Report of Attendance, 
ABSTRACTS, AND REVIEW OF PROCEEDINGS 
of the Health Department of the American Social Science 
Association, at its Annual Meeting at Sara- 
toga, N. Y., September 8, 1876, 
RELATING MAINLY TO 
Sanitary Improvement in Schools. 
Henry B. Baker, Lansing, 
MEMBER OF THE MICHIGAN 
STATE BOARD OF HEALTH, 
MEMBER CF THE AM. SOCIAL SCIENCE ASSOCIATION, ETC. 
[Reprinted from the Fourth Annual Report of the Michigan State Board 
of Health, for the Year 1876.] 
AUTHORITY. 
LANSING, MICH. 
W. 8. George & Co., 8tate Printers and Binders. 
1876. Compliments of 
Henry B. Baker, M. D., 
LANSING, MICH. REPORT OF ATTENDANCE, ABSTRACTS, AND REVIEW OF THE PROCEEDINGS 
OF THE 
HEALTH DEPARTMENT 
OF THE 
AMERICAN SOCIAL SCIENCE ASSOCIATION, 
At its Annual Meeting at Saratoga, N. K, September 8, 1876. 
By HENRY B. B JA K E B,, 
MEMBER OE THE 
STATE BOARD OF HEALTH, 
Member of the American Social Science -Association, etc. 
[Reprinted from the Fourth Annual Report of the Michigan State Board of Health, 
for the year 1876. ] REPORT OF PROCEEDINGS* 
OF THE DEPARTMENT OF HEALTH OF THE AMERICAN SOCIAL 
SCIENCE ASSOCIATION AT ITS LATE ANNUAL MEETING. 
To the President and Members of the State Board of Health: 
Gentlemen :-The Annual Meeting of the American Social Science Asso- 
ciation was held at Saratoga, Sept. 8, 1876. Herewith I respectfully report 
such items bearing upon the subject of public health, as through, my attendance 
at the meetings of the public health section of the Association, I have been 
able to gather and write out, and also a few other items and thoughts of my 
own which occur to me in connection therewith. 
Of the nine papers and topics presented and discussed, all but one were on 
subjects connected with the improvement of the sanitary condition of schools, 
and of the physical and mental condition of school children. Taking up the 
subjects in the order presented, there was first, a report upon the "Health of 
Schools," by D. F. Lincoln, M. D., of Boston, Mass. This included a history 
of some of the work lately done in this country for sanitary progress in schools, 
referring more particularly to the labors of those connected with the American 
Social Science Association. Among the papers mentioned were the following : 
" Drainage and Privies for Schools," by Frederic Winsor, M. D. ; "Contag- 
ious Diseases among School Children," by Arthur H. Nichols, M. D., of Bos- 
ton; " Measurement of the Height and Weight of 25,000 School Children in 
Boston," by Prof. H. P. Bowditch; "School Architecture," by Dr. D. F. 
Lincoln; and the "Method by which teachers should ascertain Defects of 
Hearing in Pupils," by C. J. Blake, M. D., of Boston. The report also stated 
that the investigations by Dr. Agnew, of New York, and.of others, as to the 
condition of the eyes of scholars, have been continued. Dr. Lincoln's report 
made favorable mention of the results of sixteen years trial of gymnastic in- 
struction at Amherst College, and stated that the general health of the stu- 
dents has been greatly improved. The mortality had fallen from nine per 
cent, in the 14 years previous to 1861, to less than five per cent, in the succeed- 
ing years. Before attributing all this to instruction and practice in gymnastics 
alone, I think it should be prominently kept in mind that the lessened mortal- 
ity has occurred while, the students have be6n under the careful supervision of 
a medical man. How much is due to gymnastics, and how much to the better 
care of the health, under the direction of a skillful physician, may be difficult 
*The thanks of the reporter are due to Dr. Lincoln, of Boston, for proof slips, etc., and to Dr. 
Newell, of Providence, for a copy of the Providence "Daily Journal," for Sept. 11, which have 
facilitated the preparation of this'report.-H. B. B, 66 
STATE BOARD OF HEALTH-REPORT OF SECRETARY, 1876. 
to learn; but the reduction of the death-rate to about one-half what it was 
before, is a very important result that should attract attention to the methods 
employed. 
The report mentions the work of members of the Rhode Island Medical 
Society on school hygiene, particularly the proper age at which children should 
begin to attend school, and. the hours of study. The Hon. William Wood, 
President of the Board of Education of New York City, has recommended that 
the minimum age be six years. The New York Medico-Legal Society recom- 
mended eight years, and would make three hours the maximum daily attend- 
ance for primary pupils. 
Dr. J. A. Spalding of Portland, Me., was the author of a paper read giving 
the result of tlie examination of the sight of 2,372 primary and grammar school 
children in that city with reference to the amount of short-sight. In the pri- 
mary schools the percentage of short-sight was found to be 3|, while in the 
grammar schools it was increased to 11. Dr. Spalding thinks that in combat- 
ing the increase of short-sight we should first consider the lighting of the 
schools, that the building should be placed north and south and have windows 
on one side only. In teaching music, etc., from printed charts, either the 
charts should be printed in type large enough to be read across the largest 
room, or they should be hung about the room so that all the scholars can see 
without difficulty. Scholars that are short-sighted should be so placed in the 
room as to have a good light from the side, and, except they wear glasses, 
should not be forced to draw simply because drawing is taught, or otherwise 
treated in a way to increase the defect of sight already present. 
Dr. Spalding thinks it advisable that short-sighted children should use 
glasses at an early age, but that such glasses should be carefully chosen by 
competent persons; that they will then prevent a rapid increase of short-sight, 
and rest the eye from too much exercise of its muscles of accommodation, but 
that a strong glass has a tendency to weaken the accommodative power of the 
eye and to increase the short-sight. Short-sight being often hereditary, parents 
who have such defect should be particularly careful that their children be 
taught how to use their eyes so as not to increase but to improve their power of 
vision. He placed considerable stress upon the teaching of this to children at 
home, but it seems to me that there is more hope of accomplishing this through 
the schools than at home, for this knowledge has to be gained before it can be 
taught to the children, and the prospect of its being gained by the teachers is 
much better than that it shall be gained by the parents throughout the country. 
But the teachers are necessarily dependent upon the medical profession for such 
knowledge as this, and a Medical Inspector and Advisor of Schools is an officer 
that should now appear and do much toward decreasing numerous ills of life 
that might be avoided, and very much toward increasing the health and happi- 
ness of mankind, by beginning to teach proper modes of life at the very begin- 
ning of school life, and continuing to guide the physical training throughout 
its entire course. Something like this seems to me to be the most natural 
method of preventing the great army of sickly students-girls and boys-and 
the deaths of these soon after graduation,-conditions and circumstances now 
frequently observed. 
A paper by Dr. Loring, of New York, was read. Dr. Loring thinks that all 
children's eyes should be examined when they begin their course, and the method 
suggested by Dr. Spalding of using type No. 20 at the distance of twenty feet, 
a good one. During the last year Dr. Loring, assisted by Dr. Derby, has exam- SANITARY IMPROVEMENT IN SCHOOLS. 
67 
ined the eyes of about 1,133 scholars of various ages in New York. Each eye 
was examined separately, first with the test types and then with the ophthalmo- 
scope. Among the primary scholars the proportion of near-sighted eyes was 
6.8 per cent; in the intermediate ages it was 11.67 per cent; in the normal 
scholars it was 26.67 per cent. The proportion of near-sight increases with the 
age. Ear-sight, or hyperopia, begins with 8.3 per cent; in the intermediate 
age it rises to 20.53 per cent; and at the more advanced ages sinks again to 
11.04 per cent. The proportion was greatest among the Germans, 23.23 per 
cent; next the Americans, 19.35 per cent; French, Spanish and others, few in 
number, 15.41 per cent; and the Irish 14.22 per cent. Comparing these sta- 
tistics with those collected in Germany and in Russia, it is found that the pro- 
portion of abnormal refraction is much less among the children examined in 
this country. 
A paper by C. J. Blake, M. D., of Boston, Mass., called attention to the im- 
portance of recognizing a class of school children for whom special provision in 
the way of education should be made, and pointed out the method by which 
defects of hearing should be ascertained. Among children in public schools, 
out of 8,715 cases of ear disease in which there was impairment of hearing, 25 
per cent, were children under 14 years cf age. In about 12 per cent, the dis- 
ease was amenable to treatment. In order that proper allowance be made for 
defective hearing, it was desirable that children in. schools be examined and 
placed according to degree of disability. Each child should be carefully exam- 
ined to determine the degree of deafness, tested by the distance at which the 
voice of the teacher can be distinctly heard in ordinary conversation tone, and 
again by the pronunciation of consonant tones. In testing different scholars, 
the teacher or person testing should always occupy the same position, preferably 
the rostrum or seat usually occupied in school hours, and he should speak in 
the tone of voice used in the school-room exercises. The child to be tested 
should be placed in front of the teacher, and at the farthest line of seats, and 
gradually advanced toward the teacher, the tests being repeated until a place is 
reached at which the child cah hear distinctly, the child being required to repeat 
distinctly the test words or tones employed. The child should not occupy a 
place in the school-room more distant from the teacher than the one thus found. 
The paper strongly recommended the establishment of a medical supervision of 
schools, the officer to devote his whole time to the duties of the position, and 
to be a competent physician who had thoroughly studied school hygiene. 
The next paper was by Dr. J. M. Gregory, President of the Illinois Indus- 
trial Schoo], formerly State Superintendent of Public Instruction in Michigan. 
The paper was an interesting general discussion of the subject of "Half-time 
schools," and contained valuable suggestions and testimony of teachers on the 
advantages of short time schools. 
T. Newell, M. D. of Providence, Rhode Island, then read an excellent paper 
on the same subject, dealing with it in a definite and pointed manner, and from 
a physiological standpoint. Starting out with the idea of learning the length 
of time that children of different ages are able to fix their attention, he availed 
himself of the results of the labors of Edwin Chadwick of England, and of 
others, who have found that the capacity of the mind for attention grows with 
the body, and is increased by cultivation; that very young children can receive 
lessons of one or two minutes length, that with increasing growth and cultiva- 
tion the capacity for attention is increased to five minutes, then to ten, then to 
fifteen minutes, at the age of ten years to about twenty minutes, at twelve 68 
STATE BOARD OF HEALTH-REPORT OF SECRETARY, 187G. 
years to twenty-five, and so on. It has been found that for children aged ten 
or twelve years, the capacity for bright and voluntary attention is exhausted by 
four varied lessons, requiring mental effort of half an hour each with intervals 
of relief, in the forenoon. In the afternoon this capacity is reduced one-half. 
These are statements of averages; a skillful teacher, good ventilation, proper 
lighting and warming of the room, more than ordinary stamina of children, etc., 
may increase, while opposite conditions will reduce the length of time that the 
attention will be profitably fixed on lessons. The general statement is that two 
hours in the forenoon and one in the afternoon is as long a time as children can 
be profitably employed in school. 
At first thought, it might seem that keeping children at school for a longer 
time than that during which their attention could be held would only result in 
simply a waste of the extra time, and that not very valuable; but Dr. Newell 
points out the fact that its results are much more serious ; that the long appli- 
cation is mentally injurious, produces weariness and disgust of subjects taught, 
tends to form dilatory, diffused and slow habits of thought, and is productive 
of indecorum and truancy. His belief is that children will not simply learn 
as much in the three hours as they will in the six usually forced upon them, 
but that they will actually learn more, because of the greater aptitude for 
prompt, vigorous and sustained industry. He claims that the "half-time" 
system, as it is called, will tend in many ways toward improving the health of 
children, and of teachers, that now suffers from the unnaturally prolonged re- 
straint of body and mind in rooms that become foul with the accumulated em- 
anations from overcrowded inmates. By this change the air of the school rooms 
would be much more pure, and this, in connection with the improved condition 
of the scholars, would tend to lessen the spread of contagious and infectious 
diseases so frequently due to aggregation of scholars in close ill-ventilated rooms. 
Tiie extra time can be profitably and healthfully utilized for physical training 
or industrial employment. 
He thinks there is unquestionable testimony that a child will learn more in 
the "half-time" in connection with physical or industrial training, than under 
the usual present method. Children relish physical exercise after attention to 
studies, and study with more spirit, energy and success after such exercise. He 
thought the subject of even greater importance to the welfare of the girls than 
of the boys at school. 
Dr. Newell's paper was listened to attentively, and was followed by enthusi- 
astic remarks by Mr. J. M. Barnard of Boston, and others. In the course of 
his remarks Mr. Barnard said he did not see how the health of children in 
schools, or their physical education and training, could receive proper attention 
in schools until those who control them secure the aid of the medical profession, 
or of skillful sanitarians, and bring to bear upon these questions the special 
knowledge which that profession has and can accumulate. 
Dr. Richard J. O'Sullivan, of New York City, and formerly a Medical In- 
spector of Schools, then read a paper on "The Prevention of Contagious Dis- 
eases among School Children." This paper also favored the short-time system, 
on the ground that such diseases are less likely to be spread by the short than 
by the longer use of rooms where, as is usually found in school rooms, the air 
space is not great. The other parts of the paper were interesting, but some- 
what difficult to do justice to in an abstract. 
D. F. Lincoln, M. D., of Boston, Secretary of the Public Health Section of 
the American Social Science Association, read a paper on, and exhibited plans SANITARY IMPROVEMENT IN SCHOOLS. 
69 
illustrating, the subject of " Sanitary Requirements in School Architecture?' 
The plan exhibited was of a grammar school for about 550 pupils. He thinks 
that, as a general rule, it is not best to plan for more than 600 in one building; 
that a large building is not easily kept in good sanitary condition; that placing 
four stories, one above another, almost always insures poor ventilation. At 
least as much ground as the building covers should be reserved for a play- 
ground, and be so disposed as to give free space on all sides. The land must be 
well drained,-if not naturally so,-it should be underdrained to the depth of 
the cellar. The school should not be near ponds or stagnant water; nor foun- 
dries, railway stations, or other noisy establishments; nor shambles or other 
offensive places. No room for regular study should be placed in a story of 
which any portion is under ground. The first floor used for such room is to be 
at least four feet above the street grade. The story under this may contain 
play-rooms and gymnasium, provided these face the sun, and the slope of the 
land leaves the wall entirely above ground on their side of the house. Good 
drainage, and an uncontaminated water-supply should be carefully secured. 
Walls are to be wainscoted to the height of 2| feet in rooms, and 4| in entries. 
They should be made as impervious as possible so as not to absorb exhalations 
of lungs and skin of the scholars. The doors must open outwards and be from 
8 to 12 feet wide. One must be near, and, if possible, opposite the foot of 
each staircase. A school for 600 should have two stairways, each isolated, if 
possible, by solid brick walls. Balusters are then superfluous, the hand-rail 
should be about four feet above the riser. One or two landings are desirable to 
break each flight. Wedge-shaped steps and spiral stairs are not admissable. 
The stair-cases must be from six to eight feet wide, and well lighted. Entries 
and corridors should be spacious, particularly at the foot of stairs; they should 
be warmed, and should be lighted directly from out of doors. 
For convenience of visitors the master's parlor should be not above one flight 
from the street. Other needed rooms are a great hall, and this may sometimes 
be used in recess-time, and rooms for library, cabinet, and instruments. Each 
school-room should have a clothes closet having one door into the entry, and if 
convenient, another into the school-room. The teacher should have a private 
closet. Two stories of school rooms are all that can usually be permitted; a 
third story, or portion or a story, may contain the great hall; but no class of 
girls, at all events, ought to have to climb two flights from the street. 
It is hard to comply with the sanitary requirements if more than about forty 
pupils are allowed to each teacher. The room should be oblong in the propor- 
tion of about four to five. The voice is best heard in such a room, the teacher 
sitting near one end. 
The room should never be lighted from in front of the scholars, but always 
from their left hand. The windows should open directly from the outer air 
and move easily in the frames. Window-sills should be at least four feet above 
the floor, because light entering at the level of the eyes only dazzles, and is 
useless for illuminating the tops of desks. The tops of windows should come 
within eight inches of the ceiling, which can be effected by the use of iron 
beams. This illuminates the coiling, an important source of light. The ceil- 
ing should always be white; walls may be tinted, but no wall-paper should be 
allowed. The blackboard should never be on the same side as the windows. 
The door should open directly into the entry, and had better be near the teach- 
er's desk. The room should not be less than 12| feet, nor more than 14 feet, 
in height. Each pupil should be allowed at least 250 cubic feet of air space. 70 
STATE BOARD OF HEALTH-REPORT OF SECRETARY, 1876. 
Prof. Kedzie says 300 cubic feet. A system of foul air flues, two for each 
room, and provided with powerful suction from a centrally heated shaft, is the 
only satisfactory way of getting rid of the foul air in cold weather.* Fresh air 
should be introduced not much above the temperature of the rooms. Dr. Lin- 
coln thinks the proper temperature of the room is probably 65° F. It seems to 
me important that the level for which the temperature is stated be mentioned, 
or that an equable temperature be required. In rooms where only mental labor 
is to be performed in a sitting posture, it seems to me that the temperature at 
the floor level should not be below 65° F., nor should the temperature at the 
level of the head exceed 70° F. In a room where all the scholars stand, or 
have other muscular exercise, the temperature may be less. 
Dr. Lincoln's very valuable paper contained much of interest that can hardly 
be conveyed in a brief abstract like this. 
The last paper was by Prof. Robert T. Edes, M. D., of the Harvard Medical 
School, Boston, Mass., and was on "Alcohol as an article of Diet." Perhaps 
it might as well have been entitled, "Alcohol as an article of Medicine," for 
the writer did not seem to recommend it as an article of diet for persons in 
health. A considerable part of the paper related to the experiments of Anstie 
and others going to show the fate of alcohol in the living body, that it was 
mainly decomposed. The experiments cited went to show that when moderate 
doses are given, only about two per cent, of the alcohol leaves the body as 
alcohol. When extremely large doses are given, leading to profound intoxica- 
tion, only about twenty-five per cent, can be detected as alcohol; the remain- 
der undergoes change within the body. One effect of the ingestion of alcohol 
is to lower the temperature of the body, and this may be taken advantage of by 
the skillful physician in certain cases of disease. 
If I may add my own opinion, it is that the public health will gain largely if 
the people can be brought to consider alcohol as a powerful agent for evil, 
under its ordinary unskillful use, and that its use, even as a medicine, should 
not be undertaken except by the prescription of a skillful physician. 
* It will be seen that this is substantially the plan recommended by Prof. Kedzie, of this Board; 
but Prof. Kedzie recommends withdrawing the foul air from more than two openings in the floor of 
the room, thus avoiding draughts near foul-air outlets. See Annual Report State Board of Health, 
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