helps to shoulder a vast economic burden due to preventable illness. Rapeer (50) estimates that the average family contributes one dollar in five of its regular income through some form of taxa- tion, direct or indirect, because of ill-health. The money loss is important, but the direct losses to 4 IMPORTANCE OF HYGIENE American citizenship, so subtle that they cannot be measured, are alarming. When we come to sum up in a word the value of health, we may say that it is a basic factor in individual and social efficiency and happiness. This is true to a remarkable extent of the school itself. Rapeer estimates that ill-health and phys- ical defects function largely in causing about fifteen per cent of elimination, sixteen per cent of non-promotion, and seventeen per cent of re- tardation. The work of medical inspection during the last ten years bears out the general truth of this estimate. Children with decayed teeth, de- fective eyesight, and adenoids, are not likely to be either happy or successful. Health in itself may not lead directly to happiness, but without it few individuals can realize satisfactorily their ambi- tions and their better selves, essentials in happi- ness. It is not only in school that health helps to contribute to happiness and efficiency, but also in life after leaving school. The Government and an increasingly large number of business firms are beginning to appreciate this. Excellent illustra- tions are found in the administration of our army and navy. Only men who are physically fit are accepted, and after they are regularly enrolled every means is taken to conserve their health. 5 THE TEACHING OF HYGIENE Many commercial establishments are beginning to understand that the healthy workman is an important asset. After a workman has attained a certain amount of skill in a manufacturing establishment, inability to work means a distinct loss to the employer. Many business organiza- tions employ physicians to give first aid to the injured. Often these workmen are given the advantage of baths, gymnasiums, lectures and printed matter on hygiene and sanitation. This interest in the health of the employed is justified, not merely from a humanitarian point of view, but from the idea of efficiency in business. What has been said of the army and navy and com- mercial establishments applies, of course, to all society. The prevention of disease makes for social progress and happiness. The money which society wastes in the cure of preventable disease may be diverted into helpful civic and social im- provements. 2. The outlook for the prevention of illness and the lengthening of human life In the face of such an appalling waste through sickness and needless loss of life, there is one outstanding truth of conspicuous significance: illness is largely preventable and the average 6 IMPORTANCE OF HYGIENE duration of life may be lengthened. The evi- dence bearing upon this is conclusive. The num- ber of illnesses is decreasing and the length of life is increasing wherever sanitary science and preventive medicine are applied. Smallpox, for example, which was once the scourge of the civi- lized world, has become virtually extinct so that comparatively few people to-day have ever seen a case. Through recent discoveries in preventive medicine, diphtheria has lost its terrors, and typhoid is doomed to a similar fate. Dr. Fisher believes that it is possible to lengthen the average life by fifteen years. Why, then, are we not doing more to prevent disease? There are numbers of reasons, but the most fundamental one is simply popular ignorance of the means. If the rank and file of the people really understood that we were paying large premiums for prevent- able disease, and that prevention is possible and much cheaper, we should probably find that more money would be spent by municipal, state, and national authorities for preventive measures and that the citizens would demand that the schools give pupils the proper training. It takes a long time for society to form a new habit. Through the countless centuries of the past we have concerned ourselves with the cure of 7 HE TEACHING OF HYGIENE disease, not with its prevention. The latter aspect is so new that few of our medical schools are as yet giving respectable courses in hygiene and sanitation, and few men are really equipped to apply the principles of preventive medicine ; and just at present, in spite of an unusual interest in health, these men are not in great demand. The people must be educated to desire good health and for this we must depend largely on our pub- lic schools. Although boards of public health, hospitals, charitable associations, newspapers and maga- zines are doing much to enlighten the general public; yet all of these attempts appeal almost exclusively to adults, the most of whom, being called upon rather late in life to adopt a changed view in regard to health, find a reformation of attitude difficult. We can never expect to ac- complish much in cultivating the right kind of public opinion toward health control until the schools do their part. Although there is a grow- ing interest in health matters, that interest is still too weak to demand a proper amount of money so that health officers can be properly paid and trained. Splendid as is the work which is being done by our municipal boards of health to educate the 8 IMPORTANCE OF HYGIENE people and protect them, we are just beginning to realize that such work has but begun. Franz Schneider, Jr. (58), who recently made a survey of municipal health departments in the United States, in summarizing the results of his investi- gation, says: — We have seen that at the time of this investiga- tion a fifth of the cities made no investigation of school-children; over a third did not offer the ordi- nary laboratory diagnosis for the commoner com- municable diseases; over a fourth made no effort to educate in health matters; nearly three fourths had no housing law; nineteen twentieths had no concern with the hygiene of industry; over six sevenths had no program against the venereal diseases; over a half had no proper organization to combat infant mortality; and less than a quarter had a coherent program against tuberculosis. Surely these facts argue for a surprising amount of neglected oppor- tunity. And when we consider this investigation made no effort to determine the efficiency of the work attempted, but only whether or not it was attempted; and when, with the departments with which we are familiar in mind, we reflect on the partial thorough- ness with which their slender staffs compel them to perform their work, the conclusion becomes inevi- table that public health work in this country is still in its infancy — certainly as far as application of scientific methods is concerned. THE TEACHING OF HYGIENE One of the striking results of this investigation is the showing that the smaller municipalities provide less efficient protection of health than the larger ones. In the rural districts statistics now available would tend to indicate the worst conditions. 3. The relative importance of hygiene in the curriculum Having recognized the fundamental impor- tance of health, we might ask, " What is the rela- tive value of the teaching of hygiene in the school curriculum? " At the possible risk of being called narrow and prejudiced, I wish to state as strongly as possible that in view of the foregoing facts instruction and training in hygiene seem to be more important than any other subject in our school curriculum. To read well, to write legibly, to calculate accurately, all these and many of the other varied accomplishments of the school are worth while, but they have a doubtful value un- less first of all the pupils are laying the basis for good health. Health is important, not as an end in itself, but as a means toward practically all worthy ends of life. Knowledge and skill gained without training in hygiene cannot mean educa- tion in the truest sense; for " What doth it profit 10 IMPORTANCE OF HYGIENE a man to gain the whole world and lose his own health?" Superintendent Hines with commendable in- sight has well said: "The teacher that is well trained in matters of hygiene is worth almost twice as much to the community as the teacher who can attend to the mental needs of her children only and who is indifferent to the many conditions that bear directly on the health of her charges." It is time now to inquire about the efficiency of the teaching of hygiene in our elementary schools. II THE STATUS OF THE TEACHING OF HYGIENE If health education is of first importance in a philosophy of education, we might expect to find the importance of the teaching of hygiene recog- nized in the theory and practice of our elementary schools. Let us examine the reports of some typ- ical school surveys and other investigations to find out what its status is in our public schools. i. Reports from surveys and other investigations Flexner and Bachman (27) have just submitted a report of one hundred and seventy-six pages on the educational situation in Maryland. In a chapter of twenty-two pages on " Instruction,' ' reading, spelling, arithmetic, etc., come in for their full share of space. What is said about the teaching of hygiene is introduced more or less inadvertently in a paragraph on geography. De- ploring mere textbook teaching which does not consider the environment of the child, the investi- gators use two sentences to give their impressions 12 STATUS OF TEACHING HYGIENE of the teaching of hygiene. They say: " Again in physiology, pupils recite about bacteria, first aid, and various ailments. Meanwhile they breathe an atmosphere filled with the dust just raised by an old-fashioned broom, use not infrequently a com- mon dipper, and resort to filthy and unsanitary outhouses." This stray reference is enough to show the failure of the teaching of hygiene. The Carnegie Foundation for the Advancement of Teaching (63), in its survey of the schools of the State of Vermont, does not have the word "health" or "hygiene" in its index to a volume of two hundred and forty-one pages. It does use a half-page to publish a recommendation of the State Board of Health on the sanitation of school- houses. The whole subject is so little considered as to be almost worthless. In the consideration of the teaching of school subjects the investigators make a comment one sentence long on the teach- ing of physiology, not hygiene. It is as follows: "No child in a class that was studying the bones of the" arms and shoulder by means of a book on physiology was able to locate these bones in the body." This quotation, short as it is, indicates a lack of appreciation of health instruction and some sort of belief in the efficacy of time-worn instruction in anatomy. 13 THE TEACHING OF HYGIENE Dr. Frank McMurry (40), in the New York School Investigation, found that the instruction in hygiene "failed to meet any of the standards used." It failed to arouse the interest and initia- tive of the pupils and had almost no connection with their lives. The teaching resolved itself into the teaching of physiology, anatomy, alcohol, and narcotics. This instruction was given mainly in the upper grades, and was left largely to the discretion of the individual teacher. 1 The survey of the schools of Portland, Oregon, contributes a splendid chapter on hygiene and sanitation. Dr. Terman (22), who made this investigation, says that the teaching was not "below the average," whatever that means. His statements are rather cautious, but they do sug- gest that some of the teachers did not appreciate the fact that habit formation is the great goal of instruction in hygiene. The weakness of the teaching is shown in the statement that "Most teachers have themselves had little instruction 1 It should be noted, however, that the director of physical training in replying to this criticism said that McMurry had not seen the " new course in operation in any of the half dozen schools" in the city. See Fifteenth Annual Report of the City Superintendent of Schools of the City of New York, PP. 538-39- 14 STATUS OF TEACHING HYGIENE in hygiene and need to have their own scope of knowledge enlarged." Rapeer (44) who made an investigation of educational hygiene in twenty-five leading cities, and one who therefore speaks with authority, says of the teaching of hygiene : — And yet the subject is a tail-end subject, little em- phasized, and furnished with poor textbooks for the most part, and very frequently with poor teachers in the grades and high school. Colleges do not usually give credit for nor demand a knowledge of this vitally essential subject of health and how to get and main- tain it, much to their disparagement, and conse- quently we find many schools almost neglecting it. Bobbitt (13) found, in the recent survey of the Cleveland schools, that, while the school program shows that one fifteen-minute period is devoted each week to the study of hygiene in the first four grades and one thirty-minute period each week to the four upper grades, in actual practice the subject receives less time than this. The at- tempt which was made to find out what was actu- ally being done in the classes in hygiene is in- teresting. Bobbitt says that "a member of the survey staff went on one day to four different classrooms at the hour scheduled on the pro- 15 THE TEACHING OF HYGIENE gram. In two cases the time was given up to grammar, in one to arithmetic, and in one to music." As a final comment on the teaching of hygiene, Bobbitt says: "This represents practice that is not unusual. The subject gets pushed off by one of the so-called 'essentials.'" What teachers themselves consider as most important in the curriculum is well shown by a survey made of the schools of Chicago by the teachers themselves. The report of the survey consumes nearly three hundred pages of the Sixtieth Annual Report of the Board of Educa- tion of the City of Chicago for the year ending June 30, 1 9 14; yet the teaching of hygiene is dis- missed with seven lines. Reference is made to the provisions of the Illinois School Law requir- ing " that the nature of alcoholic drinks and other narcotics and their effects on the human system shall be taught in connection with the various di- visions of physiology and hygiene as thoroughly as are other branches." Continuing, the report says that this topic is placed in the department of physical education, that excellent textbooks are in use, and that the "requirements of the law are fully met." The fact that the schools of Chicago are meeting certain legal requirements seems to be highly significant in this report 16 STATUS OF TEACHING HYGIENE The other subjects of the curriculum, such as spelling, music, geography, penmanship, art, etc., are considered in detail, in the report, as to aims, values, and methods, adverse criticism is often made and helpful suggestions given, but hygiene has scant recognition. One is left very much in the dark as to what is considered as good teaching in hygiene, and to what extent the teaching is successful beyond fulfilling the literal requirements of the law. Anything like a careful appreciation of hygiene as a school subject or enthusiasm in its teaching is not visi- ble in the report. The investigations referred to so far have had in mind the elementary school for the most part. The deficiencies in health instruction in the high schools are probably more marked than in the elementary schools. Small, who has given careful thought to health teaching in high schools, says that "few schools include health teaching in their courses of study." The teacher of physical train- ing is perhaps best fitted for such instruction, but unfortunately there are few schools that have such a teacher, and in most cases he lacks that training necessary for a successful teacher of hygiene. 17 THE TEACHING OF HYGIENE 2. Hygiene not regarded as fundamental; its teaching a failure It is fair to assume that the broad investiga- tions to which we have referred represent condi- tions in the teaching of hygiene that are fairly representative of the schools in the United States. We are forced to conclude that most educators have not yet seriously considered the fundamen- tal importance of the teaching of hygiene and that the teaching of this subject is largely a failure; that it is but little conducive to the getting and maintaining of health. In justice to the school systems referred to in this chapter it should be said that some excel- lent health work is being done through medical inspection, school nursing, play, athletics, and systematic instruction in domestic science. There is little evidence, however, that the teacher has clearly in mind the contribution that each of these activities may make to health or that there is any coordination between them and class teaching in hygiene. The status of the teaching of hygiene may still be summed up, as it was a number of years ago by Dr. Crampton, who said that "it was a sinister fact that most of the teaching of hygiene in our 18 STATUS OF TEACHING HYGIENE schools is a farce " ; or by Dr. Richard Cabot, who in a similar vein referred to hygiene as "the yel- low dog among the studies of the curriculum. ,, j. Why the teaching of hygiene has failed It is perhaps desirable at this time to try to find out why the teaching of hygiene has been so unprofitable. A careful analysis may suggest means as to how these failures may be overcome. I should like to suggest the following reasons for the inefficient teaching of hygiene. (i) The American people do not yet seriously appreciate the fundamental importance of health for happy and successful living nor the fact that health within certain limits is to be gained by the proper expenditure of money and by education. Until they have this appreciation they are not likely to demand that the school regard health education as taking the precedence over all other school subjects. Reading, writing, and arithmetic have been considered so long as fun- damental subjects because they were seen to be closely connected with the gaining of a livelihood and the realization of ambition. The time is not far distant when the public will see that hygiene has a similar and deeper significance. When we remember that during our Civil War the prin- 19 THE TEACHING OF HYGIENE ciples of antisepsis in surgery was unknown, and that there has been a wonderful revolution in medical science within the last thirty-five years, we ought to marvel that the rank and file of humanity have advanced so far. The means that are now being taken to popularize hygiene and sanitation suggest that society will soon force upon the school the responsibility of efficient health instruction. The rapid spread of medical inspection throughout the country is an index also to an awakening public opinion. (2) The school itself, as we have already seen, has little appreciation of the fundamental im- portance of health instruction. In most schools pupils are probably not marked in hygiene until they reach the upper grades, and it is seldom, except perhaps in the higher grades, that hy- giene is required for promotion. Not being held strictly responsible for results in hygiene as in arithmetic, it is easy to see that the teacher will often find it convenient to use the time assigned to hygiene for arithmetic, music, etc. Even the more conscientious teachers, under the pressure of supervisors, may yield to such temptations. The writer's experience has been something like that of Bobbitt at Cleveland. If you go out to find instruction in hygiene it is very hard to tree 20 STATUS OF TEACHING HYGIENE it, and there are abundant excuses as to why it is not being taught according to the daily program. In all this the teachers are, of course, less to blame than the school committee and the supervising staff. The responsibility eventually goes back, as we have suggested, to the mass of citizens themselves. (3) The teachers as a class have not been prop- erly trained to teach hygiene. A study of "The Teaching and Practice of Hygiene in the Public Normal Schools of the United States/' under the direction of Terman in 19 11 (54), shows that the majority of our normal schools are exceedingly defective in their training in hygiene. One half of the eighty-four normal schools reporting either offered no hygiene or none except that which came in incidentally in connection with work in physiology. Nine schools gave neither hygiene nor physiology. Until our normal schools feel the need of enlightening our future citizens on such important matters, until they feel the call with something like religious zeal, the teaching of hygiene in our elementary schools will prove ineffective. (4) Hygiene has so recently appeared in the school curriculum that its psychology and peda- gogy have not yet been worked out systemati- 21 THE TEACHING OF HYGIENE cally or satisfactorily. 1 The difficulty of teach- ing hygiene rather than arithmetic is easily seen if you stop to consider the variety of textbooks, devices, and methods which have been pretty well worked out in arithmetic and the barren- ness of these in the case of hygiene. (5) Many of the textbooks still in use devote altogether too much space to anatomy and phys- iology. Much of the material in these books is too difficult for children and is so badly presented that it arouses a permanent distaste for the sub- ject in the minds of the pupils. Such an attitude can hardly be expected to inspire a love for health or result in hygienic practices. Many of our early textbooks in physiology, the predeces- sor of hygiene, were written by physicians who believed that anatomy and physiology were of prime importance. It has been difficult for us to overcome this early impression. There can be little doubt that instruction in such matters has been barren of result. Cubberley, in a discussion of the teaching of hygiene, says: "We have been teaching physiology for nearly a half-century in our schools, yet of how little practical use it 1 Freeman's Psychology of the Common Branches (Houghton Mifflin Company, 1916), a pioneer work of its kind, omits hy- giene from its discussions. 22 STATUS OF TEACHING HYGIENE has been to us ! . . . We have learned the names and number of our bones, the pairs of muscles and nerves, and the anatomical construction of our different organs, but of practical hygiene we have learned but little." Fortunately the old- time textbook in physiology is fast disappearing. A number of good books on hygiene have re- cently appeared that could be put into the hands of children with profit. 1 (6) The hygiene that has been taught has been too general and abstract and has aimed at knowl- edge rather than health ideals and practice. For example, teachers often spend much time on the anatomy and physiology of the digestive system to the neglect of such vital topics as food values, the hygiene of eating, how to preserve food, how to keep it from becoming contaminated, the right kind of breakfast for children, a good kind of lunch to bring to school, etc. (7) The instruction in hygiene is not well or- ganized or standardized through the grades; hence repetition and tedium both for teachers 1 Among these best textbooks are the series by Gulick (Ginn & Co.), O'Shea and Kellogg (The Macmillan Com- pany), Coleman (The Macmillian Company), Woods Hutchin- son (Houghton Mifflin Company) and Ritchie-Caldwell (World Book Company). 23 THE TEACHING OF HYGIENE and for pupils are common. There is also a com- mon neglect of essentials. (8) The aims in teaching hygiene have not been clearly formulated. Few principals of ele- mentary schools have clearly in mind what re- sults they ought to get by the time the children get through the eighth or ninth grade, conse- quently there has been little systematic planning for results. They are not able properly to eval- uate facts and behavior after they have been mastered by the children. (9) Hygiene has preached too much and has referred too little to facts. Its extreme and un- scientific statements have made it an object of ridicule and contempt. Fortunately to-day we have a large body of reliable facts which, if prop- erly presented, may be convincing. (10) Few teachers like to teach hygiene. When- ever it is possible they "slight" and "dodge" it; this is due in part to their not being held up rigorously to the standards required in other subjects; but it is also a result of indifference to the subject itself. It is only natural to expect that the general vagueness as to aims, values, and methods would tend to dull the natural zeal and spontaneity possessed by the teachers. With poor training, little comprehension of the social 24 STATUS OF TEACHING HYGIENE value of what is to be taught, it is little wonder that there are failures and that the teaching of hygiene is heartily disliked. From the foregoing it is clear that our defec- tive health instruction in the elementary schools is not due to one, but to a large number of factors involving deep-seated social prejudices, defective training, etc. Interest in health conservation is growing at a rate so rapid that there will be a constantly increasing pressure brought to bear upon the school to give practical health educa- tion. How can the teaching of hygiene be im- proved? The remainder of this monograph will be devoted to the constructive problem, to the underlying principles which should govern the teaching of hygiene. Ill THE GOALS OF INSTRUCTION i. The acquisition of knowledge The most noteworthy aim in education histori- cally has been the knowledge aim; it has been dominant in education for centuries, and has always been conspicuous in the philosophy of education. Education has invariably meant being literate (literally, having control over the symbols of thought). While the great educators have always emphasized the importance of get- ting the thought from the written or printed page, unfortunately this has not always been recognized, and so one of the crying evils of every age has been the neglect of thought and the as- sumption that the mere mechanical command of mechanical symbols means education. Not infre- quently, too, there has been an emphasis on the acquisition of knowledge without relation to its being carried out in action, thus serving to adjust man to his surroundings or give him mastery over them. Knowledge for its own sake has been looked upon as cultural, while knowledge designed 26 THE GOALS OF INSTRUCTION for practical purposes has often been regarded as something sordid and unfit for the school. The knowledge aim in the teaching of hygiene has been and still is in the foreground. Often the facts presented have no practical value. The early textbooks in physiology were written largely by physicians and emphasized anatomy and physiology to the almost complete exclusion of hygiene. The only topics of a hygienic na- ture were those on alcohol and tobacco. The need of fresh air, exercise, food, etc., was dealt with sparingly. According to the writer's re- membrance of his own school days three dis- tinctive feats in the teaching of physiology and hygiene were thought by the teacher to be highly significant. They were as follows: (i) to name all the bones of the body; (2) to describe the circulation of the blood; and (3) to describe the process of digestion. The accomplishment of these exercises depended on one's ability to com- mit to memory verbatim from the book. There were never any thought questions proposed by the teacher. The only bit of concrete work in connection with these exercises was a dramatic performance of dissecting a pig's heart before the entire class. This was one of the most interest- ing events of the year, but I cannot recall any 27 THE TEACHING OF HYGIENE suggestions bearing on health. Those who had mastered one of the three exercises mentioned above were often called upon to demonstrate with the aid of charts when visitors were present. Such an exhibition may seem to us to-day to be senseless; the knowledge given gave no in- sight into how one might be healthy, and it is questionable whether the knowledge imparted made life any richer or better in the case of the boys and girls, the majority of whom were soon to leave school and go to work. The curious in- struction which I have mentioned has in most cases disappeared from our public schools, but there is still a large amount of subject-matter involving physiology and anatomy which ought not to be taught to children. While it is true that practice is more important than knowledge, yet the function of proper knowl- edge in promoting action should never be over- looked. Whatever may be said in disparagement of knowledge, it is nevertheless plain that it helps rather than retards the right kind of practice. Information acquired by children should be of such a character that it may offer possibilities of practical value if carried out. Knowledge about the carriers of disease, how to control them, and how to prevent colds may be really useful. But 28 THE GOALS OF INSTRUCTION important as personal hygiene is, the health of the individual is also dependent upon a scientific administration of health affairs. The purity of the water, milk, and food supply demands good laws, trained health officers, and a sufficient amount of money for health purposes. We can- not expect efficient administration of health affairs until the great mass of voters are intel- ligent concerning the fundamentals of public hygiene and sanitation. The proper education of future citizens in matters of health will do much to enlighten public opinion. Let us take as a concrete illustration the han- dling of food. There is no doubt but that the health of the people is greatly endangered by a lack of medical inspection of those who handle food. The case of typhoid Mary well illustrates this. She was a carrier of typhoid and wherever she went in the capacity of cook there were out- breaks of typhoid. Dr. Cleveland Floyd, of the Boston Consumptives Hospital Out-Patient De- partment, says that over two per cent of the six thousand cases examined in the course of seven years were cooks, bakers, waiters, and others en- gaged in the handling of food. It was also proved that one third of this number were throwing off tubercle bacilli in their sputum when they came 29 THE TEAGHLNG OF HYGIENE - to the clinic. Other diseases also, like syphilis may also be spread by handlers of food. Until all handlers of food are subjected to medical tests, we are menaced by a number of disease-carriers. When knowledge in regard to this danger is well enough known by the great mass of our citizens and they are led to feel keenly about it, we shall have a law placed on our statute books which will offer ample protection from danger from such a source. The right kind of knowledge imparted in the school, which lays hold of the interests of the pupils ought to contribute much toward this end. There are certain fundamental knowledge tests which every pupil graduating from our public elementary schools ought to pass without dif- ficulty. To my mind such knowledge is as im- portant as a proper command of the mother tongue and promotion should be denied those who fail in these requirements. I would propose the following standards : — (i) Ways in which disease is spread. (2) What to do in an emergency. (3) Common dangers and illnesses and how they may be avoided. (4) What the immediate community (neigh- borhood, town, city), State, and Nation are doing to prevent disease. 30 THE GOALS OF INSTRUCTION (5) How the citizens may cooperate with these social and political groups to promote hygiene and sanitation. (6) The nature and value of foods and drinks. (7) The nature of alcohol and tobacco, their relation to health (especially to the health of children and youth), and the economic and social results of their use. (8) The names and achievements of the lead- ing heroes of preventive medicine. 2. The formation of health habits But knowledge alone is a very unsatisfactory goal of education; for we live in a very practical world in which we are called upon to work out serious problems having to do with happiness and efficiency. The mere acquisition of knowl- edge is no insurance that the individual will carry out his ideas in action. Practically every- body who reads these pages is familiar with the simple rules of health, but if we come to examine our practice we shall in all probability find that it is far inferior to our theory. Although knowl- edge about hygiene may be pleasurable, yet it is inconceivable that such knowledge would ad- vance the health of the individual to any appre- ciable extent unless it were worked out in practice. 3 1 THE TEACHING OF HYGIENE One may read about the desirability of taking plenty of exercise and thoroughly masticating the food, but if one's reaction is not modified as a result of this knowledge one is no better off than before. The right kind of behavior tending to conserve and improve health is of first import- ance and takes precedence in its importance over all knowledge. It is now possible to say, as a result of the fail- ures in the teaching of hygiene and from our gen- eral observation, that we cannot expect appro- priate action unless as teachers we see that pupils form the right kind of habits. Pupils may be told from a great many points of view that exercise is desirable, but practice of this activity is likely to be intermittent and finally to cease altogether un- less the pupil forms the habit of taking exercise. A similar statement might be made of clean- ing the teeth, washing the hands, sitting and standing correctly, etc. That mere knowledge is often futile and that new habits are formed with difficulty is, perhaps, a common observation. In some of my own classes of normal-school pupils, I have frequently asked them to form a habit which would seem to them to be worth while and then keep a record each day. Even with the in- centive of a school mark behind it and the con- 32 THE GOALS OF INSTRUCTION viction that the habit was worth while, there were many lapses, and a simple habit like that of masticating the food slowly was not mastered until the end of from four to ten weeks. Health habits must, then, be the real goal of the teaching of hygiene. How they may be formed will be dis- cussed later. It has already been said that knowledge about hygiene is fully as important as knowledge about geography or English. If such knowledge is im- portant, then how important must the formation of health habits be rated. Considering the im- portance of health to the individual and society, can there be any doubt but that the formation of health habits takes precedence over any other kind of instruction or training given in the school? Any test of the efficiency of the elementary school should not neglect the testing of these fundamen- tal habits. Just as the real test of arithmetic is one's ability, not knowledge, in actually doing examples and problems, so the final test in hy- giene is a test of habits formed. It is rather sig- nificant, as showing the standing of hygiene and the formation of health habits, that most sur- veys entirely neglect any testing of health habits. Charles Hubbard Judd, for example, in his con- tribution to the survey of the Cleveland schools, 33 THE TEACHING OF HYGIENE entitled " Measuring the Work of the Public Schools," tested the work done in handwriting, spelling, arithmetic, and reading, known tradi- tionally as the essentials, and neglected hygiene entirely. I would recommend that every pupil before graduating from the elementary school should be required to pass certain fundamental tests in habit formation. No promotion should be granted without the fulfilling of these require- ments. The following classification of habits might be suggestive: — (i) Personal habits such as cleanliness, care of the teeth, manicuring the nails, etc. (2) School habits — cleaning shoes before en- tering the schoolroom, proper methods of erasing blackboards, correct posture, etc. (3) Home habits — proper amount of sleep, ventilating sleeping-room, etc. Since these must be performed in every case without the personal supervision of the teacher, they are more difficult to perform, but much can be done with the cooperation of the school nurse and through mothers' and parents' meetings. (4) Emergency habits — care of bruises, burns, etc. 34 THE GOALS OF INSTRUCTION j. The establishing of ideals Health education would be incomplete which did not have as one of its aims the establishing of ideals conducive to health. The ideal is fre- quently conceived of as something purely intel- lectual, an ideal of perfection to which the indi- vidual may or may not conform, but something which he regards with a certain amount of rever- ence because it represents that which he would be. A mature reader of hygiene once said to me that she enjoyed reading hygiene and she had certain ideals of personal hygiene, but they never seemed to have much effect upon her mode of life. This purely intellectual ideal is not what the teacher should strive for. The hygienic ideal must be an effective ideal, one which finds its expres- sion in action. The psychology of the ideal is still somewhat obscure, but probably this effec- tive ideal to which we refer has its origin in be- havior rather than in ideas. If one forms the habit of cleaning his teeth regularly before going to bed at night, he is likely to have a mental con- cept of a correct hygienic practice, but it is a concept connected with real action. But I feel quite sure from my own observation, and from inquiries made in connection with my class- work 35 THE TEACHING OF HYGIENE as a teacher of hygiene, that comparatively few people who clean their teeth in the morning and who also appreciate the importance of cleaning their teeth before retiring at night actually clean their teeth then. These people really have two ideals, one purely intellectual and ineffective, the other intellectual and effective. The effective ideal, the only one worth mentioning, seems to have its source in the action of pupils. Such ideals are not only important for personal hygiene, but helpful in cultivating social and public health ideals. For example, if children are informed as to the dangers in handling food and have themselves formed proper habits, they are likely to have a helpful attitude toward the public methods of handling food. It is believed by many teachers that the recit- ing by children of words pledging allegiance to the flag helps to cultivate a spirit of loyalty and an ideal of American citizenship. Some good teachers of hygiene also believe that the com- mitting to memory and the recital of a carefully worded health creed is of noteworthy assistance in inspiring effective hygienic ideals. Probably this is true in some measure; one of the possible dangers, however, in the teacher's use of the creed is an overestimation of what it does for 36 THE GOALS OF INSTRUCTION the pupil. A properly worded creed recited by the school will help to keep before the children the principles toward which they are working ; it may arouse some real enthusiasm and have some influence on action; but the teacher who depends largely on such a support for her work will encounter failure. Training cannot be accom- plished so easily. The teacher who is skillful in imparting information and in giving the right kind of training may find that the recital of a creed will prove of some help in the cultivation of an effective health ideal. The Massachusetts State Board of Health has recently published and distributed a health creed for the boys and girls of the State which is to be recommended if it seems to be desirable to use one. It runs as follows: — MY BODY IS THE TEMPLE OF MY SOUL Therefore : — I will keep my body clean within and without; I will breathe pure air and I will live in the sun- light; I will do no act that might endanger the health of others; I will try to learn and practice the rules of healthy living; 37 THE TEACHING OF HYGIENE I will work and rest and play at the right time and in the right way, so that my mind will be strong and my body healthy and so I will lead a useful life and be an honor to my parents, to my friends and to my country. IV SUGGESTIONS ON METHOD Success in the teaching of hygiene cannot be expected if the instruction and training are limited to a few minutes of daily class- work. The formation of effective health ideals and habits involves every attitude of mind and every mode of behavior both inside and outside of school. In the remainder of this monograph the teaching of hygiene will refer not only to class instruction, but to all the means, both incidental and sys- tematic, whereby the teacher may further the health of the pupil. Let us consider next some of the methods of realizing this end. j. Health as a motive ineffective The teacher who has clearly in mind the rea- sons why she is teaching hygiene has mastered the first essential step in successful methods; for no amount of knowledge of subject-matter and sympathy with child life, no amount of enthus- iasm, will be likely to lead to practical results un- 39 THE TEACHING OF HYGIENE less she is guided by distinct purposes. But such purposes are not likely to be attained unless there is, in the second place, a deep sympathy with the interests and ambitions of childhood. Some school subjects are fortunate enough to be so in- teresting in themselves that the teaching is nat- urally more easy. The study of the life history of the common insects appeals at once to children so strongly that failures in teaching such les- sons must be due to the inability of the teacher to use the spontaneous interest of the pupils. Lack of interest often results from foisting upon the pupils facts that are dry and bookish. What is the child's attitude toward health? Dr. Wood (58) refers to an investigation made in the Speyer School and in a fourth grade in a New York City East Side boys' school. In each grade questions bearing upon the subject of health, its meaning, means of attaining it, etc., were asked. In the first four grades of the Speyer School the questions were put orally and to individual chil- dren and in the other grades the answers were written and names were not put on the papers. By such methods the children were given free- dom of expression and were not influenced by the answers of others. Being healthy meant to a good many "feeling well," "strong," "bright," 40 SUGGESTIONS ON METHOD "lively," "feel like doing things/' etc. In reply to the question as to why they wanted to be healthy, many gave answers like these: " So I can play and go to school," " to be out of doors," " to be able to see friends," "to romp in the park," and "to chase with my dog." In summarizing this investigation Dr. Wood says: "In no answer is there any suggestion that the child is interested in health in the abstract or as a future beneficial state. His sole health concern exists in application and relation to the immediate present. Interest in growing well and strong is nowhere indicated save as this state gives increased power and capacity for present enjoyment." The child, then, has only a vague appreciation of the meaning of health. He lives in a world palpitating with the joys of present-day living. To-morrow and the days that follow have only a shadow interest compared to the zests of the present. To tell Johnny that he must get plenty of fresh air so that he may have strong lungs and avoid tuberculosis is useless. The idea of health is no motive to action. What may happen in the years to come cannot be understood and is dis- regarded. Dr. G. Stanley Hall has put the mat- ter neatly by saying: "To tell a child that Irving 4i THE TEACHING OF HYGIENE Fisher has found that by conforming to certain well-established laws of health, life may be pro- longed on the average fifteen years seems a far cry, and is ineffective, for the child is absorbed in living out all the possibilities of the present reality." 2. Some motives that will work The apparently direct motive of health proving unsatisfactory, other means must be depended upon to realize those goals of health education presented in this monograph. This must be done by associating the knowledge which is to be im- parted and the habits which are to be established with the natural or acquired interests of the chil- dren. Many illustrations of this procedure will be given later. Here we refer to only a few. The failure of instruction in knowledge has already been pointed out. In the past there has been a lack of concreteness and a remoteness of attach- ment to the interest of childhood that has proved disastrous to health education. Descriptions, for example, of the structure and functions of the interior parts of the body, which the pupils have never seen or have little interest to know about, have tended to make physiology and hygiene dry, uninteresting, and often disgusting to chil- 42 SUGGESTIONS OxN METHOD dren. Assuming that the facts to be presented are of recognized worth, they should be presented so as to ally themselves with some interest already present. Just at present, for example, there is an unusual interest in the great Euro- pean War. In every town and city men have been called to the colors. Their call and depart- ure have made a profound impression upon the children. Here is a chance to drive home some splendid information on health. What does the United States Government do for the health of the soldiers? Current newspapers and magazines and even letters written from the front throw light upon this. Regulations concerning the covering of food to protect from insects, the draining of camp-grounds, the destruction of mosquitoes and flies, and general cleanliness, — all these and many others, supplemented by illustrations from newspapers and magazines, would offer material for several excellent lessons; lessons that would be accepted eagerly by the children. Then, too, children have a genuine interest in the heroic. The history of preven- tive medicine tells eloquently of many men who offered their lives to further the cause of health. If the teacher seizes these dramatic events, con- nects them with some personality, and tells the 43 THE TEACHING OF HYGIENE story well, the children will grasp much valu- able information with interest and ease. The story of the life of Dr. Trudeau illustrates this point beautifully. A man with a brilliant future, he found himself in the loathsome grip of tuber- culosis. Invading the wilds and leaving his family behind, he fought a long fight to recover his own health, met with success, established the first fresh- air sanitarium for consumptives in America, and gave to the world a scientific program for the cure and prevention of tuberculosis. The learn- ing of the scientific facts concerning the nature, prevention, and cure of tuberculosis would be far from interesting to children generally, but told in connection with the stirring events of Dr.Trudeau's life they take on a peculiar charm. The first steps in the formation of hygienic habits are usually far from being interesting. They are extremely distasteful to children. A common complaint of both children and adults is, "It's too much trouble." Yet the most uninter- esting hygienic habit may be practiced with a good deal of eagerness. Children ordinarily do not care about posture in relation to health. They slouch down in their seats because it has become habitual or seems to be more comfortable. They fail to understand why the teacher should be con- 44 SUGGESTIONS ON METHOD tinually nagging them about the way they stand, and when told that a bad standing posture in- terferes with proper breathing and encourages lung trouble they only smile. But suppose, on the other hand, the children are told how well one looks when he stands erect and sits correctly. Suppose those who have good posture are given the preference at the head of a marching line. The child is now impelled by the spirit of pride and competition to form the right habits. Many of the hygienic habits may be established with little reference to health. One of the deepest impulses of child nature is the impulse to act. Outside of school the child spends practically all his time in doing some- thing. This same impulse may be directed with profit in the teaching of hygiene. Many of the activities connected with good health may be dramatized. The thing itself may not be of in- terest, but there is always great interest in the doing. The ordinary accidents and the cor- responding emergency treatment may well be acted out. One school known to the writer did some excellent work in writing little plays pre- senting accidents and emergencies. These plays were submitted to a committee and the best ones were finally acted out by the pupils with great 45 THE TEACHING OF HYGIENE zest to the advantage of both English and hy- giene. 3. The psychology of habit formation The importance of desirable modes of be- havior or hygienic habits has been emphasized. The establishing of these habits is the most im- portant and at the same time the most difficult problem in the teaching of hygiene. It is a com- mon assumption on the part of teachers that a good deal of talking to children about the desirability of establishing hygienic habits will speedily lead to their formation. Such an as- sumption, however, does not seem to square with practice. It is quite probable that merely talking about the formation of habits is a waste of time in ninety-nine per cent of the cases. The principal reason for this is that every habit which is to be formed involves the making of new connec- tions in the nervous systems. These connec- tions are not established by simply knowing that they ought to be made but by actually practic- ing the habit until it becomes automatic. To learn to masticate the food properly one must chew the food well and continue to do this until the act is performed mechanically. It is only by such repetition that the necessary connec- 46 SUGGESTIONS ON METHOD tions or pathways, as James calls them, are formed. Moreover, mere verbal exhortation seldom gives the individual the initiative needed to im- pel him to carry out his resolution often enough for the new habit to be really formed. Often, too, such exhortation instead of furthering the devel- opment of the habit arouses a spirit of antago- nism which is fatal to the desired result. In get- ting children to form habits the first essential is to present clearly the habit which is to be formed. Such explanations should be given simply and di- rectly. Washing the hands after coming from the toilet and before meals is one of prime importance to health. These ideas may be presented in talks to the pupils, but such ideas alone would prob- ably be ineffective. Motives must be given which will lead the pupils to desire to form the habit of keeping the hands clean. Particularly in the case of little children there would be no appreciation from a health standpoint of having clean hands. Another incentive must be found. One teacher known to the writer divided her school into two divisions, one having the name Harvard, the other Yale. They were supposed to be competing teams. The goal was to have the cleanest hands. Every morning the hands were inspected and the record 47 THE TEACHING OF HYGIENE of dirty hands was placed on the blackboard. The interest was genuine, and those who were negligent were promptly prodded by their com- panions. The crucial point in all habit formation is the possibility of a lapse in the practice of the habit before it has become mechanical. Every time one slides back into the old habits the formation of the new habit is retarded and even prevented. To prevent such lapses, the teacher must follow them up whenever possible to see that no excep- tions occur. The daily inspection of teeth, hands, and nails is an essential factor in personal hygiene. Before attempting to urge pupils to form a particular habit the teacher should see that it is physically possible to form the habit. For exam- ple, if there is a muddy school yard and no foot- scraper or mat or broom, we must expect that dirt will be tracked in. Before drilling pupils on this habit these things should first be provided. This does not always mean that the matter must be referred to the school authorities. A foot- scraper in some cases might be made by helpful pupils. Again, if there is no water, towels, or soap, it will be impossible for pupils to practice in school the art of keeping the hands clean. In time an intelligent public opinion will make 4 S SUGGESTIONS ON METHOD such a situation intolerable, but at present the teacher's ingenuity must be taxed to solve the problem. Finally, the teacher must see that the practice of the habit brings satisfaction. The importance of this has been shown many times in the lit- erature of psychology. An animal picks its way through a maze because that particular route leads to food; the crude, instinctive movements of a cat confined in a cage give way to a definite mode of reaction, a habit, as soon as a chance movement is successful; children repeat untruths when they find that they help them to gain their ends. The teacher who is skillful enough to make the practice of a desirable habit pleasurable to the child and the opposite kind of reaction pain- ful is bound to be rewarded with success. The teacher's approval and praise often greatly in- fluence the repetition of a given act, and likewise the sting of her disapproval of an undesirable act may prevent its reappearance. 4. Habits to be formed and to be avoided Standards of habit formation for pupils in the elementary school have already been presented, but a brief enumeration of some of the detailed habits necessary for health might be helpful. 49 THE TEACHING OF HYGIENE These are some of the habits that teachers should strive to get pupils to form: — (i) Cleanliness of body, especially the hands, and cleanliness in the schoolhouse and on the school-grounds; (2) cleaning the teeth; (3) cor- rect sitting and standing postures; (4) correct breathing; (5) correct use of the voice; (6) right use of the eyes; (7) care of hair and nails; (8) use of individual drinking-cups, pencils, and other materials; (9) use of the handkerchief; (10) move- ment of the bowels daily; (11) exercise and play in the open air every day; (12) cheerfulness, par- ticularly at meal- time; (13) chewing food slowly; (14) drinking plenty of water; (15) ventilating the schoolroom; (16) cleaning shoes before enter- ing the schoolroom; (17) dusting school furni- ture; (18) cleaning blackboards; (19) sleeping with windows of sleeping-room partially open. There are also some habits which should be discouraged; such as (1) putting things into the mouth; (2) expectorating on the floor; (3) biting nails; (4) thumb-sucking; (5) " swapping" gum, food, etc.; (6) coughing in another's face; (7) kissing on the lips; (8) carrying soiled handker- chiefs; (9) picking the nose; (10) licking the fin- gers in turning the pages of a book; (11) reading in a dim light; (12) rubbing the eyes; (13) putting 5o SUGGESTIONS ON METHOD foreign bodies into the ear; (14) cracking nuts with the teeth; (15) overeating; (16) eating when tired; (17) using another person's brush, comb, towel, drinking-cup; (18) wearing wet clothing; (19) bandaging a cut with a dirty cloth; (20) wearing shoes that are too small or that have high heels; (21) negligence in bathing; (22) bad pos- ture; (23) worry; (24) use of tobacco, alcohol, and narcotics; (25) leaving food exposed to flies; (26) having no regular time for exercise. 5. Give marks for habits formed The abuse of school marks is notorious, but all educators are practically agreed that they are a necessity. Besides being useful in the administra- tion of the schools, it cannot be doubted that they are incentives to children and that the mark- ing of any particular thing gives it an added im- portance in the eyes of the children. The funda- mental importance of the health habits necessi- tates their being marked as well as the intellectual attainment in hygiene. Consider the inconsis- tency of marking a child on knowledge about the teeth and their care and not giving any mark for keeping the teeth clean, the thing of greatest importance. 5* THE TEACHING OF HYGIENE 6. Special honors for hygienic living Giving marks for hygienic living is one way to stimulate right living, but there are other ways of impressing children and parents with a sense of its importance. In many schools special honors are conferred upon those who have done superior work in particular school branches. Where this is common, hygiene should not be neglected, but in every case such honors should be given for actual observation of the rules of health. This is so important that it might be desirable to offer honors in hygiene even if it were not common in the other work of the school. In the Bowdoin School of Boston those pupils who have been exceptional in healthful living have had stars placed after their names on the commencement program, with this explanatory note at the bot- tom of the page, " excellent in maintaining ideals in hygiene.' ' E. A. Hines (35), tells an interesting story of the results of a reward system in the teaching of hygiene. When a health officer in Seneca, South Carolina, a town of 13 13 population, he noticed that the schools were often obliged to close be- cause of transmissible diseases. It occurred to him that the health of the pupils would be materially 52 SUGGESTIONS ON METHOD promoted if a premium could be placed success- fully on simple cleanliness and the observance of the basic principles of hygienic living. In 1904 he offered a gold medal to the child who had demonstrated to the satisfaction of the faculty that he had carefully practiced the principles of cleanliness in person and apparel and had at- tained good marks in general scholarship. This innovation naturally attracted the attention, not only of the children and parents, but the com- munity at large. As a result Hines says that the entire student body took a pride in personal hygiene and school sanitation, transmissible dis- eases were reduced, and the general sanitation in the community was greatly improved. It might not be desirable to try this same plan in every community, but the principle involved is peda- gogically sound, to confer special honors upon those who practice the laws of health. To allow only those who have clean hands the privilege of passing materials in school is to follow out the same idea. 7. Training in habit formation in school The necessity of following up activities until they are finally rooted as habits bristles with dif- ficulties, since the number of hours that the chJl- 53 THE TEACHING OF HYGIENE dren are under the direct supervision of the teacher is limited. Therefore, the time spent in the schoolroom should be utilized to the fullest extent to see that habits are really formed. Daily inspection by the teacher will do much to help children to form habits. Hands, nails, and teeth may be inspected in this way. Training is also possible in connection with posture, ventilation, adjustment of window shades, correct use of the eyes, use of individual material, etc. Through the cooperation of medical inspector, nurse, and par- ents much may also be done, as we shall point out in detail, to establish these habits and others as well. 8. Methods of getting children to form habits outside of school Since health is connected with all the activities of life, no kind of health education is likely to be very effective which does not influence the forma- tion of habits outside of the school. One plan which has been tried effectively by Alderman (i), not only in hygiene, but in other subjects, is to assign home duties and give the child a certain amount of credit for the work done. This may be checked by getting the parent to certify to it in writing. Before assigning duties to children it 54 SUGGESTIONS ON METHOD is desirable to know something about their home life so that duties may not be assigned which have already become habitual. The teacher's health survey, referred to a little later, may be useful here. Credit might properly be given for playing a given length of time in the open air. One method which is being used in a few schools is to get the child to keep an accurate record of certain hygienic activities, such as the number of times the teeth were cleaned, baths were taken, etc. This method is psychologically sound, be- cause, unless the child is made to feel some sort of responsibility for hygienic practices and has something to remind him, habits will not be formed. Benjamin Franklin tried this method to arrive at moral perfection. He wished to gain habits of silence, temperance, order, resolution, frugality, industry, sincerity, justice, modera- tion, cleanliness, tranquillity, chastity, and hu- mility. He believed that mere speculative con- viction about these habits would not insure their being formed, so to prevent what he called "slip- ping" he copied these words in his notebook and arranged it so that he could make a record for each day by simply marking the rule which he had broken. It was his hope some day to look upon a clean sheet. 55 THE TEACHING OF HYGIENE Edward F. Brown (i i) of the Bureau of Welfare of School Children, New York City, outlines with great care a similar scheme to train children to form hygienic habits. To make his proposal con- crete he suggests that a blank be planned for chil- dren approximately ten years of age as follows: DAILY HEALTH EFFICIENCY RECORD Name. Date.. Health Habits i. Rise at seven o'clock 2. Toilet 3. Bathe daily, if possible. Otherwise every other day 4. Brush teeth and gums. Wash mouth 5. Exercise for five minutes 6. Clean, comb, and brush hair 7. Dress lightly in summer; warm in winter. . . 8. Eat breakfast. A good breakfast consists of cereal (eggs if possible), milk, bread and butter (State what you had.) 9. If weather and distance permit, walk to school 10. Eat lunch. Don't eat if overheated or ex- cited. All meals should be eaten slowly and food chewed well. A good lunch consists of hot soup or broth, meat, vegetable, if pos- sible, and bread 56 Yes No SUGGESTIONS ON METHOD Yes No n. After school play outdoors, if possible, for two hours 12. Eat light supper 13. Before retiring brush teeth and gums well 14. Sleep for ten hours 15. Keep windows of sleeping room open all night I declare that I observed of the rules of health. Observing all rules is Excellent. Observing 13 rules is Good. Observing n rules is Fair. Observing less than 1 1 rules is in the danger zone. It is Brown's idea that one of the first of the morning tasks should be to distribute to each child a blank form. The children should then be instructed to fill out the blank for the previous day's activities. The children should be expected to rate their own conduct on the basis of the standard rating. It is too much to expect that there will be no falsification, but such a system will probably help those who have a tendency to be untruthful. There will always be a substantial majority in the class that will be truthful and will profit from this method. Brown suggests that in the case of the older children there may be 57 THE TEACHING OF HYGIENE some graphic representation of the ratings. This plan encourages the pupil to maintain and better his record. While there might be some criticism of the de- tailed plan submitted by Brown for children ten years of age, there is much to commend it. It is not only likely to further habit formation of the right kind, but it may give the teacher, school nurse, and medical inspector valuable informa- tion about the individual children. Even if the expense makes the printing or duplicating of the blanks impossible, every teacher might plan a form of her own, on paper properly ruled, have the pupils copy it, and then make out the daily report in the regular way. g. Study the health of your pupils The successful teacher of hygiene will realize that the children must not only conserve what health they have, but that they ought to im- prove their health while in school. This cannot be done in a general way; the teacher must use individual methods. She must be familiar with the physical condition of her pupils first of all and this means a study of every individual in the school. Whether there is medical inspection of the pupils or not is immaterial. Such a study not 58 SUGGESTIONS ON METHOD only prepares the way for an intelligent attitude on the part of the teacher toward the pupils' health, but it also gives her an insight frequently into the conditions involved in the learning of the children. Dr. Hoag, in his splendid campaign in school hygiene in Minnesota, suggests a num- ber of questions which a teacher might ask chil- dren to get a survey of the health of the children. The abbreviated form is given below: — ABBREVIATED CARD FORM OF A TEACHERS' HEALTH SURVEY OF THE SCHOOL CHILD Name School Grade Age Date i. Have you ever been in a grade more than one year? 2. Have you ever had any serious sickness? 3. Do you feel strong and well now? 4. Do you eat breakfast every day? 5. Do you eat a noon meal every day? 6. Do you drink coffee? 7. Do you always have your bedroom window open at night? 8. Have you been to a dentist within a year? 9. Do you have toothache often? 10. Do you own a toothbrush? 11. Do you use your toothbrush every day? 12. Do you have a toothbrush of your own? 59 THE TEACHING OF HYGIENE 13. Do you have much trouble with headache? 14. Can you read writing on the blackboard from your seat? 1 5. Does the print in your books run together or look dim or crooked? 16. Do your eyes hurt after reading a good while? 1 7. Do you sometimes see two letters or two lines instead of one? 18. Do you often have earache? 19. Do your ears ever run? 20. Can you always hear the teacher? 21. Do you go to bed by nine o'clock? 22. Do you go to bed by ten o'clock? 23. Do you bathe at least once every week? 24. Have you ever been vaccinated? 25. Have you ever had smallpox? Remarks. This child has had the following diseases at the age indicated below: — Chickenpox when Whooping-cough when years old. years old. Diphtheria Pneumonia Measles Typhoid fever Tonsillitis Smallpox Mumps Tuberculosis Scarlet fever Infantile paralysis The survey should not be made until the teacher has had a chance to get acquainted with her pupils. The teacher should ask the questions of each individual pupil and record the answers. 60 SUGGESTIOxNS ON METHOD Care should be taken that every question is un- derstood. If there is any doubt, test the pupils by putting the question in a different form. Dr. Hoag (34) believes that a careful survey by the teacher will reveal ninety per cent of the physi- cal defects. If the school is visited regularly by the school physician the teacher may refer to him pu- pils that have serious physical defects, and after- wards try to cooperate with the home. If there is no medical inspector or school nurse, the teacher in some cases may get the parent to take children to some local physician. When certain defects — like eye defects, for example — are discovered, the teacher may at least do something to relieve the physical strain and facilitate the child's learn- ing, if it is no more than to give the child a favor- able seat. Then, too, if the teacher has some in- sight into the child's physical condition and mode of life, she will know what habits in particular ought to be formed and then take measures to see that they are inculcated. 1 1 For further suggestions concerning the teacher's health survey the teacher may consult Hoag and Terman: Health Work in the Schools. (Boston: Houghton MifBin Company, 1914, pp. 62-89.) Ernest Bryant Hoag, Organized Health Work in Schools. (United States Bureau of Education Bulletin, 1913, no. 44.) 61 THE TEACHING OF HYGIENE 10. Cooperate with medical inspector After this careful survey of each pupil's health the teacher will know something about the most of the individual problems with which she must cope. If there is a regular medical inspector this work will be of the greatest assistance. In many schools the medical inspector visits the schools rather infrequently, and his time is so limited that often he merely inspects those pupils that are referred to him by the teacher. Consequently the success of the medical inspector is in large measure dependent on that of the teacher. If, for example, the teacher fails to notice symptoms of illness the cooperation of the medical inspector, which would often mean the prevention of an epidemic, would in most cases be impossible. ii. Get cooperation of parents Even after the teacher's health survey and after her judgment has been strengthened by that of the medical inspector, the solution of the prob- lem will often be unsolved unless the parent is sympathetic. Many children are disorderly in school and take no interest in their lessons be- cause of acute eye-strain. If such a pupil can be supplied with glasses it may change the whole 62 SUGGESTIONS ON METHOD current of that boy's or girl's life and greatly im- prove the conditions for the work of the other pupils of the school. The teacher who can solve §uch a problem confers an everlasting benefit upon the pupil, the school, and the community. ]| the school authorities have set aside a fund for the purchase of glasses the matter is soon solved ; but unfortunately this is rare. The first respon- sibility for such an expenditure is with the par- ents, but should they prove to be too poor or obstinate Ihere is difficulty. Sometimes, if a no- tice of the needs of the child, sent out by the teacher or medical inspector is Ignored, a frank talk with the parents will adjust the matter quickly. The cultivation of understanding and sympathy between parents and teachers is often a, result of parent teai her associations. When a. 1 1 such efforts with the parents meet with failure, money can sometimes be secured by appealing to sonic charitable association. 'Hie chief objection of parents is usually a. financial one. In some cases, where the expenditure of money is not involved, but where the out of < hool life of the pupil must be regulated, the cooperation of the parents is essential. The ana-niic pupil, for ex- ample, should sleep with his window open, get plenty of fresh air during the day, and also the 63 VUF RACKING OF HYGIENE M tactful and persistent lit results. In every case - the pupil's health is defective CM v must be found to follow ft sort ol oversight over .til the p (L This sort of . d by a 9Chool nurse. A- in Qhist be from the .. Worcester - rj 11.. . lie, under- pe which left .. weakened condition. At the :. of the medical in- /^*nt wa* made wherdvy he was lent V, \:.f. './/.:.♦.'/ \'.t '■:.'. •" '" ' :.; : . <./<- v-'.-. .'. v ;',."., '.',..'.;< /'//. / v/ '. '>...., MtrtwhfA amtereace»withthemod*i f fhebcy and is doing food work. This is a kind of work in hygiene that count* . ; ' • ........... intervals a board of health which will hare gen- eral oversight over window ventilation, tempera- re, etc., of the r ^-organized health THE TEACHING OF HYGIENE fly, do away with stagnant water, screen out- houses, etc. Interest is sometimes aroused by securing buttons with the words " Health Club," or some other symbol upon it, for members of the organization. In Kansas City, Missouri, health clubs are suggested in the course of study as early as the fourth grade. Classes are to be or- ganized into "Good Health Clubs" at the begin- ning of the year, selecting their own officers, such as president, secretary, and an inspector for such groups of children as the teachers may deem wise to form. Pupils are also to keep a written record of their hygienic practices. These records are inspected as a part of the work of the Good Health Club. The health clubs if successful are not only valuable because they lead the pupils to apply the knowledge which they have gained and aid in habit formation, but they help to develop initiative and individual responsibility, necessary qualities of good citizenship. ij. Planning the course of study To attain the standards suggested in this mono- graph there must be a careful and systematic organization of the course of study through the various grades, so that plans may be made for 66 SUGGESTIONS ON METHOD the acquisition of certain knowledge and the establishment of definite habits. It is only in this way that results of a permanent value may be expected at the close of the elementary-school period. The course of study (pp. 68-72) , suggested for the fourth grade by a committee of Boston teachers, including the author, illustrates the writer's point of view. It is arranged so that the teacher may see at a glance just what know- ledge the children are supposed to gain and what habits it is intended to encourage. The most important habits, which the teacher is expected to follow up vigorously, are printed in bold-faced type. The suggestion to " keep teeth clean" is also capitalized as it is to have special emphasis during the year. 14. The plan of work in the first four grades One source of the failure of the teaching of hygiene is the assumption of teachers that pupils must always know the reason why they are to do things. Acting on this principle the result has been that the child has usually been taught a good deal of physiology and anatomy, but he has been left in a muddled state of mind as to the why and with no tendency to act in the right way. The teaching of little children demands only the 67 .8 <3 ! * ^ -a a CU t0 C3 .aw C3 CI cu o O CU ci Prt - 73 d co I CO ^Cj cj £ bO ° •§"S • -Cj CU JG ^ d a o 5 r 1 w 3 3 3 fB. CD P * P ° B * P W o & » § %*£ S g ^ (w p P P ^ O. P CB cr o Ba. p n> o p w a> m If »0 CJ 5. S p* p P 2. p. n> a p 3. ** p* p p o 5 P 0* eg w B-M p m (a & B. p* s? £ oT S* P* p s b g * p-f w o g: _. P o P SB'* •3 S a oho o P- p P £ *£. * ' p 8 2 8 - & s C 2 " B'jr w o o » w 8 £^££3* o ~^d p 3 O P P -» £ w „_ o p. i CXtt p p» p.- £,<*! p ^ ^ p ^ of the ws times, lospital.) evention O SJ J 5 <-»• o P- ^ O o gp s s $ i! p o* C P- *<: p • p & CD "I o W H 2? £ o J3 P o C 8.3 &? » R.^ « O « 5" Oq ft) £- EC P *" O P E5. w o B 2 ?° p -i e § - p^^cg ^» » n> p O C3 ft p p erf cfl I ■M O '2 us ! O co s ill' 4> etf Ci Ill ^ 1 J l *-> 9 ■8 O co O I bO O t>0 * 3 Is a 1 a o p S3 TS *« ° K cu •g & H3 1 o> o £ S c mg. eanlin Need o as i— i o a . ag> 3D o Oh H oj w u< co rg o *o ft, co Q '5 V bo 5 .-9 ^ 1 " -Sf s .S ^4 c3 i-5 +j a) - B 3 2 U hi ci P-l o m — < o 04 « s 3 CD CO 12 •« CO <* J-. CO -l -4-> O ^ CU ^ H i-t Oi JO M ^ o p p a. o p P o p &** § p* o P CO B |3. B. f •§ §. 5 §* 3; 8 p. CD rra P - O P 3 O § p. I 1 p I 4 g p- gag g* p p 3 w >* 1 o H2 to P^ 2. P rp §8 in Value of i thoroughl Clean food. p c-t- P- p P hi l "d *"d oq ft Srp^ r-f- o' P 5* p << Home Day an d drink, sted ex] nts and nts and ri dishe * P 1 2 ^ p 3. &* pop. 1 1 0"5 co P - o 5 eg S- P- PJ. p n a • o o £2 p • *T 5 p p. p- 9 I I d •s 3 T3 3 O) to £ O a- > a ID a cu 4-> O CO M .2, 5 w to to 8 o S o I—; ° •o 8 to •73 * g ■5-3 *| §-°* w ,~ a o .a a i<3 O 1915, PP. 16.) R. H. Hutchinson, A Maggot Trap in Practi- cal Use — An Experiment in House-Fly Control. (United States Department of Agriculture, Bulle- tin no. 200, 1915, pp. 15.) Ross, The Reduction of Domestic Flies. (Phila- delphia: J. B. Lippincott Company, $1.50.) The Fly-Fighter , the official organ of the fly- fighting committee of the American Civic Asso- ciation, published in Washington, D.C., con- tains much information of interest to teachers and will be sent free upon request. 15. The mosquito The mosquito, like the fly, has now been proved to be a menace to health. It is probably the sole carrier of malaria and of yellow fever. Although simple lessons on the mosquito should be given in the lower grades, the subject should be taken up more in detail in the upper grades. The method 124 IMPORTANT PROBLEMS of instruction should be similar to that given on the fly. The lessons may be made concrete and interesting to children by asking some of the children to bring in some water containing "wig- glers" and a few fruit jars. Fill each jar half or two thirds full of water and tie a piece of cheese- cloth securely around the top of each. The stages of larva, pupa, and imago may then be easily observed. Such simple experiments impart new interest and meaning to any reading done by the children. By pouring a little oil over the top of the water in one of the cans which contain larvae, or pupae, the children may readily see for themselves one way whereby the development of mosquitoes may be prevented. Every child should have accurate knowledge about the places where the mosquitoes breed, how they transfer disease and how they may be destroyed. The discovery that the mosquito is a menace to health is one of the brightest pages in the history of pre- ventive medicine, and the teacher will find that the children will absorb information much more readily if some of these stories are told. It is im- portant that children learn that all mosquitoes may not be dangerous because they are not the kind of mosquitoes that carry disease or simply because they have never been infected. Prudence 125 THE TEACHING OF HYGIENE would suggest, however, that we take necessary precautions against being bitten by them. Children may be profitably employed, as a part of the school work, in destroying any breed- ing-places found on the school premises or at their own homes. The story of what each one did might be a good theme for a composition. Many of the boards of health now issue valu- able pamphlets on the mosquito which the teacher should secure and place on file. The United States Public Health Service has prepared a pamphlet on the mosquito especially for teachers. It is entitled Carter's Malaria Lessons on Its Cause and Prevention. (Supplement no. 18 to the Public Health Reports.) An excellent book for the teach- er's reference is E. G. Mitchell's Mosquito Life. (New York: G. P. Putnam's Sons, 1907, pp. 271.) 16. The destruction of rats and mice The fact that disease is spread by living organ- isms rather than inanimate things has led the investigators of the public health to look with suspicion upon all forms of animal life. This sus- picion is well warranted in the case of both rats and mice. Their destruction is desirable from a purely economic standpoint; for according to Surgeon R. H. Creel, of the United States Public 126 IMPORTANT PROBLEMS Health Service, it costs $1.82 to keep a rat for a year. The State Board of Health of Virginia in 1 9 14 issued a bulletin entitled Rats — Kill Them, in which the astounding statement is made that rats cost the State half as much as it costs to run the Government. So far as the writer knows, no estimates are available for the mouse, but in proportion to his size he must be equally destruc- tive. Some idea of the destruction of which these small animals are capable may be had by read- ing Piper's The Nevada Mouse Plague of IQ07- 08. (United States Department of Agriculture, Farmers' Bulletin no. 352.) But it is not only because the rat destroys man's wealth and is a parasite upon society that the school should lend itself vigorously toward his destruction; he is also loathsome in his habits and carries disease, notably the bubonic plague. Forbush, in his splendid study Rats and Rat Riddance, issued by the State Board of Agricul- ture of Massachusetts, introduces this subject with these striking words : — With the lapse of ages the rat has become a para- site on man. It has developed into the greatest rodent pest ever known. It is far more destructive, directly or indirectly, to human life and property than any wild beast or venomous serpent. It appropriates 127 THE TEACHING OF HYGIENE nearly everything that man eats, and drinks many of his beverages. It follows him with its baleful in- fluence from the cradle to the grave. It destroys his poultry and molests his domesticated animals. It has been known to attack and mutilate infants, sleepers, the sick, aged and infirm. It is the forerun- ner of famine, pestilence and death. It carries the germs of disease. It infects man's ships and habita- tions with the dreaded plague; sets fire to his dwell- ings and ships, and ceases its ravages only when the house burns or the ship sinks. As if not satisfied with pursuing him through life, it follows him in death, desecrating and mutilating his mortal remains. The need of the destruction of the rat is grad- ually being felt throughout the country as the public becomes better informed. Several States have already placed a bounty on the rat. In many places a systematic warfare is being waged through rat clubs. Women's clubs and other civic organizations are also beginning to lend a hand. The Women's Municipal League of Bos- ton has just issued a poster which tells in star- tling and terse language the danger of the rat and how he may best be destroyed. (See pp. 130- No course in hygiene in our elementary schools should fail to grapple with the rat problem. First, the children need to be informed that he 128 IMPORTANT PROBLEMS is a menace to the health and property of indi- viduals. To-day we have a decided antipathy toward the snake; but most snakes now found are harmless to man, and indeed it is possible to say that they are really helpful, for they de- stroy rats and mice. We need to cultivate the same sort of feeling toward rats and mice that we have now toward the snake, and also to spare the lives of snakes known to be harmless and other enemies of rats and mice. Secondly, chil- dren should be carefully instructed as to how the rat may be destroyed. Lastly, in order to make this knowledge effective and arouse the right feeling toward rats and mice, the pupils ought to be inspired to act. This is a problem which will appeal especially to the boys, but girls may also take part. In many homes the rats and mice may be pests and parents would gladly welcome any effort to have them elimi- nated. Get up a contest to see who can kill the most. Suggest as a future topic in English com- position, "How I trapped the Rats and Mice at Our House." While the more detailed consideration of this whole topic could probably be taken up best in the seventh and eighth grades, suggestions as to the destructiveness of rats and mice and encour- 129 w H X • "3 « I .2 1 i S 5 I u * ° lA O * b 5 Ipl'si o .2 js ."a " ° S * w a s a Si s s s * •2 <* «-j .3 ** & P-S ft (. o) *; " ■ cs * J|iJ ■S °"S'S THE TEACHING OF HYGIENE agement to kill them should be given incident- ally in the lower grades. In addition to the pamphlets referred to, the teacher will find the following helpful: David E. Lantz, How to Destroy Rats. (United States Department of Agriculture, Farmers' Bulletin no. 369.) The Rat and Its Relation to the Public Health. (Public Health and Marine Hospital Service, 1910.) This book may be secured by writing to the Superintendent of Public Docu- ments, Washington, D.C. 17. The cat and sanitation It is doubtful whether in the interest of health and economic prosperity the continued existence of the cat can be logically defended. Almost at the dawn of human history the cat was the com- panion of man and has shared his fortunes from that day to this, even to having his diseases and infecting mankind. Dr. Caroline Osborne (43), in an extensive study of the cat in relation to disease, shows that the cat is susceptible to all species of disease germs which plague mankind. In many cases there is positive proof that the cat has transmitted disease to man, and the circum- stantial evidence is overwhelming in pointing out the cat as one of the most dangerous carriers 132 IMPORTANT PROBLEMS of disease to man. That she has the disease is enough to make us look upon her with suspicion. Knowledge of her habits and her close associa- tion with human beings forges the additional links in the chain necessary for her conviction. She is a universal scavenger, bringing in dead and decomposed birds and mice as well as those freshly caught. Cats left to themselves will visit the most obnoxious receptacles, thereby contract- ing some of the most serious feline diseases. She loves to roll in the dirt and in the disposal of her excreta digs in the dirt, getting dirt into her claws and so making it possible to inoculate with various diseases by her scratch. When we consider the whole range of territory that the cat covers, especially the poorly fed cat forced to forage for her food, and her intimacy with members of a family, especially with children, it is questionable whether the cat is a desirable pet. Since children, who are likely to handle a cat a good deal and come into close contact with it, are peculiarly susceptible to the diseases which the cat may 'carry, the writer believes that it would be better not to have a cat at all, or, if a cat is kept, as Dr. Osborne has suggested, she should be kept away from sources of infection 133 THE TEACHING OF HYGIENE or from people having disease. A cat known to be infected should either be disposed of or kept away from children. Stray cats, if they are har- bored, should be cared for with the thought in mind that they may be infected. The foregoing information and suggestions, not found in the ordinary school textbooks, the writer believes should be presented in all schools. It could best be taught, perhaps, in connection with the rat. The keeping of the cat has usually been defended on economic grounds, namely, that she catches rats and mice. Careful investigation shows, how- ever, that comparatively few cats habitually at- tack rats and that traps are more effective than cats in catching mice. Investigation proves that the cat, instead of being an economic asset, is a positive economic burden. Forbush (29) sums the matter up thus: — It is a member of one of the most bloodthirsty and carnivorous families of the mammalia, and makes terrific inroads on weaker creatures. It is particu- larly destructive to certain insect-eating forms of life, such as birds, moles, shrews, toads, etc. Every year the cats of New England undoubtedly destroy mil- lions of birds and other useful creatures, therefore indirectly aiding the increase of insects which de- 134 IMPORTANT PROBLEMS stroy crops and trees. Such insects possibly cost the people of Massachusetts from seven and one half million to nine million dollars annually. The cat protects them, thus increasing the cost of living to every citizen. The good that cats accomplish in the destruction of field mice, woods mice, and insects is of little consequence beside the ravages they inflict among insectivorous birds and other insect-eating and mouse-eating creatures. Public opinion is not ready now and may never be ready to dispose of cats entirely, so the school should tell the truth about them and the way they may be controlled. Forbush suggests that this can be done by reducing the number of cats to a minimum, limiting breeding, destroying su- perfluous kittens at birth, restraining or confin- ing cats kept as pets and as ratters (particularly at night and during the breeding-season of the birds), quarantining cats in cases of infectious diseases, and destroying all stray and feral cats, wherever they may be found. Teachers will find the scholarly and fascinat- ing bulletin of Edward Howe Forbush, The Do- mestic Cat (Economic Biology Bulletin no. 2, State Board of Agriculture, Boston, 19 16, pp. 112), of unusual interest and value. 135 THE TEACHING OF HYGIENE 18. Training for emergencies Some of our textbooks in physiology and hy- giene have given some brief suggestions as to what should be done in emergencies, but the authors have invariably believed that skill in do- ing could be satisfactorily gained by merely im- parting knowledge. Some books, for example, have given explicit directions, reinforced by cuts, showing what to do in case of drowning. So far as the subject has been taught the children were asked to produce the words of the text. To com- mit such material to memory is exceedingly un- interesting to children. What is learned is seldom understood, and it is doubtful whether anybody with such knowledge has been able to apply it correctly at a critical time. What is needed is not mere book knowledge, but training, and instead of this topic being one of the driest in hygiene, it may be made one of the most interesting be- cause the child's love of action may be used to advantage. Children may be taught to make bandages, apply them to make-believe wounds, carry a companion assumed to be injured, re- suscitating one feigning suffocation, etc. This kind of training enables the individual in an emer- gency to act promptly and also to control the IMPORTANT PROBLEMS emotions. It would be amusing if it were not sometimes serious to see how helpless most people are in giving assistance to others who have been cut or bruised. If hygiene is a practical rather than a theoretical subject this training in emer- gencies should be of vital importance. It seems fully as significant as being able to do cube root or locate Baltimore. The writer believes that the work of an entire grade, possibly the seventh, should be devoted to emergencies. Training may be given not only by dramas, but it may have a more practical application. Children at school are likely to have cuts, bruises, and burns. Under such conditions there is usually no hygienic method of treatment. In the case of a wound a dirty rag or a soiled hand- kerchief may be wrapped around it to stop the flow of blood so that the wound is liable to be infected. When such a condition arises, the ideas and habits that have already developed from the systematic work on emergencies should now find their direct practical application. An emergency outfit should be on hand so that the children with the suggestion of the teacher may treat the case themselves. Assuming that the teacher is trying to get along at a minimum of expense, I suggest the following as being indispensable for the purpose : — 137 THE TEACHING OF HYGIENE Pins, common and safety. i dram bottle oil of cloves (for toothache; a drop on cotton in cavity). i pair scissors. i small package of absorbent cotton; bandages (may be bought at the drug store or loosely woven pieces of clean cloth may be brought from home by the children). i roll of surgeon's plaster. i small bottle of carron oil (for burns). i package of borax (for gargle). i half -pint of witch hazel (for sprains), one quar- ter of a pound of creolin (Pearson's) ; one tea- spoonful in one pint of water makes antiseptic solution. i ounce boracic acid (i eye wash). If it is impossible at first to get these, bandages may at least be made and a small supply of creolin or other antiseptic provided. Much of this material, if not all of it, may be supplied in small quantities by the children. Drug stores, too, will often give samples of creolin, etc. Care should be taken that emergency materials are not exposed to the dust. It is desirable that such materials should be put into a box that has a secure cover. A box measuring 11x10x4! inches on the inside would suffice. This box should be readily accessible. The little book, 138 IMPORTANT PROBLEMS Emergencies, of the Gulick Hygiene Series (Ginn & Co.), is almost indispensable for teacher and pupils. The subject-matter which it contains should be presented in all schools. The interested teacher who does not wish to buy this book may receive much valuable information from Lynch's First Aid in the Home. This pamphlet of fifty- seven pages may be received free from the Metro- politan Life Insurance Company, New York. iq. Prevention of fires and accidents Knowledge of what to do in case of an emer- gency, and practical training in applying this knowledge, are secondary in importance, how- ever, to the prevention of all conditions that endanger health and life. It is estimated that the fire losses for 191 2 in the United States and Canada, due to ignorance and carelessness, amounted to $196,000,000, and that many lives were also lost. The problem of fire prevention is therefore one of importance both to economics and hygiene. This problem, if attacked by children in the seventh or eighth grades, might be approached by asking children to read the newspapers for a certain length of time and report on the causes of fires. It will be found that most fires are due to negligence. The Fire 139 THE TEACHING OF HYGIENE Prevention Commissioner of Massachusetts gives these valuable suggestions which might be useful to teachers : — CELLAR i. Keep your cellar free from rubbish and waste paper. Place no combustible material under the stairways. 2. Never put hot ashes in a wooden box or barrel. 3. Be sure your chimney, furnace, and furnace pipes are in good condition. Have them in- spected in the fall before starting your fires. 4. If you have paints or oils in the cellar, put them in a metal box with metal cover. 5. Do not let your furnace become overheated. 6. Keep smoke pipes, heat pipes, and gas jet away from woodwork. Protect the ceiling over your furnace. 7. Do not try to thaw out frozen water pipes with a flame. Such pipes are usually situated where a flame will easily do great damage. Wrap the frozen part of the pipe with cotton cloth, and pour hot water upon it. KITCHEN 8. Use safety matches. If you must use common matches, keep them in a metal box with metal cover. 9. Look out for stove polishes and metal polishes. 140 IMPORTANT PROBLEMS Many of them contain naphtha. Do not use them near a flame. 10. Keep no greasy or oily cloths, or waste, except in metal cans, with metal covers. ii. Keep your kerosene can and kerosene lamp in good condition. Do not use a glass lamp. Get a copy of " ¥ -rosene Cautions " from your oilman. 12. Never hang clothing or cloths back of the stove. Never place them too near the stove. 13. Do not use gasoline or naphtha for cleansing in your home. The vapors given off when mixed with air are explosive. 14. Do not let your range become overheated. OTHER PARTS OF THE HOME 15. Under NO conditions let children have matches. Keep the matches where the children cannot get them. 16. Do not leave young children alone in the house. If you cannot take them with you, some good neighbor will be glad to look out for them. 17. Never take a candle or a lamp into a closet. 18. Never allow a gas jet where it may reach a cur- tain, or woodwork. 19. Do not smoke in bed, or on a couch. 20. Extinguish matches and cigarettes before throw- ing them away. 21. Be careful about electric lights. Don't put too many lights, or motors, on the wires in your home. Consult your wire inspector. 141 THE TEACHING OF HYGIENE 22. Keep a window, or windows, open in your bed- room at night. Smoke destroys more life than fire. For lack of this precaution, six lives were lost at one fire in Chelsea last summer. THE YARD 23. Do not allow rubbish to collect in the shed or yard. Especially do not allow it to be piled against the house. 24. Light no rubbish or leaf fires without the permit of the Chief of the Fire Department. The instruction given in regard to prevention of fire, like other instruction in hygiene, should function in action and habit, but training chil- dren in this has limitations in the school. The teacher can only hope to make the children in- telligent in regard to fire prevention and present the subject so concretely and vividly that habit may result. Something could be done by asking children to write a composition telling what they do in their own homes that might possibly lead to a fire. These compositions could then be considered by the class and suggestions given. Afterwards the children might be asked to report until certain habits were formed. The care of ashes might be one of the problems discussed and afterwards followed up in the reports. A 142 IMPORTANT PROBLEMS discussion of the prevention of fire and the train- ing of children might be a profitable topic for dis- cussion at a parent-teachers' association. An excellent textbook for children on fire prevention is Weeks's The Avoidance of Fires. (New York: D. C. Heath & Co., 1916, pp. 128.) The rush and tear of our modern life are respon- sible for an alarming yearly "accident" death- rate and the making of a vast number of cripples. Rosenau says that " about ten thousand persons are killed and one hundred thousand more or less seriously injured on the railroads of the United States every year." Much of this is preventable. The Interstate Commerce Commission, in its Report for 191 2, states that during that year 5434 persons were killed while trespassing on railroad property and 5687 were injured. Many of these trespassers were children. It is estimated that within the last twenty years twenty-five thousand young people under eighteen years of age — many of them under ten years of age — have been killed and injured. Besides trespassing, lack of precaution in crossing tracks and board- ing and alighting from cars are chiefly responsible for accidents. The accidents to both children and adults from railroads, automobiles, etc., have led several States to pass laws requiring 143 THE TEACHING OF HYGIENE the school to give instruction on safety. Every teacher should know the geography of the region from which the children come and the dangers to which they are particularly subject. Every child needs to be informed as to possible dangers and how they may be avoided. When it is known that children are recklessly exposing themselves to accidents, such as stealing rides, boarding or alighting from moving cars, crossing the street in front of or just behind cars, automobiles, etc., cooperation with the parents and sometimes with the police is desirable. Older children may get valuable training by safeguarding the younger ones on their way to and from school. The Great Northern Railway gives these sug- gestions for the prevention of deaths and injuries on and about railroads: — i. Don't attempt to cross a track in front of a moving train; wait until it passes. 2. Don't attempt to cross a track without first stopping and listening, and looking in both di- rections to see if a train is approaching. 3. Don't step off one track on to another to let a train pass; step clear off ALL tracks. 4. Don't stand upon or near tracks to carry on a conversation or kill time. It is extremely dan- gerous, especially at stations and crossings and in yards. 144 IMPORTANT PROBLEMS 5. Don't use the tracks as a pathway; there is un- limited space outside of the rails and off the railroad company's right of way where you are free from danger. 6. Don't permit dumb brutes to be on crossings or tracks if you can prevent it. It is both dan- gerous and cruel. Drive them off. 7. Don't permit children to play or go upon the tracks for any purpose. 8. Don't get on or off trains while in motion. 9. Don't stand up in trains or unnecessarily pass from one part of the train to another while in motion. 10. Don't get on trains on which you do not intend to become a passenger and remain thereon until after the train has started. Say good-bye to your friends before getting on the train. 11. Don't allow boys to indulge in the dangerous practice of "hopping" on and off moving cars and trains. 12. Don't steal rides on trains. 13. Don't stand or walk on track until train is al- most upon you before getting off; have a due respect for the engineer's feelings and promptly observe the warnings he sounds for your protec- tion. 14. Don't stand on platforms or in open doorways of moving coaches, and don't place hand on posts or jamb or open door; the movement of train may swing the door shut and mash your hand. 145 THE TEACHING OF HYGIENE 15. Don't place suitcases, satchels, or other heavy packages in racks in coaches, as they are liable to fall out and injure those sitting under- neath. 16. Don't throw banana peels, orange peels, or other fruit remnants on floor of station or car, out of car windows at stations, or in other places where they are liable to be stepped upon. DON'T BE RECKLESS OR FOOLHARDY — YOU WILL EVENTUALLY PAY THE PRICE IF YOU ARE Lessons on safety would be exceedingly unin- teresting and largely useless if they were con- fined merely to teaching children certain rules of conduct, like "Wait until the car stops before you get off." Such a procedure would be like committing the dictionary to memory. All these practical ideas on safety must be presented in such a way that they will interest. Stories founded on local examples of accidents, to which many of the children can contribute personal experience, will often be effective. The teacher, of course, will need to use caution in the selection of these danger stories, so that they may be adapted to the age of the pupils. Teachers should aim to develop prudence rather than fear. The teacher may find it helpful to keep an envelope for newspa- 146 IMPORTANT PROBLEMS per clippings and pictures which can be used in connection with the lessons on safety. The Bul- letin of the Department of Public Instruction of the State of New Jersey on The Teaching of Hygiene and Safety suggests some stories about safety that have been told with success. The forces that are chiefly responsible for accidents — steam, automobiles, fire, and electricity — are considered as giants which do good, but may be harmful if they are not properly controlled. This is the one on " Steam ": — Once there was a man who sat before a fire; there was a kettle on the fire and it was singing; steam was coming out of its nose and the lid was bobbing. He watched it a long time and then a fairy whispered in his ear — or maybe it was the song the kettle was singing — this: " There's a Giant in that kettle; catch him and build a strong harness around him and he will pull your ships across the ocean without sails, and pull your trains across the land." And they caught the Steam Giant and built an iron harness — a machine we call an engine — and he pulls ships across the sea and trains across the land. His name is Steam. He does great things, goes fast and does many good things; but sometimes he does cruel things. If you get too near Steam it will burn you — scald you; and if you walk on the railroad track, sometimes he can't stop and runs over you. 147 THE TEACHING OF HYGIENE Children will enjoy reading Bailey's Sure Pop and the Safety Scouts. (Yonkers-on-Hudson, New York: World Book Company, 191 6, pp. 128.) 20. Mental hygiene The school should further the mental as well as the physical life of the child. As Dr. Burnham has suggested, "It is better to prevent mental dis- order by observing the principles of hygiene in the school than to cure disease by re-education in the sanitarium." Getting the child to conform to the simple and well-established hygienic rules relating to exercise, sleep, food, fresh air, temper- ance in all things, etc., are all involved in mental health, but mental hygiene proper, so far as it affects the school, refers to the proper way of learning. Intellectual activity is as fundamen- tally instinctive as physical activity, and the school must provide plenty of the right kind and direct it in the proper way. This means that children should form habits of proper alternation of work and rest, avoidance of worry, forming of orderly associations, natural reaction to feeling, self-control, and wholesome attitudes and inter- ests. From the foregoing it will be seen that men- tal hygiene is not a subject to be taught, but an 148 IMPORTANT PROBLEMS end to be gained. The personality of the teacher will determine in large measure success or failure in attaining the end. The sour, nagging, pessi- mistic, unsympathetic teacher will excite hatred for the school, fretfulness, worry, despondency, and nervousness. The teacher who keeps herself physically fit, enjoys her leisure and her work, loves children, has a variety of interests, a whole- some philosophy, and a hopeful and optimistic attitude toward her profession naturally inspires success, concentration of attention, freedom from hurry and nervousness, mental poise, and an attitude of leisure and enjoyment, all of which are essential to health, happiness, and usefulness. A more detailed treatment of mental hygiene will be found in Terman, The Hygiene of the School Child (Boston: Houghton Mifflin Com- pany, 1914, pp. 289-334); Beik, The Hygiene of Instruction (Educational Hygiene, edited by L. W. Rapeer. New York: Charles Scribner's Sons, 19^, PP- 5 6 7-6o2). VI THE TEACHING OF HYGIENE IN THE RURAL SCHOOLS 1 i. Is the country healthier than the city? It is usually assumed that the country is health- ier than the city, and, without careful study of the facts, this assumption would seem to be justi- fied. The country offers space, quiet, sunshine, fresh milk, home-grown fruits and vegetables, and an occupation necessitating vigorous exer- cise in the open air. The congested city suffers from the lack of these things, yet with all these serious handicaps, the city has probably out- stripped the country in its healthfulness because it has paid more attention to the fundamental principles of sanitation and hygiene. The dia- gram on the next page shows how the mortality rate in New York City has steadily decreased while the death rate in the rural districts has re- mained about the same over the same length of time. In 19 10 New York City was as healthy as 1 The author is preparing a volume entitled Health Educa- tion in Rural Schools. 150 IN THE RURAL SCHOOLS the rural districts and since that time it has had a lower death-rate. This is a situation which is probably typical of the whole United States, for recent sanitary surveys in country districts show deplorable conditions. 1900 1 21 10 11 12 13 20.6 20.1 .19.8 1 \ ^8.6 / 18.3 N y. 17.9 V* 16.2 ISA 16.8 15.2 ._A ^2~- 15.6^ "^ 15.2 7^ CT"" ■ JU 15.4 V \ \ <& 14.4 15:1 & 15.0 15.1 \ 1« 13.9* 1 is.r 19 18 17 16 15 14 13 A similar comparison may be made between the health of school pupils in city and country. Dr. Thomas D. Woods (59), whose extensive investigations allow him to speak with authority, says: "Statistics show that most physical de- fects are as prevalent, or more prevalent, among pupils in rural schools as among those who go to schools in the city." 151 THE TEACHING OF HYGIENE 2. Present sanitation in rural schools A comparison of the sanitation in rural and city schools would reveal even wider differences. Fortunately a number of rather extensive inves- tigations have been made and the needs of the rural schools have been set forth. We shall refer to only one which might be regarded as typical. Dr. Fletcher B. Dresslar (23) sent out a ques- tionnaire to the two counties regarded as most progressive in nineteen different States. Twelve hundred and ninety-two returns were received. Considering these as fairly typical of the condi- tions of the rural schools throughout the country, the situation is deplorable. Sixty-three per cent of the buildings are old, and even the newer ones in the majority of cases have been built with little thought of hygiene. The lighting is usually bad, three fourths of the desks are non-adjustable, and the jacketed stove is seldom encountered. Nearly two thirds of the schools depend for their water- supply on springs and wells outside of the school grounds, so that neither clean nor fresh water is available in most cases. The open bucket and common drinking-cup are still in use, and even when the individual cups are used they are not infrequently mixed. The doors and windows of 152 IN THE RURAL SCHOOLS the schoolhouses are seldom screened. Toilet fa- cilities are generally a disgrace and a menace to the health of the community. Not more than one per cent of the toilets is sanitary. The school- grounds are, as a rule, too small for the children's play. To add to this the people of the community are usually ultra-conservative and in little sym- pathy with progress in hygiene and sanitation. 5. Minimum essentials in sanitation How far the average school buildings are from even minimum requirements is easily seen by reading "Ten Sanitary Commandments for Rural Schools" prepared by the National Com- mittee on Health Education of the National Education Association in a pamphlet on The Minimum Requirements for Rural Schools (Chi- cago, 1914). The commandments are as follows : — In every school which may be considered passably sanitary the following conditions shall obtain: — 1. Heating by at least a properly jacketed stove. (No un jacketed stove to be allowed.) Avoid overheating. Temperature should never go above 68° F. Ventilation by direct outdoor air inlets and by adequate and direct foul air outlets. 153 THE TEACHING OF HYGIENE 1 2. Lighting from left outside of room or from left and rear through window space at least one fifth of floor space in area. 3. Cleanliness of school as good as in the home of a careful housekeeper. 4. Furniture sanitary in kind, and easily and fre- quently cleaned. Seats and desks adjustable and hygienic in type. 5. Drinking water from a pure source provided by a sanitary drinking fountain. 6. Facilities for washing hands, and individual towels. 7. Toilets and privies sanitary in type and in care (with no cesspools unless water-tight) and no neglected privy-boxes or vaults. 8. Flies and mosquitoes excluded by thorough screening of schoolhouse and toilets. 9. Obscene and defacing marks absolutely absent from schoolhouse and privies. 10. Playground of adequate size for every rural school. 4. Status of teaching of hygiene There are few data on the teaching of hygiene in the rural schools, but considering the lack of professional training of the majority of the teachers and the slowness with which the latest ideas are received, it is fair to assume that it is, if anything, inferior to that offered in the city. 154 IN THE RURAL SCHOOLS Hodges, in his compilation from superintendent's reports of important features of rural school im- provement, does not refer once to any special achievement in health instruction, although the reports show that many districts have been ac- tive in introducing systematic work in domestic science and in getting play apparatus. Cubberley, in his Rural Life and Education (21) (Houghton Mifflin Company), says: "We have been teaching physiology for nearly a half century in our schools, yet of how little practical use it has been to us ! . . . We have learned the names and number of our bones, the pairs of muscles and nerves, and the anatomical construction of our different organs, but of practical hygiene we have learned but little." 5. Some special difficulties and their solutions The teaching of hygiene in rural schools should not differ fundamentally as regards aims and methods from the teaching of the same subject in city schools. But since there are some problems of sanitation peculiar to the country there must necessarily be an introduction of new subject- matter, and similar topics must have a slightly different emphasis; for it must be remembered that the information imparted and the habits 155 THE TEACHING OF HYGIENE inculcated should aid the child to solve the health problems in the country. One difficulty which the rural teacher is likely to encounter is the ultra-conservatism of the average rural community. Unless the teacher is cautious and tactful her efforts are likely to be misinterpreted and barren of results. The train- ing of the pupils in hygiene and the elevation of the community demands the cooperation of the parents. Meeting with parents is highly desira- ble. This may often be brought about by plan- ning with the children a short but interesting en- tertainment to which the parents may be invited. After the entertainment is over the parents may be invited to stay to talk over with the teacher some of their common problems, among these matters pertaining to health. The teacher may then explain some of her aims and point out, for example, the value of habit in health and how the home and the school may cooperate. There should be, of course, a number of meetings, and, if they are to be successful, the teacher must plan not merely to get the parents to listen, but to do something. Such meetings, if well managed, ought to give the parents insight and sympathy with the teacher's efforts and also give them much new and valuable information. 156 IN THE RURAL SCHOOLS Another common difficulty is the lack of models of sanitation in the community. For example, in a great many rural communities it would be almost impossible to find a model dairy. When such a dairy is within easy range, the pu- pils may correlate observation with the informa- tion presented by the teacher and the textbook. Such field trips are exceedingly valuable in arousing interest and imparting exact knowledge. When such concrete observation is not available, the teacher may supply the deficiency to some extent by showing pictures. Fortunately, the rural school is a community and has some of the same problems of sanitation and hygiene as the homes from which the children come. It is the business of the teacher to see that the pupils are well informed, inspired, and trained to do something to make the school community to a large extent a model in hygiene and sanitation. One example will suffice. Probably the most crying need of the country is a sanitary disposi- tion of its sewerage. Dr. North (42) says that in- vestigation indicates that sixty per cent of the wells in the United States are polluted with house and barnyard drainage; that human and animal excreta are usually exposed to flies in a manner that makes it easy to transfer bacteria to the 157 THE TEACHING OF HYGIENE home and to the food of its occupants. It should also be said that the vile and loathsome school privy, too often found in the rural schools, is a menace to the health of the school, and is a type of danger which threatens every rural district. In some States of the South where the hookworm has been prevalent, the lack of outhouses and the insanitary outhouses have been an especially loathsome and dangerous source of disease. Pu- pils should be correctly informed as to the dan- gers from the insanitary outhouse. The question might then be proposed to the children: "Is our own outhouse sanitary?" Some teachers have found it advisable to suggest that a committee known as the " Board of Health," make an in- vestigation and report with recommendations. This may lead to asking the school authorities first to put the outhouse in a sanitary condition, promising, however, that it will be kept so there- after. It might also mean that the children would volunteer to do some things to make it sanitary. The discussion involved would include consideration of the fly problem, the washing of the hands after coming from the toilet, etc. An attack upon a practical problem in this fashion gives the children information which is likely to be retained and inculcates some habits and 158 IN THE RURAL SCHOOLS ideals likely to be permanent. Indirectly it may be relied upon to influence the community. The fly, rat, cat, mosquito, lunch, dust, heating, ven- tilating, and play problems may be approached in the same practical way. The following references to hygiene and sanita- tion will be serviceable to the teacher: — Dr. H. B. Bashore, The Sanitation of a Country House. (New York: Wiley & Sons, Inc.) (Gives teachers a good idea of what is necessary to make a country home healthful.) Dr. H. B. Bashore, Outlines of Rural Hygiene. (New York: Wiley & Sons, Inc.) (Brief treatment of most important health problems.) I. W. Brewer, Rural Hygiene. (Philadelphia: J. B. Lippin- cott Company, 1909, pp. 227.) (A rational treatment of rural health problems.) Fletcher B. Dresslar, Rural Schoolhouses and Grounds. (United States Bureau of Education, Bulletin No. 12, 1914, pp. 162.) (A careful study of rural school architecture with many practical suggestions for teachers.) S. P. Gates, Farm Water Supplies. (Massachusetts State Board of Agriculture, Boston, Circular no. 18, 1914. pp. 8.) (Describes the advantages and disadvantages of dif- ferent kinds of wells, and how water may be best made available. Refers more to the methods of getting water than to hygiene. Illustrated.) X. H. Goodnough, The Sanitary Side of Farm Water Sup- 159 THE TEACHING OF HYGIENE plies. (Massachusetts State Board of Agriculture, Boston, Circular no. 43, 191 5, pp. 11.) (Excellent.) Charles E. North, M.D., Sanitation in Rural Communi- ties. (Current Educational Topics no. 3, United States Bureau of Education, Bulletin no. 496, 191 2, pp. 22.) (Interesting presentation of rural health problems and methods of solution.) H. W. Riley, Sewerage Disposal for Country Homes. (Pub- lished under direction of A. L. Martin, Director of Institutes, Commonwealth of Pennsylvania, Harris- burg, 1914, pp. 42. Also published by New York State College of Agriculture at Cornell University, Sanitation Series no. 4.) (" Last word on drainage for rural homes." Tells how sewerage plant may be constructed at minimum cost. C. W. Stiles, Country Schools and Rural Sanitation. (United States Public Health Service, Reprint no. 116, 1913, pp. 5.) (Shows plainly the sanitary needs of rural schools.) C. W. Stiles, The Sanitary Privy. (United States Depart- ment of Agriculture, Farmers' Bulletin, no. 463, 1915, PP. 32.) (Drawings, plans. Very valuable.) G. C. Whipple, Pure Water. (State Board of Health of Jacksonville, Florida, Publication 128, 1914, pp. 21.) (Gives a good idea of the dangers of an impure water- supply and what a city water-supply ought to be. Illus- trated.) The Danger Zone on the Farm — Sewerage Disposal. (Vir- 160 IN THE RURAL SCHOOLS ginia State Board of Health Bulletin, vol. vn, no. 6, pp. 248-62.) (Excellent. Describes in detail how to make a sanitary outhouse. Many drawings.) The Sanitary Box. (Virginia Health Bulletin, vol. vi, extra no. 6, pp. 136-38.) (How to build a sanitary device cheap enough for the poorest home. Drawing.) 6. The importance of training This book has failed utterly in its purpose if it has not made clear to the reader that the teacher's work is to be judged, not by the charac- ter or the amount of information that the chil- dren acquire, but by improved tendencies in behavior, particularly in the formation of hy- gienic habits. The effective teacher of hygiene is one who trains her pupils to act in the right way. In our best city schools, under the stimulus of medical inspection, a good beginning has been made in actually training children to con- serve and improve their health; but the vast majority of our rural schools have scarcely be- gun to consider the problem. This has been shown by every recent survey of rural schools. The survey of the rural schools of Porter County, Indiana (18a), by the United States Public Health Service shows, for example, that 18.3 161 THE TEACHING OF HYGIENE per cent of the boys and 10.5 per cent of the girls never used a toothbrush at all, and the daily use of the toothbrush was noted in but 13.9 per cent of the boys and in 40.9 per cent of the girls. An investigation of the other hygienic habits would probably show the same deplorable lack of school training. In previous pages many suggestions have been offered as to how this training may be given. Dr. Burnham (38a) has recently suggested that in every rural school a training class might be formed. He describes a visit to a rural school, and offers suggestions as to training in these words: — Recently I visited a little rural school of excel- lent character. The teacher was intelligent, sensible, interested in her work. She had splendid discipline without any apparent show of authority. The chil- dren were bright, helpful, obedient, active, ready to play hard at recess, ready to work in the school- room. But apart from the admirable discipline and the scholastic training in the matter of studying the daily lessons, the work of the schoolroom seemed to be all instruction with little or no training. That there was plenty of opportunity in this school for training was obvious. The children might have been more careful in their own personal hygiene; their teeth especially were not properly cared for. As 162 IN THE RURAL SCHOOLS regards the schoolhouse, the toilets, although new, were unsanitary; in the schoolroom the curtains shut out the light from the upper half of the window where it was needed; a little later in the season the room would probably be overheated or improperly heated. In general, the sanitary condition could have been much improved. This school is typical of a large number, probably of most schools, in the rural districts in this coun- try. In such a school a training class in hygiene would find plenty of opportunity for learning. Among its exercises could be included the acquisi- tion of habits of personal hygiene, normal posture, special care of the teeth, care of the school grounds, cleanliness of the schoolroom, the use of fresh earth, if nothing better, in the toilets every day, adjust- ment of the windows for proper ventilation with regard to the direction of the wind, the regulation of the temperature of the room, adjustment of the curtains, and the like. Membership in such a class should be made a mark of honor, since service is always honorable. With a tactful teacher such a class would give training that would be far more valuable than mere instruction in hygiene. The school can do little in the way of giving instruction, but it will accomplish a great deal if it develops an hygienic attitude and fosters the acquisition of certain habits of health that will remain permanent after the children leave school. Instruction is good and it is easy; training 163 THE TEACHING OF HYGIENE is better but it is difficult. The past decade has been a period of talk about school hygiene, the next decade should be one of training in school hygiene. BIBLIOGRAPHY i. L. R. Alderman, School Credit for Home Work. (Bos- ton: Houghton Mifflin Company, 1915, pp. 181.) 2. J. Mace Andress, "The Teaching of Hygiene in Elementary Schools." Chapter xxv in Edu- cational Hygiene, edited by L. W. Rapeer. (New York: Charles Scribner's Sons, 1915.) 3. "The Teaching of Hygiene Below the High School." Elementary School Teacher (March and April, 1914). 4. "What Results Should we Expect from the Teaching of Hygiene in the Elementary Schools?" Educational Standards (March, 1916). 5. "Suggestions for the Effective Teaching of Hygiene in the Rural Schools." The Rural School Teacher (September, October, 191 5). 6. "Free Publications for Teachers of Hygiene." The Rural School Teacher (November, Decem- ber, 191 5). 6a. " Health Education in Rural Schools." Amer- ican Journal of School Hygiene (March, April, 1917), PP- 49-53, 80-88. 6b. " The Study of Habit in a Course in Psychol- ogy, with Special Reference to Health Hab- its. American Journal of School Hygiene (Sep- tember, 1917), pp. 126-30. 165 BIBLIOGRAPHY 7. Donald B. Armstrong, "Social Aspects of Industrial Hygiene." American Journal of Public Health, vol. vi (19 1 6), pp. 546-54. 8. J. H. Beard, " The Avoidable Loss of Life." Popular Science Monthly, vol. n (February, 19 16), pp. 105-18. 9. Charles Scott Berry, Physiology and Hygiene in il High-School Education." Edited by Charles Hughes Johnson. (New York: Charles Scrib- ner's Sons, pp. 346-60.) 10. John S. Billings, Physiological Aspects of the Liquor Problem (1903), p. 23. 11. Edward F. Brown, "Suggesting Another Method of Teaching Personal Hygiene." School and So- ciety, vol. iv, no. 82 (1916), pp. 148-51. 12. Thomas J. Browne, "Habit and Posture." Ameri- can Physical Education Review, vol. xxi (1916), pp. 89-98, 176-90. 13. Franklin Bobbitt, What the Schools Teach and Might Teach. (Cleveland: The Survey Committee of the ClevelandFoundation, 1916, pp. 82-87.) 14. W. H. Burnham, A Health Examination at School Entrance." Pedagogical Seminary, vol. xxi (1914), pp. 219-41. 15. "Orderly Association as a Condition of Men- tal Health." Pedagogical Seminary, vol. xx, pp. 360-91. 16. Mental Hygiene for School. (United States Bureau of Education, Bulletin no. 48, 1913, pp. 68-70.) 16a. "The Effect of Tobacco on Mental Efficiency." Pedagogical Seminary (September, 191 7), pp. 297-317. 166 BIBLIOGRAPHY 17. Richard C. Cabot, "The Teaching of Hygiene." American Physical Education Review, vol. xiv (1909), pp. 352-58. 18. W. W. Charters, Teaching the Common Branches. (Boston: Houghton Mifflin Company, 1913, pp. 300-09.) 1 8a. Clark Collins Treadwell, Rural School Sanitation, • Including Physical and Mental Status of School Children in Porter County, Indiana. (United States Public Health Bulletin no. 77, pp. 87.) 19. Ward Crampton, "The Teaching of Hygiene." Pro- ceedings, Fourth Congress of American School Hygiene Association (1910), pp. 138-42. 20. Clifford Crosby, "Physiology, How and How Much?" School Science and Mathematics, vol. vn (1907), p. 738. 21. Ell wood P. Cubberley, Rural Life and Education. (Boston: Houghton Mifflin Company, 19 14, pp. 264-65.) 22. The Portland Survey. (Yonkers-on-Hudson: The World Book Company, 191 5, pp. 361-62.) 23. Fletcher B. Dresslar, "The Hygiene of the Rural School." Proceedings and Addresses, National Education Association (191 2), pp. 1 103-10. 23a. George W. Ehler, " Preparation for Peace or War." The Playground, vol. x, no. 5 (August, 191 6), pp. 72-78. 24. John A. Ferrell, The Rural School and Hookworm Disease. (United States Bureau of Education, Bulletin no. 20, 1914, pp. 43.) 25. Irving Fisher and Eugene Lyman Fisk, How to Live. (New York: Funk & Wagnalls Company, 19 15, PP- 345-) 167 BIBLIOGRAPHY 26. Irving Fisher, Bulletin of the Committee of One Hun- dred on National Health. (Washington, D.C., 1909, pp. 138.) 27. Abraham Flexner and Frank P. Bachman, Public Education in Maryland. A Report to the Mary- land Educational Survey Commission (19 16), pp. 176. 28. Roy K. Flannagan, Sanitary Survey of the Schools of Orange County, Virginia. (United States Bu- reau of Education, 1914, Bulletin no. 17, pp. 28.) 29. Edward Howe Forbush, The Domestic Cat. (Eco- nomic Biology Bulletin no. 2, Massachusetts State Board of Agriculture, Boston, 1916, pp. 108.) 30. Rats and Rat Riddance. (Economic Biology Bulletin no. 1, Massachusetts State Board of Agriculture, Boston, pp. 87.) 31. F. M. Gregg, "Teaching Hygiene as Nature Study." Proceedings, Fourth International Congress on School Hygiene (i9i4),pp. 262-69. 32. Harry W. Haight, "The Case System of Teaching Hygiene and Preventive Medicine in the Upper Grades." Educational Review, vol. xlix (191 5), PP- 503-09. 33. Hemenway, American Public Health Protection. (Indianapolis: Bobbs-Merrill Company, 1916, PP. 283.) 34. Henry H. Hills, Jr., The Present Position of Infant Mortality. Its Recent Decline in the United States. (Quarterly Publications of the American Statistical Association, December, 191 5.) 35. E. A. Hines, " School Hygiene Simplified — The Re- ward System." Proceedings, Fourth Interna- 168 BIBLIOGRAPHY tional Congress on School Hygiene, vol. in (1014), pp. 225-29. 36. Ernest B. Hoag, Organized Health Work in Schools. (United States Bureau of Education, 1913, Bulletin no. 44, pp. 56.) 37. C. F. Hodge, " Learning Disease Prevention in School — The House-Fly as a Practical Les- son." Proceedings, Fourth International Con- gress on School Hygiene, vol. ni (19 14), pp. 10-14. 38. C. L. Hunt and M. Ward, School Lunches. (United States Department of Agriculture, Farmers' Bulletin no. 712, pp. 26.) 38a. G. E. Jones, Hygiene and War. (Introduction by Dr. W. H. Burnham.) (Carnegie Endowment for International Peace, Washington, pp. 23-24.) 39. C. N. Kendall and G. A. Mirick, How to Teach the Fundamental Subjects. (Boston: Houghton Mifflin Company, 19 15, pp. 289-315.) 40. Frank M. McMurry, Elementary School Standards. (Yonkers-on-Hudson: World Book Company, 1913, PP- 5i-54, 148-54.) 41. Moseley, "Some Ways of Teaching Practical Hy- giene." School Science and Mathematics, (Jan- uary, 191 2.) 42. Charles E. North, Sanitation in Rural Communities. (United States Bureau of Education, Bulletin no. 496, pp 22.) 43. Caroline A. Osborne, "The Cat: A Neglected Factor in Sanitary Science." Pedagogical Seminary (December, 1907), pp. 439-60. 44. Louis W. Rapeer, School Health Administration. (New York: Teachers College, 1913, pp. 358.) 169 BIBLIOGRAPHY 45. Louis W. Rapeer, Rural School Hygiene. A section of the Pennsylvania Rural School Report (19 14), pp. 24. 46. "School Health Responsibilities." Reprinted from School and Home Education, pp. 8. 47. (editor). Educational Hygiene. (New York: Charles Scribner's Sons, 191 5.) 48. Milton J. Rosenau, Preventive Medicine and Hy- giene. (New York: D. Appleton & Co., pp. 1074.) 49. Willard S. Small, Educational Hygiene. Report of the United States Commissioner of Education (1915), vol. 1, pp. 408-23. 50. W. S. Small, "Health Teaching in High Schools," in Educational Hygiene, edited by L. W. Rapeer. (New York: Charles Scribner's Sons, 1915, pp. 494-518.) 51. F. C. Smith, Exercise and Health. (United States Public Health Service, Supplement no. 24 to the Public Health Reports, 1915, pp. 7.) 52. Franz Schneider, Jr., "A Survey of the Activities of Municipal Health Departments in the United States." American Journal of Public Health, vol. vi (1916), pp. 1-18. 53. A. M. Stimpson, The Citizen and the Public Health, (United States Public Health Service, Supple- ment no. 4 to the Public Health Reports, 19 13, pp. 12.) 54. Lewis M. Terman, The Health of the School Child. (Boston: Houghton Mifflin Company, 1914, pp. 416.) 55- The Teacher's Health. (Boston: Houghton Mifflin Company, 1913, pp. 137.) 170 BIBLIOGRAPHY 56. Terman and Hoag, Health Work in the Schools. (Bos- ton: Hough ton Mifflin Company, 1914, pp. 321.) 57. G. W. Turner, "An Experiment in Student Control of School Sanitation and Hygiene.' ' Proceed- ings, Fourth International Congress on School Hygiene, vol. m (1913), pp. 283-88. 58. Thomas D. Woods, Health and Education. Ninth Year-Book of the National Society for the Study of Education, part 1, pp. 113. 59. Thomas D. Woods, "Health Problems in the Ameri- can Public Schools." Proceedings and Ad- dresses, New England Association (1914), pp. 294-301. 60. Lillian M. Towne, "The Teaching of Hygiene." Proceedings, Fourth International Congress on School Hygiene, vol. in (1913), pp. 225-29. 61. "School Instruction in the Effects of Stimulants and Narcotics." Educational Review, vol. xxrv (1902), pp. 31-47. 62. Editorial, "The Lag of Health Laws Behind Sci- ence." American Journal of Public Health, vol. vi, pp. 560-61. 63 . Carnegie Foundation for the Advancement of Teach- ing, Bulletin no. 7 (New York, 1914), pp. 416. 64. "A Health Survey of White County, Illinois." Illinois Health News, vol. 11, no. 2 (February, 1916), pp. 19-38. 65. The Teaching of Hygiene and Safety. (State of New Jersey Department of Public Instruction, Tren- ton, 1915, pp. 156.) 66. Tentative Course of Study for the Elementary School, Kansas City. (Missouri Public Schools, 19 15, pp. 113-72.) 171 BIBLIOGRAPHY SELECTED LIST OF BEST REFERENCE BOOKS FOR TEACHERS Jessie H. Bancroft, The Posture of School-Children. (New York: The Macmillan Company, pp. 322. $1.50.) (Contains many helpful suggestions on the training of children in correct posture. Almost indispensable to any school.) Jessie H. Bancroft, Games for the Playground, Home, School and Gymnasium. (New York: The Macmillan Company, 1917, pp. 456. $1.50.) (The most complete manual on plays and games.) Isaac William Brewer, Rural Hygiene. (Philadelphia: J. B. Lippincott Company, 1909, pp. 227. $1.25.) (An interesting and practical treatment of the health problems of the country.) F. W. and J. D. Burks, Health and the School. (New York: D. Appleton & Co., pp. 393. $1.50.) (An interesting presentation of hygiene through round table discussions.) Henry S. Curtis, Play and Recreation for the Open Country. (Boston: Ginn & Co., 1914, pp. 265. $1.25.) (Special consideration of the problems of rural recrea- tion. One part devoted to the play of the Rural School. Illustrated. Excellent.) Fletcher B. Dresslar, School Hygiene. (New York: The Macmillan Company, 1913, pp. 369. $1.25.) (Particularly good on the sanitation of the school plant.) Fisher and Fisk, How to Live. (New York: Funk & Wag- nails Company, pp. 345. $1.00.) (The best single volume on personal hygiene.) 172 BIBLIOGRAPHY T. W. Galloway, Biology of Sex, for Parents and Teachers. (New York: D.C. Heath & Co.,ioi3,pp. 105. $1.00.) (A temperate discussion of sex hygiene.) Luther H. Gulick, The Efficient Life. (New York: Double- day, Page & Co., 1913, pp. 195. $1.20.) (Personal hygiene, attractive style, carries conviction.) Hough and Sedgwick, The Human Mechanism. (Boston: Ginn & Co., 1906, pp. 564. $2.00.) (Excellent reference for general physiology and hygiene.) Woods Hutchinson, Preventable Diseases. (Boston: Houghton Mifflin Company, 1909, pp. 442. $1.50.) (Popular, interesting, profitable for general reading.) Joseph Lee, Play in Education. (New York: TheMac- millan Company, pp. 494. $1.50.) (A delightful interpretation of play, a book every teacher ought to read.) L. W. Rapeer {editor), Educational Hygiene. (New York: Charles Scribner's Sons, pp. 639. $2.25.) (A contribution to practically every phase of educa- tional hygiene by leading experts.) Lewis M. Terman, The Hygiene of the School Child. (Bos- ton: Houghton Mifflin Company, 1914, pp. 417. $1.65.) (Latest information on the health of the school child.) Lewis M. Terman, Health Work in the Schools. (Boston: Houghton Mifflin Company, 1914, pp. 321. $1.60.) (Contains helpful matter for the grade teacher.) Lewis W. Terman, The Teacher's Health. (Boston: Houghton Mifflin Company, pp. 136. 70 cts.) (Contains helpful suggestions on the hygiene of teach- ing and the teacher's health.) 173 BIBLIOGRAPHY George Lincoln Walton, Why Worry? (Philadelphia: J. B. Lippincott Company, 1909, pp. 269. $1.00.) (A popular and interesting treatment of a bad habit. Useful for any teacher, a helpful book to lend.) OUTLINE I. THE FUNDAMENTAL IMPORTANCE OF HYGIENE IN THE CURRICULUM i. The value of health I 2. The outlook for the prevention of illness and the lengthening of human life 6 3. The relative importance of hygiene in the cur- riculum 10 II. THE STATUS OF THE TEACHING OF HYGIENE 1 . Reports from surveys and other investigations. 1 2 2 . Hygiene not regarded as fundamental ; its teach- ingafailure 18 3. Why the teaching of hygiene has failed 19 III. THE GOALS OF INSTRUCTION 1. The acquisition of knowledge 26 2. The formation of health habits 31 3. The establishing of ideals 35 IV. SUGGESTIONS ON METHOD 1. Health as a motive ineffective 39 2. Some motives that will work 42 3. The psychology of habit formation 46 4. Habits to be formed and to be avoided 49 175 OUTLINE 5. Give marks for habits formed 51 6. Special honors for hygienic living 52 7. Training in habit formation in school 53 8. Methods of getting children to form habits out- side of school 54 9. Study the health of your pupils 58 10. Cooperate with medical inspector 62 11. Get cooperation of parents 62 1 2. Health clubs 65 13. Planning the course of study 66 14. The plan of work in the first four grades 67 15. The plan of work in Grades V-VIII 74 16. Free printed matter on hygiene 75 17. How secured — general sources of supply 76 18. How used — some general suggestions 78 19. Planning a health day — making use of printed matter, exhibits, essays 81 V. IMPORTANT PROBLEMS AND THEIR SOLUTION 1. Alcohol and health 86 2. The use of tobacco 93 3. Prevention and care of colds 95 4. Fresh air and tuberculosis 96 5. Cleanliness 98 6. Exercise and play 100 7. Care of the teeth 105 8. Foods and hygiene of feeding 107 9. Pure milk in 10. Elimination of intestinal wastes 112 176 OUTLINE ii. The care of the eyes 114 12. The care of babies 115 13. Sex hygiene 116 14. The house fly 1 19 15. The mosquito 1 24 16. The destruction of rats and mice 126 17. The cat and sanitation 132 18. Training for emergencies 136 19. Prevention of fires and accidents 139 20. Mental hygiene 148 VI. THE TEACHING OF HYGIENE IN THE RURAL SCHOOLS 1. Is the country healthier than the city? 150 2. Present sanitation in rural schools 152 3. Minimum essentials in sanitation 153 4. Status of the teaching of hygiene 154 5. Some special difficulties and their solution. ... 155 6. The importance of training 161 RIVERSIDE EDUCATIONAL MONOGRAPHS Edite d by HENRY SUZZ ALLO Andress's The Teaching of Hygiene in the Grades $ .75 Atwood's The Theory and Practice of the Kindergarten .75 Bailey's Art Education .75 Betts's New Ideals in Rural Schools .75 Betts's The Recitation .75 Bloom6eld's Vocational Guidance of Youth .75 Cabot's Volunteer Help to the Schools .75 Campagnac's The Teaching of Composition .40 Cole's Industrial Education in Elementary Schools .40 Cooley's Language Teaching in the Grades .40 Cubberley's Changing Conceptions of Education .40 Cubberley's The Improvement of Rural Schools .40 Dewey's Interest and Effort in Education .75 Dewey's Moral Principles in Education .40 Dooley's The Education of the Ne'er-Do- Well .75 Earhart's Teaching Children to Study .75 Eliot's Education for Efficiency .40 Eliot's Concrete and Practical in Modern Education .40 Emerson's Education .40 Evans's The Teaching of High School Mathematics .40 Fairchild's The Teaching of Poetry in the High School .75 Fiske's The Meaning of Infancy .40 Freeman's The Teaching of Handwriting .75 Haliburton and Smith's Teaching Poetry in the Grades .75 Hartwell's The Teaching of History .40 Haynes's Economics in the Secondary School .75 Hill's The Teaching of Civics .75 Home's The Teacher as Artist .40 Hyde's The Teacher's Philosophy .40 Jenkins's Reading in the Primary Grades .75 Kendall and Stryker's History in the Elementary Grades .75 Kilpatrick's The Montessori System Examined .40 Leonard's English Composition as a Social Problem .75 Lewis's Democracy's High School .75 Maxwell's The Observation of Teaching .75 Meredith's The Educational Bearings of Modern Psy- chology .75 Palmer's Ethical and Moral Instruction in the Schools .40 Palmer's Self-Cultivation in English .40 Palmer's The Ideal Teacher .40 Palmer's Trades and Professions .40 Perry's Status of the Teacher .40 Prosser's The Teacher and Old Age .75 Russell's Economy in Secondary Education .40 Smith's Establishing Industrial Schools .75 Snedden's The Problem of Vocational Education .40 Suzzallo's The Teaching of Primary Arithmetic .75 Suzzallo's The Teaching of Spelling .75 Swift's Speech Defects in School Children .75 Terman's The Teacher's Health .75 Thorndike's Individuality .40 Trowbridge's The Home School .75 Weeks's The People's School .75 3016 +p LIBRARY OF CONGRESS 022 152 222 9 MM. m