LB 
 
 -■v^.^ ^•vV r v:-t.^v-c:-7.;:;:.:;.r:,;./V<f ) :::.? 
 
 
 
UNITED STATES PUBLIC HEALTH SERVICE 
 
 RUPERT BLUE, Surgeon General 
 
 A REPORT OF A SANITARY SURVEY OF SCHOOLS 
 
 AND OF MEDICAL INSPECTION OF SCHOOL 
 
 CHILDREN IN CERTAIN SECTIONS OF NORTH 
 
 AND SOUTH CAROLINA 
 
 A. D. FOSTER 
 
 II 
 Passed Assistant Surgeon 
 United States Public Health Service 
 
 REPRINT NO. 211 
 
 PROM THE 
 
 PUBLIC HEALTH REPORTS 
 
 July 31, 1914 
 
 WASHINGTON 
 
 GOVERNMENT PRINTING OFFICE 
 
 1914 
 
 Monograph 
 
 T>0(**\1 
 
D. OF D. 
 SEP I 1914 
 
i -<b^ u 
 
 
 V 
 
 SCHOOL HYGIENE. 1 
 
 A REPORT OF A SANITARY SURVEY OF SCHOOLS AND OF MEDICAL INSPECTION OF 
 SCHOOL CHDLDREN IN CERTAIN SECTIONS OF NORTH AND SOUTH CAROLINA. 
 
 By A. D. Foster, Passed Assistant Surgeon, United States Public Health Service. 
 
 As a part of the systematic investigation of school hygiene being 
 made by the service in different parts of the country, a sanitary 
 survey of schools and a medical inspection of school children was 
 undertaken in certain sections of North and South Carolina. A 
 total of 107 white and 16 colored schools were visited, and 14,119 
 white and 2,327 colored children examined. 
 
 In the mountainous sections of North and South Carolina a special 
 feature of the work was the investigation to determine the preva- 
 lence of trachoma among school children, while in the lowland 
 section of South Carolina, in addition to the trachoma inspection, 
 particular attention was given to those conditions which frequently 
 occur in children of a school age and which, if uncorrected, are a 
 detriment to the health of the child and to its progress in school work. 
 
 Sanitary Conditions of Schools. 
 
 In the larger cities visited, most of the schools were found to be of 
 modern construction, special attention having been given to the 
 heating, lighting, and ventilation of the school buildings. The sani- 
 tary conditions of the buildings in the larger communities were as a 
 rule good, and the importance of the sanitary drinking fountain in 
 place of the common drinking Cup was generally recognized. 
 
 Rapid progress is being made also in some of the smaller towns of 
 the mountain districts in the improvement of construction and 
 sanitation of school buildings. 
 
 It is in the rural districts that the need for improvement along the 
 line of heating, ventilation, and sanitation is greatest. 
 
 The usual method of heating the buildings in the rural districts 
 was by means of the ordinary wood stove or trash burner. This type 
 of heater requires constant attention in replenishing fuel. The school 
 room is unevenly heated. In distant parts of the room the tempera- 
 tures is too low, while in close proximity to the stove the heat is 
 unbearable. In scarcely any of the schools was any provision made 
 for furnishing moisture to the air. The lack of moisture in the air 
 
 1 Reprint from the Public Health Reports, vol. 29, No. 31, July 31, 1914. 
 56359°— 14 3 
 
4 SANITARY SURVEY OF SCHOOLS IN" NORTH AND SOUTH CAROLINA. 
 
 is an important factor in the causation of colds and catarrhal condi- 
 tions of the mucous membrane of the throat, nose, and air passages. 
 Also the lack of moisture necessitates a greater amount of heat to 
 render the room comfortable and thus causes a needless waste of fuel. 
 
 These rural schools should be heated by stoves surrounded by sheet- 
 iron drums, and ventilated with fresh air from without, brought in 
 near the bottom of the stove, passing up between the stove and drum; 
 the air is thus warmed and gives good ventilation without chilling or 
 draft. As great a length as possible of stovepipe should be exposed in 
 order to get the full benefit of the heat from it. A suitable outlet for 
 foul air can be provided by raising the lower window sash and placing 
 beneath it a board the width of the window and about 6 inches in 
 height, thus allowing exit to foul air through the interspace between 
 the window sashes. Moisture should be added to the heated air. 
 
 In the large majority of the rural schools visited the toilet facilities 
 were entirely inadequate, and such as were present were for the most 
 part insanitary. Ordinary surface closets were in use, many of them 
 not even being provided with pits to receive the excreta. In many 
 of the closets the doors were broken down and no provision was made 
 to screen against flies. 
 
 The question of the proper disposal of excreta is an especially 
 important one in the districts infected with hookworm, owing to the 
 fact that the children go barefooted in the summer time. 
 
 It is gratifying to note the passing of the common drinking cup 
 and the use of the individual cup in schools of this section, even in the 
 rural districts. 
 
 A wide interest in many parts of the State of South Carolina is 
 being manifested in the subject of medical inspection of school children. 
 In the cities of Spartanburg and Seneca the school authorities have 
 already instituted a system of medical inspection, these cities being 
 the first in the State to undertake this work. In order to stimulate 
 further interest, conferences were held in the various localities with 
 the health and school authorities, and talks on the subject were made 
 to the teachers and pupils of the various schools visited. 
 
 Details of Sanitary Survey and Medical Inspection of School Children in Certain 
 Cities of South Carolina. 
 
 The scope of the survey included: (1) A medical inspection of the school children 
 of the public schools, with especial reference to the occurrence of contagious and infec- 
 tious diseases, particularly tuberculosis and trachoma, and the existence of defective 
 teeth, defective eyesight, hypertrophied tonsils or adenoids, and (2) a sanitary inspec- 
 tion of the school buildings and grounds. 
 
 HIGH-SCHOOL BUILDING, FLORENCE, S. C. 
 
 This is a two-story brick building which was built in 1892. It is located in the 
 center of the town, one block from the main business street. The location is not a 
 suitable one for a school building for the reason that the street upon which it is located 
 
SANITARY SURVEY OP SCHOOLS IN NORTH AND SOUTH CAROLINA. 5 
 
 is not very wide, and, together with the trees which line the street, prevent a sufficient 
 amount of sunlight from entering the building. The building is very poorly lighted, 
 and in some of the rooms it is impossible to distinguish writing on the boards from the 
 center of the rooms. 
 
 Out of the total number of pupils, 263, who were examined as to their visual acuity 
 80 were found to have deficient vision. The seats in the front schoolroom on the right 
 side of the hall were so placed that the light from the windows entered over the right 
 shoulder of the pupils and cast a shadow during writing. 
 
 There are no cloakrooms provided and wraps are hung upon hooks in the halls. A 
 sanitary drinking fountain is placed on each floor of the building. 
 
 The toilet rooms are located in a separate building in the yard in the rear of the 
 school building. The girls' toilet contains 12 closets, which flush automatically. 
 
 The boys' toilet contains 10 closets and a trough urinal. The closets are flushed 
 automatically. There is a stationary washstand in the toilet room. The room was 
 dirty and badly kept. 
 
 WHITE GRADED SCHOOL AT FLORENCE, S. C. 
 
 The graded school for white pupils is located on South Dargan Street. The school 
 grounds are ample, and cover an area of about one-half of a city block. The school 
 building is comparatively new, having been built five years ago. It is a three-story 
 building, and constructed of brick. The school building is heated by hot air, and 
 the plenum system of ventilation is used. The furnaces are two in number, and 
 located in the basement. The fresh air is drawn in from the outside by means of a 
 blower. It is then passed into the hot-air chamber, where it is heated, and finally 
 forced through large pipes to the hallways and the different rooms. There are no 
 means provided for filtering the air to remove dust as it is brought in from the outside, 
 nor is there any provision made for supplying moisture to the air before it is delivered 
 to the school rooms. 
 
 The warm-air inlets are placed in the walls about 7 feet from the floor, and the foul- 
 air exits are placed in the wall at the level of the floor. The foul air is carried out 
 through ventilating shafts passing up between the walls to the outside air at the roof 
 of the building. The amount of warm air delivered to the schoolroom can be con- 
 trolled from the room. 
 
 The toilet rooms are located in the basement, and are two in number, one for boys 
 and one for girls. The boys' toilet room contains 14 closets and a trough urinal 8 feet 
 long. The toilets and urinal are flushed automatically every three minutes. The 
 girls' toilet room contains 16 closets. There is also provided a sanitary washstand 
 and container, with liquid soap. The principal of the school stated that it was the 
 intention of the board of education to provide paper towels for the use of pupils. 
 
 On the first floor above the basement are the grade rooms, six in number, the audi- 
 torium, seating 800 persons, and the superintendent's office. There are also two 
 toilet rooms on this floor for the use of the female teachers and girl pupils. 
 
 Two sanitary drinking fountains are placed on each floor. The drinking water 
 furnished is the water which is supplied to the city and is of an excellent quality, 
 coming from artesian wells 638 feet in depth. 
 
 There are six grade rooms on each floor. The corner rooms have seven windows 
 in each room, while the other rooms have five windows. There are cross lights in 
 the corner rooms which make it exceedingly difficult to see the blackboards. In 
 two of the comer rooms the seats were so placed that the light entered the room over 
 the right shoulder of the pupils instead of the left. This should be remedied by 
 rearranging the seats. The wall boards in the schoolrooms on the first floor are colored 
 green, while those on the second floor are black in color. 
 
 The seats in the schoolrooms are of the nonadjustable kind. Several pupils were 
 seen in the lower grades who had entered school at a later age than others of the same 
 
6 SANITARY SURVEY OP SCHOOLS IN NORTH AND SOUTH CAROLINA. 
 
 grade, and in these cases the seats were much too small and ill adapted to the size 
 of the pupils, causing them to sit in a cramped position. This could be remedied 
 by the use of adjustable seats and thus the occurrence of postural deformities avoided. 
 
 The stairways leading from the second to the third floor are wide and amply large 
 enough to allow a rapid emptying of the schoolrooms in case of fire or other occasion 
 necessitating the sudden emptying of the building. The exit doors are wide and 
 open outward as should always be the case in public buildings of this kind. 
 
 In the school yard there are two sanitary drinking fountains. The grounds need 
 some filling in in certain places to prevent water collecting during rainy weather. 
 
 The janitor lives in a house on the school grounds in the rear of the school build- 
 ing. On the premises is a privy, which should be connected with the city sewer. 
 
 Table 1. — Showing defects observed among pupils arranged according to age periods. 
 
 Age. 
 
 Defective 
 vision. 
 
 Defective 
 teeth. 
 
 Enlarged 
 tonsils. 
 
 Adenoids. 
 
 Enlarged 
 cervical 
 glands. 
 
 Oral and 
 nasal de- 
 fects. 
 
 Other 
 condi- 
 tions. 1 
 
 
 40 
 79 
 33 
 
 45 
 
 38 
 
 7 
 
 124 
 63 
 6 
 
 80 
 24 
 
 7 
 
 5 
 6 
 2 
 
 4 
 
 
 6 
 
 
 
 4 
 
 
 
 
 
 Total 
 
 152 
 
 90 
 
 193 
 
 104 
 
 7 
 
 13 
 
 14 
 
 
 
 i Astigmatism, 8; strabismus, 2; myopia, high degree, 1; congenital syphilis, 1; scoliosis and hip-joint 
 disease, 1. 
 Total number of defects noted among pupils, 573; total number of pupils examined, 733. 
 
 SOUTH CAROLINA INDUSTRIAL SCHOOL, FLORENCE, S. C. 
 
 This is an institution maintained by the State for the care and education of incor- 
 rigible boys. It is located just outside the city of Florence, S. C. In connection with 
 the school the State maintains a large farm where the boys are taught dairying, agri- 
 culture, and manual training. 
 
 The school buildings are three in number, two of which are of recent construction, 
 while the third is an old building, the use of which as a school building is to be dis- 
 continued in the near future. 
 
 The two new buildings are similar in architecture, construction, and equipment. 
 They are three stories in height and constructed of stone and cement. 
 
 The upper floor is used as a dormitory having about 50 boys. The building is 
 heated by steam and is well ventilated and lighted. The sleeping cots are of iron 
 and are so arranged that they can be elevated during the cleansing of the dormitory 
 floors which are of cement and easily cleansed. 
 
 The second floor is used as a school room. The lighting and ventilation of the school- 
 rooms are excellent. The desks are of the ordinary nonadjustible kind and are prop- 
 erly placed with reference to the source of light. 
 
 The basement is fitted up with iron lockers for storage of clothing. It also contains 
 shower baths with mixers regulating the temperature of the bath water. 
 
 Sanitary self-flushing water-closets are provided in sufficient number. Each boy 
 is provided with individual towel and drinking cup. 
 
 An old building is still in use as a dormitory, classroom, dining room, and kitchen. 
 The lighting and ventilation of this building is insufficient. An inspection of the 
 kitchen and dining room showed them to be clean and well kept, but it was noted 
 that the door and window screens were broken in places, allowing entrance of flies to 
 these rooms. 
 
 The school buildings are connected with the city Bewage system, and the water 
 supply is furnished from artesian wells and is of excellent quality. 
 
SANITARY SURVEY OF SCHOOLS IN NORTH AND SOUTH CAROLINA. 7 
 
 Table 2. — Showing defects observed among pupils of the South Carolina Industrial 
 
 School, Florence, S. C. 
 
 Age. 
 
 Defective 
 vision. 
 
 Enlarged 
 tonsils. 
 
 Adenoid, U^f 
 
 Ocular 
 defects. 
 
 Other 
 condi- 
 tions. 
 
 Defective 
 teeth. 
 
 
 2 
 21 
 
 23 
 
 1 
 
 17 
 6 
 
 
 2 
 
 20 
 6 
 
 
 
 
 
 3 
 1 
 
 8 
 10 
 
 3 
 3 
 
 12 
 5 
 
 
 
 Total 
 
 46 
 
 24 
 
 4 
 
 28 
 
 18 
 
 
 
 17 
 
 
 Among the "Other conditions" noted were 1 case of feeble-minded, 1 of congenital syphilis, 1 of Vin- 
 cent's angina, and 2 cases of pellagra. 
 Total number of defects noted among pupils, 143; total number of pupils examined, 150. 
 
 COLORED SCHOOL BUILDING AT FLORENCE, S. C. 
 
 The school building for colored pupils is conveniently located in the colored section 
 of the city. It is a frame building recently completed and occupied for the first time 
 during the present year. 
 
 The first floor contains seven g^ade rooms which are well lighted for the reason that 
 the rooms are all outside rooms. In one of the rooms on the first floor it was noticed 
 that the seats were wrongly placed, which allowed the light to enter over the right 
 shoulders of the pupils instead of over the left. 
 
 Separate cloakrooms are not provided and the pupils' wraps are hung on hooks in 
 the hallways. 
 
 Two stairways, one in each end of the building, lead from the first to the second 
 floor. The stairways are amply wide so that the building may be rapidly emptied 
 in case of necessity. 
 
 In one of the grade rooms on the second floor it was noticed that the desks were not 
 rightly placed, as the light entered over the right shoulder of the pupil instead of over 
 the left shoulder. 
 
 The building is heated by means of stoves in the grade rooms. Ventilation ia 
 obtained by lowering the upper sash of the windows. 
 
 The toilet rooms are in a separate building in the rear of the school and are well 
 lighted and ventilated by means of four windows in each of the rooms. Toilet paper 
 is provided for the pupils. The floors are of cement, which permits them to be easily 
 kept clean. The girls' toilet has 12 self-flushing closets, and the boys' toilet has 10 
 self-flushing closets and a trough urinal which is constantly flushed by running water. 
 
 Drinking water is supplied by a sanitary drinking fountain placed in the school 
 yard. A fountain should be placed in the school building, as it was noticed that in 
 one of the schoolrooms there was a tin pail of drinking water with a common dipper; 
 the teacher had an individual drinking cup, but the pupils were not so provided. 
 
 The school yard is large and well drained. 
 
 Table 3. — Defects noted among pupils. 
 
 5 to 10 years . 
 10 to 15 years 
 15 to 20 years 
 
 Total. . 
 
 Defective 
 vision. 
 
 50 
 
 Defective 
 teeth, 
 
 Enlarged 
 tonsils. 
 
 168 
 139 
 17 
 
 Adenoids. 
 
 116 
 
 131 
 
 6 
 
 253 
 
 Enlarged 
 glands. 
 
 Oral and 
 
 nasal 
 
 defects. 
 
 Other 
 condi- 
 tions. 
 
 Among the " Other conditions " noted were 1 case of pulmonary tuberculosis, 2 cases of congenital syphilis, 
 1 of traumatic cataract, 1 of alopecia areata, 1 of strabismus, and 1 of hydrocephalus. 
 Total number of defects noted among pupils, 790; total number of pupils examined, 568. 
 
8 SANITARY SURVEY OF SCHOOLS IN NORTH AND SOUTH CAROLINA. 
 
 PUBLIC SCHOOL AT EFFINGHAM, S. C. 
 
 The schoolhouse in this village is a typical two-room building of the type often 
 met with in the rural districts. It is constructed of wood and consists of two rooms 
 with a hallway intervening in which the pupils' wraps are hung. The building is 
 heated during the wintertime by means of an ordinary wood-burning stove. The 
 only means of ventilation is provided by opening the windows. 
 
 The schoolrooms are lighted by windows on two sides, which results in cross lights,' 
 which render it difficult to see the blackboards. In place of the ordinary school 
 desks long wooden benches and desks are used. 
 
 Drinking water for the pupils is kept in a large tin pail. The children use indi- 
 vidual paper cups which they themselves make out of paper. The drinking water 
 is obtained from a well located not more than 40 feet from the school privy. 
 
 A separate privy for girl and boy pupils is provided, the entrances to which are 
 properly secured from view. The privy is very insanitary as the excreta are deposited 
 upon the ground in close proximity to the well furnishing drinking water. The 
 privy is not screened to prevent access of flies. 
 
 Table 4. — Defects noted among pupils. 
 
 Age. 
 
 Defects 
 of eyes. 
 
 Defective 
 teeth. 
 
 Enlarged 
 tonsils. 
 
 Enlarged 
 glands. 
 
 Adenoids. 
 
 Other 
 condi- 
 tions. 
 
 
 3 
 
 16 
 
 7 
 
 3 
 
 6 
 
 5 
 
 
 
 Among " Other conditions" noted were 4 cases of pellagra and 1 case of tuberculosis of hip joint. 
 Total number of defects noted among pupils, 40; total number of pupils examined, 45. 
 
 WHITE PUBLIC SCHOOL, DARLINGTON, S. C 
 
 This is a two-story brick building of modern construction, located in the center of 
 the town, adjacent to the city park. The building is heated by hot-air furnaces and 
 is well ventilated and lighted. Stairways are amply wide to permit of rapid emptying 
 of the building. 
 
 The desks used are the ordinary nonadjustable school desks, and in all the school 
 rooms they were found to be properly placed with reference to the source of light. 
 
 Separate cloakrooms are provided for each grade room. Toilet rooms are located 
 in the basement of the building and were exceedingly well kept and clean. The 
 closets in both boys' and girls' toilets and the urinal in the boys' toilet are flushed 
 automatically at frequent intervals. 
 
 Stationary washstands, with liquid soap and paper towels, are provided for the 
 use of all pupils. 
 
 Drinking water is furnished by means of a sanitary drinking fountain located in the 
 school yard. The water, coming from an artesian well, is of excellent quality and the 
 supply inexhaustible. 
 
 A large area of ground surrounds the school building, which is used as a playground 
 by the pupils both during recess and after school hours. 
 
 Many of the pupils in this school come from a distance and use horses in coming to 
 and going from school. Stables are provided for the animals, where they may be kept 
 during school hours. The stables are located at a great enough distance from the 
 school building not to be objectionable. 
 
SANITARY SURVEY OF SCHOOLS IN NORTH AND SOUTH CAROLINA. 9 
 Table 5. — Defects noted among pupils. 
 
 Age. 
 
 De- 
 fective 
 vision. 
 
 De- 
 fective 
 teeth. 
 
 En- 
 larged 
 tonsils. 
 
 Adenoids. 
 
 Ocular 
 defects. 
 
 Other 
 condi- 
 tions. 
 
 5 to 10 years. 
 10 to 15 years 
 15 to 20 years 
 
 Total.. 
 
 102 
 
 30 
 
 Among "Other conditions" were noted 3 cases of anemia, 1 of goiter, 1 of cleft palate, 1 of enlarged 
 epitrochlear glands, and 1 of suspected pulmonary tuberculosis. 
 Total number of defects noted among pupils, 356; total number of pupils examined, 464. 
 
 "MILL SCHOOL" AT DARLINGTON, S. C. 
 
 This school is located in the cotton-mill district of the town. The school occupies 
 two rooms in the second story of a brick building which is owned by the cotton-mill 
 company. The first floor of this building is partly used as a general store and partly 
 occupied by the mill Young Men's Christian Association. 
 
 The schoolrooms are well lighted and in winter are heated by steam. Ventilation 
 is obtained by lowering the upper sash of the windows of the room. 
 
 Desks used are the ordinary nonadjustable school desks. 
 
 Toilets. — The boys in this school use a toilet in the Young Men's Christian Associa- 
 tion building on the ground floor which is connected with the town sewerage system. 
 
 The girls use a surface closet in the vicinity of the school which is an extremely 
 insanitary affair. The privy is unscreened and was swarming with flies. The excreta 
 is deposited upon the surface of the ground not only beneath the seats in the privy, 
 but in the vicinity of the privy as well. As there are many cases of hookworm among 
 the children in this mill, this privy should be condemned and a closet connecting 
 with the city sewers should be built in its place. 
 
 There are no facilities at the school for washing the face and hands, as the pupils 
 all reside in the immediate neighborhood and it is supposed to be done at home. 
 
 The drinking water used is the city water supply, which is of good quality. 
 
 There is no yard in connection with the school, and they are allowed to play in an 
 adjoining yard which is set aside for that purpose by the Young Men's Christian 
 Association. 
 
 Table 6. — Defects noted among pupils. 
 
 Age. 
 
 Defective 
 vision. 
 
 Defective 
 teeth. 
 
 Enlarged 
 tonsils. 
 
 Adenoids. 
 
 Anemia. 
 
 Other con- 
 ditions. 
 
 6 to 12 years 
 
 2 
 
 16 
 
 9 
 
 5 
 
 11 
 
 2 
 
 
 
 Total number of defects noted among pupils, 45; total number of pupils examined, 46. 
 MAYO SCHOOL (COLORED), DARLINGTON, S. C 
 
 This school is conveniently located in the colored section of the town. The build- 
 ing is a two-story frame structure recently erected and occupied for the first time 
 during the present year. 
 
 The building is heated by stoves. It is well lighted and ventilated. Separate 
 cloak rooms are provided for the pupils' wraps, one cloakroom being provided for each 
 classroom. 
 
 The school desks are of the ordinary nonadjustable kind and are properly placed 
 with reference to the source of light. 
 
10 SANITARY SURVEY OF SCHOOLS IN NORTH AND SOUTH CAROLINA. 
 
 The two stairways which lead from the first to the second floor of the building are 
 amply wide so as to permit of rapid emptying of the building in case of necessity. 
 
 Toilet rooms are provided for pupils of both sexes.. They consist of the ordinary 
 surface closet, the entrance to which is properly screened from view. 
 
 The closets were, when built, properly screened with wire netting to prevent 
 access of flies, but at the time of inspection the screens were found to be torn and 
 useless. The excreta is received in an impervious trough, which is cleaned weekly 
 by the city scavengers. 
 
 Drinking water is furnished by a pump in the school yard. Individual drinking 
 cups are not used in this school; a tin dipper hung on the pump is in common use. 
 
 The school yard is large, and owing to the sandy character of the soil, is well drained. 
 
 Table 7. — Defects noted among pupils. 
 
 Age. 
 
 Defective 
 vision. 
 
 Defective 
 teeth. 
 
 Enlarged 
 tonsils. 
 
 Ocular 
 defects. 
 
 
 6 
 2 
 
 10 
 
 7 
 2 
 
 13 
 
 
 1 
 
 
 
 
 
 
 
 
 
 
 Total 
 
 S 
 
 19 
 
 19 
 
 3 
 
 
 
 Total number of defects noted among pupils, 49; total number of pupils examined, 115. 
 
 PUBLIC SCHOOL AT M'COLL, S. C 
 
 This building is constructed of brick and is two stories in height. It is located just 
 outside of the corporation limits of the town. The school grounds are ample in size 
 and are well drained owing to the sandy character of the soil. 
 
 The school rooms are large and well Ugh ted. Heating is furnished by means of 
 stoves. The desks used are of the ordinary nonadjustable kind and are properly 
 placed with reference to the source of light. 
 
 Each grade room has a separate cloakroom for the pupils' wraps. 
 
 Two stairways lead from the first to the second floor and are amply wide to permit 
 of rapid emptying of the building. 
 
 Water coolers are placed in the hallways, but it was noticed that most of the pupils 
 obtained drinking water from a pump in the school yard. Owing to the location of 
 the school outside of the town limits, the city water supply is not available. The 
 pump from which drinking water is obtained is very insanitary, as waste water seeps 
 back into the well. Its use should be discontinued or it should be reconstructed so 
 as to render it safe. 
 
 The toilets are located in the yard in the rear of the school building. They consist 
 of two wooden privies inclosed by a board fence which acts as a screen to the entrance. 
 The privies are not screened, thus permitting access of flies. 
 
 The use of these privies should be discontinued and new sanitary closets connected 
 with the city sewage system should be provided. 
 
 Table 8. — Defects noted among pupils. 
 
 Age. 
 
 Defec- 
 tive 
 vision. 
 
 Defec- 
 tive 
 teeth. 
 
 Enlarged 
 tonsils. 
 
 Ade- 
 noids. 
 
 Other 
 condi- 
 tions. 
 
 
 3 
 4 
 
 7 
 5 
 
 10 
 1 
 
 7 
 3 
 
 4 
 
 
 3 
 
 
 
 Total 
 
 7 
 
 12 
 
 11 
 
 10 
 
 7 
 
 
 
 Among "Other conditions" noted were 1 case of eczema, 1 of pulmonary tuberculosis, 3 cases of follicular 
 conjunctivitis, 1 of partial paralysis from poliomyelitis, and 1 of elongated uvula. 
 Total number of defects noted among pupils, 47; number of pupils examined, 64. 
 
SANITARY SURVEY OF SCHOOLS IN NORTH AND SOUTH CAROLINA. 
 
 11 
 
 PUBLIC SCHOOL AT LITTLE ROCK, S. C. 
 
 This school building is constructed of brick and two stories in height. It is a new 
 building recently completed, and has been in use for the paet two months. There 
 are four grade rooms on the first floor, and a separate cloakroom is provided for each 
 of the grade rooms. The rooms are to be heated in winter by a stove in each grade 
 room, but as yet the stoves have not been provided. 
 
 There is no means provided for ventilation except by opening the windows. The 
 rooms are well lighted, and the windows are provided with shades to lessen the glare 
 of the afternoon sun. It was noticed that in two of the grade rooms the seats were not 
 properly placed, the light entering over the right shoulder of the pupils, which cast 
 a shadow while writing. 
 
 The desks used in this school were the ordinary desks, which varied in size accord- 
 ing to the age of the pupils. It was noticed that the space between the desk and the 
 seat was greater than it should be, as it necessitated the pupil leaning forward too 
 much, thus causing an improper posture while writing. 
 
 The second floor of the school building was used for the auditorium and for two addi- 
 tional grade rooms to be used in case the attendance of pupils should increase. 
 
 The stairway leading to the second floor is amply wide enough to permit the build- 
 ing to be rapidly emptied in case of necessity. 
 
 The yard is large and well drained. 
 
 Toilets. — An ordinary surface toilet in the school yard is used. There is no screen 
 in front of the entrance to the privy. This privy is very insanitary, as the excreta 
 is deposited upon the ground and the building is not screened to keep out flies. 
 
 There are no means provided for the pupils washing. Drinking water is obtained 
 from a pump in the school yard. Individual drinking cups are not in general use 
 among the pupils, although a few are so provided. 
 
 Table 9. — Defects noted among 'pupils. 
 
 Age. 
 
 Defective 
 vision. 
 
 Defective 
 teeth. 
 
 Enlarged 
 tonsils. 
 
 Adenoids. 
 
 Follicular 
 conjunc- 
 tivitis. 
 
 Defective 
 speech. 
 
 
 12 
 6 
 
 2 
 
 9 
 2 
 
 9 
 6 
 1 
 
 7 
 2 
 
 3 
 1 
 
 1 
 
 
 15 to 20 years 
 
 
 
 
 
 
 
 Total 
 
 20 
 
 11 
 
 16 
 
 9 
 
 4 
 
 1 
 
 
 Total number of defects noted among pupils, 61; total number of pupils examined, 52. 
 
 PUBLIC SCHOOL, CONWAY, S. C 
 
 The school building is located on a hill on the outskirts of the town. It is two stories 
 in height and. constructed of brick. The building is heated by means of hot air. The 
 rooms are fairly well lighted. Cloakrooms are not provided. The children's wraps 
 being hung on hooks in the hallways. 
 
 The desks used are the ordinary nonadjustable school desks. Drinking water is 
 furnished from a flowing well in the school yard. Toilet facilities are provided for by 
 means of two ordinary surface closets in the school yard. The wooden fence which 
 originally served as a screen to the entrance of the boys' toilet was broken down and 
 the closet door was torn from the hinges. The boys' toilet was exceedingly filthy and 
 insanitary, but the girls' toilet was found to be fairly clean. 
 
 The excreta is deposited in a ravine at the rear of the closets. As this section of 
 the county is heavily infected with hookworm, it is very important that the insanitary 
 conditions of the toilets should be remedied. 
 
12 SANITARY SURVEY OF SCHOOLS IN NORTH AND SOUTH CAROLINA. 
 Table 10. — Defects noted among pupils. 
 
 5 to 15 years. 
 
 Defective 
 vision. 
 
 11 
 
 Defective 
 teeth. 
 
 Enlarged 
 tonsils. 
 
 10 
 
 Adenoids. 
 
 11 
 
 Ocular 
 defects. 
 
 Other 
 condi- 
 tions. 
 
 Total number of defects noted among pupils examined, 49; total number of pupils examined, 47. 
 EXAMINATION OF SCHOOL CHILDREN OF HORRY COUNTY. 
 
 During the course of inspection of the school at Conway and Loris, S. C, a number 
 of school children were brought in for examination by their parents and teachers from 
 school districts in various parts of Horry County. 
 
 The following table gives the defects observed in school children representing 14 
 rural schools of the county. 
 
 Table 11. — Defects noted among pupils. ■» 
 
 Age. 
 
 Defec- 
 tive 
 vision. 
 
 Defec- 
 tive 
 teeth. 
 
 Enlarged 
 tonsils. 
 
 Ade- 
 noids. 
 
 Hook- 
 worm. 
 
 Other 
 condi- 
 tions. 
 
 
 7 
 4 
 1 
 
 4 
 4 
 
 
 5 
 
 8 
 2 
 
 10 
 
 4 
 
 12 
 
 
 4 
 
 
 3 
 
 
 
 
 
 
 Total 
 
 12 
 
 8 
 
 14 
 
 10 
 
 14 
 
 19 
 
 
 
 Among "other conditions" noted were 1 case of feeble minded, 1 defective speech, of defective hearing, 
 1 of suspected pulmonary tuberculosis, 2 of nasal obstruction, 1 of tongue tie, 1 of hypertrophied turbinates, 
 1 of inguinal hernia, 2 of impetigo contagiosa, 1 of strabismus, and 1 of follicular conjunctivitis. 
 
 Total number of defects noted, 77; total number of pupils examined, 81. 
 
 o 
 
LIBRARY OF CONGRESS 
 
 020 948 946 
 
 ' ■.-';- 
 
 ■j 
 ! 
 
 
 .; 1 
 
 
 v'J. ' 
 i 
 
 ] 
 
 
 ' ] 
 I 
 
 ■;■•:&