HX64073998 R A425 St7 1 920 A general outline an RECAP :r*-c .i : , ;;,ii T, A. STOREY Executive Secretary, United Slaters Interdepartmental 1 College of ^tpsiciansf anb ^urgeong ^tttxtntt Hihvavp A GENERAL OUTLINE - and - SYLLABUS ON HYGIENE By T. A. STOREY, M. D., Ph. D. Secreiary-General, Fourth International Congress on ~ School Hygiene. Buffalo, 1913 Professor of Hygiene, College of the City of New Yorl^ Inspector of Physical Training, Military Training Commission, Stale of New York Executive Secretary, United Slates Interdeparlmental Social Hygiene Board, Washington, D. C. WASHINGTON Preliminary Edition : September, 1919 — Revised Edition: June, 1920 WASHINGTON GOVERNMENT PRINTING OFFICE 1920 CONTENTS. Page. A Gexekal Sylt.abus outlining the subject material to be covered in four college terms of approximately 16 weeks each: Introduction 5 Definitions of the main divisions of hygiene 8 A word to the teacher and to the student 9 PART 1. Syllabus on general hygiene 11 Syllabus on individual hygiene 17 Syllabus on group hygiene 19 Syllabus on intergroup hygiene 32 References on general, individual, group, and intergroup hygiene 38 PART 2. A SrppLEMENTARY SYLLABUS showiug in detail the places in the syllabi on general hygiene, individual hygiene, group hygiene, and intei group hygiene, in which the professor of hygiene or the special teacher of hygiene may develop his class program, " emphasizing with appropriate and due proportion and with proper tact and persistency the serious importance of the venereal diseases, their causes, carriers, and preven- tion," in accordance with the agreements that now exist between cer- tain normal schools, colleges, and universities and the United States Interdepartmental Social Hygiene Board 53 PART 3. Supplementary Syllabi on special group and intergroup hygiene for the u.se of the professor of hygiene or the special teacher of hygiene 79 Division 1. — Special group lnjgiene — I. Domestic hygiene 79 II. School hygiene 81 III. College and university hygiene 85 IV. Occupational hygiene 88 V. Institutional hygiene 90 Division 2. — Special intergroup hygiene — I. Rural intergroup hygiene 95 II. Municipal hygiene (village and city) 98 III. State intergroup hygiene 100 IV. National intergroup hygiene 102 V. Military and naval hygiene 105 VI. International hygiene 108 (3) Digitized by tine Internet Arciiive in 2010 witii funding from Open Knowledge Commons http://www.archive.org/details/generaloutlinesyOOstor A GENERAL OUTLINE AND SYLLABUS ON HYGIENE. INTRODUCTION. " Sec. 6. That there is here appropriated * * * the sum of $300,000 which shall be paid to such universities, colleges, or other suitable institutions or organizations as in the judgment of the Interdepartmental Social Hygiene Board are qualified for scientific research, for the puii30se of discovering and developing more effective educational measures in the prevention of venereal, diseases =^' * */ This general outline and syllabus on general, individual, group, and intergroup hygiene has been issued for the assistance of those educational institutions that are cooperating with the United States Interdepartmental Social Hygiene Board for the purpose of dis- covering and developing more effective educational measures in the l^revention of venereal diseases. Each of these institutions is under obligation to organize, or complete the organization of, " a department of hygiene, the curriculum of which shall include courses and confer- ences in informational hygiene, and courses, conferences, and train- ing in the applications of hygiene, emphasizing, w^ith appropriate and due proportion and with proper tact and persistency, the serious importance of venereal diseases, their causes, carriers, and preven- tion, and emphasizing at the same time the other important facts and applications of general hygiene, individual hygiene, group hy- giene, and intergroup hygiene."^ Each of these institutions will develop its own programs and syl- labi for the several divisions of activity covered by its department of hygiene in accordance with its agreement with the board. No in- stitution is under obligation to use this particular syllabus for its courses in general, individual, group, and intergroup hygiene. Each of these departments of hygiene will develop its own more detailed presentation of these subjects, using the plan and the subject organi- zation of this syllabus, if such usage seems wise. The directors of these departments of hygiene Avill supply the board with copies of their own syllabi on general, individual, group, and intergroup hy- giene, and it is expected that the board will be given the benefit of such criticisms — especially constructive criticism — as the various ex- 1 Taken from sec. 6 of Ch. XV, Pnb. No. in.S, 65th Cong., Army appropriation bill of .Tuly 9, 1918. - From Regulations govornin.!;- the Edncatinnal Research and Development Fund of the United States Interdepartmental Social ITyuicne Board, par. 5, p. 4. (0) 6 pertly qualified teachers in these seA^eral institutions may develop in relation to this syllabus. This s^dlabus has been organized to cover four college terms of approximately 16 weeks each. Each of the four major divisions of the syllabus may be used for a two-hour course in a single term. It is assumed that one hour of class work calls for aj^proximately two hours of preparation by the student. With these facts in mind, the professqr or special teacher of hygiene will fill in his own details, develop his special emphases, and organize his class procedures, demonstrations, illustrations, graphic material, experiments, field Tvork, quizzes, and assigned work to fit the needs of his own schedule and his own student groups. It is obvious that general hygiene should be the first subject cov- ered, and then that the applications of the general laws of hygiene to the individual, the group, and then to associations of groups form a logical sequence for the presentation of these main divisions of hygiene. General hygiene is concerned with the scientific facts that Iiear on health. Individual hygiene has to do with the applications of these facts to the health welfare of the individual. Group hy- giene is concerned with the application of these laws for the health w^elfare of groups of individuals living together for periods of time, as in the home group, the school group, the factory, or the reforma- torj. Intergroup hygiene applies the laws of hygiene to the health welfare of many groups more or less intimately related to each other and dependent upon each other, as in the rural, village, or city com- munity, or in the State or the Xation. The second division of part 1 of this syllabus — individual hy- giene — would appear at first sight to be disproportionatelj^ small. A closer examination, however, will discover the fact that its details call for a considerable expansion by the teaclier. For instance, it is obvioush^ unnecessary in this syllabus to expand to its logical limit the physiological, hygienic, and other considerations that must be considerably developed by the teacher in his class work on " indi- vidual health examinations and advice " or " the elements of human physiology " in connection with the care of the body and its organs. The subject matter of individual hygiene, group hygiene, and inter- group hygiene falls very logically into several main divisions. These divisions have been designated in this syllabus as: Educational hygiene, informational hygiene, defensive hygiene, and constructive hygiene. The important subdivisions of defensive hygiene are: Protective hygiene, preventive hygiene, remedial hygiene, and aggressive hygiene. Educational hygiene is the instruction or training in hygiene that leads to the formation of habits of good judgment in matters that relate to health and to the formation of good habits of conduct. in relation to the preservation of health. Informational hygiene is concerned with the acquisition of accu- rate and scientific knowledge relative to hygiene, and it is concerned also with the various methods that are effective for the distribution of this knowledge. The term " defensive hygiene " needs no explanation other than that connected with the definitions of its subdivisions, which follow. Protective hygiene is a subdivision of defensive hygiene and deals with the passive measures that may be adopted for the care of the body and its organs, such as the building and equipment of habita- tions or the wearing of clothes, the habit of washing one's hands, and chewing one's food well, and so on. This, of course, is a very large subdivision of hygiene. Preventive hygiene includes more active procedures, such as vaccination or inoculation for the prevention of smallpox or typhoid fever or other diseases. The habits of cheerful- ness and happiness belong to preventive hygiene, especially to pre- ventive mental hygiene. Remedial hygiene covers first aid and emergency treatment, medical and surgical care, nursing, dentistry, and so on. Aggressive hygiene is a term that applies best to group or intergroup procedures that are concerned with the eradication of disease, using the word " disease " in a very broad sense. A " safety- first " campaign is a part of intergroup aggressive hygiene. The campaign against venereal diseases that was developed so vigorously during the Great War was a powerful piece of intergroup aggressive hygiene. Constructive hygiene covers those parts of hygiene that have to do with growth, development, and the improvement of physiological functions. It includes nutrition, play, recreation, exercise and ath- letics, work, and rest. The use of this framework or outline described above is recom- mended not only for the larger divisions of practical hygiene, but also such subdivisions of group hygiene as domestic hj^giene, school hy- giene, or institutional hygiene, and for such subdivisions of intergroup hygiene as rural hygiene, municipal hj^giene. State hygiene, or na- tional hygiene. This general outline and syllabus on hj^giene is taken very largely from publications developed by the author in connection with his work in the department of hygiene of the College of the City of New York and in connection with the formation and application of the syllabus on physical training proposed by the Military Training Com- mission of the State of New York and adopted by the regents of the University of the State of New York for use in all the schools of that State. It is hoped that the normal schools, colleges, and universities cooperating with the United States Interdepartmental Social Hy- giene Board will make free use of the material contained in this general outline and sjdlabus on hygiene, giving such credit as may be deserved to the United States Interdepartmental Social Hygiene Board and to the author for having placed it at their disposal. The United States Interdepartmental Social Hygiene Board has made its various appropriations to normal schools, colleges, and universities, assisting them in the organization of departments of hygiene 'and in the organization of programs for those departments under the strong conviction that the educational influences of these departments will be such as to produce a citizenship possessed of a wiser judgment in matters that relate to healthy a. tnore accurate in- formation concerning facts that relate to the preservation of hecdth^ arid safer habits of defensive and constructive hygiene. The board believes that no program of education in matters of hygiene is com- plete that does not include the venereal diseases and does not present accurate facts concerning the causes of those diseases, their carriers, and the effective defense of the individual, the home, and the com- munity against their ravages. Xo institution cooperating with the board under this fund can do less than emphasize these facts in ap- propriate places and by proper methods in the various activities that make up its institutional program. • If there is an accurate way through which to secure a measurement of the influence and the value of these departments of hygiene, that procedure should eventually demonstrate that these departments educate men and women to live longer and happier and to be physi- ologicalh' more productive: to be wiser and better teachers of hygiene in their own families and in their relations with other human beings ; and to be relatively more free from the preventable and avoidable diseases, including gonorrhea and syphilis, two diseases that are incapacitating so mam^ human beings and destro^dng so many lives as to rank them among the verv greatest enemies of mankind. -..' t? DEFINITIONS OF THE MAIN DIVISIONS OF HYGIENE. Hygiene: The science and the art of preserving health. "A part of the wisdom of the Egjq^tians at least 1500 B. C." General hygiene: The natural laws that govern health. The science of hygiene includes scientific information concerning the agents that injure health, the contributory causes of poor health, the car- riers of disease, the defenses of health, and the producers of health (constructive hygiene). Individual hygiene: The applications of the natural laws of hygiene for the health welfare of the individual. Group hygiene: The applications of the natural laws of hygiene for the health welfare of groups of individuals, the members of a 9 group being associated more or less intimately with each other for considerable periods of time under common environmental influ- ences, common hygienic advantages and disadvantages, and under common health responsibilities and regulations. Includes the hy- giene of such groups as the family, the school, the occupations, and certain public institutions. Intergroup hygiene: The application of the natural laws of hygiene for the health welfare of associated groups of humans, the several groups being dominated by common interests, exposed to common health dangers, and competent to establish and enforce common standards of individual and group responsibility for community health. Includes the hygiene of the rural community, the village, the city, the town or township, the county, the State, the Nation, and alliance of nations. A WORD TO THE TEACHER AND TO THE STUDENT. A slacker is a human who, being able, fails ; one who can but does not try ; one who could but does not " deliver the goods." There never has been a place for such men and for such women; but the dead weight of their burden, the size of their useless expense, and the extent of their damage to the community and to the Nation is felt more to-day than ever before, and we are in no mood for such company. It is possible to be a teacher slacker or a student slacker. There may be civilian slackers and there may be soldier slackers. The type of one's occupation does not exclude him from the class. The program of instruction in hygiene outlined in this syllabus is for the teacher and for the student who proposes to make good. Its usefulness depends upon the determination of each to " deliver the goods." A successful instruction in hygiene means fewer men in the civilian or military discard, less sickness, fewer postponable deaths, longer lives, greater national human resource, and larger national happi- ness. But there can be no successful instruction in and no adequate realization of these possibilities if either the teacher or the student is a slacker. The effective presentation of this subject may be accomplished through recitations, discussions, and quizzes, written exercises, in- spections, and conferences. Lectures, demonstrations, lantern slides, and motion pictures may serve a useful purpose if employed without reducing the necessity for thoughtful study on the part of the student and instructor. Informational hygiene is not of much use unless it in some way. becomes applied hygiene. The instructor is wholly justified in holding his pupil responsible for the practice of a reason- 10 able degree of good individual hygiene. Poor posture, unclean wear- ing apparel, dirty fingernails, skin, or hair, poor dental hygiene, uncorrected visual defects, unsatisfactory care of the feet, poor muscular condition, and so, on, are within reasonable limitations, evidences either of poor instruction or of poor application by the student and should be treated and recorded as such. Every recita- tion should require a thoughtful and careful preparation from the student and from the instructor. Instruction concerning the facts of general hygiene and their prac- tical application in individual Iwgiene and in group hygiene and intergroup hygiene as contemplated in this outline and sjdlabus, involves : A persistent emphasis of health as a national resource — of man power and of woman power as a national asset ; An insistence that individual health is a serious patriotic duty and a compelling social obligation ; An impressive reiteration of the supreme importance of saving the enormous amount of time, productivity, resource, and happiness lost in peace time and in war time on account of avoidable accident, preventable disease, and remediable physical defect; A constant repetition that will drive home the disturbing fact that we lose every day in peace or in war the services of an enormous army of men and women because of physical de- fect, poor health, avoidable accident, preventable disease, and postponable death : A convincing statement and restatement of the fact that national health depends equally upon the health habits of the indi- vidual on the one hand and upon those of the community on the other, and that the health progress of neither can go very far without the other ; A deliberate and persistent effort to secure a compelling realiza- tion by the student of the fact that poor development, inca- pacity, inadequac}', poor health, and sickness are usually a man's own fault ; The establishment of an ideal that will not permit the individual to expose himself uselessly to disabilitj^ or disease; The cultivation of a biting conscience that will sting as against the accusation of being a slacker or a spy whenever a man yields to the temptation of being needlessly sick, as with gonorrhea or syphilis, or becomes voluntarily unht for peace-time or war-time service, as with drunkenness or sexual excess, or in any other way " aids the enemy "' through habits that take his strength, put him out of condition, and makes him a burden to those about him. PART 1. SYLLABUS ON GENERAL INDIVIDUAL GROUP AND INTERGROUP HYGIENE. Division 1.— GENERAL HYGIENE. I. THE AGENTS THAT INJURE HEALTH. 1. The inanimate agents that injure health. (a) Mechanical agents. The source of many accidents, mili- tary and civil; postural defects and many precancerous irritations. {h) Physical agents, such as heat, cold, variations in atmos- pheric pressure, light, X ray, and electricity. (c) Chemical agents. Industrial and military; drugs. 2. Animate agents — Pathogenic organis77is. (a) Bacteria. Elementary facts of morphology, habitat, re- production, avenues of entry into the tissues, influences on the human host, conditions modifying infection, elimination, etc. ; stress particularly the common patho- gens of respiratory, intestinal, and venereal diseases. (h) Higher plants. (c) Protozoa. Cover biology of the protozoa as completely as with the bacteria, giving special attention to the com- mon and more dangerous forms. (d) Higher animal parasites (metazoa). Cover only parasites of importance, such as the hookworm and the trichina. S. Physiological in^uences. (a) The hygiene of heredity. The vehicle of inheritance, the limitations of heredity, racial heredity, family heredity, the problems that arise from what the individual in- herits and the problems that may arise from what he transmits, emphasizing particularly the influences of alcohol and syphilis. Hereditary disease distinguished from congenital disease. (5) Prenatal hygiene. The development of the human from the union of two cells; influences that affect the health of the unborn babe ; the hygiene of childbirth ; impor- tance of alcohol and venereal disease. (11) 12 3. Physiological in^ueiices — Continued. (c) Age. Infancy, childhood, adolescence, maturity, old age. {d) Sex. {e) The secretions that may affect health through excess, de- ficiency, or absence. (/) Emotional influences (mental hygiene), such as anger, rage, fear, apprehension, obsession, nervous excitement ^ ("shell shock.'' neuroses), sex emotion. {g) Xeuro-muscular activit}^ — excess, as in writer's crump, fatigue. ( A ) Other functional excesses. 4. Deficiencies and deprivations. The nature and the importance of the deprivations and defi- ciencies that injure health: health values of oxygen, water, food and food factors, work. play, recreation, cheerfulness, and rest, and the injuries that may be due to their insuffi- ciency or absence. 5. The unknown agents that injure liealtli: (a) The filterable and ultramicroscopic viruses and their im- portance. (&) The nature. preA'ention. and treatment of cancer. 11. THE CARRIERS OF PATHOGENS. 1. The human carrier in health., while sick, and after recovery from disease : (a) Dissemination of pathogens by way of the excretions and discharges from the respiratory tract; organisms elimi- nated in health, during disease, and after recovery; methods of elimination and transmission and conditions faA'oring; importance. (h) Dissemination by way of discharges from the eyes and the ears in health and disease. (c) Dissemination by way of the intestinal tract: importance. (d) Dissemination by way of the genito-urinary tract: im- portance. (e) Dissemination by way of the skin: surface contamina- tions and punctures by blood-sucking insects : opportu- nities for insects to secure pathogens from or through the skin. (/) Importance of the human carrier. 2. Insect carriers: (a) Sources from which insect carriers secure pathogens; ways in which they transport and distribute pathogens ; con- sideration of special insects, their biolog}^ (elementary),. 13 2. Insect carriers — Continued. and their importance as disease carriers; ticks, flies, mosquitoes, fleas, lice, bedbugs, gnats, and possibilities with ants, cockroaches, etc. {b) General preventive measures applied to insect carriers. 3. Animal carriers: (a) Animals known to be carriers. (b) Sources from which pathogens are secured. (c) Ways in which animals carry and distribute pathogenic organisms— contact, excretions, blood-sucking insects, and animal foods (milk). (d) Special consideration — dog, cat, cow, hog, rat, etc. (e) Importance of the animal carriers. (/) General preventive measures. 4. Contact infections: Special consideration of the more important contacts and the common infections disseminated by such contacts — respira- tory, venereal, and intestinal diseases. 5. Infection through secondary carriers: Air currents, dust, water, food, etc. III. THE CONTRIBUTORY CAUSES OF POOR HEALTH. 1. Definition, agents, influences, and conditions that make it easier for humans to become sick and harder to get well. 2. Influences that favor the multiplication of pathogens or their car- riers, such as seasons, climate, weather, geographical location, soil, and drainage, especially favorable surroundings. 3. Influences that increase the vitality of pathogens or their carriers. 4. Influences that favor the distribution of pathogens and their car- riers, such as seasons, climate, bad weather, drainage, transpor- tation, travel, immigration, commerce, war, poverty, congestion, carelessness, ignorance, prostitution, etc. 5. Influences that tend to interfere with or break down our home and community (tent or camp) defenses, such as poor policing, poor discipline, carelessness, illiteracy, ignorance, vice, industrial con- ditions, business and commercial greed, immigration, low stand- ards of hygiene, poverty, hazardous occupation, bad politics, experiences of war, 6. Influences that weaken the health defenses of the individual, making it easier for him to be sick and harder to get well, such as: (a) Age, sex, heredity, physical defects (defective vision, de- cayed teeth, sore gums, obstructed breathing, sore ears, defective heart, defective arteries and veins, chronic indigestion, bad posture, hernia, obesity, chronic irritations and inflammations. 14 the aftereffects of acute disease, traumatic injuries, etc.). func- tional excesses (e. g.. Avorry. obsessions, excitement, etc., hard neuro-muscular labor, strain), dissipation (alcohol, drug, and other devitalizing habits), exposure, (h) Deficiencies and de- privations that contribute to poor health (e.g.. inadequate nour- ishment from any cause — poor food, poor cooking, bad habits of eating, etc. — incomplete dietary, insufficient water, poor ventila- tion, inadequate work, poor recreation, insufficient play, unsatis- fying rest, and unhapiDiness) . IV. DEFENSES OF HEALTH. 1. The nature and the importance of our natural environmental de- fenses, such as sun, light, heat, good air, unfavorable conditions for pathogens and their insect carriers. 2. Agencies that may be used to destroy pathogens and their insect carriers; removal and destruction of breeding and feeding places ; antiseptics ; home and community sanitation ; emergency and first-aid measures. 3. Other " safetj^-first " measures in relation to mechanical, physical, and chemical agencies that injure health and destroy life. 4. The nature and the importance of the surface defenses of the indi- vidual : the skin, the mucous membranes, surface secretions, the cilia and their action, etc. 5. The nature and the importance of the internal human defenses in health and disease : phagocytes, lysins, antitoxins, etc. : the main facts of protective inflammatory reaction. 6. Individual defensive hygiene. General health defense of the in- dividual: importance to the individual of wise health habits — good health is its own greatest defense. Emphasize impor- tance of wise habits of (a) health information, (b) health ex- amination and early and rational treatment of acute and chronic disorders, (c) bodily care and repair, {d) health protection, and (e) daily habits of Pt,dequate nourishment, effective excre- tion, vigorous work, sufficient interesting exercise, play and recreation, happiness and adequate rest. 7. Group and intergroup defensive hj'giene : (a) Defensive importance of high standards of intergroup, group, and individual hygiene. Good individual health is not easih^ possible in the presence of low standards of group or intergroup hygiene. On the other hand, good group or intergroup hygiene is not possible in the ab- sence of good standards of individual hygiene. {7j) Definition of groui:) and intergroup hygiene: Group hy- giene has to do with the application of the laws of gen- 15 (Troup and interfrroiip defensive hygiene — Continued. eral hygiene for the health defense of groups of indi- viduals, as in the home, the school, the occupations, and in certain institutions. Intergroup hygiene has to do with the application of the laws of general hygiene for the health defense of associated groups of individuals, as in the rural community, the village, the city, the county, the State, the. Xation, or in agreements between nations, (c) Summary of some of the more important group and inter- group activities involved in defensive hygiene : (1) The construction of buildings, their location, rela- tion to each other, material, structure, ventila- tion, heating, illumination, cleaning, plumbing, sewage, fire defense and protection, equipment and furniture, safety-first devices, freedom from nuisances, and so on. (2) The making, supervision, and use of streets, parks, recreation places, playgrounds, public baths, and so on. (3) Community water supply. Adequacy and safetj^ for human consumption, fire protection, sewage disposal, etc. (4) Community illumination. Street lights, no dark alleys. (5) Communitj^ sewage. (6) Regulation of noise, smoke, fumes, odors, and other nuisances. (7) Street cleaning and garbage removal, street sprinkling, removal of snow. (8) Establishment and maintenance of hospitals, clinics, institutions for the sick, crippled, poor, and homeless. (9) Provisions for education in hygiene in rural, vil- lage, and city schools. Health examination of school children, physical training, and athletics. (10) The city, county, and State department of health and other agencies of the State or its various subdivisions that are concerned with the defense of health. (Police protection, law enforcement agencies.) (11) The United States Public Health Service, the United States Interdepartmental Social Hygiene Board, and the other Federal agencies active in the assistance of the States in the health defense of their citizens. 16 7. Group and intergroiip defensive hygiene— Continued. (c) Summary of some of the more important g-roup and inter- group activities involved in defensive hygiene — Contil. (12) The medical departments of the Army and of th3 Xavy. (13) Voluntary organizations concerned with defensivt hygiene : the American Public Health Associa- ' tion ; the American Social Hygiene Association ; the Society for the Study and Prevention of Tuberculosis: the Red Cross: the International Board of Health, etc. (11) Colleges, universities, medical schools, and other institutions with scientific laboratories con- cerned in the discovery of better methods of defensive hygiene. (15) Special campaigns against: malaria, typhoid, tuberculosis, hookworm, gonorrhea, syphilis, pellagra, bubonic plague, cholera, yellow fever, industrial accidents, street accidents, and so on. (16) Special organization and preparation for the after care of great disasters — fires, floods, famine, etc. V. THE PRODUCERS OF HEALTH (Constructive Hygiene). 1. Sources and importance of reliable health information. 2. Heredity ; importance of the conservation of good heredity. 3. Health examination and advice. 4. Care of the body and repair of its organs. 5. Special emphasis upon and discussion of the health-producing and health-conserving values of wise habits of (a) nourishment, (h) excretion, (c) play, recreation, exercise, and work, and (d) rest. 6. The value of hj^giene : Good, active, aggressive health"is the most important asset in the life of man, because the best success of whatever man undertakes is dependent upon the quality of • health with which he supports his enterprises. (a) Social values of such products of good hygiene as: Re- duced morbidity : prolongation of life ; increased phj^si- ological efficiency; better general education (suscepti- bility, receptivity) ; termination of poor heredities and improvement of others ; greater happiness, contentment, and sociability. (h) Economic values of the above products of good hygiene. (c) Spiritual values of the same. 17 6. The value of hygiene — Continued. (d) Civic and military values of man power and woman power. Lessons of the Great War; England; France; the draft; protection against destructive diseases; venereal disease campaigns, etc. (e) Health a personal obligation and a patriotic duty. Division 2.— SYLLABUS ON INDIVIDUAL HYGIENE. I. INFORMATIONAL AND EDUCATIONAL HYGIENE. 1. Sources of information, literature — books, pamphlets, journals, reprints, etc. 2. Surveys and investigations. 3. Parental instruction, health advisers, teachers. 4. Individual health examinations and advice. Importance of pe- riodic examinations of posture, skin, eyes, ears, nose, teeth, throat, lungs, heart, arteries, blood, veins, abdomen, genital organs, urine, nervous reactions, joints, and signs or symptoms of abnormality. Importance of different age periods — infancy, childhood, adolescence, youth, maturity, and old age. 5. Health warnings, signs, and symptoms — their safe interpretations, significance, and use — e. g., pain, aches, cough, loss in weight, weakness, surface irritations, abnormal growth, shortness of breath, mouth breathing, nasal speech, mental backwardness, etc. 6. Obsessions, groundless fears, misinterpretations of unusual or un- important sensations and functional experiences. T. Unsafe tradition, superstition, misinformation; special applica- tions to heredity, mental status, and sex life. IL DEFENSIVE HYGIENE— THE CARE OF THE BODY AND ITS ORGANS. 1. The elements of human physiology. — Cover the more important elements of anatomy and physiology and protective hygiene in- volved in the care of the skin, muscles, the skeleton (bones and joints), the hair and the nails, the ears, eyes, nose, throat, teeth, lungs, heart, arteries, veins, blood and circulation, digestive or- gans, excretory organs, ductless glands (internal secretions), reproductive organs, heat - regulating organs, nerve centers, nerves, and emotions. 2. Protective individual hygiene. — Covered above in part. (See II (I)-) («) Importance of periodic health examinations. Emphasize the protective and preventive use of information secured through such examinations. (See I (4), above.) 2058—20 2 18 2. Protective individual hygiene — Continued. (&) Measures and habits for protection against pathogeons and their insect carriers, animal carriers, human carriers, and secondary carriers, such as infected water, infected milk, and other infected food, etc. (c) Care of certain organs for the protection of other organs: The teeth, in order to protect the joints, the heart, the ' nerves ; the nose and throat, in order to protect the ears ; the reproductive organs, in order to protect the brain, the mind, nerves, joints, etc. {d) " Safety-first " habits. Physical development and mus- cular endurance and control for protection from certain mechanical and physical injuries, as in swimming, row- ing, the safe use of a rope fire escape, certain emergen- cies in military service, boxing, wrestling, and so on. (^) Protective habits in relation to chemical injuries. Safety from lead poisoning, illuminating gas, careless use of antiseptics and powerful drags, and so on. (/) Protection of mentality. Protective mental hygiene, con- servation of heredity, avoidance of venereal diseases and alcoholic poisoning. Hygiene of the emotions. 3. Preventive individual hygiene. (a) Possibility of increasing the active and passive immunity resources of the individual through constructive hy- giene, e. g., through appropriate nourishment, adequate excretion, sufficient play, recreation, entertainment, and work, and satisfying rest. (5) Vaccination and inoculation for the pre^^^ention of cer- tain infections. Possible value of venereal prophylaxis and its moral dangers. (c) Antiseptic and aseptic treatment of minor wounds. 4. Remedial individual hygiene. (a) First aid and emergency treatment. (1) Accidents, mechanical, physical, and chemical. (2) Infections. (3) Pain. (4) Unconsciousness. (h) Importance of early expert, reliable medical or surgical service in cases of important acute health injuries. (1) Diphtheria properly treated within the first few hours of the infection practically always re- sults in early recovery. (2) Rabies, syphilis, gonorrhea, a common cold, ton- sillitis, appendicitis, hernia, the partially drowned, etc. 19. 4. lU'inedial individual hygiene — Continued. {c) Importance of early treatment of precancerous and can- cerous conditions. III. CONSTRUCTIVE INDIVIDUAL HYGIENE. ( 'over in practical detail : 1 . Nourishment ; food and food constituents ; water ; habits of eat- ing (importance of cheerfulness at meals, pleasant surround- ings, appetizing food, slow eating, etc.). 2 Fresh air and sunshine. -3. The hygiene of growth, development, and training. Cover play, recreation and entertaimnent, exercise, athletics, and work, and their importance and limitations in the different age periods. 4. Rest, relative and absolute. IV. INDIVIDUAL HYGIENE IN RELATION TO GROUP AND INTER- GROUP HYGIENE. A basis for productive service. An obligation of the individual for the benefit and protection of society. High standards of group and intergroup hygiene are impossible in the presence of low stand- ards of individual hygiene. One individual may destroy the defenses of a home or community. Division 3.— SYLLABUS ON GROUP HYGIENE. General Consideration of Group Hygiene. L DEFINITION AND SCOPE OF GROUP HYGIENE. This subject is concerned with the relations and applications of the laws of general hygiene to groups of individuals, the members of a group being associated more or less intimately with each other for considerable periods of time under common environmental in- fiuences, common hygienic advantages and disadvantages, and under common health regulations. IL MAIN GROUPS TO BE DISCUSSED. The social and economic variations and the dominating hygienic considerations that characterize — 1. TJie liome e/roup, e. ,f^., the home without children; the home of the large family ; the farm ; the rural home ; the city home ; the home in the apartment house; the home in the hotel. 20 2. The school group^ e. g., the kindergarten; the elementary school; the secondary school ; the college or university ; the i^rof essional school; the small school; the large school; the ungraded school; the graded school; the segregated school; the coeducational school ; the rural school ; the village school ; the city school ; the trade school; the night school; the continuation school. 3. Th^emjjloyed group ^ e. g., the brain workers; the muscle workers; sedentary occupations, active occupations, mining, agriculture, manufacturing, transportation, buying and selling; construction; the small emploj^ed group ; the large employed group ; the float- ing employee; the hazardous occupations; the seasonal occu- pations. 4. The institutional group: (a) Institutions for the care of the acutely sick, e. g., the hospital. (h) Institutions for the care of the chronically sick, the inva- lid, the cripple, the blind, the insane. (c) Institutions for the commitment and restraint of offenders against law and order, the jail, the prison, the reform school, the reformatory. {(I) Institutions for the care of the poor and homeless. III. THE ECONOMIC BASIS OF GROUP HYGIENE. 1. Good hygiene costs mone3^ Health advantages are expensive. The price of good health is more than the individual can pay. 2. The group represents the combined intelligence and resource of its membership and can afford to purchase hygienic advantages that are not within the reach of the individual. B. Tradition has taught the importance of utilizing the wisdom and intelligence of the most competent members of the group for its protection against the A^arious enemies of the group, the agents that injure health being a very important inclusion. 4. Good hygiene produces health and prosperity through greater efficiency, longer life, lessened loss of "working time, reduced expense for sickness, etc. IV. THE SOCIAL BASIS OF GROUP HYGIENE. 1. Responsibilities of the individual to himself and to the group. 2,. Responsibilit}^ of the chief member or chief members of the group to dominate and direct the policy of the whole group in the interest of the better health of the group. "3. Relation of health to poverty, illiteracy, retardation, delinquency, degeneracy, and crime, and to comfort, contentment, prosperity, and happiness. 21 V. THE MAIN SUBDIVISIONS OF GROUP HYGIENE. 1. Educational hygiene. — Concerned with the education of tlie indi- vidual that would lead him, to maintain voluntaril}^ and intelli- gently a high standard of individual hygiene and to do his part in maintaining a high standard of group and intergroup hy- giene. 2. Informational hygiene. — Information derived from scientific in- vestigations, surveys, statistics, individual health examinations, and so on. 3. Protective hygiene. — The applications of the laws of general hy- giene for the protection of the individual or for the protection of groups of individuals. 4. Preventive hygiene. — Includes active, defensive measures or more vigorous procedures for the conservation of health. 5. Remedial hygiene. — Includes the handling of emergencies, first aid, medical and surgical treatment of acute and chronic dis- eases, and the correction and repair of physical defects. 6. Aggressive hygiene. — Includes programs for the eradication of disease carriers or for the removal of other agencies that injure health. 7. Constructive hygiene. — Has to do with those hygienic procedures that stimulate growth and development and that maintain the organic life of the individual. Constructive hygiene includes, therefore, (1) nourishment; (2) excretion; (3) work, play, recreation, entertainment, athletics: (4) rest, relative and abso- lute. VI. CONSIDERATION OF THE SUBDIVISIONS OF GROUP HYGIENE IN RELATION TO THE MAIN GROUPS COVERED IN II ABOVE. (A) GROUP EDUCATIONAL HYGIENE. 1. Home educational hygiene. (a) Responsibilities and obligations of the parent or guardian. (6) Importance of the opportunities presented in the different age periods of children for lasting, effective, dominating education in hygiene. (c) Educational emphases to be especially stressed in infancy, childhood, and youth. (d) The parent or guardian as a teacher of hygiene. (e) The infant, child, or youth is the pupil. (/) Method of instruction. Its variation in infancy, child- hood, and youth. It varies also with different children and with the sexes. (g) Content of home educational hygiene in the different age periods. 22 1. Home educational hygiene — Continued. {K) Hygienic importance of sex education. Necessity for a high type of character education. (i) Dominating influence of the economic, social, and educa- tional status of the home. 2, Educational hygiene in the school. Qi) Responsibilities of school trustees, superintendents, prin- cipals, and teachers. (h) Responsibilities of parents and guardians. (c) Importance of the opportunities presented in the different age periods of children in school in correlation with the educational hygiene of the home and for correcting and adding to that education. The influences of school edu- cational, hygiene are second only to that of the home. Important that both home and school should maintain high standards of educational hygiene. (d) Special educational emphases appropriate and important in the different grades of the elementary and secondary school ; with different mentality ; and in older children ; and with the two sexes. (e) Every teacher a teacher of hygiene. The special teacher of hygiene. Physical training teacher. The athletic coach with older pupils. The classroom teacher has an opportunity second only to that of the mother to teach enduring habits of hygiene. Importance of training all teachers to meet their opportunities and obligations in educational hygiene. Perils of health instruction by untrained or poorly prepared teachers. (/) Every school child a pupil in hygiene. Every class and every recitation should bring its appropriate influence to bear upon right living. This emphasis must neces- sarily vary to a considerable degree in different classes. (g) Method of instruction varies with the grades, with the age of the pupil, with sex, with the subject, and with the school activity to which the instruction in hygiene is attached. Class instruction, group instruction, and individual conference. Importance of a confidential, personal, voluntary, and very tactful relationship in conferences on health with older children. (A) Content of educational hygiene for the different grades of the elementary and of the secondary school and for the sexes with the older children. Place of sex educa- tion in the elementary and secondary school, its serious importance, and its great dangers from wrong emphases by incompetent teachers. Educational hygiene in the school — Continued. (/) Bearing of home education (or lack of it), preparation of teachers and of curricukim content upon the effec- tiveness of educational Iwgiene in the school. Educational hygiene in the occupations. (a) Responsibilities and obligations of the employer to pro- vide within reasonable limitations instruction in educa- tional hygiene that will safeguard his employees. (b) Responsibilities of emplo^^ees. (c) Importance of educational hygiene in the occupations. Seventy per cent of the children that enter elementary schools fail to graduate. Onlj^ 30 per cent of them enter the high school. Over 700,000 of our young men of military age were found illiterate in our Arnw dur- ing the Great War. (d) Educational emphases in the occupations. (1) General instruction relative to common agents that injure health and to common health defenses, as in tuberculosis, typhoid, gonorrhea, syphilis, hookworm, pneumonia, and heart disease. (2) Special instruction concerning the health hazards that are peculiar to the occupation of the worker. (e) The teacher of hygiene in the occupations. (1) Older employees — influence sometimes good; often bad. (2) Special teachers employed for the purpose in larger establishments. (3) Agents from the department of health. (4) Lecturers from university extension courses and from various associations and organizations con- cerned with the acquisition and conservation of health. (/) All emploj^ees should be pupils, but in order to accomplish this result instruction must be worth while. (g) Method of instruction: Lecture, demonstration, lantern slide, film, exhibit, conference, and literature. (h) Content of educational hygiene in the occupations. Should vary with the type of worker to be reached and with the type of occupation to which the worker is re- lated. Should cover the laws of general hygiene that bear upon the daily life of the worker and should in- clude the special health hazards to which he is exposed. 24 Educational hygiene in the institutions. (a) Eesponsibilities and obligations of the board of trustees or directors governing the institution, of the superin- tendent or other official in charge, and all other em- ployees. (6) Eesponsibilities of inmates. (the Commission on Train- ing Camp Activities and later the field service of the Interdepartmental Social Hygiene Board contacted over 30,000 delinquent women and girls in the neigh- borhood of military and naval camps during the period in which the United States participated in the Great War. The restoration of many of these delinquents to health and usefulness is impossible without institu- tional care. (d) Educational emphases in the institutions must vary with the age, previous education and training, mental capac- ity, and disposition of the inmate. It is often a part of the special effort of the institution to prepare the inmate for return to normal life. It would seem logical to expect that provision be made in the various institu- tions safeguarding the health of the inmates while under the care of the institution and preparing them for their health obligations after leaving the institution. (e) The teacher of hygiene in the institution. Every member of the instructing staff in those institutions in which teachers are employed should be qualified to teach the elements of hygiene and should be expected to make such instruction a part of his regular teaching activity in the institution. In those institutions in which teach- ers are not employed provision should be made whereby qualified agents from the city, county, or State depart- ment of health or from university extension courses or societies and associations interested in public health may be secured for the instruction of inmates in hygiene. (/) All inmates should be " pupils." Within the limitations of institutional resource they should be classified in groups according to age, sex, mental condition, and edu- cational needs. 25 4. Educational hygiene in the institutions — Continued. {g) The method of instruction must necessarily vary enor- mously in these different types of institution. The prob- lems of education in hygiene in connection with the in- mates of the several types of institutions under con- sideration are ordinarily ver}^ much more difficult than in the case of the normal child or citizen. {h) The content of Educational Hygiene in the institution must vary with the age, previous education, mentality, and special needs of the imnate. In general, it would seem logical to expect that w^ithin reasonable limitations institutions should see that their inmates are instructed concerning the general laws of hygiene and their com- mon applications to the lives of their inmates. Special health needs and special health defects or deficiencies should receive appropriate educational consideration, (B) GROUP INFORMATIONAL HYGIENE. 1, Infor^national hygiene for' the home. (a) The sort of information needed by the parent or guardian for his own use and for his guidance in his relationship wdth the educational hygiene of the home. Information concerning the hygiene of heredity, prenatal hygiene, the hygiene of childbirth, the hygiene of infancy, child- hood and adolescence, sex hygiene, and the preventive hygiene of venereal diseases. The parent should also have access to information concerning the laws of gen- eral hygiene, individual hygiene, group hygiene, and intergroup hygiene. (b) Informational hygiene for the children in the home. This information should be appropriate to the different age periods, the sex of the child, its previous education and information, and its general or special health needs. (c) The sources of informational hygiene. Stories, books, magazines, talks. The information imparted by the parent or guardian is the most important information that the growing child will receive. This is particularly true with reference to information given the child in response to its questions concerning the origin of life and problems of sex. The informational service of the parent in this connection may be very good or it may be and often is very bad. The boy or girl on the street, the immoral woman or the man of loose character is too frequently the source of uncorrected information or misinformation concerning hygiene received by the 1. Informational hygiene for the home — Continued. child. Home education and home influences must neu- tralize impressions made by vicious associates, sugges- tive billboard advertisements, immoral moving picture and theatrical productions, and common presentation oi sex problems in modern literature. 2. InfoYmational hygiene for the school. {a) Informational needs of the teacher, principal, and super- intendent. Unfortunately a very large proportion of teachers of children are immature, poorly educated, poorly prepared, inexperienced, and underpaid. (5) Informational needs of the children, particularly the older children. The sort of information needed in the school varies with the age of the school child and with his pre- vious information concerning hygiene. It is evident that the older child can make use of a more serious t^^^pe of information than the younger child. {c) The sources of informational hj^giene for the school. In- formation concerning matters relating to general hy- giene is secured through books, special magazines, health publications, special lectures, charts, diagrams, pictures, lantern slides, reels, demonstrations, reports on surveys, and investigations. The health examina- tions of teachers, employees, and children inform. school officials and parents and, if necessary, the children themselves concerning their individual health needs. 3. Informational hygiene for the occufations. (a) The employer should have ready access to recent infor- mation concerning occupational hygiene as well as in- formation concerning important advances in general hygiene. In those occupations in which the policy of the organization is dominated by a board of directors it would be productive of a better type of occupational hygiene if information of this type could be brought to the attention of the board. (h) Informational needs of employees. (c) Sources of information. Literature, lectures, moving- picture films, conferences, demonstrations. 4. Informational hygiene for the histitution. (a) Informational needs of the directors or commissioners in charge of the institution and of the superintendent and other officials. (Ij) Informational needs of inmates. Varies from the type of inmate that can not receive information to the nor- mal child in the orphan's home. 27 4. Inforinational hygiene for the hisfyitufion — Continued. (c) Sources of information. The officers. The teaching staff where one is employed. Informing agents from the city, county, or State department of health ; from uni- versity extension courses; from societies, associations, and organizations concerned in informational health publicity. Books, circulars, magazines, reports, lan- tern slides, moving-pictures, charts, demonstrations. (C) CONSTRUCTIVE HYGIENE FOR THE GROUP. 1. Constructive hygiene for the home group. (a) Responsibility of the parent or guardian to make every reasonable provision for the establishment in the chil- dren of the family of good habits of nourishment, excretion, play, recreation, exercise, work and rest. Involves an obligation on the part of the parent or guar- dian to supply adequate opportunity for the develop- ment of these habits. Provisions for the practice of good habits of constructive hygiene in the home are essential to the acquisition and conservation of health, not only for the children of the home but also for the adult members of the family. 2. Constructive hygiene for the school. (a) Importance of provisions for and importance of the prac- tice of wise habits of constructive hygiene by the teachers, other officials, and pupils in the school. (6) Lunch periods, school lunches, special attention to chil- dren showing evidences of malnutrition. (c) Adequate toilet facilities and reasonable encouragement of adequate excretion. (d) Equipment, schedule provision, teaching provision, incen- tive and stimulation for games, play, organized recrea- tion, organized, directed, and supervised athletics. (e) Relaxation periods. Limitations of home work. Limita- tion of number of recitation hours per week. Rational management of examinations. Open-air schools; mal- nutrition classes, vacation schools, school camps. 3. Constructive hygiene in the occupations. (a) The lunch period. Some large establishments have found it profitable to supplj^ restaurant facilities for their employees at cost prices. Adequate nourishment and low wages are not a possible combination unless the worker has income from some other source. (5) Importance, of supplying adequate toilet facilities and reasonable opportunity for their use. 28 3. Constructive hydiene in the occupations — Continued. (f) Optimum rate of work and quantity of output. " efficiency.'' fatigue, laziness, and shirking. Value of relief and rest periods of intermission. (f/) Provisions for and encouragement of recreation and ath- letics. Entertainment: encouragement of social life "* among employees. 4. C onstructive hygiene in the institution. — The responsibilities and obligations of the commission or board in charge of the institu- tion and of the superintendent or other chief officer of the insti- tution for adequate provisions for and encouragement of good habits of nourishment, excretion, work, play, recreation, and, where consistent, athletics and rest for the inmates of such institutions. (D) PROTECTIVE HYGIENE IN CERTAIN GROUPS. 1. Protective hygiene in the home. — The obligations of the parent or guardian make them responsible for a defensive policy toward the whole range of agencies that injure health and carry dis- ease. Importance of the protection of heredity, prenatal pro- tection, protection of the child and mother at time of childbirth, protection during infancy, childhood, and youth. Protection against human carriers, animal carriers, insect carriers, infected food and infected water, and protection against vicious moral influences. 2. Protective hygiene in the school. — The responsibilities of the trustees, teachers, and janitors in the school. Under obligation to provide protection for the different ages, sexes, and physical limitations under their care and supervision for a number of hours each day. This protection must be developed with refer- ence to all the agencies that are commonly the source of injury to the health of school children and all the carriers that may bring injury to the health of school children. The responsi- bilities of the children, especially older ones in connection Avith protective hygiene. Responsibility of parents. 3. Protective hygiene in the occuyations. — Responsibilities of em- ployers, directors, and employees vary with different types of occupation and with different types of employees. Special pro- tective measures involved in the hazardous employments. The employer is under obligation to protect the employee during periods of work, within reasonable limitations, from the com- mon agents that injure health and from the common carriers of disease. He is under a peculiar obligation to protect his em- 29 8. Protective hygiene in the or-e^/y^r^/ycz/s— Continued. ploj'ees from the health injury due to the special employment in which he is engaged. The employee is under obligation to take reasonable measures to protect his own health. He can not expect to be continued in employment if he needlessly exposes himself to disease or loses his health because of his own care- lessness. 4. Protective hygiene in the institution. — Responsibilities of commis- sioners, directors, superintendent, or other chief officials. Special protections vary with different types of institution. Authorities are under obligations to protect their charges against the com- mon agents that injure health and against the common carriers of disease. It is their special responsibility to provide protec- tion against health injuries that are peculiar to the institution or group under their charge. The responsibility of inmates must vary from those of the foundling asylum or hospital for the insane to the home for the crippled. (E) PREVENTIVE HYGIENE IN CERTAIN GROUPS. 1. Preventive hygiene in the home. — Importance of destroying agents that injure health. Removing the sources from Avhich they come and eliminating their carriers. Problems of isolation, quarantine, sterilization, destruction of insects and their breed- ing and feeding places, care of animals, provisions of clean social life and healthy social contacts for the children and adults in the home. The importance of vaccination and inocu- lation against certain diseases. 2. Preventive hygiene in the school. — Regular health examinations of teachers, janitors, and children at intervals of a year — ^bet- ter at intervals of a half year. Rational treatment of carriers. Regulations concerning vaccinations and inoculations. De- struction of the breeding places and feeding places of insects. Installation of '* safety-first " devices. Importance of physical and health eligibility requirements for admission to athletics and for continuation of athletic training. 3. Preventive hygiene in the occupations. — Periodic health examina- tions of officers and employees for carriers and effective treat- ment of carriers when such are discovered. " Safety-first " devices. 4. Preventive hygiene in the institution. — Periodic health examina- tions of officers, employees, and inmates, with proper isolation and effective care of carriers. Vaccination. Inoculation. Early treatment. 30 (F) REMEDIAL HYGIENE. 1. Remedial hygiene in the home. — Necessarily involves a relation- ship with hygienic advisers outside the home. Importance of adult intelligence and common sense with reference to the limi- tations of home treatment and the selection of safe hygienic adyisers (physicians, nurses, etc.). Home judgment (diagno- sis), home treatment, and home nursing should all be made as effective and dependable as is pra .tie ally possible. Many homes can not use outside advice. It is too far aAvay. or there may be none available, or it ma}^ be too expensive. 2. Remedial hygiene in the school. — Responsibilities of the teacher to be continually upon the alert for the detection of symptoms of abnormal health. Should be a subconscious sensitiveness on the l^art of the teacher and not necessarilj^ a routine examination. Responsibilities of the principal or superintendent. Responsi- bilities of the medical examiner and the nurse. The importance of the " Follow up " after the medical inspection of school chil- dren for the purpose of discovering what has been done for the cases that are found in need of remedial treatment. Problems of remedial hygiene in the elementary school and in the sec- ondary school. 3. Remedial hygiene^ in the occupations. — Importance varies with different occupations. First-aid and emergency measures. Availability of hospital service, medical and surgical help. Some large-sized establishments provide their own hospital fa- cilities, clinic, medical service, and nurses for the effective remedial hj^giene for their employees. 4. Remedial hygiene in institutions. — Importance of remedial hy- giene varies in different types of institutions. Necessity for first-aid and emergency measures and for available hospital and clinical service (physicians and nurses). Importance of early treatment. (G) HYGIENIC MEASURES FOR RECUPERATION, REHABILITATION, AND RESTORATION IN THESE GROUPS. PROPERLY^ A PART OF CONSTRUCTIVE- HYGIENE. 1. Provisions for recuperation., etc., in the home. — In the case of the average child in the home these procedures are matters of ordi- nary constructive and protective hygiene. Special provisions may be necessary in case of special health injuries. Such pro- visions should be developed with the advice of a reliable hygienic expert — a dependable physician — as in recover}^ from infantile paralysis, gonorrhea, typhoid fever, syphilis, pneumonia, tuber- culosis, or influenza. , Provision for recuperation, etc., in the school. — No place in the ordinary school for pupils that require special hygienic meas- ures for recuperation, rehabilitation, or restoration. Special classes, as after an epidemic of influenza or infantile paralysis. Organized more for pupils that are behind because of poor health than for the purpose of giving them special hygienic instruction. Open-air classes, malnutrition classes, vacation classes, school camps, etc. Provisions for recuperation, etc., in the occupations.^^usinQss demands make it unprofitable for the employer to provide em- ployment for workers who are handicapped through the effects of acute or chronic health injury. It is, however, not uncommon for business concerns to make provision for those of their em- ployees that sustain health injury because of their work with the concern. Employers' liability and workmen's compensation acts (provisions of intergroup hygiene) have become the law in 45 States. These provisions can not be said to apply directly to the recuperation, rehabilitation, and restoration of the injured worker. They do provide, however, more or less inadequately the means whereby the worker may help himself. Provisions for recuperation and rehaUlitation, in the i)istitutio72. — (a) Necessity for such provisions and the nature of such pro- visions must vary in the different types of institutions. (h) Responsibilities of institutional authorities. In institu- tions in which humans are committed for long terms there is a clear responsibility on the part of the institu- tion to do everything that reasonably can be done for the acquisition and conservation of the health of its inmates. Such obligation from the point of vieAv of the com- munity (intergroup hygiene) includes provision for the restoration of the inmate to self-sustaining, protective, orderly health citizenship. (c) The convalescent cripj^le must have something more from the institution than the scars of healed wounds or than •artificial limbs. His future health welfare depends on his restoration to economic usefulness. He must be taught how to do something which will feed him and clothe him and give him at least the minimum require- ments for bodily nourishment, bodily comfort, and self- respect. (d) The delinquent woman must not only be cured of her venereal disease ; she must learn how to support herself in an honorable way or remain in the reformatory or its equivalent under mild restraint in order that she may not infect others. 32 SPECIAL GROUP HYGIENE. The more important groups that may call for special consideration are : (1) The family. (Domestic hygiene, home hygiene, or family hygiene. ) (2) The school. (School hygiene.) ^3) The college and university. (4) The occupations. (Industrial hygiene, occupational hy- giene.) (5) The institution. (Institutional hygiene, hospital hygiene, hygiene of the reformatory, the jail, etc.) These subjects in special group hygiene may be systematically studied and presented if they are developed with reference to their — (1) Educational hygiene. (2) Informational hygiene. (a) Eesearch, investigation, examination, etc. (&) Distribution of information. (3) Defensive hygiene. Directed against the agents that in- jure health, the carriers of pathogens, and the contribu- tory causes of poor health. Involves a consideration of— (a) Protective measures. (b) Preventive measures. (c) Remedial measures. (d) Aggressive measures. ("i) Constructive hygiene. (a) The hygiene of nutrition (and excretion). (h) The hygiene of play, recreation, exercise, and v^^ork. (c) The hygiene of rest. The professor or special teacher of hygiene v^ill develop his own svUabus and class presentation for such subjects in special group hy- giene as maj^ be included in his curriculum courses. Division 4.— SYLLABUS ON INTERGROUP HYGIENE. GENERAL CONSIDERATION OF INTERGROUP HYGIENE. 1. Definition. — Intergroup hygiene is concerned with the applications of the natural laws of hygiene to associated groups of humans, the several groups being dominated by common interests, ex- posed to common health dangers, and competent to establish and enforce legislation and regulations for the defense of their common health. These group relations are found in such en- tities as the rural community, the town, the village, the city, a combination of towms or villages or cities, the country, the - State, a union of States, the Nation, and alliance of nations, Intergroup hygiene then comprehends such considerations as 33 1. Definition — Continued. " rural hygiene," " community hygiene," " municipal hygiene," II county hygiene," " State hygiene," " Federal hygiene," and "international hygiene." Obviously the establishment and support of standards of intergroup hygiene are largely govern- mental functions. The several divisions of intergroup liygiene are usually carried, if they are carried at all, by various de- partments of village, town, city, county. State, or National Government. The health regulations adopted, the health laws enacted, and the appropriations made in the interests of com- munity health represent the hygienic education and judgment of the lawmakers and their advisers in a given community. Standards of intergroup hygiene can not, therefore, be high if the standards of the groups involved are not high. Just as the hygiene of the group is dependent u|>on the hygiene of the individuals that form the group, so the standards of hygiene maintained by groups in association with each other are de- pendent upon the standards of each group involved. It is evident that the individual is a compelling factor in the solu- tion of the problems of group and intergroup hygiene. His education in hygiene, his information concerning the laws of hygiene, and his habits of hygiene have a dominating influence upon the standards of the hygiene of the group and of the association of groups of which he is an individual member. It is impossible, therefore, to disassociate individual hygiene, group hygiene, and intergroup hygiene. The education and training of the individual is the fundamental problem and ob- ligation of group and intergroup hygiene, for upon the indi- vidual rests all progress and all improvement in the standards of the group, and of society, which is made up of association of groups. But neither the individual nor the group has ordi- narily the authority, power, or resource with which to secure the educational and informational hygiene, or with which to provide the applications of hygiene, or through which to secure the regulation of individual or group conduct necessary for the establishment and maintenance of high standards of intergroup hygiene. The importance of this fact becomes im- pressively significant in the presence of a great disaster which brings death, incapacity, destruction of property, pov- erty, famine, and pestilence. Power and material resource come with organized government. The village, city. State, and Nation furnish the collective authority, the higher civic intelli- gence, and the larger financial resource necessary for the ade- quate health protection and for the progressive health im- provement of the family and the individual. 2058—20 3 34 2. The economic hasis of intergroup hygiene. (a) The economic values of reduced morbidity, lowered mor- tality, and greater physiological efficiency; relation of physiological efficiency to the success of whatever enter- prise man undertakes mentally, morally, or physically. (&) Economic importance to the individual and to the group. ■(c) Economic importance to the community, the city, the State, the Nation (i. e., to the association of groups). (d) Inability of the individual or of the group to furnish the necessary resource to secure hygienic advantages and defenses important to the health welfare of the indi- vidual and of the group. 3. 2'he social hasis of iniergroup hygiene. (a) Social values of health — comfort, contentment, happiness, greater earning capacity. (b) Social values to the individual. (c) Social values to the group. (d) Intergroup social values — bearing of high standards of intergroup hygiene upon poverty, illiteracy, retarda- tion, delinquency, crime, moral degeneracy, mental de- generacy, physical deterioration, and heredity. 4. Legislative basis of intergroup hygiene. (a) The health defensive agencies of intergroup hygiene are directly or indirectly the products of legislation, e. g., the county, the city, or the State department of health, the department of educational hygiene, the city hospital, reformatory, etc. (b) Importance of law enforcement. Police service, protec- tion of water" supply, supi^ression of prostitution, en- forcement of quarantine. 5. Discussion of the main subdivisions of intergroup hygiene. {a) Intergroup educational hygiene. Obligations of the com- munity, State, or Nation to provide education in hygiene for the individual groups that are without sufficient resource and authority to provide such education them- selves. Educational hygiene is an important function of the department of health, the school, the college, the university, and the State and national department of education or its equivalent. {b) Intergroup informational hygiene. It is only through intergroup action that important surveys, inspections, examinations, investigations, researches, and records can be made from which will be secured accurate in- formation relating to the problems of intergroup hy- giene. It is also true that it is only through intergroup 35 5. Discussion of the main subdivisions of intergroup hygiene. — Con. (5) Intergroiip informational h^^giene — Continued. agencies that this information can be effectively dis- tribut,ed to the individuals and groups that are con- cerned. The acquisition and distribution of informa- tional hygiene are functions of the department of health ; scientific laboratories ; the research divisions of colleges and universities, schools, societies, and organi- zations of experts. (c) Intergroup protective hygiene. An important function of the department of health, the school, the police, and the other law-enforcement agencies. (f/) Intergroup preventive hygiene. An important function of the department of health. {e) Intergroup remedial hygiene. An important function of the hospital, the clinic, and certain institutions con- cerned with the restoration and rehabilitation of health. (/) Intergroup aggressive hygiene. An important function of the department of health and of special law-enforce- ment agencies, boards, or commissions. Includes cam- paigns against malaria, venereal disease, typhoid, tuber- culosis, etc., organization and preparation for the relief of great disasters, such as fire, flood, tornadoes. {g) Intergroup constructive hygiene. One of the most im- portant functions of the school, the college, of the park, and of the playground. (7z) Intergroup reconstructive hygiene. An important func- tion of certain institutions concerned with the rehabili- tation and restoration of the inmate to some degree of useful productive citizenship. 6. Discussion of the more im^povtant agencies of intergroup hygiene. (This discussion should be developed for each agency con- sidered, using the following headings: Educational, informa- tional, defensive, protective, preventive, remedial, aggressive, and constructive hygiene. ) {a) Legislative bodies as agencies for intergroup hygiene. It is only through authoritative competent legislation that programs of intergroup hygiene may become effective operating realities, safeguarding the health interests of the individuals and groups of individuals concerned. Through such legislation laws are provided and appro- priations made — (1) For the reporting and control of communicable diseases. 36 6. Discussion of the more important agencies of intergroup hygiene — Continued. {a) Legislative bodies as agencies for intergroup hygiene — Continued. (2) For the hygiene and sanitation of public build- ings and streets. (3) For the establishing of city, county, and State re- "* c|uirements in educational hygiene. (4) P"or creating and empowering health officers, de- partments of health, and other law enforce- ment services. (.5) For providing for and regulating hospitals, clin- ics, reformatories, and other public institutions. (6) For providing adequate and clean water supply, building sewer systems; constructing parks, playgrounds, and public baths. (7) For regulating child labor, establishing a mini- mum wage, providing employers' liability and workmen's compensation policies, etc. (8) And for other purposes of intergroup hygiene. (&) Department of health. The source of promulgations on health, its acquisition, conservation, and defense for the entire community. The community or State agency for the investigation of health conditions, enforcement of health laws, the control of health emergencies, and so on. (1) Discussion of organization and functions of — a. Rural b-oard of health and the rural health officer. b. The Aillage. city, or municipal department of health. c. The State department of health. d. A national department of health. (c) Educational agencies; organization and intergroup hygiene functions of — (1) The schools, their curricula on hygiene, physical education, medical inspection, etc. (2) The college, the university, the research lul)ora- tory. (3) The training school for teachers. (4) The State department of education or its equiva- lent State educational l)ody. (5) A national department of education. 37 6. DiscusHlon of the more Importanf agencies of mtergvoup hygiene — Continued, (f/) Governmental agencies concerned with intergroup hygiene. Analyze concisel}^ the organization and relevant functions of the — (1) Medical service of the Army and other Army organizations. (2) Medical service of the Navy and other Nav}'^ or- ganizations. (3) United States Public Health Service. (4) United States Interdepartmental Social Hygiene- Board. (5) Bureau of Education, Department of the Interior. (6) Children's Bureau, Department of Labor. (7) Internal Revenue Service. (8) Bureau of Animal Industry. (9) Commission on training camp activities of the War Department and the Department of the Navy. (e) Voluntary organizations that serve as agencies for inter- group hygiene. Analyze concisely the organiza- tion and relevant functions of the following : (1) The Red Cross. (2) The American Social Hj^giene Association. (3) The Society for the Study and Prevention of Tuberculosis. (4) The State and Provincial Board of Health. (6) The International Board of Health. (6) The American Physical Education Association. (7) The Playground and Recreation Association of America. (8) The American Medical Association. (9) The National Education Association. (10) Universities, medical schools, scientific labora- tories. (11) Selected charity organizations and other special health organizations. (12) Life insurance companies. (13) The Church, Sunday School, and other religious organizations. (14) The Boy Scouts and the Girl Scouts. 38 SPECIAL INTERGROUP HYGIENE. The more important associations of groups that may be sele:?te(l for special study and presentation are : (1) Rural hygiene. (2) Village and city hygiene. (Municipal hygiene.) (3) State hygiene. (Hygiene of the Commonwealth.) (4) Federal or national hj^giene. Each of these subjects Taa.j be systematically studied and presented if it is developed with reference to its — (1) Educational hygiene. (2) Informational hygiene. (a) Research, investigation, examination, etc. (h) Distribution of information. (3) Defensive hygiene. Directed against the agents that in- jure health, the carriers of pathogens, and the con- tributory causes of poor health. Involves a considera- tion of intergroup — (a) Protective measures. (5) Preventive measures. (c) Remedial measures. (d) Aggressive measures. (4) Constructive hygiene. Intergroup measures and pro- visions for — (a) The hygiene of nutrition (and excretion). (h) The hygiene of play, recreation, exercise, and work. (c) The hj^giene of rest. The professor or special teacher of hygiene will develop his own sjdlabus and his own class program for such subjects in intergroup hygiene as may be included in his curriculum courses. REFERENCES ON GENERAL HYGIENE, INDIVIDUAL HYGIENE, GROUP HYGIENE, INTERGROUP HYGIENE. The references herein listed have been selected with considerable care by various agencies expertly qualified for the purpose. In many cases the books listed in the bibliography are recent editions. In a few instances it has seemed advisable to include books that were published several years ago. In such cases the teacher will have to weigh the value of the facts and the evidence contained. He must make his selections and pass his judgments with discriminating care. It is hoped that every teacher will thus develop his own syllabus and text and make them products of his own critical investigation and research. 39 GENERAL HYGIENE. Author. Title. Publisher. Abbott Bainbridge, FA . . Bainbridge, W. S Beham Bergey Billings Bishop Bowen Bundy Burbank Cabot Cannon Chandler Chapin Do Chittenden Conklin Crissey Curtis Davis Doty Do Do Dubois Dulles Edelmann Egbert Eisenberg Fantham Fishburg Fisher-Berry Fisher-Fisk Folin Goddard Do Goldmark Gulick Do Do Guyer Haldane Hall.... Hartmann-Bibb. . Hill Hough-Sedwick . . Howard Howe Hutchinson Do Jewett King Lee, R, I Lee, Joseph Lee, F. S Hygiene of Transmissible Diseases... Physiology of Muscular Exercise .... The Cancer Problem - Pain Principles of Hygiene Focal infection The Narcotic Drug Problem Applied Anatomy and Kinesiology . . Textbook of Anatomy and Physiology The Training of the Human Plant. . . Physical Diagnosis Bodily Changes in Pain, Hunger, Fear, and Rage. Animal Parasites How to Avoid Infection The Sources and Modes of Infection. . The Nutrition of Man Heredity and Environment The Story of Foods Education Through Play Consumption Good Health Prevention of Infectious Diseases The Mosquito Infiueiice of the Mind on the Body... Accidents and Emergencies Meat Hygiene Hygiene and Sanitation Principles of Bacteriology Animal Parasites of Man Pulmonary Tuberculosis Physical Effects of Smoking How to Live Preservatives and Other Chemicals in Food. Feeble-mindedness The Kallikak Family Fatigue and Efficiency A Philosophy of Play Morals and Morale Physical Education by Muscular Exercise. Being Well Born New Physiology Nutrition and Dietetics The Human Body and Its Enemies . . The New Public Health The Human Mechanism The House Fly . . How to Prevent Disease Common Diseases Preventable Diseases The Next Generation Battle with Tuberculosis Health and Disease Play in Education The Human Macliine and Industrial Efficiency. W. B. Saunders Co. Longmans, Green & Co. TheMacMillanCo. D. Appleton & Co. W. B.Saunders Co. D. Appleton & Co. The MacMillan Co. Lea & Febiger. P. Blakiston's Son & Co. The Century Co. William Wood & Co. D. Appleton & Co. John Wiley & Sons. Harvard University Press. John Wiley & Sons. F. A. Stokes Co. Princeton University Rand, McNally & Co. The MacMillan Co. F. A. Davis Co. D. Appleton & Co. Do. Do. Funk& WagnallsCo. P. Blackiston's Son & Co. Lea & Febiger. Do. C. V.MosbyCo. William Wood & Co. Lea & Febiger. Association Press, N. Y. Funk & Wagnalls Co. Harvard University PrGSS The MacMillan Co. Do. Russell Sage Founda- tion. Association Press, N. Y. Do. P. Blakiston's Son & Co. The Bobbs-Merrill Co. J. B. Lippincott Co. D. Appleton & Co. The World Book Co. The MacMillan Co. Ginn & Co. F. A. Stokes Co. Harper & Bros. Houghton Mifflin Co. Do. Ginn & Co. J. B. Lippincott Co. Little, Brown & Co. The MacMillan Co. Longmans, Green & Co. 40 General injgiene — Coutinued. Title. Publisher. Locliliead Lorand Lusk \ ]\Iarshall McCullum McKenzie Metchnikoff Overton Parkes Park- Williams Popenoe-Johnson, Price Pv.apeer Reese Pdchards Rosenau Ross Sargent Simon Do Storey Thomas-Ivy Wallin AYeaver Wide AVilliams AVilev Do Winslow Zinsser Classbook of Economic Entomolog}^. .' P. Blakiston's Son & Co. Old Age Deferred ; F. A. Da\is Co. The Elements of the Science of ' W. B. Saunders Co. Nutrition. ]\Iicrobiology P. Blakiston's Son & Co. Newer Knowledge of Nutrition The MacMillan Co. Exercise in Education and Medicine. W. B. Saunders Co. The Prolongation of Life G. P. Putnam's Sons. General Hygiene American Book Co. Manual of Practical Hygiene William Wood & Co. Pathogenic Microorganisms Eea & Feljisrer. Applied Eugenics The Mac^Millan Co. Hygiene and Public Health Lea & Febiger. Educational Hygiene Chas. Scribner's Sons. Outlines of Economic Zoology" P. Blakiston's Son & Co. Air, Water, and Food John Wiley & Sons. Preventive Medicine and Hygiene. .. D. Appleton & Co. The Reduction of Domestic Flies J. B. Lippiucott Co. Health, Strength, and Power Dodge Publishing Co. Human Infection Carriers Lea & Febiger. Infection and Immunity Do. An Epitome of General Hygiene Department of Hygiene, I College of the City of New York. Applied Immunology j J. B. Lippincott Co. Problems of Subnormality ' World Book Co. Mind and Health = . : The MacMillan Co. Handbook of Orthopedic and ]\redi- Funk & Wagnalls Co. cal Gymnastics. Healthy Living The ]\Iac]\Iillan Co. Beverages and Their Adulteration. . .! P.. Blakiston's Son & Co. Foods and Their Adulteration j Do. Prevention of Disease , W. B Saunders Co. Infection and Resistance ' The MacMillan Co. INDIVIDUAL HYGIENE. Bigelow Bowers Brackett Brady Brown Burnham Bussey Cabot Cady Camp Carroll Do Chancellor Chapin CooUdge Curtis Eliason Emerson Emerson-Betts Sex Education I The Mac:\mian Co. Side stepping ill-health ; Little, Brown & Co. Care of the teeth j Harvard LTniversity ! Press. Personal Health ' W. B. Saunders Co. Principles of Nm-sing Lea & Febiger. First Aid Do. Manual of Personal Hygiene Ginn & Co. A Laymen's Handbook of Medicine. .| Houghton ^Vlifflin Co. The Way Life Begins ' American Social Hy- j giene Association, New York. Keeping Fit All the Way [ Harper & Bros. Mastery of Nervousness' i The MacMillan Co. Our Nervous Friends ' Do. Health of the Teacher Forbes & Co. Health First The Century Co. Adenoids and Tonsils Harvard Universit> Press. Recreation for Teachers The MacMillan Co. Fii-st Aid in Emergencies i J. B. Lippincott Co. Nervousness { Little, Brown & Co. Physiology- and Hygiene j Bobbs-Merrill Co. 41 Individual hygiene — Continued. Author. Title. Publisher. Exner Fielding Fischer Fisher Fisher-Fisk Forel Foster Galbraith Do Gerrish Gulick Hall Do Head Hirschfeld Hoag Holt Hopkins Hough-Sedwick. Howard Howe, G. L Howe, E.C Howell Hutchinson Do Kaufmann Kelly Kerr- Agar.... . . . Kirkes Kitson Latimer Lippitt Lowrey Do Do Lyster Malchow Marshall Mirtin McCann Mclssac Mjore Morrow Mosher Mumey Owen Posey Pusey Pyle Richards Starr Stiles Do Do Stokes Tolman Town Rational Sex Life for Men Sanity in Sex The Physiology of Alimentation The Health Care of the Growing Child. How to Live Nervous and Mental Hygiene The Social Emergency Personal Hygiene and Physical Training for Women. The Four Epochs of a Woman's Life Sex Hygiene The Efficient Life ■. . . Girlhood and Its Problems Youth and Its Problems Mouth Hygiene The Heart and the Blood Vessels. . . Health Studies Diseases of Infancy and Childhood. The Care of the Teeth Elements of Physiology How to Rest How to Prevent Disease Syllabus of Personal Hygiene Physiology A Handbook of Health Instinct and Health Care of the Mouth and Teeth High Road to Health Lectures on Sex and Heredity Handbook of Physiology How to Use Your Mind Girl and Woman Personal Hygiene and Home Nursing Herself Himself Preparation for Womanhood Textbook of Hygiene for Teachers . . The Sexual Life Mouth Hygiene The Human Body The Science of Eating Hygiene for Nurses Keeping in Condition Immediate Care of the Injured Health and Happiness Hygiene for Nurses , Treatment of Emergencies Hygiene of the Eye TJie Care of the Skin and Hair Personal Hygiene Hygiene for Girls The Adolescent Period Human Physiology Nutritional Physiology The Nervous System and Its Con- servation. The Third Great Plague Hygiene for the Worker , Habits that Handicap , Association Press, N. Y. Dodd, Mead & Co. John Wiley & Sons. Funk & Wagnalls Co. Do. G. P. Putnam's Sons. Houghton Mifflin Co. W. B. Saunders Co. Do. The Gorham Press, Bos- ton. Doubleday, Page & Co. John C. Winton Co. Do. W. B. Saunders Co. Funk & Wagnalls Co. D. C. Heath & Co. D. Appleton & Co. Do. Ginn & Co. Edward J. Clode. Harper & Bros. Wellesley College. W. B. Saunders Co. Houghton Mifflin Co. Dodd, Mead & Co. Rebman Co. Dodd, Mead & Co. The MacMillan Co. William Wood & Co. J. B. Lippincott Co. D. Appleton & Co. World Book Co. Forbes & Co. Do. Do. Warwick & York. C. V. Mosby Co. J. B. Lippincott Co. Henry Holt & Co. George H. Doran Co. The MacMillan Co. Do. W. B. Saunders Co. , Funk & Wagnalls Co. C. V. Mosby Co. W. B. Saunders Co. J. B. Lippincott Co. D. Appleton & Co. W. B. Saunders Co. D. C. Heath & Co. P. Blakiston's Son & Co. W. B. Saunders Co. Do. Do. Do. American Book Co. The Century Co. 42 Individual hygiene — Continued. Author. Title. Publisher. Walters Principles of Health Control Pes' Alonsr. . D C Heath & Co Walton? J. B. Lippincott Co. Do T\Tiv Worry Weaver The" Mind and Health The MacMillan Co ^ATiite Principles of Mental Hygiene Sex Hygiene. Do Wile Duffield & Co Winslow Healthy Living C. E. Merrill & Co. Woodhull Personal Hvgiene John Wiley & Sons. Woodworth The Care of the Body The MacMillan Co. GROUP HYGIENE. Adams... Andress.. Ashburn. Ayers Do.. Bancroft. Bashore . . Do.. Do.. Brewer Broadhurst . . Bryant Burgenstein. Burk Coolidge Cornell Cutler. Donahoe Dressier Fisher and Fisk . . . Forsyth Gerhard Do Harris Harrison Hoag and Terman . Holt Kelly and Bradshaw Kober and Hanson L^Tich . Do. Neumeyer . O'Donnell. Ogden Osborne. . . Price Pry or Putnam . . . The Health Master. Health Education in Piiral Schools. The Elements of Military Hygiene... Open Air Schools Healthful Schools The Posture of School Children Overcrowding and Defective Housing. Sanitation of a Country Home Sanitation of Recreation Camps and Parks. Rural Hygiene Home and Community Hygiene School Feeding School Hygiene Health and the School Home Care of Sick Children Health and Medical Inspection of School Children. The Care of the Sick Room Manual of Nursing School Hygiene Health for the Soldier and Sailor Children in Health and Disease Sanitation of Public Buildings Modern Baths and Bath Houses Health on the Farm Home Xursing Health Work in the Schools Diseases of Infancy and Childhood . . Handbook for School Nurses Diseases of Occupation and Voca- tional Hygiene. How to Keep Fit in Trench and Camp. Special Fii'st Aid Editions: jMiners, Police, Firemen. Railroad, Women. Medical and Sanitary Inspection of Schools. The Family Food Rural Hygiene The Family House The }.Iodern Factory Xaval Hygiene School Janitors Houghton Mifflin Co. Do. Do. Doubleday. Page & Co. Houghton Mifflin Co. The MacMillan Co. John Wiley & Sons. Do. Do. J. B. Lippincott Co. Do. Do. F. A. Stokes & Co. D. Appleton & Co. Do. F. A. Da^is Co. Harvard L'niversity Press. D. Appleton & Co. The ]MacMillan Co. Funk & Wagnalls Co. P. Blakiston's Son & Co. John Wiley & Sons. Do. Sturgis & Walton Co. The MacMillan Co. Houghton Mifflin Co. Do. The MacMillan Co. P. Blakiston's Son & Co. Do. Do. Lea & Febiger. The Penn Publishing Co. The MacMillan Co. The Penn Publishing Co. John Wiley & Sons. P. Blakiston's Son & Co. Press American Acad- emy of Medicine, Eas- ton, Pa. 43 Group hygiene — Continued. Title. Publisher. Richards... Shaw Solis-Cohen Starr Strong Struthers... Talbot Terman. . . Thompson . Tolman..-. . Whipple . . . Winslow... Wright .... Home Sanitation ' '^Tiitcomb & Barrows. School Hygiene I The MacMillan Co. The Family Health Penn Publishing Co. P. Blakiston's Son & Co. Do. G. P. Putnam's Sons. Hygiene of the Xursery Home Hygiene and Care of the Sick The School Xurse House Sanitation WTiitcomb & Barrows. Hygiene of the School Child Houghton Mifflin Co. The Occupational Diseases D. Appleton & Co. Hygiene for the Worker American Book Co. Questions in School Hygiene C. W. Bardeen, Pub- ' lisher. The Home Medical Adyiser D. Appleton & Co. Industrial Nursing The MacMillan Co. INTERGROUP HYGIENE. Addams Allen, E.F Allen, W.H.... Ash Bishore Blair... Bowen Brainard Broadhurst .... Brown Cabot Capes Colman Egbert Endleman Fielding Flexner Ford Foster Fredericksen . . Gardner Gerhard Godfrey Gorgas Harrington Hemenway. . . . Hill ' Do Hodge-Dawson. Hough-Sedwick Hunter Hutchinson Do Klein Kneeland Leland The Spirit of Youth and the City Streets . Keeping Our Fighters Fit for War and After. Ci\dcs and Health Organization in Accident Preyention . Outlines of Practical Sanitation Public Hygiene Safeguards for City Youth at Work and at Play. Organization of Public Health Nursing. Home and Community Hygiene Health in Home and Town Social Work Municipal Housecleaning The People's Health Hygiene and Sanitation Meat H\'giene Sanity in Sex Prostitution in Europe Elements of Field Hygiene and San- itation. The Social Emergency The Story of Milk. . . ." Practical Sanitation Guide to Sanitary Inspections The Heahh of the'City Sanitation in Panama Practical Hygiene American Public Health Protection... Sanitation for Public Health Nurses.. . The New Public Health A Ciyic Biology Hygiene and Sanitation Ciyic Biology Ciyilization and Health Community Hygiene Milk Hygiene Commercia;! Prostitution in New York Sanitation in War The Macmillan Co. The Century Co. Ginn & Co. McGraw-Hill Book Co. John Wiley & Sons. The Gorham Press. The Macmillan Co. Do. J. B. Lippincott Co. D. C. Heath & Co. Houghton Mifflin Co. E. P''. Diitton & Co. The Macmillan Co. Lea & Febiger. Do. Dodd, Mead & Co. The Century Co. P. Blakiston's Son & Co. Houghton Mifflin Co. The Macmillan Co. C. V. Mosby Co. John W^iley & Sons. Houghton Mifflin Co. D. Appleton & Co. Lea & Febiger. Bobbs-Merrill Co. The Macmillan Co. Do. Ginn & Co. Do. American Book Co. Houghton Mifflin Co. Do. J. B. Lippincott Co. The Century Co. P. Blakiston's Son & Co. 44 Intcrgroup liygiene — Continued. Author. Title. MacNutt Manual for Healt li Officers March . . , Towards Eacial Health McCann The Starving World Overlock The Workino- People Overton The Heahh Officer Pani Hygiene in Mexico Parkes Hygiene and Public Health Parsons Disposal of Municipal Refuse Price Handbook on Sanitation Do Hygiene and Public Health Race Examination of Milk for Public Health Purposes. Richards Conservation by Sanitation Do Cost of CI' anness Ross The Prevention of Malaria Sedwick Science and the Puljlic Health Tuttle Principles of Public Health Vedder Syphilis and the Public Health Do j Sanitation fcr ]VIedical Officers Whipple State Sanitation , Publisher. Do I Vital Statistics Wood I Sanitation Practically Applied . John Wilev & Sons. E. P. Dutton &. Co. G. H. Doran & Co. The Blanchard Press. W. B. Saunders Co. G. P. Putnam's Sons. P. Blakiston's Son & Co John Wilev & Sons. • Do. ■ I/ca & Febiger." John Wiley & Sons. Do. Do. E. P. Dutton & Co. The Macmillan Co. World Book Co. Ijca & Febiger.. Do. Harvard University Press . John Wilev & Sons. Do. GENERAL REFERENCES. Federal Government. — Man}^ of the btilletin.s published by the fol- lowing departments contain valuable information for the student and the teacher. The various Government departments will place the name of any institution on the mailing list if proper application if made to the Secretary of the department from which bulletins bearing on hygiene are desired. A list of the publications of the different departments that are available for free distribution, or for n small fee, can be secured from the Superintendent of Documents, Government Printing Office, Washington, D. C. : Bureau of Education, Department of the Interior : Organized health worlv in schools, E. -B. Hoag. Bulletin No. 44. 1913. 10 cents. Physical growth and school progress, B. T. Baldwin. Bulletin No. 10, 1914. 25 cents. ^ .'] The health of school children, W\ H. Heck. Bulletin No. 4, l9lk 15 cents. Schoolhouse sanitation, William A. Cook. Bulletin No. 21, 1915. 10 cents. Health of school children, W. H. Heck. Bulletin No. 50, 1915. 20 cents. Medical inspection in Great Britain, E. L. Roberts. Bulletin No. 49, 1916. 15 cents. Activities of school children in out-of-school hours, C. D. Davis. Bulletin No. 20, 1917. 5 cents. Military training of youths of school age in foreign countries, \\. S. Jesien. Bulletin No. 25, 1917. 5 cents. Physical education in s-econdary schools. BiiUetin No. .50, 1917. 5 cents. 45 Bureau of Education. Depurtiiieut of the Interior — Continued. Recent State legislation for pliy.sical education, Storey and Small. Bul- letin No. 40, 1918. 5 cents. Standardization of medical-iuspection facilities, J. H. Berkowitz. Bulletin No. 2, 1918. 10 cents. Educational hygiene, Small. Bulletin No. 48, 1919. 5 cejits. Report of the public-school system of Memphis, Tenn. Part 7, health work. Bulletin No. 50, 1919. The eyesight of children, Berkowitz. Bulletin No. 65, 1919. Schools and classes for feeble-minded and subnormal children. Bulletin No. 70, 1919. Part ly, Educational Directory, 1919-20. Schools for the blind, lor the deaf, and for the feeble-minded. Bulletin No. 71, 1919. Schools and classes for the blind, 1917-18. Advance sheets from Biennial survey. 1916-1918. Bulletin No. 78, 1919. Schools for the dtaf, 1917-18. Advance sheets from the Biennial survey, 1916-1918. Bulletin No. 79. 1919. Health Education Series — No. 1. Wanted teachers to enlist for child health service. 5 cents. No. 2. Diet for the school child. 5 cents. No. 3. Summer health and play school. 5 cents. No. 4. Methods of teaching health. 5 cents. Public Health Service, Treasury Department (weekly reports) : The more im- portant reprints on the general subject of hygiene are listed in the bib- liography on page 47. Children's Bureau, Department of Labor. (Many bulletins on child welfare.) Department of Agriculture. (Bulletins on food, drugs, beverages, insects, etc.) Department of Labor. (Bulletins on industrial hygiene, accidents, etc.) State government. — Bulletins published by the State department of health and the State department of education frequently contain valuable information on the problems of health conservation and development. The following State departments of health publish bulletins, which are available for distribution. STATE DEPAETMENT OF HEALTH BULLETINS. Arizona State Board of Health Bulletin, Phoenix. California State Board of Health Monthly Bulletin, San Francisco. Connecticut Health Bulletin, Hartford. State board of health. Florida Health Notes, Tampa. State board of health. Bulletin of the State board of health, Augusta, Ga. Illinois Health News, Springfield. State board of health. Monthly Bulletin of the Indiana State Board of Health, Indianapolis. Iowa Health Bulletin, Des Moines. State board of health. Bulletin of the Kansas State Board of Health, Topeka. Bulletin of the State Board of Health of Kentucky, Bowling Green. Louisiana State Board of Health Monthly Bulletin, New Orleans. Maine State Department of Health Bulletin, Augusta. Public Health Bulletin of the Massachusetts State Department of Health, Boston. Public Health, Lansing. State board of health. Health Bulletin, Jackson, Miss. State board of health. Montana Bulletin of the Department of Public Health, Helena. ■46 Quarterly Bulletin of the State Board of Health of Ne^y Hampshire, Concord. Public Health News, State department of health, Trenton, N. J. Health News, monthly bulletin of the New York State Department of Health, Albany. Health Bulletin, North CaroUua State Board of Health, Raleigh. North Dakota State Board of Health, Devils Lake. Ohio Piiblic Health Journal, State board of health, Columbus. Pennsylvania Health Bulletin, State department of health, Harrisburg. Bulletin of the Rhode Island State Board of Health, Providence. Bulletin of the Texas State Board of Health, Austin. Utah Health Bulletin, State board of health, Salt Lake City. Quarterly Bulletin of the Vermont State Board of Health, Rutland. Virginia Health Bulletin, State department of health, Richmond. Quarterly Health Bulletin, State board of health, Madison, Wis. STATE DEPAKTMENT OF EDUCATION BXJLLETINS. The following State departments of education have prepared syllabi on physi- cal education (including hygiene, sanitation, first aid, etc.) : California, Indiana, New Jersey, New York, Michigan, Rhode Island, Virginia, Oregon, Kentucky, Nevada, Utah, Washington. MAGAZINES, JOURNALS . ETC. The following journals are more or less devoted to the general subject of hygiene : American Physical Education Review, 93 Westford Avenue, Springfield, Mass. American Journal of Public Health. 169 Massachusetts Avenue, Boston, Mass. American Journal of Nursing, 19 West Main Street, Roche.ster, N. Y. The Public Health Nurse, 21.57 Euclid Avenue, Cleveland, Ohio. Mind and Body, New Ulm, Minn. The PlaygTOimd, 1 Madison Avenue, New York. Physical Training, 347 Madison Avenue, New York. Mental Hygiene, 50 Union Square, New York. Good Health, Battle Creek, Mich. Social Hygiene, 105 West Fortieth Street, New York City. Journal American Medical Association. 535 North Dearborn Street, Chicago, 111. Bulletin of the National Association for the Study and Prevention of Tuber- culosis, 105 East Twenty-second Street, New York. How to Live, published by the Life Extension Institute, New York. American Journal of School Hygiene, Worcester, Mass. Journal of the Outdoor Life, 381 Fourth Avenue, New York City. Journal of Industrial Hygiene, The Macmillan Co. Journal of Heredity, American Genetic Association, Washington, D. C. EEFEEENCE BOOKS. Reader's Guide to Periodical Litei-ature. Published by H. W. Wilson Co., Uni- versity Place, New York City. Contains a monthly bibliography of all articles occurring in periodicals. The Cumulative Book Index. Published by H. W. Wilson Co. Monthly bibliog- raphy of all books published. Index Medicus. Published by the Carnegie Institution, of Washington, D. C. A monthly bibliography of all medical literature. 47 Selected Bibliography of Physical Training. Published by the American Physi- cal Education Association, 93 Westford Avenue, Springfield, Mass. Proceedings of the Fourth International Congress on School Hygiene, BufCalo, N. Y. Printed by the Courier Co., of Buffalo. REFERENCES. Publications that may be secured through the United States Public Health Service, Washington, D. C. : GENERAL HYGIENE. Misc. Pub. 20. Uncle Sam's Guides to Health. Supp. 31. Safe Millv. An Important food problem. By Earnest A. Sweet. May 25, 1917. Supp. 30. Common Colds. By W. C. Bucker. Mar. 16, 1917. Supp. 29. The Transmission of Disease by Flies. By Earnest A. Sweet. Apr. 14, 1916. Supp. 21. Scarlet Fever : Its Prevention and Control. By J. W. Schere- schewsky. Nov. 27, 1914. (Revised April, 1918.) Supp. 19. Yellow Fever : Its Epidemiology, Prevention, and Control. Lec- tures delivered at the U. S. Public Health Service School .of Instruction. By H. R. Carter, senior surgeon, U. S. Public Health Service, Lecture No. 1 (Mar. 26, 1914), Lecture No. 2 (Mar. 27, 1914). Sept. 11, 1914. Supp. 18. Malaria: Lessons on its Cause and Prevention. (For use in schools.) By H. R. Carter. July 17, 1914. Supp. 16. The Summer Care of Infants. By W. C. Rucker and C. C. Pierce. June 19, 1914. Supp. 14. Diphtheria : Its Prevention and Control. By J. W. Schere- schewsky. Apr. 17, 1914. Supp. 12. Vital Statistics. A Discussion of What They Are and Their Uses in Public Health Administration. By John W. Trask. Apr. 3, 1914. Supp. 10. The Care of the Baby. Prepared by a Committee of the American Association for the Study and Prevention of Infant Mortality and presented to the Association at its Annual Meeting, held in Washington, D. C, Nov. 14-17, 1913. Dec. 19, 1913. Supp. 8. Trachoma : Its Nature and Prevention. By John McMullen. Nov. 21, 1913. Supp. 6. Contagious Diseases : Their Prevention and Control in Children's Institutions. By James P. Leake. Apr. 11, 1913. Supp. 3. Tuberculosis : Its Predisposing Causes. By F. C. Smith. Feb. 7, 1913. Supp. 1. Measles. By W. C. Rucker. Jan. 24, 1913. Rep. 509. Standards for Measuring the Efficiency of Exhaust Systems in Polishing Shops. By C. E. A. Winslow% L. Greenburg, and H. C. Angermeyer. Mar. 7, 1919. Rep. 476. Malaria Control. Results obtained by a Local Community Fol- owing Antimosquito Demonstration Studies by the United States Public Health Service in Cooperation Avith the International Health Board. Direction : J. E. Sparks, M. D. ; Advisory Supervision, R. C. Derivaux and H. A. Taylor, M. D. July 12, 1918. Rep. 461. Pellagra : Its Nature and Prevention. By Joseph Goldberger. Apr. 5, 1918. 48 Rep. 456. The Application of Ozone to the Purification of Swimming Pools. By Wallace A. Manheimer, Ph. D. Mar. 1, 1918. Rep. 454. Prophylaxi.s of Malaria. Immunization by Quinine. By H. R. Carter. Mar. 29, 1918. (Pubhshed as Reprint No. 175 in 1914, under the title Quinine Prophylaxis for Malaria.) Rei^ 448. Industrial Efficiency. The Bearings of Physiological Science Thereon : A Review of Recent Work. By Frederic C. Lee, Ph. D. Jan. 11, 1918. Rep. 436. The Control of Communicable Diseases. Report of the American Pul)lic Health Association Committee on Standard Regulations, appointed in October, 1916. Oct. 12, 1917. Rep. 435. Vaccination Against Smallpox. The Kind of Vaccine to Use and How to Use It. Nov. 80, 1917. Rep. 413. Meningococcus Carriers. Their Recognition and Treatment. .Tuly 2J, 1917. Rep. 400. Occupation and Mortality. Their Relation as Indicated by the Mor- tality Returns in the City of New York for 1914. By Shirley Wilmotte Wynn. M. D., and William H. Guilfoy, M. D. June 8, 1917. Rep. 397. Drinking Fountains. Investigation of Fountains at the Uni versity of Minnesota. By H. A. Whittaker. May 11, 1917. Rep. 395. Typhoid Fever and Municipal Administration. By A. W. Free- man. May 4, 1917.- Rep. 387. Climate and Tuberculosis. The Relation of Climate to Recovery. By .John W. Trask. Feb. 23, 1917. Rep. 382. Malaria. A Public Health and Economic Problem in the United States. By John W. Trask. Dec. 22, 1915. Rep. 366. The Physical Care of Rural School Children. By Tahaferro Clark. Oct. 6, 1916. Rep. 362. The Sewage Pollution of Streams. Its Relation to the Public Health. By W. H. Frost. Sept. 15, 1916. Rep. 350. Poliomj^elitis (Infantile Paralysis). What is Known of Its Cause and Modes of Transmission. By Wade H. Frost. July 14, 1916. Rep. 249. Hay Fever and Its Prevention. By W. Scheppegrell, M. D., presi- dent American Hay Fever Prevention Association, New Orleans, La. .July 21, 1916. Rep. 319. The Practicing Physician. What He Should Know about the Reg- istration of Births and Deaths and the Reporting of Sickness. By J. W. Trask. Jan. 14, 1915. Rep. 309. Tuberculosis : With Special Reference to Its Epidemiology, Trans- missibility, and Prevention. By George M. Kober, M. D. Oct. 29, 1915. Rep. 302, Industrial Hygiene. A Plan for Education in the Avoidance of Occupational Diseases and Injuries. By J. W. Schereschewsky. Oct. 1, 1915. Rep. 287. The Practical Use of Disinfectants. By H. E. Hasseltine. .July 2, 1915. Rep. 271. Typhus Fever. Its Etiology and the :\Iethods of Its Prevention. By John F. Anderson. Apr. 30, 1915. Rep. 225. The Chemical Disinfection of Water. By Earle B. Phelps. <')ct. 9, 1914. Rep. 189. Pure Drugs and the Public Health. By Martin I. Wilbert. :\Iay 8, 1914. Rep. 171. Public Health Administration. The Factors upon which Its Efti- ciency Depends. By W. C. Rucker. Mar. 6, 1914. Rep. 155. Heat and Infant Mortality. By J. W. Schereschewsky. Dec. 5, 1913. 49 Rep. 150. The Citizen and the Public Health. The Individual's Relation to the Health of the Community. By John W. Trask. Nov. 7, 1913. Rep. 105. Antimalarial Measures for Farmhouses and Plantations. By Henry R. Carter. Dec. 6, 1912. Rep. 100. Whooping Cough — Its Nature and Prevention. A Popular Discus- sion of a Widespread and Dangerous Disease for which Familiarity has Bred Contempt. By W. C. Rucker. Oct. 25, 1912. Rep. 88. The Eradication and Prevention of Bubonic Plague. By William Colby Rucker. July 19, 1912. Rep. 76. The Necessity for Safe Water Supplies in the Control of Tsrphoid Fever. By A. J. McLaughlin. Mar. 22, 1912. 13 pages. 5 tables. Paper. Rep. 69. Epidemic Cerebrospinal Meningitis. A Review of its Etiologj', Transmission, and Specific Therapy, with Reference to Public Measures for its Control. By W. H. Frost. Jan. 26, 1912. 27 pages. Paper. Rep. 28. Prevention and Destruction of Mosquitoes. By Joseph Goldberger. July 17, 1908. 11 pages. Paper. V. D. B. 38. Need for Sex Education. A Two-page Illustrated Statement for Parents, Containing a Li.st of Books for Use in the Family. V. D. B. 32. The Parent's Part. A Pamphlet Telling Parents How they May Instruct their Children and Safeguard them from Conduct Which May Ulti- mately Lead to Venereal Diseases. (Published by the New Jersey State Board of Health and distributed temporarily by the Public Health Service.) V. D. B. 22. To-day's World Problem in Disease Prevention. By J. H. Stokes, M. D. A 136-page book dealing with the Causes, Effects, Prevention, and Cure of Syphilis. P. H. B. 101. Studies of Methods for the Treatment and Disposal of Sewage. (Made under the supervision of Earle B. Phelps.) The Treatment of Sewage from Single Houses and Small Communities. By Leslie C. Frank and C. P. Rhynus. April, 1919. P. H. B. 88. Malaria Control. A Repox't of Demonstration Studies Conducted in Urban and Rural Sections. By R. C. Derivaux, H. A. Taylor, and T. D. Haas. 1917. P. H. B. 36. Tuberculosis : Its Nature and Prevention. By F. C. Smith. 1910. 12 pages. 1 plate. Paper. (Revised Edition.) P. H. B. 35. The Relation of Climate to the Treatment of Pulmonary Tuber- culosis. By F. C. Smith. 1910. 17 pages. Paper. (Revised Edition.) P. H. B. 77. Rural School Sanitation, Including the Physical and Mental Status of School Children of Porter County, Ind. By Taliaferro Clark, G. L. Collins, and W. L. Treadway. P. H. B. 76. Health Insurance : Its Relation to the Public Health. By B. S. Wan-en and Edgar Sydenstricker. March, 1916. P. H. B. 73. Tuberculosis Among Industrial Workers : Report of an Investi- gation Made in Cincinnati, with Special Reference to Predisposing Causes. By D. E. Robinson and J. G. Wilson. March, 1916. Revised March, 1919. P. H. B. 69. Typhoid Fever: Its Causation and Prevention. By L. L. Lumsden. May, 1915. P. H. B. 68. Safe Disposal of Human Excreta at Unsewered Homes. By L. L. Lumsden, C. W. Stiles, and A. W. Freeman. April, 1915. P. H. B. 58. Open-air Schools for the Cure and Prevention of Tuberculosis Among Children. By B. S. Warren. October, 1912. P. H. B. 37. The Sanitary Privy: Its Purpose and Construction. By Prof. C. W. Stiles. 1910. 24 pages. 12 figures. Paper. Supp. 24. Exercise and Health. By F. C. Smith. May 7, 1915. 2058—20 4 50 INDIVIDUAL HYGIENE. Misc. Pub. 20. Uncle Sam's Guides to Health. Supp. 36. What to do to Become Physically Fit. Information for Those Dis- qualified for Active Military Service Because of Physical Defects. Oct. 4, 1918. K. W. S. 6. Cancer. Facts Which Every Adult Should Know. K. W. S. 5. The Safe Vacation. Useful Advice on the Selection of a Place to go and What to do in Case of Sudden Accident or Illness. K. W. S. 4. Diphtheria. How to Recognize the Disease. How to Keep from Catching It. How to Treat those who do Catch It. K. W. S. 3. How to Avoid Tuberculosis. The Essential Facts Concerning the Cause, Recognition, and Prevention of Tuberculosis. K. W. S. 2. Adenoids. A Brief Description of What They Are and How to Treat Them. K. W. S. 1. The Road to Health. A sixteen-page Pamphlet Giving Concise Directions for Keeping Well. Includes a Table of Average Weights for Men and Women. V. D. B. 38. Need for Sex Education. A two-page Illustrated Statement for Parents, Containing a List of Books for Use in the Family. V. D. B. 31. Important Confidential Information. A Pamphlet Containing Instructions for Persons Infected with Venereal Diseases. This Pamphlet is prepared for Physicians to Give to Patients. V. D. B. 6. Manpower. A Pamphlet for Men, giving the Facts of Venereal Diseases and Material on Sex Hygiene. P. H. B. 102. A Home-made Milk Refrigerator. Simple Method of Con- structing a Satisfactory Refrigerator with Materials Usually on Hand in the Home. By C. Bolduan. April, 1919. P. H. B. 94. Rural Sanitation. A Report on Special Studies made in 1.5 Counties in 1914, 1915, and 1916. By L. L. Lumsden. October, 1918. P. H. B. 78. Influence of Occupation on Health During Adolescence : Report of a physical examination of 679, male minors iinder 18 in the cotton industries of Massachusetts. By M. V. SafCord. GROUP HYGIENE. H. L. B. 89. Sewage Pollution of Interstate and International Waters, with Special Reference to the Spread of Typhoid Fever. VI. The Missouri River from Sioux City to its Mouth. By Allan J. McLaughlin. May, 1913. 84 pages. Paper. Supp. 15. The Administration of a Yellow Fever Campaign. By William C. Rucker. June 12, 1914. Rep. 506. A Unified Health Service. By B. S. Warren. Feb. 28, 1919. Rep. 504. The Treatment of Sewage from Single Houses and Small Commu- nities. By Earle B. Phelps. Feb. 14, 1919. Rep. 499. Code of Lighting for Factories, Mills, and Other Work Places. Re- port of the Divisional Committee on Lighting, Section on Sanitation, Committee on Welfare Work of the Committee on Labor, Advisory Commission, Council of National Defense. Jan. 24, 1919. Rep. 497. Safe Milk for the Small Town. By K. E. Miller. Dec. 13. 1918. Rep. 439. Appropriations for City Health Departments. Summary of Ex- penditures of 330 Cities in the Central and Eastern United States for Public Health work. By Paul Preble. Dec. 7, 1917. Rep. 395. Typhoid Fever and Municipal Administration. By A. W. Free- man. May 4, 1917. 51 Rep. 392. A Program of Public Health for Cities. By W. C. Pucker, Apr. 6, 1917. Rep. 285. The Model State Law for Morbidity Reports. As amended by the Thirteenth Aurmal Conference of State and Teri-itorial Health Authorities with the U. S. Public Health Service, Washington. May 13, 191.5. .July 2, 1915. Rep. 192. Bacteriological Standards for Milk. May 15, 1914. Rep. 171. Public Health Administration.' The Factors upon which Its Efii- ciency Depends. By W. C. Pucker. Mar. 6, 1914. Rep. 46. What the Local Health Oflicer Can Do in the Prevention of Ty- phoid Fever By L. L. Lunisden. Feb. 4, 1910. 14 pages. Paper. V. r>. B. 43. The Public Health Nurse and Venereal Disease ^'ontrol. A Pamphlet Showing Opportunities for Useful ^^'ork in the Fight Against Ve- nereal Diseases. V. D. B. .39. Compilation of Suggested and Adjudicated Ordinances Which Have Proved Successful in Combating Venereal Diseases. A Compilation of Ordinances for Adoption by Municipalities Dealing with Prostitution and Ve- nereal Diseases. V. D. B. 11. A'enereal Disease — A I'ublic Health Prol)lem for Civilian Com- munities. A one-page Pamphlet Containing Graphs Showing The Prevalence of Venereal Diseases. V. D. B. 7- The Problem of Sex Education in the Schools. A Pamphlet for Educators. P. H. B. 88. Malaria Contro\ A Report of Demonstration Studies Con- ducted in Urban and Rural Sections. By R. C. Derivaux, H. A. Taylor, and T. D. Haas. 1917. P. H. B. 77. Rural School Sanitation, Including the Physical and Mental Status of School Children of Porter County, Ind. By Taliaferro Clark, (4. L. Collins, and W. L. Treadway. P. H. B. 76. Health Insurance: Its Relation to the Public Health. By B. S. Warren and Edgar Sydenstricker. March, 1916. P. H. B. 73. Tulierculosis Among Industrial Workers : Report of an Inve.stl- gation Made in Cincinnati, A^'ith Special Reference to Predisposing Causes. By D. E. Robinson and J. G. Wilson. March, 1916. Revised March, 1919. P. H. B. 69. Typhoid Fever : Its Causation and Prevention. By L. L. Lunis- den. May, 1915. P. H. B. 58. Open-air Schools for the Cure and Prevention of Tuberculosis among Children. By B. S. Warren. October, 1912. P. H. B. 54. Organization, Powers, and Duties of Health Authorities. An Analysis of the Laws and Regvdations Relating Thereto in Force in the United States. By J. W. Kerr and A. A. Moll. August, 1912. P. H. B. 52. A'accination. Analysis of the Laws and Ileguiations Relating Thereto in Force in the United States, Containing Court Decisions and a Summary of Some Foreign Vaccination Laws. By J .W. Kerr, .January, 1912. 82 pages. Paper. INTERGROUP HYGIENE. Rep. 76. The Necessity for Safe Water Supplies in the Control of Typhoid Fever. By A. J. McLaughlin. Mar. 22, 1912. 13 pages, 5 tables. Paper. Rep. 125. Water and Ice Supplied by Interstate Carriers. May 16, 1913. Rep. 244. Impounded Water : Some general considerations on its effect on the prevalence of malaria. By H. R. Carter. Dec. 26, 1914. 52 Rep. 283. Interstate Migration of Tuberculous Persons : Its Bearing on the Public Health, with Special Reference to the States of Arizona and Colorado. By A. J. Lanza. June 18, 1915. Rep, 356. The Sanitation of Raihvay Cars. By Thomas R. Crowder, M. D., Chicago, 111. Aug. 11, 1916. Rep. 361. Poliomyelitis (Infantile Paralysis). Its Interstate and Intrastate Contro?. Minimum requirements for Its Control. Reports of Committees Adopted by the Special Conference of State and Territorial Health Authorities with the U. S. Public Health Service, Washington, D. C, August 17 and 18, 1916. Sept. 1 and 8, 1916. Rep. 362. The Sewage Pollution of Streams. Its Relations to the Public Health. By W. H. Frost. Sept. 15, 1916. Rep. 368. Drinking Water on Interstate Carriers. A Study of Conditions on Steam Vessels Engaged in Interstate Commerce in the Sanitary District of the Great Lakes. By J. O. Cobb, C. L. Williams, and H. P. Letton. Oct. 13, 1916. Rep. 380. Relationship of Milk Supplies to Typhoid Fever. By W. H. Frost. Dec. 1, 1916. Rep. 384. Control of Pollution of Streams. The International Joint Com- mission- and the Pollution of Boundary Waters. By Earle B. Phelps. Jan. 26, 1917. Rep. 480. The Relation of the Railroads in the South to the Problem of Malaria and Its Control. By R. C. Derivaux. Aug. 2, 1918. P. H. B. 87. Stream Pollution. A Digest of Judicial Decisions and a Com- pilation of Legislation Relating to the Subject. By Stanley D. Montgomery and Earle B. Phelps. 1917. PART 2. S Showing in detail the places in the syllabi on general hygiene, individual hygiene, group hygiene, and intergroup hygiene in which the professor or the special teacher of hygiene may develop his class program, " em- phasizing with appropriate and due proportion and with proper tact and persistency the serious importance of the venereal diseases, their causes, carriej-s, and prevention " in accordance with the agreement that now exists between his institution and the Interdepartmental Social Hygiene Board. PREFACE. The main syllabus which precedes this siij^plementary syllabus is an organized classification of the content of the divisions and sub- divisions of hygiene. It is an analj^'sis of subject matter — a frame- work Avhicli the teacher may utilize in his study of original and secondary sources for the elaboration of his text. That syllabus does not relieve the teacher of his obligation to make an exhaustive study of the details of his special subject, nor to prepare his own text, nor to formulate his own methods of presentation and instruc- tion, nor to supply inspiration, leadership, stimulation, and incentive so that he may measure the success of his instruction in terms of the mental and moral, physical, and spiritual health habits achieved by his student, the he'alth ideals established, and the methods of impres- sive teaching acquired. These facts are equally true of this supplementary syllabus. It points out the places in the main syllabus in which the teacher may emphasize the hygiene of the venereal diseases where such emphasis suits the sequence of his plan. It does not relieve him of the obliga- tion to make his own plans, nor of the responsibilit;/ for the program in his institution. The teacher is under obligation to stress the venereal diseases with appropriate emphasis. He is also under obli- gation to emphasize " the other important facts and applications of general, individual, group, and intergroup hygiene." He will make a mistake if he does not weave his references to venereal diseases into his consideration of these other agencies naturally and unobtrusively but none the less impressively. This supplementary syllabus, like the main syllabus, supplies a plan, a method, a specification. But the teacher must furnish the (53) 54 compelling force that leads the student to think. He must supply the dramatic emphases that establish indelible memories. He must pro- duce a full realization of the significance of hygiene in every phase of life and prove that right living and right conduct are composite health habits essential to normal physiology, to happiness, and to the fullness of life. Colleges receiving aid from the United States Interdepartmental Social Hygiene Board should teach the answers, so far as they can be given, to the following questions : (a) What are the venereal diseases? (b) How do they do harm to and why are they objectionable to the individual, the family, the local community, the Xation. and civilization in general ? (f) How and why are they spread? (d) What forces and influences favor their spread? (e) "What preventiA'c measures should logically be used to suppress them ? AXS^VERS. (a) Gonorrhea, chancroid, syphilis. Other diseases may be spread similarly, but they are not usually considered venereal diseases. De- scribe these three briefly. (h) They do harm by weakening or destroying the persons who contract them, by causing suffering and shame, by reducing produc- tivity of labor, by spreading to wives and children innocent of wrong- doing, by causing inefficiency and poverty, by undermining the mar- riage relation and the civilization built upon the monogamous marriage. (c) They are spread mainly by promiscuous and illicit sexual rela- tions, by the improper carrying of them into the marriage relation, by innocent contacts within the family, and by infection of children before or at the time of birth. They are spread because most men and some women are not chaste. (d) The evil misconception that sexual indulgence is necessary to health, or a necessary evil: the lenience of public opinion toward male unchastity: the permitted existence of prostitution; lack of proper mental and moral training: lack of interest or opportunity to indulge in a sufficient amount of wholesome work. play, or recreation ; the lack of sufficiently high ideals and standards of honor: promis- cuous association of sexes in poor or debasing surroundings; lack of sufficient proper treatment of infected persons: lack of knowledge concerning the existence, dangers, and spread of the disease: failure to disinfect a part exposed to infection : failure of individuals to do 55 their part in forming a public opinion favorable to chastity and un- favorable to promiscuous sexual indulgence. {e) 1. All measures tending to the formation and strengthening of high character, high ideals, self-respect, honor. 2. All measures tending to lessen temptation and opportunity to do wrong, especially the suppression of prostitution, but also the provision of good educational facilities, proper working conditions, clean, wholesome, and inter- esting amusement and recreation, diffusion of informa- tion, and the formation of sound public opinion in regard to sexual life and venereal disease. The removal from business, politics, and police control of any opportunities to profit from prostitution by rental, fees, votes, or the sale of protection. 3. The importance of early diagnosis of all cases which may be suspected of being syphilis or gonococcus infections; the proper treatment and necessary supervision of those persons already infected ; the application of social service follow-up methods to the detection of additional cases among the families or intimate associates of infected individuals; and, so far as it may be practicable and consistent with the general campaign against venereal diseases, the disinfection under adequate supervision of persons who find themselves in the position of having been exposed to these diseases. SUPPLEMENTARY SYLLABUS EMPHASIZING THE VENEREAL DISEASES, THEIR CAUSES, CARRIERS, INJURIES, AND DE- FENSES. [Note. — The sequence of subjects in this supplementary syllabus is precisely the sequence presented in the main syllabus.] Division 1.— GENERAL HYGIENE. I. THE AGENTS THAT INJURE HEALTH. 1. The inanimate agents. {a) Mechanical agents. (&) Physical agencies. May note the influence of the X-ray on the reproductive cells. {c) Chemical agents. May give examples from the chemical poisons produced by the gonococcus and by the trepo- nema of syphilis. 2. The animate agents. {a) The bacteria. The development of the syllabus and text here should include a discussion of the cause of gonor- rhea and the cause of chancroid following the outline contained in the main syllabus and emphasizing their important relations to human health. (&) The protozoa. 1. Discuss the treponema of syphilis and its injuries to the human race. 3. Physiological influences. (a) The hygiene of heredity. The possible effects of syphilis on heredity. Hereditary disease compared with con- genital disease. (5) Prenatal hygiene. 1. Effects of gonorrhea and syphilis upon the unborn babe and upon the prospective mother. (c) The hygiene of childbirth. Infections of gonorrhea or syphilis at this time; their consequences and avoidance, and the importance of early treat- ment. (56) 57 3. Physiological influeiices — Continued. {d) Age as an influence on health. 1. Infancy and gonorrheal ophthalmia. Congenital syphilis. 2. Childhood and perverted sex habits. 3. Adolescence and youth. The period of sexual pas- sion and consequent danger from lack of self- control. 4. Maturity. Parenthood. The period of transmission of gonorrhea or syphilis or chancroid to the in- nocent wife, husband, child, sister, mother, or father. 5. The climacteric. 6. Old age and aggravated sexual desire. 7. Impotency. {e) Sex as a, physiological influence on health. 1. Passion in man and in woman. Variations in in- tensity in different individuals, in different races, and at different periods of life. Variations in mentality and consequent variations in will power. The prostitute — male and female. 2. Continence and its relation to health. (/) The physiological secretions that may affect health through excess, deficiency, or absence. 1. Internal secretions of the male reproductive organs and their possible influences on health. 2. Internal secretions of the female reproductive organs and their possible influences on health. 3. Influences of other internal secretions on sex life, e. g., the pituitary- bodies. The adrenals. {g) Emotional influences, mental hygiene. (See above under (e).) 1. The acquirement of sex obsessions. The overem- phasis of sex emotions. The influence of erotic thoughts. {h) Neuro-muscular activity. 1. Fatigue and sex morality. 4. Deficiencies and deprivations. (a) The normal sex life at different age periods. 5. The unknoivn agents that injure health. (a) History of gonorrhea and the final discovery of its cause. (&) History of syphilis and the final discovery of its cause. II. THE CARRIERS OF PATHOGENS. 1. The human carriers. (a) The distribution of disease organisms through the respira- tory excretions. The prostitute, male or female, is often '' afflicted with syphilitic sores in the mouth and other upper air passages. The same condition is often present in persons innocently infected with syphilis. The dam- age from syphilis innocently acquired is as great as the damage of syphilis of the guilty. (h) Discharges from the eyes and ears as carriers of disease organisms. The discharges of gonorrheal ophthalmia very easily transfer the disease from the eyes of one person to another. Discuss gonorrhea of the eyes. (c) Dissemination of disease organisms by way of discharges from the digestive tract. Syphilis of the digestive tract is fairly common in the later stages of that disease. Under such circumstances fecal excretions contain the organisms of syphilis. (d) Dissemination of disease by way of discharges from the genito-urinary tract. Syphilis, gonorrhea, and chan- croid are spread most commonly by means of discharges from the genito-urinary tract. The infection usually takes place in the act of sexual intercourse. (e) Dissemination by way of the skin. May mention the fact that surgeons and nurses have been infected with syphilis and with gonorrhea through contact with sur- gical wounds of infected patients. (/) The importance of the prostitute and the near prostitute in the spread of gonorrhea, syphilis, and chancroid. 2. Insect carriers. — Remote possibility of biting and blood-sucking insects becoming carriers of syphilis and gonorrhea. None of these insects is known to serve as a biological carrier of these diseases. 3. Animal carriers. — No animal other than man is known to be a com- mon carrier of gonorrhea, syphilis, or chancroid. It is possible to infect certain animals, but only under very artificial condi- tions. 4. Contact infections. — Syphilis, gonorrhea, and chancroid are the most typical of the contact infections. Importance of innocent contact in the home. Disastrous effects of syphilis and gonor- rhea acquired innocently by the wife, husband, child, sister, brother, or mother of the guiltv carrier. 59 5. Secondary carriers. — Possibilities of infection with syphilis, gon- orrhea, or chancroid through secondary carriers such as wash cloth, towel, napkin, pipe, drinking cup, eating utensils, etc. III. THE CONTRIBUTORY CAUSES OF POOR HEALTH. 1. Definition. Agents, influences, and conditions that make it easier for humans to become sick and harder to get well. Syphilis and gonorrhea are examples of agents and influences that de- stroy vitality, decrease resistance, and establish chronic ill health in. their human victims so that they more easily become sick and with more difficulty recover health. ^. Influences that faA^or the multiplication of pathogens or their car- riers. The organisms that cause gonorrhea, syphilis, and chan- chroid will grow only in human beings. The only carriers of these pathogens are their human carriers. The prostitute (male and female) is the most common human carrier. There- fore any influence that favors the increase of prostitution is inevitably a contributory cause of gonorrhea, syphilis, and chancroid. 3. Influences that increase the vitality of pathogens or their carriers. Treatment of the prostitute that cures gonorrhea or syphilis but does not cure prostitution is a procedure that increases the vital- ity of a potential carrier of either or both of these diseases. 4. Influences that favor the distribution of pathogens and their car- riers. Note the relation between transportation, travel, immi- gration, war, poverty, congestion, and ignorance and prostitu- tion. Note relations between ignorance and carelessness and the spread of venereal disease, especially from guilty to innocent. Relation of ignorance and carelessness to ineffective treatment and to no treatment at all. Relation to exposure : If men and women were better informed there would be fewer exposures to infection and there would be more persistent treatment when infection does occur. 5. Influences that tend to interfere with or break down our home and community (tent or camp) defenses, such as poor policing, poor discipline, carelessness, illiteracy, ignorance, vice, industrial conditions, business and commercial greed, immigration, low standards of hygiene, poverty, hazardous occupation, bad poli- tics, experiences of war. Each one of these influences may be illustrated by examples of their relations to the occurrence of syphilis, gonorrhea, and chancroid. 60 6. Influences that weaken the health defenses of the individual, making it easier for him to be sick and harder to get well. Sy2)hilis, gonorrhea, and chancroid may be used as examples of such influences. (See S^dlabus, p. 13.) (a) Age, sex, heredity, physical defects, functional excesses, dissipation (alcohol, drug, and other devitalizing habits), exposure. Xote the possibility of syphilitic heredity: physical defects due to sj^philis, gonorrhea, and chancroid; functional excesses of a sexual char- acter. (6) Deficiencies and deprivations that contribute to poor health. Xote tl-o importance of clean, healthful recrea- tion, character-building entertainment, and chivalry and sportsmanly ideals in play and athletics and dis- cuss the effects of their deficiency or absence upon the sexual conduct of the individual and their consequent relation to the occurrence of venereal disease. IV. DEFENSES OF HEALTH. ^ 1 . The nature and importance of our natural environmental defenses. Pathogenic organisms die quickly under unfavorable conditions. The carriers of gonorrhea, syphilis, and chancroid will not live very long except in the tissue of human beings. 2. Agencies that may be used to destroy pathogens and their insect or animal carriers — the human is the only carrier of gonorrhea, sj'philis, and chancroid. Emphasize the health protective value of suppressing prostitution. 3. Other " Safety first " measures in relation to mechanical, physical, and chemical agencies that injure health and destroy life. 4. The nature and the importance of the surface defenses of the indi- vidual. May illustrate with examples from the venereal diseases. 5. The nature and the importance of the internal human defenses in health and disease. May give examples from syphilis or gonorrhea. 6. Individual defensive hygiene. General health defense of the in- dividual; importance to the individual of wise health habits — good health is its own greatest defense. A good place to em- phasize habits of individual hygiene as defensive measures against venereal disease, (a) Expand the value of accurate in- formation; (&) go into detail as to the protective value of regu- lar health examinations and early rational treatment; (c) insist on the practicality of avoiding exposure to venereal disease ; {d) and drive home the importance of the right sort of play, recrea- tion, and entertainment. 61 7. Group and intergroup defensive hygiene, (a) Illustrative mate- rial from our knowledge of group and intergroup defenses against syphilis and gonorrhea may be used to advantage in connection with every phase of the discussion of group and inter- group defensive hygiene. The professor or teacher of hygiene will have these possibilities in mind in elaborating this portion of his text. V. THE PRODUCERS OF HEALTH (CONSTRUCTIVE HYGIENE). 1. Sources and importance of reliable health information. 2. Heredity ; importance of the conservation of good heredity. 3. Health examination and advice. 4. Care of the body and repair of its organs. 5. Special emphasis upon and discussion of the health-producing and health-conserving value of wise habits of — (a) Nourishment. (6) Excretion. (c) Play, recreation, exercise, and work. {d) Eest. Note.— The expansion of the above chapter and its development into a text for class use gives large opportunity for effective emphases on the prevention of the venereal diseases. The judgment and diplomacy of the teacher may be taxed in making a wise decision as to where and how these opportunities may be used to the very best advantage. 6. The value of hygiene. Good, active, aggressive health is the most important asset in the life of man, because the best success of whatever man undertakes is dependent upon the quality of health with which he supports his enterprises. A judicious use of appropriate material from the hygiene of syphilis and gonor- rhea may serve a powerful purpose in the development of the discussion of the social, economic, spiritual, civic, and military values of good hygiene. Division 2.— INDIVIDUAL HYGIENE. I. INFORMATIONAL AND EDUCATIONAL HYGIENE. 1. Sources of information. — Include discussion of the importance of reliable literature on the hygiene of gonorrhea and syphilis. 2. Surveys and investigations. — May find it wise to discuss inves- tigations of the status of sex information. 3. Parental instruction, health advisers, ^e^cAers.— Important to point out inadequacy and inaccuracy of this instruction espe- cially along lines of venereal hygiene. 62- 4. Individual health examinations and advice. — The teacher in folloTving the main syllabus here will find good opportunities to emphasize the importance of good advice relative to the correction, repair, and remedy of injuries resulting frouL syphilis, gonorrhea, and chancroid. The relation between the "'examiner and the individual is one of extraordinary oppor- tunity for confidential, personal advice on matters of intimate nature. * 5. Health u'nrnings. s'lgns and si/mptorns— their safe interpretation,. significance, and use : A good place to Avarn against the quack. 6. Obsessio?is, groundless fears, misinterpretations of unusual or unimportant sensations and functioned, expjeriences. 7. Unsafe tradition^ superstition^ misinformation; special appli- cations to heredity, mental status, and sex life. II. THE CARE OF THE BODY AND ITS ORGANS. 1. The elements of hnrnan physiology. — This chapter may be used to include a careful presentation of the physiology and hygiene of the reproductive organs of the male and the female. 2. Protective individual hygiene. — Covered above in part. (See II (a).) {a) Importance of periodic health examinations. (6) Measures and habits for protection against pathogens and their insect carriers, animal carriers, human carriers, and secondary carriers. May consider here the gonococcus and the treponema of syphilis and their carriers, espe- cially the prostitute. (c) Care of certain organs for the protection of other organs: The reproductive organs in order to protect the Ijrain, the mind, nerves, joints, etc. [d) " Safety-first " habits. {e) Protective halnts in relation to cliemical injuries. (/) Protection of mentality. Conservation of heredity,. avoidance of venereal diseases and alcoholio poisoning. Hygiene of the emotions. 3. Preventive individual hygiene. 4. Remedi/d individual hygiene. {a) Fir.st aid and emergency treatment. {h) Importance of early expert, reliable medical, or surgical service in cases of imj^ortant acute health injuries. Very important to em])hasize the need of early and per- sistent treatment of gonorrliea. syphilis, and fhancroid. [c) Importance of early treatment of jH-ecancercus and can- cerous conditions. 63 III. CONSTRUCTIVE INDIVIDUAL HYGIENE. Cover in practical detail : (a) Nourisliment. (b) Fresh air and sunshine. (c) The hygiene of growth, development, and training. Import- ant to emphasize values of character building and the estab- lishment of high ideals of sex conduct. (d) Eest, relative and absolute. IV. INDIVIDUAL HYGIENE IN RELATION TO GROUP AND INTER- GROUP HYGIENE. A good place to bring out the obligations of the individual and of society in relation to the prevention of venereal diseases. Division 3.— GROUP HYGIENE. L GENERAL CONSIDERATION OF GROUP HYGIENE. 1. Main groups to he discussed. — The social and economic variations and the dominating hygienic considerations that characterize — (a) The home group, (i^) The school group. (c) The employed group. (d) The institutional group. 2. The economic basis of group hygiene. — The teacher in following this main syllabus here may find it advantageous to discuss the economic bearings of syphilis and gonorrhea and of prostitu- tion. 3. The social basis of group hygiene. — The social influences of gonor- rhea and syphilis and of the prostitute may very properly be emphasized here. 4. The main subdivisions of group hygiene. — In developing the sub- divisions of this chapter it is suggested that the teacher make occasional and significant use of examples from the hygiene of the venereal diseases. {a) Educational hygiene. {b) Informational hygiene. (c) Protective hygiene. {d) Preventive hygiene. {e) Remedial hygiene. (/) Constructive hygiene. 64 ■5. C onsideration of the subdivisions of group hygiene in 7'elation to the main groups covered in 4, above. {a) Group educational hygiene. (1) Home educational hygiene. — A stud}^ of home edu- cational hygiene must include an analysis of the character-building and judgment-forming influ- ences in the home. It involves a very careful consideration of the sort of hygiene that should be taught in the different age periods and to dif- ferent personalities and of how this instruction should be given. School methods and home methods must differ. The parent faces a heavy obligation and an extraordinary opportunity to influence the children in the home through vari- ous avenues to achieve safe judgment and wise conduct in matters and affairs that relate to sex life, sex hazard, and venereal disease, as well as to other imj^ortant dominating health problems. (2) Educational hygiene in the school. — In his elabora- tion of the main syllabus the teacher should in- clude here a full discussion of the part that the school may play in educating children so that they will arrive at safe judgments in relation to sex matters and sex conduct ; should bring out the opportunities for such education present in such school subjects and activities as biolog}^, botany, physiolog}% history, English literature, domestic arts, school dramatics, health examination, ath- letic instruction and training, physical education, and so on. (3) Educational hygiene in the occupations. — In pre- senting the needs of the employed group the teacher should give due consideration to the fact that the child and the adult in the occupations have had, as a rule, little or no home education or school education in hygiene. The necessity for wise instruction concerning sex, sex hazards, and venereal disease becomes, therefore, a matter of compelling importance and should influence the teacher in his development of this part of the main syllabus. (4) Educational hygiene in the institutions. The op- portunities and needs for education relative to sex, sex hazards, and venereal diseases vary in the 65 5. C onsideration of the suhdivisions of group hygiene in 7'elation to the main groups covered in Ij.. above — Continued. («) Group educational hygiene — Continued. (4) Educational hygiene in the institutions — Contd. different types of institutions. It would seem that the welfare of society would be construc- tively served if these phases of educational hygiene could be fully and effectively stressed in those institutions that are charged with the care of children, delincjuent girls and women and delinquent boj^s and men. This appears to be particularly true of those institutions that are taking care of persons with venereal disease who are likeh^ to be returned sooner or later to community life. These facts should influence the professor or teacher of hygiene to develop this part of his sjdlabus with appropriate references to their importance. (5) Group informational hj^giene. (1) Informational h3"giene for the home. The main syllabus carries headings here that will lead the teacher to develop his own text so that it will include a study of appropriate home information on sex hygiene and venereal disease. (2) Informational hygiene for the school. The devel- opment of the syllabus here should include a reemphasis of the fact that tiie school child comes into association with other school children and through this association receives information concerning sex that is usually dangerous to the moral and physical health of the jDupil ; that the school should do everything reasonable within its power to bring safeguarding information to the pupils ; and should in every practical way coordi- nate its inform.ational and educational emphases with those of the home. (3) Informational hygiene for the occupations. In presenting this subject for studj^ the teacher should include an analysis of selected informa- tional material relating to the venereal diseases and available for distribution to employers and employees, as well as informational material bearing on other important phases of hygiene. 2058—20 5 5. Consideration of the subdivisions of groirp hygiene in relation to the Tnain groups covered in If., cibove — Continued. {lA Group informational hygiene — Continued. (4) Informational lirgiene for the institution. The part Trhich venereal disease plays in its relation to institutions should be stressed here, and the importance of this information should be empha- sized because of its value to and influence on the policies and programs of certain institutions and the policy of the public toTvarcl those institutions, (e) Constructive hygiene for the group. (1) Constructive hygiene for the home group. The teacher must not neglect here to bring out the value of clean play and wholesome recreation in relation to the prevention of venereal disease. The habits of play, recreation, and entertainment established at home seem to have played no small part in leading individuals in their maturer years to seek clean play, healthful recreation, and wholesome entertainment rather than play, recre- ation, and entertaimnent that endanger health, happiness, and life itself. (2) Constructive hygiene for the school. The play. games, entertainments, and athletics of the school and the college imder wise guidance mav serve a very important purpose in constructive hygiene. Habits of cheerfidness and happiness, habits of wholesome interested activity are jDOwerful ob- stacles to dissipation and to sexual irregularities and to venereal disease. The athletic teacher, the coach, and the trainer have opportunities to influence the ideals and lives of young men that are often truly powerful. This elaboration of this section of the main syllabus should cover these possibilities in relation to sex life and venereal disease as well as in relation to other very important matters in general and individual hygiene. (3) Constructive hygiene in the occupations. Here again the constructive and conservational values of clean play, wholesome entertainment, and vig- orous, sportsmanly athletics should be strongly emphasized. If the men and women and the boys 67 5. Consideration of the suhdivlHions of group hygiene in relation to the main groups covered in L^ aoove — Continued. (c) Constructive hygiene for the group — Continued. (3) Constructive hygiene in the occupations— -Contd. and girls in the occupations could be brought regularly under the influence of this type of con- structive hygiene, the influence on national health would be enormous and the measures of inter- group hygiene directed toward the suppression of venereal disease would more easily achieve success. (4) Constructive hygiene in the institutions. Play, recreation, entertainment, and athletics may serve a very powerful purpose in certain types of institutions. These activities of constructive hy- giene are particularly valuable in those institu- tions that care for younger, growing himians. They are of special importance in the treatment of delinquent boys and girls and men and women. Constructive hygiene may serve purposes here that are mental and moral -as well as physical. {d) Protective hygiene in certain groups. (1) Protective hygiene in the home. While the parent or izuardian is seekino; to educate the children in the home so they will make wise judgments in matters that relate to health, and while the home program is being developed so as to bring accu- rate and appropriate safeguarding information to the home group, it is equally important that reasonable and effective measures should be adopted to protect the members of the home group, and particularly the children and youths of the home, from dangerous contacts, influences, and temptations that are unnecessary, avoidable, and too early in their appearance in the life of the individual. (2) Protective hygiene in the school. The school pro- gram, like the home program, should protect the child from unnecessary and avoidable exposure to health injury. This program should not neg- lect a protection against exposure to vicious sex information, sex temptation, and venereal dis- ease. C onsideration of the subdivisions of group liygleiie in relation to the main groups covered in J),, aSo ye— Continued. (c/) Protective hygiene in certain groups — Continued. (3) Protective hygiene in the occupations. Sex haz- , ards in certain occupations. The protection of the waitress, the laundress, the clerk, the nurse. Need for protection. Sex hygiene in occupations in which men and women are thrown together informally and more or less intimately. Sex hazards in child labor. Protective measures for the purpose of avoiding unnecessary exposure and temptation. (4) Protective hygiene in the institution. Problems of protective sex hygiene that should be met in in- stitutions that care for children or adults of both sexes. Dormitory protection. Importance of employing women to take charge of female in- mates. Serious need for segregation of hard- ened sex offenders and separation of persons of lower mentality, sex obsessions, and exaggerated sex impulses. {e) Preventive hj^giene in certain groups. (1) Preventive hygiene in the home. Discussion of the extreme importance of early and effective treatment of venereal disease whenever and wher- ever it appears. Syphilis and gonorrhea of the innocent is quite as disastrous as syphilis or gon- orrhea of the guilty. (2) Preventive hygiene in the school. The periodic health examinations of pupils and students should be accompanied by the exclusion of all who are found to be carriers of communicable disease. This regulation would include gonor- rhea, syphilis, and chancroid. (3) Preventive hj^giene in the occupation. Periodic health examinations of officers and employees for carriers and effective treatment of carriers when such are discovered. This regulation should apply especially to gonorrhea, syphilis, and chancroid, and is especially important in connection with occupations in which food is handled, children cared for, and intimate con- tacts take place between employee and customer. 69 5. Consideration of the subdivisions of group hygiene in relation to the main groups covered in 4, ahove — Continued. (e) Preventive hygiene in certain groups — Continued. (4) Preventive hygiene in the institution. Periodic health examinations of officers, employees, and inmates, with proper isolation and effective care of disease carriers. The importance of this pro- gram in relation to the venereal diseases should be emphasized. (/) Remedial hj^giene. (1) Remedial hygiene in the home. Point out the ne- cessity for very early and very persistent remedial treatment of the venereal diseases and make clear the fact that the success of remedial treatment for the individual means prevention and protection for the other members of the family. (2) Remedial hj^giene in the school. The rapid reme- dial treatment of communicable diseases in school children or college students means not only a more successful esca]oe from damage or disaster by the individual — it means also the protection of those other individuals with whom he comes in contact. The application of this fact to the venereal diseases is apparent. (3) Remedial hygiene in the occupation. Importance of early and effective remedial treatment of com- municable diseases, including the venereal diseases in those occupations in which are handled food and food products, and in those occupations in which the worker comes into close contact with other workers or with customers. (4) Remedial hygiene in institutions. Emphasize the importance of remedial hygiene in those institu- tions that are established for the purpose of tak- ing care of children, the homeless, the aged, the delinquent, etc. It is seriousl}^ important that men, women, and children sent to institutions (reformatories, jails, etc.) for periods of time should not be returned to society as carriers of disease. The inmate with gonorrhea or syphilis presents a complicated problem in that he must be cured not only of venereal disease but also of prostitution. 70 6. Consideration of the subdivisions of group hygiene in relation to the main groups covered in 4, above — Continued. {g) Hygiene measures for recuperation, rehabilitation, and restoration in these groups. Properly a part of con- 's structive hygiene. (1) Provisions for recux^eration, etc., in the home. See text of main sjdlabus. (2) Provisions for recuperation, etc., in the school. (3) Provisions for recuperation, rehabilitation, and restoration in the occupations. (4) Provisions for recuperation and rehabilitation in the institutions. See paragraph {d) in the main syllabus. The delinquent woman must not only be cured of her venereal disease; she must learn how to support herself in an honorable way or remain in the reformatory or its equivalent under mild restraint in order that she may not infect others. Division 4.— INTERGROUP HYGIENE. 1. Definition. — It may be found wise in develo])ing the details of this definition to illustrate with material from our knowledge of gonorrhea, syphilis, and prostitution. 2. The economic basis of intergroup hygiene. — Convincing illustra- tive facts may be cited here from the effects of syphilis, gonor- rhea, and chancroid on physiological efficiency. The control of these diseases is very obviously an intergroup function. Z. The social basis of intergroup hygiene. — The social importance of the venereal diseases and of prostitution should be presented here in some detail, and the fact should be established that re- lief can come only through the effective operation of intergroup agencies. 4. Legislative basis of intergroup hygiene. — Use laws and ordinances on prostitution, injunction and abatement, control of venereal disease, establishment and management of reformatories, care of the feeble-minded, etc., as illustrations of the necessity for legis- lative action for health protection. 5. Discussion of the main subdivisions of intergroup hygiene. (a) Intergroup educational hygiene. In developing this part of the presentation the teacher should stress the fact that the general public will be educated concerning the dangers and defenses of venereal disease only after vig- orous intergroup educational methods and programs have been in ox)eration for a long period of time. 71 5. Discussion of the main suhdivislons of interrjroiq) hygiene— Con. {h) Intergroup informational hygiene. The text under •■ In- tergroiip informational hygiene'" may be effectively illustrated with examples from surreys, investigations, and researches on gonorrhea, syphilis, and prostitution, and -with examples of intergroup agencies that are concerned with the distribution of such information. (c) Intergroup protective hygiene. Could make use of illus- trations taken from protective measures against vene- real disease carriers, isolation, quarantine. {d) Intergroup preventive hygiene. May discuss here the remedial treatment of venereal-disease carriers in order to prevent its transmission to others, (e) Intergroup remedial hygiene. Emphasize the very se- rious importance of early and effective treatment of venereal disease. Point out the fact that every case of untreated gonorrhea or syphilis is of importance to the community as a whole. (/) Intergroup aggressive hygiene. It is only through inter- group aggressive hygiene that gonorrhea, syphilis, and prostitution can be controlled and eradicated. {g) Intergroup constructive hygiene. A good place to empha- size the values of community influences that help in the formation of fine character, high ideals, and clean con- duct. These are powerful products of intergroup con- structive hygiene that have much to do with the control of venereal disease. (A) Intergroup reconstructive hygiene. The damages done by syphilis and gonorrhea are sources of much of the need for reconstruction. Bring out the importance of moral reconstruction in case of the prostitute. In mak- ing up the details under each of the subheadings of the several divisions of this section of the syllabus frequent opportunity will arise for the effective use of illustra- tions and applications from the hygiene of the venereal diseases. 6 Discussion of the more hnfortant agencies of intergroup hy- giene.— In making up the details of this part of the main syl- labus the professor or teacher of hygiene will find opportunities under each of the subheadings of the several subdivisions of the syllabus for the effective use of illustrations and applications from the intergroup hygiene of the venereal diseases. The 72 6. Discussion of the tnore important agencies of Intergrou-p hygiene — Continued, teacher should make judicious use of these opportunities for emphases in discussing the following agencies : ' {a) Legislative bodies as agencies for intergroup hygiene. (1) Examples of Federal legislation for the control of venereal disease and prostitution: The Mann Act; the importation of prostitutes (immigration laws) ; sections 12 and 13 of the act of Congress "to authorize the President to increase tempo- rarily the Military Establishments of the United States," approved May 18, 1917; Chapter XV, Army appropriations bill, July 9, 1918 — Cham- berlain-Kahn Act. (2) Examples of State laws. (3) Examples of county and municipal ordinances. {h) The department of health. Emphasize the special organi- zation and functions that are concerned with gonorrhea and syphilis, their prevention, treatment, and control. {c) Educational agencies. Discuss curriculum and program provisions in State and public schools, normal Schools, colleges, and universities for the prevention and control of venereal diseases through education, information, defensive measures, and constructive hygiene. {d) Governmental agencies. Emphasize organizations and functions that have been established for the prevention, treatment, and control of venereal diseases in : The United States Interdepartmental Social Hygiene Board ; the Division of A^enereal Diseases of the United States Public Health Service; the Medical Service of the Army and the Medical Service of the Navy; the " Sixth Division" of the Navy; and the Education and Recreation Branches of the War Plans Division of the General Staff of the Army. {e) Voluntary organizations that serve as agencies for inter- group hygiene. Analj^ze concisely the organizations and functions that have been established or may be used for the prevention, treatment, or control of venereal disease in : The American Social Hygiene Association ; certain State social hygiene organizations; the State and provincial board of health ; the International Board of Health; the American Medical Association; certain universities, medical schools, and scientific laboratories ; Law Enforcement Section of the Commission on Train- 73 6. Discussion of the more important agencies of intergroup hygiene — Continued. (e) Voluntary organizations that serve as agencies for inter- group hygiene — Continued, ing Camp Activities during the war; the church, Sun- day school, and other religious organizations; social clubs, athletic organizations, recreational clubs, societies for entertainment. REFERENCES FOR THE SUPPLEMENTARY SYLLABUS. These references have been selected by experts and are therefore ver}^ likely to be dependable. Nevertheless, the individual professor or other special teacher of hygiene should consult such of these refer- ences as may be available to him in the same painstaking and critical spirit that should dominate all his investigations as a student of hygiene. SELECTED REFERENCES FOR USE V*^ITH THE SUPPLEMENTARY SYLLABUS. Division 1.— GENERAL HYGIENE. Author. Title. Publisher. Hutchiii£on Syphilis Funk & Wagnalls Co. American Medical Asso- Pusey Syphilis as a Modern Problem The Third Great Plague The Biology of Sex Stotes ciation. W. B. Saunders Co. Galloway D. C. Heath Co. Division 2.— INDIVIDUAL HYGIENE. Cady, B.CandV.M Galloway Gulick Hood Smith Hall Do Moore Hall Do Exner , Howard Jewett The Way Life Begins. Sex and Life Dynamic of Manhood For Girls and Mothers of Girls. The Three Gifts of Life Life's Beginning From Youth Into Manhood . . . Keeping in Condition Life Problems Pi,eproduction and Sexual Hygiene, The Rational Sex Life for Men Pex Problems in Worry and Work . The Next Generation American Social Hy- giene Association. Association Fress. Do. The Bob.bs-Merrill Co. Dodd, Mead & Co. Association Press. Bo. The Macmillan Co. American Medical Asso- ciation. Association Fress. Do. E. J. Clode. Ginn & Co. 74 Selected references for %ise with the supplementary syllabus — Coutinued. DmsiON 3.— GROUP HYGIENE. Author. Title. Publisher. Biofelo'w ?ex Fducation .... The Macmillan Co Chapman How shall I Tell my Child? Marriage and the Sex Problem Toward Racial Health F. H Revell & Co Foerster F. A. Stokes Co. March E. P. Button & Co. Moll The Sexual Life of the Child Social Diseases and Mamage The Renewal of Life The Macmillan Co Morrow Lea & Febiger Morlev A. C. McClurg & Co. Cocks Engagement and ^Marriage Problems and Principles of Sex Education. Youth: Its Education, Regimen, and Hygiene. Association Press. Exner . .... Do. Hall D. Appleton & Co. Division 4.— INTERGROUP HYGIENE. Bloch ■ Sexual Life of Our Times Rebman Co. Ellis Task of Social Hygiene Houghton Mifflin Co. Forel Sexual Question Rebman Co. Stokes Today's World Problem in Disease U. S. Public Health Prevention. Service. rSvphilis as a Public Health Prob- 1 Vedder lem. Syphilis and Public Health vLea & Febiger. Foster The Social Emergency Houghton Mifflin Co. The Macmillan Co. Addams A New Conscience and an Ancient Evil. Saleeby Parenthood and Race Culture Moffat, Yard & Co. Goddard The Kallikak Family The Macmillan Co. Flexner Prostitution in Ji lU'ope ... . The Century Co. Creighton The Social Disease and How to Fight It. Longmans, Green & Co. Ashburn Elements on Military Hygiene Houghton ]VIifflin Co. The following references for use with the supplementary syllabus may be secured from the Division of Venereal Diseases of the United States Public Health Service, Washington, D. C. : GENERAL HYGIENE. -A Public Health Problem for Civilian Corn- By Dr. J. H. Stokes. Approximately the V. D. B. 11. Venereal DLseases- munities. 22. To-day's World Problem in Disease Prevention. 26. Shan We Finish the Fight? 30. The Percentage of Venereal Diseases Among Second Million Drafted Men — By States. 42. Ravage of Innocents Must Stop. 46. A People's War. 47. The Percentage of Venereal Diseases Among Approximately the Second Million Drafted ^len — By Cities. 7o INDIVIDUAL HYGIENE. I. The care of the body and its organs. V. D. B. 1. Keeping Fit. 6. Man Power. 8. On Guard. 3.3. To Girls in Industry. 49. The Facts About Venereal Diseases. II. The hygiene of correction and repair. Y. D. B. 81. Important Confidential Information (for persons having a venereal disease). III. Protective hygiene — Avoidance of the agents that injure health. V. D. B. 1. Keeping Fit. 6. Man Power. 8. On Guard. 33. To Girls in Industry. 49. The Facts About Venereal Diseases. GROUP HYGIENE. I. Hygiene of the home and the family. V. D. B. 32. The Parent's Pai't. II. School hygiene. V. D. B. 7. The Problem of Sex Education in Schools. 9. The Need for Sex Education. 10. Why Should High Schools and Colleges Provide Sex In- struction ? 38. The Need for Sex Education (with book list). 41. The Place of Sex Education in Biologj- and General Science. -50. A High School Course in Physiology in which the Facts of Sex are Taught. III. Occupational hygiene. V. D. B. 12 to 20. (Pamphlets for Industrial Program.) INTERGROUP HYGIENE. V. D. B. 11. Venereal Diseases — A Public Health Problem for Civilian Com- munities. 22. To-day's World Problem in Disease Prevention. By Dr. J. H. Stokes. 26. Shall We Finish the Fight? 30. The Percentage of Venereal Diseases Among Approximately the Second Million Drafted Men — By States. 42. Ravage of Innocents Must Stop. 46. A People's War. 47. The Percentage of Venereal Diseases Among Approximately the Second Million Drafted Men — By Cities. I. Interfamily hygiene, comnmnity or municipal hygiene. V. D. B. 39. Venereal Disease Ordinances. 48. How to Fight Venereal Diseases in your City. 76 The following references for use Trith tlie Supplementary Syllabus may be secured through the American Social Hygiene Association, 105 West Fortieth Street. Xew York City. GEXERAL HYGIENE. BuJ.Xo. Title. Author. 7 45 58 63 73 75 85 100 103 111 112 118 126 130 161 171 173 180 182 184 186 189 193 194 195 196 198 206 207 208 213 214 222 223 237 238 239 240 242 243 244 245 246 247 251 252 The Regulation of Prostitution in Europe | ]\Iorals and Venereal Disease BiograpMcal Sketch and Portrait of Doctor Mor- j ro'R": Morals and Venereal Disease. The Pioneer Qualities of Doctor Morrow as a Social Reformer. Friend or Enemy Segreeation of Prostitution and the Injunction and Abatement Law. Medical Aspects of Social Hygiene The Way Life Begins j Study of Venereal Prophylaxis in the Xavy I Public Morals and Recreation i ]\Iethod of Attack on Venereal Diseases \ Venereal Diseases; A Sociologic Study j ^Medical Adviser and His Correspondence File ; Next Steps - . - , William Henry "Welch. President of the American j Social Hygiene Association; Biographical I Sketch with portrait. I A Good Samaritan Gift Prohibition and Social Hygiene Case against Prophylaxis Mothers of America Law Enforcement Police and the Pul ilic Health Social Legislation and Vice Control The Matter and Methods of Sex Education Why Let It Burn? A History and a Forecast Recreation ]\Iedical Measures - Education The Sex Problem. Eugenics and Racial Poisons The Sexual Necessity The Need for Sex Education A State-wide Progi-am for Sex Education Reproduction and Sex Hygiene The American Social Hygiene Association — Organization and Purpose. Suggestions for Conununity Action Against Vene- real Disease. The Treatment of the ^^enereal Disease Patient. . , The Failure of Segregation as a Protector of Inno- cent Womanhood. Venereal Disease Among Prostitutes Social Hvsiene Publications The End of the Road . . . . . Lecture Film: Venereal Diseases, Their Origin and Results. Modern Diagnosis and Treatment of S;\'philis The .American Plan Woman's Lecture Film Wamiug About Prostitutes (in Yiddish ) Facts About Gonorrhea (in Yiddish i Abraham Flexner. E. L. Keyes. jr. Do. ' C. W. Eliot. M. J. Exner. .1. D. Greene. B. C. & V. M. Cady C. E. Riegs. C. W. Hayes. W. F. Snow. Bascom Johnson. G. W. Wende. R. A. Woods. Edith H. Hooker. Mabel S. Ulrich. R. W. Pullman. Joseph ]\Iayer. P. A. Morrow. Do. W. H. Howell and E. L. Keyes. W. H. Eddy. D. L. Jewell. H. E. Kleinschmidt. R. H. Eyerett. Benjamin Malzberg. Motion pictures on social hygiene. 77 General liygiene — Coutinued. Bui. No. Title. Author. 253 Facts Ahout Rj^liilis fin Yiddish ) 255 256 257 258 259 260 261 262 263 Standard Form of Law. (Repression of Prostitu- tion; Form 1.) Standard Form of Law. (Repression of Fornica- tion; Form 2.) Standard Form of Law. (Injunction and Abate- ment Act; Form 3.) Standard Form of Law. (Control of Venereal Diseases; Form 4.) Standard Form of Law. (Ouster Law; Form 5.) Standard Form of Law. (Estaljlishment of a Reformatory for Women or Giils; Form 6.) Experimental Medicine and the Venereal Diseases. The American Plan as Seen by an Englishwoman. . What to Read W. F. Snow and T. A. Storey. Edith Picton-Tubervill. 264 AVarnin"' About Prostitutes (in Spanish) 265 266 Facts About Gonorrhea (in Spanish ) Facts About Syphilis (in Spanish ) INDIVIDUAL HYGIENE. 43 48 Hygiene Sexual para los Jovenes (Spanish) Sexual Hygiene for Young Men W. T. Belfield. Do. 52 Sex in Life . Donal B. and E. B 99 Keep in Fighting Trim Armstrong. 101 Sword of Damocles W. r. Rucker. 181 The Girl's Part Mabel S. Llrich. 201 The Young Mans Problem P. A. Morrow. 211 A Reasonable Sex Life for a Man 216 Vigorous ^lanhood 242 Social Hvgiene Publications 263 What to Read GROUP HYGIENE. 33 41 60 107 172 187 199 202 203 217 221 225 226 227 228 229 230 231 Educational Attacks on Problems of Social Hygiene. Home and Community The Mother's Reply .\ Responsibility of the Dean of Women for Sex Education. Illinois Social Hygiene League Prudery and the Child Sexuality in Plants Instruction in the Physiology and Hygiene of Sex The Bov Problem '. When and How to Tell the Children Sex Education in the Home and High School Outline of Plan Order Blank Pamphlet, ' ' For Girls " Pamphlet, "Facts About Venereal Diseases for Men." Pamphlet. "Questions and Answers for Girls" U. S. Public Health Service Placard for Men Woman's Placard . , M. A. BigeloAv. Nellie M. Smith. Louise F. Brown. R. H. Gault. W. M. Gallichan. D. S. Johnson. P. A. Morrow. Do. James E. Peabody. Industrial program. Group Hygiene — Contiuued. Bui. No. Title. Author. 242 Social Hygiene Publications 248' Child Questions and Their Answers Helen W. Brown. 254 263 Child Questions and Their Answers (in Yiddish) . . What to Read 267 Child Questions and Their Answers (in Spanish) . . INTERGROUP HYGIENE. 7 59 61 77 108 109 116 117 121 124 132 149 159 ]65 168 175 176 178 ' 185 188 233 234 235 236 241 242 250 263 The Regulation of Prostitution in Europe Prostitution and the Police Prevention of Venereal Diseases in the Army — Clinics for Venereal Diseases Social Hygiene and the War. Washington, the Cleanest Capital in the World. . . Recent Progress in New York's Venereal Disease Campaign. What Some Communities Have Done for the Pro- tection of Morals and Health of Soldiers and Sailors. Vice Repression as a War Policy Community Control of Venereal Diseases California Program for Prevention of Venereal Diseases. Venereal Diseases in the Army, Navy, and Com- munity. Social Hygiene and the War Educational Prophylaxis of Venereal Diseases . . . Social Hygiene Legislation in 1917 The Social Hygiene Sergeant Experiences of a Lectiu"er Social Hygiene and the War The Massachusetts Plan Exhibit Catalog The Public Health Service Campaign Against Venereal Diseases. The Work of the United States Interdepartmental Social Hygiene Board. The Sixth Division of the Bureau of Navigation. The Red Cross Conference at Cannes Public Health Education and the American Army in France. Social Hygiene Publications Conquering an Old Enemy What to Read , Abraham Flexner. R. B. Fosdick. Otto May. W. F. Snow. Do. David Lawrence. Bascom Johnson. Walter Clarke. F. J. Osborne. W. A. Sawyer. Rt. Rev. Wm. Lawrence. Katherine B. Davis. H. E. Kleinschmidt. Joseph Mayer. W. A. Bradley. Rachelle S. Yarros. M. J. Exner. A. N. Thomson. C. C. Pierce. T. A. Storey. C. B. Mayo. W. F. Snow. C. E. Barr. Will Ir^vin. PART 3. SUPPLEMENTARY SYLLABI ON SPECIAL GROUP AND SPECIAL INTERGROUP HYGIENE. Division 1.— SYLLABUS ON SPECIAL GROUP HYGIENE. I. DOMESTIC HYGIENE OR HYGIENE OF THE HOME AND FAMILY. 1. &ite and location of the home. — IiifiuLnce of climate: soil; drain- age ; water supply ; sewage ; neighborhood ; nuisances, such as smoke, fumes, dust, and noise ; social life ; school ; hospitals and clinics; police and fire protection; health standards of com- munities; availability of department of health; availability of physicians and nurses ; local morbidity ; moral standards of com- munity. Importance of sunshine, cheerful surroundings, and other influences that lead to health, happiness, and prosperity. 2. Planning the home. — Selection of house already built, selection of a tenement or apartment. Rooms in a family hotel. 3. C onstruction and equipment of a home: (a) Material used. (&) Number and variety of rooms. Living rooms, sleeping- rooms, sleeping porches, dining room, social rooms, playroom, room for emergency, isolation and quaran- tine, bathroom, toilet accommodations, kitchen, pantry, storeroom, basement, attic, and closet. The small, medium-sized, and large house. (c) Illumination. Candle, oil. gas, and electric; angle and direction of light; light reflectors; direct, indirect, and semi-direct illumination; location and size of windows; curtains, shades, awnings, and relation of covered porches to room illumination ; interior color scheme. (d) Heating and ventilating. Fireplace. Stoves: oil, gas, wood, and coal. Furnace : hot air, steam heat, hot- water heat. Location of heaters. Humidity. Tem- perature. Purity of air, dust, smoke, fumes, and odors. Motion of air; plenmii and vacuum ventilation. Win- dow ventilation, ventilation through fireplace, stove, and hot-air furnace. (79) 80 3. Construction and equipment of a home — Continued. (e) Cleaning. Importance of smooth surfaces with no sharp angles to catch the dust. Sweeping, mopping, dusting, and vacuum cleaning. Disposal of refuse and garbage. , Special problems in tenement houses, apartment houses, family hotels, and in neighborhoods in which families live close together. (/) Bathrooms. Tub and shower. Warm-water supply. Gas heaters. Stove heaters. (^) Disposal of excretions. The yard privy. House toilet. Cesspool. Conununity sewage systems. (7i) Porches, sun parlors, roof gardens, roof play and recrea- tion arrangements. (i) Yard and yard buildings, size of j^ard. Play and recrea- tion space. Flower and vegetable gardens. Yard houses, barn, garage, playhouse, lounging space, ham- mocks, swings, tennis, croquet, quoit, etc. Limitations and possibilities in the rural home, the village home, and the city home. The home of the man in poor cir- cumstances, of moderate means, and of considerable resource. 4. Furniture. — Postural considerations. Chairs, desks, lounges, tables, sinks, wash stands, bookcases, shelves, mantels, sideboards, beds, etc. Importance of comfort, attraction, and utility. 5. Importance of cheerful.^ attractive surroundings. — "Why worry" and " Keep busy." 6. Hygiene of heredity. — Preparation for parenthood, parental hygiene. 7. Prenatal hygiene. 8. The hygiene of childhirth. 9. The hygiene of infancy^ childhood^ and youth. — Special importance of each age period in the physical, moral, and mental growth and development of the child. Emphasis of various dominating factors in educational hygiene, constructive hygiene, informa- tional hygiene, protective hygiene, and remedial hygiene. Habit- forming periods of supreme importance. Special problems of adolesence. Period of questions on matters of sex reproduction that calls for most careful parental consideration. {a) Care of the baby. (6) Care of young children. (c) Care of the adolescent. {d) Care of the young adult — the young woman and the young man. (e) Care of the mother at different physiological and age periods. 81 10. Family food supply. — Quality, quantity, preparation, balanced diet modifications for different age periods, habits of eating. Great importance of cheerfulness at mealtime. (See discus- sion under Individual hygiene.) 11. Care of excretions ., respiratory and intestinal. — (See discussion in General hygiene, the carriers of disease, etc.) 12. Provisions and pTogram for play., recreation.^ exercise., social life., and rest for parents mid children. The importance of wise employment of leisure time. 13. The general education of the child. Its hygienic aspects. 14. The mental and moral health of the child and the parent. Hy- giene of the emotions. 15. Work of older hoys and girls and of ^parents. 16. Protective^ preventive., and remedial hygiene in the home. The common health? injuries of infants, children, adolescents, young adults and parents, their causes and carriers and their methods of defense. Emphasize particularly : The infectious diseases of children, malnutrition, adenoids and tonsils, bad posture, tuberculosis, influenza, dental troubles, typhoid fever, gonor- rhea, syphilis, heart diseases, nervous diseases, malignant dis- ease and the diseases of decay (nephritis, arteriosclerosis, apoplexy, and heart disease), and common local diseases (i. e., hookworm, pellagra, goitre). 17. The sick room. — Location in the home. Scanty general furnish- ings, equipment, ease of isolation, ease of supervision, and easy .disposal of excretions. 18. Family relations loith other families of the neighhorhood. Inter- family hygiene. II. SCHOOL HYGIENE. The Scope, Objects, and Importance or School Htgiene — Its Eco- nomic AND Social Values to Pupils, Parents, and Community. BUILDINCxS AND GROUNDS. 1. School huildings. — {a) Importance of practical, experienced ad-' vice in planning a school building and school grounds. The school child is too often forgotten because of a competing inter- est in subjects, architecture, or furniture. (&) Types and con- struction of buildings for rural, village, or city schools ; (c) site, neighborhood, accessibility; {d) location of building or build- ings and grounds ; {e) water supply; (/) drainage; {g) sewage disposal; {h) fire hazard; (i) entrances; (_/') exits, fire escapes; {h) windows; (Z) office rooms; {m) waiting rooms; {n) cloak 2058—20- — 6 82 1. School huildings — Continued. rooms or locker rooms: {o) lavatories, toilets, shower baths, and sAvimmino: pools; (/») indoor play space, gymnasium, entertain- ment hall, auditorium; {q) general limitations and possibilities in rural, village, and city communities. 2. Lighting of school huildings. — {a) Measurement of illumination; (&) angle of light; (c) direction of light, location of seats;: (f/) "windows; {e) curtains and shades; (/) artificial illumina- tion: {g) direct and indirect illumination; (A) electric, gas, and oil; {i) practical consideration in rural, village, and city schools. 3. Ventilation and heat. — {a) Temperature; (&) humidity; {c) mo- tion of air; {d) dust: {e) odors, gases, and other impurities; (/) window ventilation;, {g) plenum and vacuum systems; (/() air filters and hmnidifiers: {i) stoves: {j) furnaces; (Z') steam heat: (7) hot-water heater; (m) limitations and pos- sibilities in rural, village, and city schools. 4. Drinking fountains, wash rooms, toilet provisions, plumbing, and sewage. Varying possibilities in rural, village, and city schools. 5. Provisions for cleaning. — (a) Sweeping; (h) scrubbing: (r) vacuum cleaning: (d) treatment of floors: (e) construction of trim with no sharp angles or fretted work in which dust easily lodges and which are difficult to clean: (/) rural, village, and cit}'' possibilities. 6. The class7'0077i and its equipment. — {a) Size and shape: (?>) walls and ceiling; (c) floor; {d) windows and doors; {e) teacher's platform: (/) desks adjustable to different sizes of pupils and teachers: {g) aisles; (A) blackboards; {i) charts, maps, and screens; {]) books (size of tj^pe, color of imprint, etc.); {k) laA-^atory; (Z) drinking font; {ni) provisions for expectoration; {n) possibilities of the rural, village, and city school. 7. Gi/mnashini., playroom., exercising hall. — {a) Size; {l>) shape; [c) height of ceiling ; (fZ) floor; (e) platform; (/) ventilation; {g) illumination; (A) heating; (^) relation to locker and shower room; {j) facilities for cleanliness of room, trim, and equipment; {h) bulletin board for announcements; (Z) screen, blackboard, charts, and diagrams; (m) equipment — practical- ity, safety, and maintenance; {n) shower baths and swimming pool; {o) limitations and possibilities of rural, village, and city schools. 8. Assembly hall, auditorium. — Provisions for entertainment in small, medium-sized, and large schools. 9. Special rooms for: (a) Health examinations; (h) isolation or detention; (c) rest and restoration; (d) domestic science; (e) manual training; (/) laboratory activities; {g) lunches; (h) restaurant facilities; (^) study rooms; (j) club or society meetings; (k) social activities; (l) limitations of smaller schools. 10. Fire prevention and profectioji. 11. School grounds. — Play space, recreation areas, athletic field, out- door gymnasium, outdoor swimming pool, skating, tennis, base- ball, football, track, etc. THE HYGIENE OF INSTRUCTION. 1. Genercd considerations. — {a) Individual capacity: (5) fatigue; (c) exceptional children; (c/) subnormal children; (e) defec- tives; (/) school" age; {g) coeducation. 2. The pupil and the curriculuin. — (a) Size of classes; (&) school hours; (c) carrying of books; {d) inspection for cleanliness and health (the teacher should always be subconsciously alert to evidences of health abnormality in her pupils) ; (e) length of class periods; (/') "relief drills" ; {g) recesses and recess programs; (A) lunch period — usually too short; («') sequence or order of subjects; (j/) the one or two session day; {W) part time schedule; (Z) dual system; (??z) home work; in) extra work; (o) outside activities; {j)) examinations, mid-term, and final; {^q) overwork; (r) discipline and punishments; (s) school suicides; it) vacations; {u) field work; (v) school clubs for nature study, woodcraft, etc; {w) athletic organizations and competitions. 3. The hygiene of different school subjects. — (a) Reading; {h) writ- ing; (c) handwork; (d) domestic science; (e) manual train- ing; (/) gymnastics, play, and athletics; (g) singing; (A) dangers of unwise sex instruction. i. Specicd schools. — Open-air schools, malnutrition classes, schools for crippled children, blind, deaf and dumb, feeble-minded, delinquent, and incorrigible. INSTRUCTION IN HYGIENE. 1. General. — {a) Hygiene in training schools for teachers. Every teacher should be as well prepared in hygiene as he or she is in English or arithmetic; {h) hygiene in elementary schools; {c) hygiene in secondary schools; {d) special opportunities, necessities, and difficulties in rural schools, village schools, and city schools. Organization proposed by the United States In- terdepartmental Social Hygiene Board for instruction in hy- 84 1. General — Continued. giene in the university, college, and normal school. Applicable to elementary and secondary schools, with such variation in in- structional emphasis and vrith such safeguards as are logical for file age period covered. 2. Content of. — General hygiene, individual hj^giene, group hygiene, and intergroup hygiene. Modifications, special emphases, ' and careful methods of presentation necessar}^, particularly in the elementary school. 3. The 'principles and administration of physical training. — Every teacher should be able to direct the play and games of school children and the common athletic activities of the older boys and girls. And every pupil should carry on such physical ex- ercise as is within the limits of his strength. 4. Health examinations. — Frequency; scope, purpose; common health abnormalities, deficiencies, and defects found in school children; the school physician; school nurse; dentist; clinic; health conference ; " follow up " of advice. 5. Physical training. — Gymnastic exercises ; recreation ; games ; play ; athletics; swimming; special provisions for pupils organically unfitted for regular physical activities; team and group organ- ization ; opportunities for effective, confidential relationship be- tween physical training teacher and player. 6.' Special hnportance of sex hygiene. — Opportunities for instruction in sex hygiene in connection with other subjects as well as hy- giene ; place of sex hygiene in the curriculum as a part of vari- ous subjects rather than a distinct subject separately presented. HYGIENE OF THE TEACHER. 1. Imq)ortance of health of teachers. — ■(«) Should be considered in connection with the planning of school buildings and grounds and in connection with their furnishing and equipment; (&) teaching hours; (c) length of schedule; {d) preparation of work; () Type, size, and number of rooms for: Administration, in- mates, employees, sleeping rooms, instruction, play, rec- reation and entertainment, work and occupation, care 91 4. Construction and equipment — Continued. (?>) Type, size, and number of rooms for — Continued. and treatment, convalescence, bathing, preparation of meals, serving of meals, restrictive confinement in its various degrees, and for leisure time. (c) Illumination. (See discussion in syllabus of school hygiene or domestic hygiene.) Special needs of different types of institution, e. g., institutions for the blind or for the insane. {d) Heating and ventilating. (See syllabus on school hygiene or domestic hygiene.) Precautions necessary for irre- sponsible, homicidal, suicidal, or malicious inmates. (e) Cleaning. (See discussion in syllabus on school hygiene and syllabus on domestic hygiene.) Special considera- tion necessary in connection with institutions that care for inmates of low grade intelligence, malicious habits, and with certain diseases. (/) Central power house or plant for illuminating, heating, ventilating, vacuum system, and electrical power. {(/) Bathing facilities specially devised for the particular type of institution concerned. Dangers of steam and hot water with the crippled and helpless. Importance of provisions for supervised bathing. (A) Disposal of excretions. Provisions for the normal inmate and for the hel^Dless inmate. (i) Porches, sun parlors, roof parlors, and accommodations for play, games, and entertainment. {]) Yard and grounds. Play space, athletic field, garden, farm, dairy, etc. Yard and grounds and farm build- ings. Barn, green houses, garage, tool house, work house, warehouse, milk room, chicken house, etc. Im- portance of sanitary and hygienic arrangements and supervision over these buildings. 5. Furniture. Fitted for the special purpose of the institution and for the individual requirements of the inmates. Plain and durable. Postural considerations. 6. Inqwrtance of cheerful and attractive surroundings in the sev- eral types of institution. 7. Educational and informational hygiene in- the institution. {a) In institutions in which an educational program is carried out, the principles of educational hygiene apply as they do in the school. 92 7. Educational and infoimational hygiene in the institution — Con. {h) Some form of educational and informational hygiene could be eifectivelv given in all institutions in which the inmates are not mentally incapacitated. The orphan's home, the school for the blind, the deaf and dumb, and "> for the crippled may present the hygienic problems of the normal or nearly normal child. The sanitarium calls for education and information connected with the . defensive hygiene of tuberculosis or some other health injury responsible for the presence of the individual in the institution. The reformatory, the jail, and the penitentiary contain inmates who are in a large per- centage of cases victims of venereal disease and of vicious sex habits. Their instruction and information concerning the causes, carriers, injuries, and defenses of syphilis, gonorrhea, and chancroid is both logical and important. 8. Food supply for the institution. Balanced diet. Food inspec- tion. Good cooking. Habits of eating. Importance of cheer- ful, pleasing influences at meal time. 9. Care of excretions. 10. Provisions and, program for games and play. Entertainment. athletics. 11. Work of inmates and its relation to health and to future economic independence. 12. Protective and preventive hygiene in institutions. 13. Sj)ecial provisions for remedied hygiene for recuperation and re- habUitation. Developed to the greatest extent in the general and special hospital. 14. Relations hetv^een the institution and the puMic. Obligation of the institution to do everything it reasonabh^ can to return its inmates to community life and health, and able to do some- thing toward self-support. REFERENCES. DOMESTIC HYGIEXr. Author. Title. Publisher. Adams The Health :Nraster Overcrowding and DefectiA'e Hous- ing. Sanitation of a Country Home Home and Commiinitv Hygiene Home Tare of Sirk Children The Care of the Sick Room Children ir. Health and Disease Health on the Farm - Houghton MifHJn Co. John Wiley & Sons. Do. ' . 15; Lippjrxott Co. D. Appleton & Co. Harvard University Press. F. Blakiston's Son & Co. Sturgis & Walton Co. Bashore Do Broaclhurst Coolii'j^e Cutler: Fors-'th Harris 93 References — Continued. DOMESTIC HYGIENE— Continued. Author. Harrison. . Holt Do.... O'Donnell. Osborne Richards. . . Solis-Cohen , Starr Strong Talbot Do ^Yinslo^v. . . . Title. Home Nursing Tlie Care an.d Feeding of Children. Diseases of Infancy and Childhood. The Family Food . ." The Family House Home Sanitation The Family Health Hygiene of the Nn rsery Home Hygiene and Care of the Sick. House Sanitation - do - The Home Medical Ad^dsor Publisher. The MacMillan Co. D. Appleton& Co. Do. The Penn Publishing bo. Whitcomb & Barrows. Penn Publishing Co. P. Blakiston's Son & Co. Do. Thomas Todd & Co. Vv hit comb & Barrows. D. Appleton & Co. SCHOOL HYGIENE. Andress Ayers Do Bancroft Bryant Burgenstein. . . Chancellor Burk Cole-Ernst Cornell Doty Dressier Hoag-Terman, . K elly-B r ad shaw Xeumeyer Putnam Rapeer Shaw Struthers Terman Health Education in Rural Schools. Open Air Schools Healthful Schools _. The Posture of School Children School Feeding School Hygiene Health of the Teacher Health and the School First Aid for Boys ■« . Health and Medical Inspection of School Children. Prompt Aid to the Injured School Hygiene Health Work in the Schools Handbook for School Nurses Medical and Sanitary Inspection of Schools. School Janitors Educational Hygiene School Hygiene The School Nurse Hygiene of the School Child . Houghton MifHin Co. Doubleday, Page & Co. Houghton Miffi in Co. The MacMillan Co. ,T. B. Lippincott Co. F. A. Stokes & Co. Forbes & Co. D. Appleton & Co. Do. F. A. DaAis Co. D. Appleton & Co. The MacMillan Co. Hoi ghton Miff in Co. The MacMillan Co. Lea & Febiger. Press American Acad- emy of Medicine, Easton, Pa. Chas. Scribner's Sons. The MacMillan Co. G. P. Putnam's Sons. Houghton Mifflin Co. OCCUPATIONAL HYGIENE. Dulles Accidents and Emergencies P. Blakiston's Son & Co. Kober-Hanson . Diseases of Occupation and Voca- tional Hygiene. Do. Lee The Human Machine and Industrial Efficiency. Longmans, Green & Co. Lynch.. Special First Aid Editions: Miners, Police, Firemen, Railroad, Women. P. Blakiston's- Son & Co. Price The Modern Factory John Wiley & Sons. Thompson The Occupational Diseases D. Appleton & Co. Tolmai: Hygiene for the Worker American Book Co. Wright Industrial Nursing The MacMillan Co. 94 References — Continued. INSTITUTIONAL HYGIENE. Author. Title. Publisher. Elias(?ii First Aid in Emergencies Samtation of Public Buildings Feeblemindedness J. B. Lippincott Co. John Wilev & Sons. The ]\IacMillan Co Gerhard Goddard Mclsaac Hvgiene for Xurses Do. McKenzie Mnmey Worcester Exercise in Education and Medicine . Hygiene for Nurses Small Hospitals, Establishment and Maintenance. W. B. Saunders Co. C. B. Mosby Co. John Wiley & Sons. FUBLICATIOXS THAT MAY BE SECURED THROUGH THE UNITED STATES PUBLIC HEALTH SERVICE. WASHINGTON, D. C. DOMESTIC HYGIENE. Rep. 504. The Treatment of Sewage from Single Houses and Small Communi- ties. By Earl B. Phelps. Feb. 14, 1919. SCHOOL HYGIENE. P. H. B. 58. Open-air Schools for the Cure and Prevention of Tuberculosis among Cmidren. By B. S. Warren. • October, 1912. \. D. B. 7. The Problem of Sex Education in the Schools. A Pamphlet for Educator.^. OCCUPATIONAL HYGIENE. Rep. 499. Code of Lighting for Factories, Mills, and Other W^ork Places. Report of the Divisional Committee on Lighting, Section on Sanitation, Committee on Welfare Work of the Committee on Labor, Advisory Commission, Council of National Defense. Jan. 24, 1919. P. H. B. 73. Tuberculosis among Industrial Workers : Report of an Investiga- tion made in Cincinnati, with Special Reference to Predisposing Causes. By D. E. Robinson and J. G. Wilson. March, 1916. Revised, March, 1919. 95 PT7BLICATI0XS THAT MAY BE SECURED THROUGH THE AMERICAN SOCIAI^ HTGIEXE ASSOCIATION, 10 5 WEST FORTIETH STREET, NEW YORK CITY. DOMESTIC HYGIENE. Bill. No. ■Title. Author. 41 60 63 181 187 203 217 221 248 Home and Community The Mother's Reply. '. Xellie M. Smith, A. M. Friend or Enemv M. J. Exner, M. D. The Giii's Part ." ; : Dr. Mabel S. Ulrich. Prudery and the Cliild W. M. Gallichan. The Boy Problem : P. A.' Morrow. "\Mien and How to Tell the Children [ Sex Education in the Home and High School ' James E. Peabody. Child Questions and Their Answers Helen W. BroAvn. SCHOOL HYGIENE. 107 j Responsibility of the Dean of Women for Sex Louise F. Bro-wn. Education. 221 I Sex Education in the Home and High School James E. Peabody, OCCUPATIONAL HYGIENE. 225 I Outline of Plan (Industrial Program) 227 I Pamphlet, '-For Girls " 228 I Pamphlet, "'Facts about Venereal Diseases for I Men." 229 i Pamphlet, "Qaestions and Answers for Girls" Division 2.— SYLLABUS ON SPECIAL INTERGROUP HYGIENE. 1. RURAL HYGIENE. 1. Rural educational hygiene. {a) Important habits of self -information, of defensive hj^giene, and of constructire hygiene that should be taught in rural communities. (&) The country medical practitioner as a teacher of hygiene. {c) The rural health nurse as a teacher in the home. {d) The rural school and educational hygiene, (e) State educational agencies in rural communities. (/) Federal agencies in rural communities. {g) Local, State, and National organizations, associations, and societies that are concerned with rural educational hygiene. 96 2. Rural informational hygiene. — Intimatelj^ associated with educa- tional hj'-giene. Informational hygiene is too frequently called educational hygiene, but distinct separation is not always possible. (a) Local tradition is the source of much superstition, mis- 5 information, and lack of information. (&) Local surveys, investigations, and inspections. Made by local agencies, State agencies, and National agencies, (c) Literature, reports, bulletins, etc. (1) Issued by county, State, or National govern- . mental agencies in the interests of rural hygiene. (2) Issued by State or National organizations or societies that are concerned with special phases of rural hygiene. (fZ) Lectures, conferences, and so on from local, county, State, or Federal agencies concerned with the acquisition and conservation of health, (e) Vital statistics. Reportable diseases, births, deaths. 3. Rural defensive hygiene. (a) Hygiene of the farm. (See syllabus on domestic and home hygiene.) (1) The farmhouse. Site; location; construction; rooms and their relations; illumination, natural and artificial; ventilation, natural and artificial; heating; cleaning; water supply; sewage and sewage disposal; bathing. (2) The barn, the dairy, and other farmhouses. Rela- tion to each other and to the living house ; clean- liness ; care of animals ; care of milk ; relation to the well; spring; removal of manure, etc. (3) Fire protection. (h) Rural school as an agency in defensive hygiene. (See syl- labus on school hygiene.) (1) The present-day status of the rural school, rural teacher, the rural pupil. The need for better schools, better trained teachers, longer school terms, and for better provision for instructional hygiene in rural communities. (2) The rural school versus the graded rural union school. (3) Modifications necessary to adapt curricula on hy- giene to meet the needs of the smaller rural schools in spite of their limitations in size and material resources. 97 3. Rural defensive hygiene — Continued. (/>) Eural school as an agency in defensive hygiene — Contd. (4) Provisions for the better preparation in liygiene of the rural teacher. (5) Need for greater facilities for play, recreation, ath- letics, and other physical training activities in. rural schools, (c) Kural health officer as an agent of defensive hygiene. The rural board of health. (1) Functions in relation to the health defense of the rural community : Search for, identify, take proper care of foci infection, carriers of disease, and probable source of health injury. Vital sta- tistics. Quarantine. Kegulation of medical prac- tice, the practice of the nurse, the midwife. (2) The safeguarding of streams, springs, and wells for the protection of the water supply. Elimination of insanitary privies, control of soil pollution. Control of the breeding and feeding places of liies, mosquitoes, and other insects. Supervision of diseased animals. Problem of human carriers. (3) Supervision of dairies, slaughter-houses, etc. (4) Law enforcement in relation to communities. De- tention, quarantine, isolation, and commitment to institutions. {d) The rural nurse as an agent of defensive hygiene. (e) Defenses of rural water supply. (1) Protection of streams and springs. (2) The construction of special water supply. The pro- tection of watershed. Regu^lar examinations of water for drinking purposes. Treatment of water in case of pollution or infection. (/) Rural sewage and intergroup defensive hj^giene. The pol- lution of streams and lakes, construction and care of cesspools, rural sewer systems, purification of sewage. {g) Rural garbage and refuse. Its collection and disposal. Economic problems involved. (A) Rural hospital, clinic, and emergenc}^ service. Local, rural community usually without sufficient resource with which to meet the expense of this agency of de- fensive hygiene. Need of help from the larger com- binations of groups, i. e., county, State, or National Government. 205S— 20 7 98 3. Rural defensive hygiene — Continued. {i) Rural care of mental cases: Crippled, orphan, blind, deaf and dumb, homeless, and poor. (_/') Intergroup programs of defenses against certain more important diseases common in rural communities. (1) Typhoid fever. (2) Tuberculosis. (3) Gonorrhea and syphilis, (•i) Hookworm. (5) Pellagra. (6) Malaria and yellow fever. 4. Rural constructive hygiene. {a) Rural food supply. Rural nutrition. {l>) Rural provision and custom in relation to play, games, recreation, and athletics. {c) Rural work. {d,) Rural rest. 5. EniphaBis of the usual insufficiency of the local rural resource to meet the needs of the rural' commumty for better education^ bet- ter information^ l>etter protection., and better opportunities for the acquisition and consercation of health. State the mental obligation and responsibilities of larger units ; the county. State, or National Governments to spend public money and apply expert public service for the support of those localities that are unable to supply such resources themselves. II. CITY OR MUNICIPAL HYGIENE. 1. Provision for educational hygiene. (a) Municipal agencies that are related to educational hygiene in the home. The neighborhood nurse. The school nurse. " Classes " for prospective mothers. Mothers' classes. Infant feeding stations, and so on, {b) Public lectures, talks, conferences, demonstrations on gen- eral and special health subjects carried on by the depart- ment of health, department of education; extension courses in universities and by local societies and organi- zations. (c) School curricula on hygiene, physical education, and physical training. (d) School medical inspection as a factor in educational hy- giene. (e) Special health educational measures for working people. 99 2. Prorision for inforviational hygiene. ■ (a) Appropriations for service, investigations, inspections, and reports for the control of such things as infantile paralysis, typhoid fever, influenza, prostitution, and so on. {!)) Establishment and support of research laboratories. (c) Economic, sociologic, psychological, and medical re- searches for information on health. (d) Vital statistics. (e) Health examinations in schools, hospitals, clinics, and the great insurance companies. (/) Distribution of information secured through («), (&), (c), (d), and (e) , above; and secured also from special agencies outside the community. Importance of litera- ture, lectures, conferences, demonstrations, moving pic- tures, and so on. 3. Discussion of municipal jjroiyisions and agencies for defensive hijgiene. (Protective hygiene, preventive hygiene, remedial and aggressive hygiene.) («) Laws, ordinances, and regulations governing buildings — the material, structure, their size, height, location, con- struction, ventilation, illumination, heating, plumbing, sewage service, cleaning, size of rooms, congestion, and so on. {b) Organization and functions of a municipal department of health. (c) Municipal control of milk supply, slaughter-houses, and other sources of food supply. {d) City defensive hygiene in the regulation of transportation agencies : Street cars, trains, subways, elevated trains, ferryboats, passenger trains, and boats. {e) The defensive hygiene of city traffic regulations. {/) Municipal street cleaning. {g) City sewage systems. (A) City illumination — park and public places. {i) City water supply. {j) Fire protection. {k) Police protection---enforcement of municipal health laws. (Z) Garbage and refuse disposal. (m) Kegidations of smoke, noise, fumes, odors, and other nuisances. {n) Organization and health-defending functions of city hos- pitals, clinics, detention homes, and so on. 100 3. Discussion of municipal jjro visions artel agencies for defensive hygiene — Continued. {o) City institutions, orphans' homes, houses of correction, reformatories, and other city institutions concerned with the defense of human life and health. , {p) Aggressive municipal hygiene. Special city programs for the control or eradication of certain diseases, e. g., malaria, typhoid fever, yellow fever, syphilis and gon- orrhea, smallpox, infantile paralysis, influenza. Pro- grams for the control of malnutrition, for the control of occupational diseases, and for the control of acci- dents. 4. Discussion of village^ city-, or municipal constructive hygiene. (a) Community influence on adequate food supply and nour- ishment — (1) Regulation of transportation facilities. (2) Regulation of hours of labor, lunch period. (3) Municipal wages. (&) Parks, playgrounds, recreational centers, etc., in relation to the play, games, recreation, athletics, and entertain- ment of the community. (c) School activities in constructive hygiene. School play- grounds, games, athletics, physical training. (cl) College and university provisions. (e) Athletic clubs and other community recreational organi- zations. (/) Other city club or municipal agencies concerned with recreation, play, athletics, and healthful entertainment. (g) Municipal control of noise and other rest-disturbing fac- tors. 5. IntercomjmMnity hygiene. Problems that arise between villages and between cities. Water supply, sewage disposal, smoke, odors, and fumes. Common streams, lakes, and water fronts; interurban transportation ; quarantine ; the city and the sub- urbs; travel. III. STATE HYGIENE— HYGIENE OF THE COMMONWEALTH. 1. Lef/isldfive hasis of official State activities and requirements in educational., informational^ protective., preventive., remedied., ag- gressive, constructive., and reconstructive hygiene. 101 2. Educational hygiene of the State. {a) Provisions for educational hygiene under the State educa- tional law. Requirements in hygiene, physical educa- tion, and medical inspection. Applications to elemen- tary and secondary schools— public, institutional, pri- vate — colleges and universities. Special laws of New York, California, and New Jersey. (b) Regulations of the State department of education. See programs and syllabi on hygiene, physical education, and so on— State of Xew York, California, New Jersey, Indiana, Michigan, Virginia, Rhode Island, and Nevada. (c) Provisions for educational hygiene in State health laws. Requirements and regulations of the State department of health. (d) Educational hygiene in other divisions of the State gov- ernment. (e) Programs of educational hygiene developed by State so- cieties, organizations, and associations. 3. Informational hygiene of the State. (a) Agencies for the acquisition of information. (1) Special investigations, inspections, and examina- tions. Special functions of departments of health. (2) Special research commission. (3) Laboratories for scientific investigations: Depart- ments of health, colleges, medical schools, etc. (h) Agencies for the distribution of information. (1) State departments of health, schools, colleges, uni- versities, and public organizations. 4. Defensive hygiene of the -S'z'a^e.— Organization and functions of agencies concerned with protective, preventive, remedial, and. aggressive hygiene. {a) Organization and functions of the State department of health. (&) Organization and functions of the elementary schools and higher educational institutions of the State in relation to defensive hygiene. The State department of education. (c) Organization and functions of certain State institutions concerned with defensive hygiene. Hospitals, clinics, reformatories. {d) Organization and relevant functions of certain State boards and commissions that are concerned with de- fensive hygiene. The public service commission. Com- mission on highways, waterways, canals, conservation of food, industrial relations, and so on. 102 4. Defensive hygiene of the State — Continued. {e) State police and otlier laAA'-enforcement agencies. (/) Important voluntaiy agencies. Medical societies, religious organizations, educational societies, civic leagues, busi- ness men's leagues, labor unions, special health societies. {g) Special aggressive programs. Law-enforcement commit- , • tees and commissions. Campaigns against typhoid fever, hookworm, influenza, syphilis and gonorrhea, malaria, and so on. 5. The constructive hygiene of the State: {a) The beneficial control and improvement of civilian nutri- tion by the State or by agencies that influence the State. {h) State parks, playgrounds, and highways as recreational provisions. (c) State control of hours of labor — the eight-hour day in rela- tion to constructive hj^giene. 6. Reconstructive hygiene of a State. — Function of reformatories with special relationship to the feeble-minded, the delinquent, the prostitute, and the crippled. 7. Interstate hygiene: (a) Interstate agreements for protective, preventive, and ag- gressive hygiene. (h) Interstate constructive hygiene. Parks, water supply, highways and their relationship to recreation, to play, and to entertainment. 8. The econorrdc and social values of intergroup hygiene to the State. IV. FEDERAL OR NATIONAL HYGIENE AS A DIVISION OF INTERGROUP HYGIENE. The central Xational Government has the authority, the power, and the resource necessary for the acquisition and maintenance of a. high grade of intergroup hygiene for the Nation as a whole. 1. National intergroup educational hygiene. (a) Federal intergroup educational hygiene. (1) Division of school hygiene, Bureau of Education, of the Department of the Interior. Other divi- sions of the Bureau of Education engaged in edu- cational hygiene, (2) The United States Interdepartmental Social Hy- giene Board and its programs for educational hj'^giene. (3) Educational liygiene in the Army. (4) Educational hygiene in the Xav}^ (5) Educational h^^giene in the IT. S. Pul)lic Health Service. 103 1. National intergroup educational hygiene — Continued. (6) National intergroup educational hygiene agencies other than those of Federal origin. (1) Various educational foundations. (2) National educational associations. (3) The greater colleges and universities. 2. National mtergvoup informational hygiene. {a) Discussion of Federal agencies engaged in acquiring in- formation concerning scientific facts of hygiene. (1) Medical service of the Army. (2) Medical service of the Navy. (3) Medical service of the U. S. Public Health Service. (4) Bureau of Education. (5) Children's Bureau. (6) Department of Agriculture. (7) Special commissions. (6) Federal agencies engaged in distributing educational in- formation. (1) The Army. (2) The Navy. (3) The Commission on Training Camp Activities. (4) The War Camp Community Service. (5) The United States Public Health Service. (6) Bureau of Education. (7) Children's Bureau. (8) Bureau of Animal Industry. (c) National agencies other than governmental engaged in acquiring information concerning the laws of hygiene. (1)' The great universities and medical schools that carry on research activities. (2) Special laboratories and centers of investigations and researches. (3) International Health Board. {d) The more important national agencies other than govern- mental that are engaged in distributing informational hygiene. (1) Educational societies and organizations. (2) Medical associations. (3) Health societies and organizations. (4) Organizations for the control of special diseases, such as tuberculosis, gonorrhea, and syphilis. (5) The great insurance companies. (6) Societies and associatians concerned with construc- tive hygiene, e. g., play, athletics, recreation. (7) Certain magazines, journals, and publishing houses. 104 3. The defensive hygiene of the Nation. — Organizations and func- tions of some of the agencies that are concerned with national protective, preventive, remedial, and aggressive hygiene. (r(')The organization and functions of the Medical Corps of the Army. Other provisions of the Army. {!>) The organization and functions of the Medical Corps of , the Navy. Other provisions of the Navy. {c) The organization and functions of the U. S. Public Health Service. {(I) The organization and functions of the U. S. Interdepart- mental Social Hygiene Board. {e) The organization and functions of the Bureau of Animal Industry, Department of Agriculture. (/) The organization and functions of the Reel Cross. {g) The organization and functions of the committees on train- ing camp activities during the Great War. (A) The organization and functions of the International Health Board. {i) Special commissions for aggressive hygiene. (1) Eradication of malaria. (2) The eradication of hookworm. (3) The eradication of yellow fever. (4) The eradication of cholera. (5) The eradication of typhoid. (6) The eradication of gonorrhea and syphilis. (7) The eradication of pellagra. (8) The eradication of trachoma. 4. National constructive hygiene. {a) Constructive hygiene in the Army. (&) Constructive hj^giene in the Navy. (c) Federal measures for adequate food supply. {d) Federal measures for recreation, play, entertainment, na- tional parks. {e) Federal measures for rest — the eight-hour day, vacation, and so on. 5. National reconstructive hygiene. (a) Reconstruction program for the wounded, injured, in- valided, and crippled in the Army and in the Navy. Proo-ram of the U. S. Public Health Service. 105 V. MILITARY AND NAVAL HYGIENE AS A DIVISION OF INTER- GROUP HYGIENE. The armies in all history up to the campaign between Russia and Japan suffered more from disease than from war. Good military hj^giene will save more lives than peace with the best of the poor hygiene that peace has yet been able to apply. I. APPLICATION TO THE INDIVIDUAL SOLDIER AND SAILOR. 1. Informational hygiene for the individual soldier. {a) Literature. (&) Lectures and demonstrations. (c) Medical examination and advice; importance. {d) Health warnings and their safe interpretation. {e) Obsessions, apprehensions, misinterpretations of feelings. (/) Unsafe traditions in the Army. 2. Protective measures in the Arfm/ and Nojvy in relation to: (a) The agents that injure the health of the soldier: (1) The inanimate agents — mechanical, physical, chemi- cal. (2) The animate — bacteria, protozoa, and other plants and animals. (3) Physiological influences, emphasizing especially emotional influences, fatigue, sexual excesses. (4) Deficiencies and deprivations, emphasizing impor- tance of interesting healthful play, recreation, and exercise. (5) The unknown agents. (h) The carriers of pathogens: (1) The human carrier; emphasize especially protection against tuberculosis and venereal diseases. (2) Insect carriers, especially the louse, mogquito, and fly. (3) Animal carriers, (4) Contact infections; the prostitute and the roue. (5) Secondary carriers; dust, dirt, infected water, milk. 8. Habits of hodily care for the soldier and the sailor. (a) Hygiene: The skin, muscles, bones, joints, feet, nails, hair, ears, eyes, nose, throat, teeth, lungs, heart, arteries, cir- culation, digestive tract, and digestion, kidneys, bowels, reproductive organs, heredity, mind, nerves, and emo- tions. Emphasize especially care of the feet. 106 3. Habits of hodily care for tlie soldier and sailor — Continued. {h) Constructive h3^o;iene : Emphasize especially value of good digestion, adequate nourishment and excretion, fresh air, cheerful, attractive play, recreation and exercise, and the right sort of rest. Emphasize also the supreme importance of fine condition upon Trhich to develop the -i special training for strength, endurance, and skill neces- sary in the life of the soldier. 4. IvifOTtance of individual hygiene of the soldier. — It is the stutf that makes the Army. The sick soldier is a liability. The sol- dier that needlessly exposes himself is vrorse than a slacker — he may be as injurious to the Army as a spy. The men that fight longest and harde&l, the men that can keep on fighting when others are "vrorn out — those men will be in the Army that wins. II. APPLICATION TO SOLDIERS IN GROUPS— THE TENT. The health of a tent depends upon the health standards of every man in the tent. 1. Resjjonsihility of each inan in a tent or in a harracks for good^ safe., and regular habits of — {a) Health examination. (6) Bodih' care and care of special organs, (c) Correction and repair of defects. {d) Health protection against the causes and carriers of dis- ease. {e) Constructive hygiene. 2. Necessity for discipline., especially in the matters of hygiene and sanitation. III. APPLICATION TO THE MILITARY CAMP OR THE SHIP. The health and therefore the fighting resources of a camp or of a ship depends upon the health of every company of which it is com- posed. The man that fails to take care of himself hurts not only himself but also his company and the larger unit of which the com- pany is a part. 1. Importance of special camp measures for — (a) Rapid and accurate information concerning the presence in the camp of the agents that injure health or of the carriers of disease. {I)) TCarly and effective treatment of men sick, especially those sick Avith transmissible disease, (c) The establishment of drastic precautions and provisions for the exclusion of disease carriers. 107 1. Importance of special camp measures for — Continued. {d) The practice of health habits that save men's lives and enable them to fight longer and harder — i. e., habits of health information, bodily care and repair, health pro- tection, and especially those habits of constructive hy- giene that bring vigor, strength, skill, and endurance (play, recreation, exercise, athletics, and special drills). IV. APPLICATION TO THE ARMY OR THE NAVY. The health standards of the soldier, or of the tent, or of the camp can not be higher than the standard set by the Army or Navy or by the control back of them. 1. Imi^ortance of safe information and practical directions to offi- cers and men, and the importance to the central command of immediate and accurate information concerning morbidity and mortality — the vital statistics of the Army and of the Navy. 2. Provisions made by the Army and Navy for the examination and treatment of men. 3. Provisions for the practice of habits of individual hygiene — espe- cially play, recreation, and athletics. 4. Provisions for the exclusion or control of the agents that injure health and the carriers of disease. V. APPLICATION BETWEEN SOLDIERS AND THE INHABITANTS OF TERRITORY OCCUPIED— CIVILIAN, MILITARY, FRIENDLY, NEUTRAL, AND UNFRIENDLY. 1. An army has not only its own health problems to deal with ; it is also concerned with the health conditions in the territory it occu- pies. It has also a concern with the influence it may have on its surroundings, and, when its men are discharged, upon the health conditions they may find or injure when they reach home. 2. Standards of hygiene established between opposing armies by in- ternational law. 3. Provisions made between military camps and their civilian en- vironmental communities for mutual protection against the agents that injure health and the carriers of disease. 4. Recreational and athletic activities provided in camp environment. 5. The control of health dangers to and from armies of invasion and occupation. 6. The control of the health hazards that attend demobilization and return to civilian life. 108 VI. INTERNATIONAL HYGIENE. 1. International educational hygiene. (a) International educational commissions. (7)) International congi-esses on tuberculosis, hygiene, and de- mography and school hygiene. (c) International functions of the Eed Cross. Xd) An international board of health. 2. Internatio7ial informational hygiene. {a) International commissions established for scientific inves- tigations. (5) International vital statistics. 3. I nternationcd defensive hygiene. — National agencies concerned with preventive, protective, remedial, and aggressive hygiene in their international relationships. {a) Problems of immigration and emigration. {}j) Problems connected with international highways, water- ways, canals, travel, transportation of animals, and ani- mal products. REFERENCES. RURAL INTERGROUP HYGIENE. Author. Title. Andress Health Education in Rural Schools. . Bashore Outlines of Practical Sanitation Brevrer j Rural Hygiene Broadhurst Home and Communitv Hygiene Brown { Health in Home and Town Fredericksen The Story of ^Milk Klein Milk H vcriene 0?den and Cleve- Practical Methods of Sewage Disposal. land. Ross Wood-. Publisher. The Prevention of Malaria . . . . Sanitation Practically Applied. Houghton :^rifflin Co. John Wiley & Sons. J. B. Lippincott Co. Do. D. C. Heath & Co. The MacMillan Co. J. B. Lippincott Co. John Wiley & Sons. E. P. Dutton & Co. John Wilev & Sons. MUNICIPAL HYGIENE. Allen Civics and Health Ash j Organization in Accident ProA-ention . Bashore Sanitation of Recreation Camps and i Parks. Bowen Safeguards for City Youth at Work ■ and at Play. Broadhin-st Home and Community Hygiene lirown i Health in Home and Town Cabot ' Social Work Capes Municipal Housecleaning Foster ; The Social Emergency Gerhard ! Modem Baths and Bath Houses Godfrey The Health of the City Hodge-Dawson . . . . | A Civic Biology Hunter 1 Civic Biologv' Hutchinson j Community Hygiene Kneeland ' Commercialized Prostitution in New j York City. Xewmayer I Medical Inspection of Schools Ginn & Co. McGraw-Hill Book Co. John Wiley & Sons. The McMillan Co. J. B. Lippincott Co. D. C. Heath & Co. Houghton Mifflin Co. E. P. Dutton & Co. Houghton Mifflin Co. John Wiley & Sons. Houghton Mifflin Co. Ginn & Co. American Book Co. Houghton Mifflin Co. The Century Co. Lea & Febiger. 109 References — Continued. MUNICIPAL HYGIENE— Continued. Author. Title. Ogden and Cleve- PracticalMethodsofSevrage Disposal, land. Overton I The Health Officer Parsons i Disposal of Municipal Refuse Price I Handbook on Sanitation Race ! Examination of Milk for Public j Health Purposes. Richards Cost of Cleanness Von Behring The Suppression of Tuberculosis Wood Sanitation Practically Applied Publisher. John Wiley & Sons. W. B. Saunders Co. John Wiley & Sons. Do. Do. Do. Do. Do. STATE HYGIENE. Blaii- Colman... Egbert . . . Endleman Gardner . . . Gerhard . . Hill MacXutt-. Price .... Race Tuttle . . . . "^Tiipple-. Public Hygiene The People's Health Hygiene and Sanitation Meat Hygiene Practical Sanitation Guide to Sanitary Inspections Sanitation for Public Health Xurses . Manual for Health Officers Handbook on Sanitation Examination of Milk for Public Health Purposes. Principles of Public Health State Sanitation The Gorhan Press. The MacMillan Co. Lea & Febiger. Do. C. V. Mosby Co. John Wiley & Sons. The MacMillan Co. John Wiley & Sons. Do. Do. World Book Co. Harvard University Press. NATIONAL INTERGROUP HYGIENE. Allen Brainard Fielding Fisher-Fisk Flexner Fosdick & Flexner. Gardner Goddard Gorgas Havard Hemenwav Hill ■ Hutchinson Leland March McCann Overlock Pani Parkes Price Pryor Richards Ross Sedwick Tuttle Vedder Do W' hippie Keeping our Fighters Fit for War and After. Organization of Public Health Nursing! Sanity in Sex Health for the Soldier and Sailor. . . . Prostitution in Europe Police and Prostitution in the U. S. . .' Public Health Nursing [ Feeblemindedness Sanitation in Panama Militarjr Hygiene American Pubhc Health Protection The New Public Health Ci\'ilization and Health Sanitation in Vv'ar Towards Racial Health The Starving World The Working People Hygiene in Mexico Hygiene and Public Health Hygiene and Public Health Naval Hygiene Conservation by Sanitation The Prevention of Malaria Science and the Public Health Principles of Public Health Syphilis and the Public Health Sanitation for Medical Officers Vital Statistics The Century Co. The MacMillan Co. Dodd, Mead & Co. Funk & V\'agnalls Co. The Century Co. Do. The MacMillan Co. Do. D. Appleton & Co. Wm. Wood & Co. Bobbs-Merrill Co. The MacMillan Co. Houghton, Mifflin Co. P. Blakiston's Son & Co. E. P. Dutton & Co. G. H. Doran & Co. The Blanch ard Press. G.'P. Purnam's Sons. P. Blakiston's Son & Co. Lea & Febiger. P. Blakiston's Son & Co. John V\'ilev & Sons. E. P. Dutton & Co. The MacMillan Co. V\'orld Book Co. Lea &. Febiger. Do. John Wiley & Sons. 110 Publications that may be secured throuirh the United States Puljlic Health Service. T\"ashington. D. C. : RURAL IXTflRGROUr HYOIEXE. Hep. 504. The Treatment of Sewage from Single Hon.<;e.s and Small Com- mimitie.s. By Earle B. Phelps. Feb. 14. 1919. *J7. Safe Milk for the Small Town. By K. E. Miller. Dec. 13, 1918. 46. What the Local Health Officer Can Do in the Prevention of Ty- phoid Fever. By L. L. Liimsden, Feb. 4. 1910. 14 pages. Paper. V. D. B. 43. The Pul>lic Health Nurse and Venereal Disease Control. A Pam- phlet Showing Opportunities for Useful Work in the Fight Again.st Venereal Diseases. 11. Venereal Diseases — ^A Public Health Problem for Civilian Com- munities. A One-page Pamphlet Containing Graphs Showing the Prevalence of Venereal Diseases. 7. The Problem of Sex Education in the Schools. A Pamphlet for Educators. P. H. B. 77. Rural School Sanitation, Including the Physical and Mental Status of School Children of Porter County, Ind. By Taliaferro Clark, G. L. Collins, and W. L. Treadway. 69. Typhoid Fever : Its Catisation and Prevention. By L. L. Lumsden. May, 191-5. VILLAGE AND CITY HYGIENE. Ren. 497. Safe Milk for the Small-Town. By K. E. INIiller. Dec. 13, 1918. 439. Appropriations for City Health Departments. Summary of Ex- penditures of 3.30 Cities in the Central and Eastern United States for Public Health Work. By Paul Preble. Dec. 7. 1917. .395. Typhoid Fever and Municipal Administration. By A. W. Freeman. May 4, 1917. .392. A Progi-am of Public Health for Cities. By W. C. Rucker. Apr. 6, 1917. 46. What the Local Health Officer Can Do in the Prevention of Typhoid Fever. By L. L. Lumsden. Feb. 4, 1910. 14 pages. Paper. V. D. B. 43. The Public Health Nurse and Venereal Disease Control. A Pam- phlet Showing Opportunities for Useful Work in the Fight Against Venereal Di.sea.ses. 89. Compilation of Suggested and Adjudicated Ordinances Which Have Proved Successful in Combating Venereal Diseases. A Compilation of Ordinances for Adoption by Municipalities Deal- ing with Prostitution and Venereal Diseases. 11. Venereal Diseases — A Public Health Problem for Civilian Com- munities. A one-page Pamphlet Containing Graphs Showing the Prevalence of Venereal Diseases. 7. The Problem of Sex Education in the Schools. A Pamphlet for Educators. Ill p. H. B. 73. Tuberculosis Among Industrial Workers : Report of an Investiga- tion Made in Cincinnati, with Special Reference to Predisposing Causes. By D. E. Robinson and .J. G. Wilson. March. 1916. Re- ^^sed March, 1919. .69. Typhoid Fever: Its Causation and Prevention. By L. L. Lumsclen. May. 1915. 58. Open-air Schools for the Cure and Prevention of Tuberculosis Among Children. By B. S. Warren. October. 1912. STATE IXTERGROrP HYGIENE. H. L. B. 89. Sewage Pollutiou of Interstate and International Waters, with Special Reference to the Spread of Typhoid Fever. YI. The Missouri River from Sioux City to its ^Mouth. By Allan .7. Mc- Laughlin. May, 191.3. S4 pages. Paper. Supp. 15. The Administi"ation of a Yelldw Fever Campaign. By William C. Rucker, June 12, 1911. Rep. 285. The Model State Law for ilorbidity Reports. As amended by the Thirteenth Annual Conference of State and Territorial Health Authorities with the U. S. Public Health Service, Wa.shington. May 13, 1915. .July 2, 1915. 171. Public Health Administration. The Factors upon which its Effi- ciency Depends. By W. C. Rucker. March 6. 1914. 46. What the Local Health Officer Can Do in the Prevention of Tyiihoid Fever. By L. L. Lumsden. February 4, 1910. 14 pages. Paper. Y. D. B. 43. The Public Health Nurse and Yenereal Disease Control A Pam- phlet Showing Opportunities for Useful Work in the Fight Against Yenereal Diseases. 89. Compilation of Suggested and Adjudicated Ordinances which have Proved Successful in Combating Yenereal Diseases. A compila- tion of Ordinances for Adoption by Municipalities Dealing with Prostitution and Yenereal Diseases. 11. Yenereal Disease — A Public Health Problem for Civilian Commu- nities. A one-page Pamphlet Containing Graphs Showing the Prevalence of Yenereal Diseases. 7. The Problem of Sex Education in the Schools. A Pamphlet for Educators. P. H. B. 88. Malaria Control. A Report of Demonstratidn Studies Conducted in Urban- and Rural Sections. By R. C. Derivaux. H. A. Taylur. and T. D. Haas. 1917. 78. Tuberculosis Among Industrial Workers : Report of an Investiga- tion Made in Cincinnati, With Special Reference to Predisposing Causes. By D. E. Robinson and J. G. Wilson. March, 1916. Re- vised March. 1919. 69. Typhoid Fever : Its Causation and Prevention. By L. L. Lumsden. May, 1915. 54. Organization, Powers, and Duties of Health Authorities. An Analy- sis of the Laws and Regulations Relating Thereto In Force in the United States. By J. W. Kerr and A. A. Moll. August, 1912. 52. A'accination. An Analysis of the Laws and Regulations Relating Thereto in Force in the United States. Containing Court Deci- sions and a Summary of Some Foreign Yaccination Laws. By .7. W. Kerr, .January, 1912. 82 pages. Paper. 112 NATIONAL INTERGROUP HYGIENE. H. L. B. 89. Sewage Pollution of Interstate and International Waters, with Special Reference to the Spread of Typhoid Fever. YI. The Missouri River from Sioux City to its Mouth. By Allan J. Mc- Laughlin. May, 1913. 84 pages. Paper. Supp. 15. The Administration of a Yellow Fever Campaign. By William C. Rucker. June 12, 1914. Rep. §06. A Unified Health Service. By B. S. Warren. Feb. 28, 1919. V. D. B. 39. Compilation of Suggested and Adjudicated Ordinances Which Have Proved Successful in Combating Venereal Diseases. A Compila- tion of Ordinances for Adoption by Municipalities Dealing with Prostitution and Venereal Diseases. 11. Venereal Disease — A Public Health- Problem for Civilian Communi- ties. A one-page Pamphlet Containing Graphs Showing the Preva- lence of Venereal Diseases. P. H. B. 88. Malaria Control. A Report of Demonstration Studies Conducted in Urban and Rural Sections. By R. C. Derivaux, H. A. Taylor, and T. D. Haas. 1917. 76. Health Insurance: Its Relation to the Public Health. By B. S. Warren and Edgar Sydenstricker. March, 1916. 73. Tuberculosis Among Industrial Workers : Report of an Investiga- tion Made in Cincinnati, with Special Reference to Predisposing Causes. By D. E. Robinson and J. G. Wilson. March, 1916. Revised March, 1919. 54. Organization, Powers, and Duties of Health Authorities. An Analy- sis of the Laws and Regulations Relating Thereto in Force in the United States. By J. W. Kerr and A. A. Moll. August, 1912. 52. Vaccination. An Analysis of the Laws and Regulations Relating Thereto in Force in the United States, Containing Court Decisions and a Summary of Some Foreign Vaccination Laws. By J. W. Kerr. January, 1912. 82 pages. Paper. Rep. 76. The necessity for Safe Water Supplies in the Control of Typhoid Fever. By A. J. McLaughlin. Mar. 22, 1912. 13 pages, 5 tables. Paper. 125. Water and Ice Supplied by Interstate Carriers. May 16, 1913. 244. Impounded Water : Some General Considerations in Its Effect on the Prevalence of IMalaria. By H. R. Carter. Dec. 26, 1914. 283. Interstate Migration of Tuberculous Persons : Its Bearing on the Public Health, with Special Reference to the States of Arizona and Colorado. By A. J. Lanza. June 18, 1915. 356. The Sanitation of Railway Cars. By Thomas R. Crowder, M. D., Chicago, 111. Aug. 11, 1916. 361. Poliomyelitis (Infantile Paralysis). Its Interstate and Intrastate Control. Minimum Requirements for Its Control. Reports of Committees Adopted by the Special Conference of State and Territorial Health Authorities ^vith the U. S. Public Health Service. Wa.-^hington. D. C, Aug. 17 and 18, 1916. Sept. 1 and 8, 1916. 362. The Sewage Pollution of Streams. Its Relation to the Public Health. By W. H. Frost. Sept. 15, 1916. 113 Rep. 368. Drinking Water on Interstate Carriers. A Study of Conditions on Steam Vessels Engaged in Interstate Commerce in the Sanitary- District of the Great Lakes. By J. O. Cobb, C. L. Williams, andl H. P. Letton. Oct. 13, 1916. 380. Relationship of Milk Supplies to Typhoid Fever. By W. H. Frost. Dec. 1, 1916. 384. Control of Pollution of Streams. The International Joint Commis- sion on the Pollution of Boundary Waters. By Earle B. Phelps. Jan. 26, 1917. 480. The Relation of the Railroads in the South to the Problem of Ma- laria and Its Control. By R. C. Derivaux. Aug. 2, 1918. P. H. B. 87. Stream Pollution. A digest of Judicial Decisions and a Compila- tion of Legislation Relating to the Subject. By Stanley D. Montgomery and Earle B. Phelps. 1917. PUBLICATIONS THAT MAT BE SECURED THROUGH THE AMERICAN SOCIAL, HYGIENE ASSOCIATION, 105 WEST FORTIETH STREET, NEW YORK CITY. RURAL INTERGROUP HYGIENE. Bui. No. Title. Author. 117 124 What Some Communities Have Done for the Protec- tion of Morals and Health of Soldiers and Sailors. Community Control of the Venereal Diseases...... Bascom Johnson. Frank J. Osborne. VILLAGE AND CITY HYGIENE. 41 59 73 74 109 117 124 182 Home and Community Prostitution and the Police Segregation of Prostitution and the Injunction and Abatement Law. State Laws concerning White Slave Traffic, Keep- ing Disorderly Houses, and the Age of Consent. Washington, the Cleanest Capital in the World What Some Communities Have Done for the Pro- tection of the Morals and Health of Soldiers and Sailors. Community Control of Venereal Diseases Law Enforcement Raymond B. Fosdick. David Lawrence. Bascom Johnson. Frank J. Osborne. STATE INTERGROUP HYGIENE. 7 45 59 74 116 132 180 182 185 The Regulation of Prostitution in Europe Morals and Venereal Diseases Prostitution and the Police State Laws Concerning White Slave Traffic, Keeping Disorderly Houses, and Age of Consent Recent Progress in New York's Venereal Disease Campaign. California Program for the Prevention of Venereal Diseases. Mothers of America Law Enforcement The Massachusetts Plan Abraham Flexner. • Edward L. Keyes, jr. Raymond B. Fosdick.. Louis Chargin, M. D. William A. Sawyer, M. D Dr. Mabel S. Ulrich. A. N. Thomson. 2058—20- 114 NATIONAL INTERGROUP HYGIENE. Bui. No. Title. Author. 7 The Regulation of Prostitution in Europe Abraham Flexner. 45 Morals and Venereal Disease Edward L. Keyes, jr. Otto May, M. D. Charles E. Riggs, M. D. William F. Snow. 61 74 100 108 The Prevention of Venereal Diseases in the Army. State Laws Concerning White Slave Traffic, ^ Keeping Disorderly Houses, and Age of Consent. A Study of Venereal Prophylaxis in the Navy Social Hygiene and the War 121 Vice Repression as a War Policy Walter Clark 149 159 Venereal Diseases in the Army, Navy, and Com- munity. Social Hygiene and the War Rt. Rev. Wm. Lawrence. Katherine B. Davis. 168 Social Hygiene Legislation in 1917 Joseph Mayer. William A. Bradley. 175 The Social Hygiene Sergeant 180 Mothers of America Dr Mabel S. Ulrich. 182 Law JEnforcement .... 233 ;234 235 236 The Public Health Campaign Against Venereal Diseases. The Work of the United States Interdepartmental Social Hygiene Board. The Sixth Division of the Bureau of Navigation.. The Red Cross Conference at Cannes C. C. Pierce. Thomas A. Storey. C. B. Mayo. W. F. Snow. 241 Public Health Education and the American Army in France. C. E. Barr. o DUE DATE M] 1 5 1993 ,1 ULT6 \m jm^*ii 1 1 201-6503 Printed in USA COLUMBIA UNIVERSITY LIBRARIES 0037543857