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In 1870, the population of Massachusetts was 1,457,351. It may fairly be estimated to have increased to 1,500,000, up to the close of 1873. In 1872, there were in the 5,198 public schools of the State, 276,602 children. Add to these the number of pupils in the incorporated academies and the private schools (17,952), and we have an aggregate of 294,554 pupils at school. That is to say, more than one-fifth of the population are at school, and subject to the physical as well as the mental influences of school-life. To investigate the hygienic influences of this occupation of school-going, and offer suggestions as to the means of improving these influences, is the purpose of the present paper. No subject within the scope of the investigations of the Board of Health can be of greater importance to the State or of more vital and anxious interest to every family in it, and since the public interest in the schools is so warm, and the public assurance of their immense value is so complete, as to cause a natural jealousy of any criticism of them, lest it should prove a cover for an attack on our school system which might in some way impair its usefulness, it may not be inappropriate at the beginning of this inquiry to state that there is about it nothing of hostility, and that its aim is to make an impartial investigation. Like every other occupation, schoolgoing must have its liability to peculiar hygienic disadvantages. Let us seek to discover these, and also the means whereby they may be reduced to a minimum.

It must be considered, that this one-fifth of our population whose occupation is under investigation, are all in the growing, formative, susceptible stage of life, not only most readily, but most permanently affected by every influence to which they are subjected. Without doubt, the instinct of childhood is for frequent, almost constant, change of position and interest during the waking hours, and any steady occupation within a restricted space, may be fairly termed unnatural for children. But since the vast majority of children cannot have an " education,” without some degree of violation of what may be termed the normal conditions of childhood, and since some education is a necessity, it becomes of the first importance to maintain a constant, jealous watch over the health of school children, and to persevere in the attempt to harmonize school methods and influences with the healthy instincts of childhood. Confinement, vitiated air, enforced quiet, prolonged mental effort, the use of the eyes on small objects in trying arrangements, are all, in some degree, conditions necessary to school, but threatening danger to the health of the scholars. To reduce this to a minimum, and there maintain it, is a public duty.

If this could be accomplished at once, there would still remain a host of injurious influences which are acting on children when out of school, and for which the schools are in no way responsible. Disease, whether preventable or inevitable, poverty, ignorance, dirt, at one end of the social scale; luxury, fashion, social dissipation and amusement, at the other end,-all these are harming the health of the children of Massachusetts, far more than any school influence. But the consideration of these evils is not within the scope of the present paper, and they would not be mentioned here, except from the desire to avoid misapprehension. All that is attempted here, is a contribution to the subject of school hygiene.

No claim to originality is made in this paper. There is probably no suggestion in it which has not been previously made elsewhere. But it does combine and compare the testimony of a large number of new witnesses with that which was previously at our disposal, and attempt to put the gist of the whole into a shape that may prove a contribution of some practical value to the solution of the hygienic side of the school question. What was the method taken to obtain the fresh testimony, will appear from the following circular. It will be observed, that it calls for replies based on personal observation. Nine-tenths of the answers were reiurned before October 1st, 1873.


The list of " references" given at the end of each division of the paper, although very incomplete, is offered as likely to be of assistance to readers who wish to investigate the literature of the subject in this country. The plan of the paper accounts for the comparative neglect of foreign authority.


STATE BOARD OF HEALTH, BOSTON, July 25, 1873. To Correspondents of the Board.

GENTLEMEN :—The subject of “School Hygiene ” is one on which we desire to collect as much information as possible. For this purpose the following questions have been prepared, and we respectfully ask for replies, based upon your personal observation. Any information on this general subject will be received with many thanks.

Replies may be sent at any time previous to October 1st, 1873, to the Secretary of the Board, by whom they will be transferred to Dr. FREDERICK WINSOR, of Winchester, who will give the result of his investigation of this subject to our Board, for publication in our next Annual Report. In behalf of the State Board of Health,

GEORGE DERBY, M.D., Secretary.

1. Is one sex more liable than the other to suffer in health from attendance on school?

2. Does the advent of puberty increase this liability ?

3. Is the injury most apt to fall on the osseous, the respiratory, the digestive, or the nervous system ?

4. Does eyesight often suffer ?

5. What opinion does your experience lead you to entertain in regard to study out of school, in addition to ordinary school attendance ?

6. Is a single long session different in its hygienic influence from two shorter sessions ?

7. Do your observation and experience enable you to separate the hygienic influence of study from that of emulation, anxiety about rank, etc. (say of work from “worry")? Also from the influence of confinement, bad air, etc. ?

8. Is the occupation of school-going worse hygienically than other occupations in which children would engage if not in school?

9. Have you any opinion based on observation of the so-called “ half-time system"?

10. How can our schools be modified to improve their hygienic influences ?

(a.) As to tasks and discipline
(b.) As to physical conditions ?



In the number and nature of the replies which have been obtained, we find the strongest evidence of the wide-spread sense of the importance of the questions raised, and the corresponding desire to help in correctly answering them. is with great regret that we admit the necessity of laying before the public the results only of these very valuable replies. The proper limits of the present paper will admit of quoting merely a small portion of that which the parents and teachers of Massachusetts would read with lively interest and profit.

Replies have been received from 160 persons, of whom 115 are physicians ; 19 are physicians and members of school committees; 14 are teachers of experience, and six are superintendents of schools.

Without doubt many more than nineteen of the physicians have served on school committees, though there is direct evidence with regard to this number only. It will also occur to all who know New England life, that not a few of these physicians must have taught school while acquiring their education in colleges and medical schools.

Taking up the questions in order, we will, so far as possible, classify the answers obtained and present them in numerical form, giving more at length certain replies which have a peculiar significance, whether agreeing with the majority or not.

The reader who may attempt to make the sum of the various answers tabulated under each question agree with the total of correspondents, or even with the number stated as having answered any one question, will often fail. From the nature of most of the questions a simple " yes” or no” answer could not be expected and was not desired, and one answer often contains several distinct points of importance. Other replies did not admit of classification. No distinction has been indicated between these classes of correspondents, either in the tabulated statements or in the passages quoted, for on none of the questions of the circular did it appear that those of one occupation held opinions as a class at variance with those of another.

QUES. I. Is one sex more liable than the other to suffer in health from attendance on school?

Answered substantially as follows :

"Females more liable than males,” by
“Males more liable than females," by
“Both alike liable," by
“Neither is in danger," by .
"Not in district schools," by
“Not if both sexes exercise alike in the open air," by
“Unable to answer," by


1 31 4 1 1 5

One correspondent says, "Girls in the proportion of two to one.” Another, "During forty years' practice in the country, I recollect but one instance of a male who has suffered, while I can recall many instances of females.”

QUOTATIONS FROM CORRESPONDENTS. 118. “The female scholars are more susceptible to emotional influences, and if there be stimuli in a school appealing to pride and vanity, they are 80 emulous as to injure themselves. This is the source of most of the injuring suffered by the scholars in most schools."

80. “Beyond doubt, the girls, from the fact that they are girls, are more liable to suffer than boys. In my own experience with both sexes, I found this excess of liability to be very manifest, and I governed my methods accordingly, keeping limitation in abeyance with them, and moderating brain-work and supervising physical exercises. At certain periods I think that study with girls should wholly cease for some days. Any one who has taught boys and girls,-in separate schools, I mean,--must have noticed the greater proportionate irregularity of attendance by the latter, and as a parent he would readily know the reason, and know the necessity of cessation from work. I refer to girls between twelve and twenty years of age.”

148. “While pleas for lenity to boys on account of feeble health are rare, they are a common thing in connection with the girls."

102. “My pupils were all girls. I gave them more variety of study and less hard labor than boys can bear."

Many others of the 109 express themselves in terms equally strong, some of whom will be quoted elsewhere.

QUES. II. Does the advent of puberty increase this liability?

Answered substantially as follows :

“Yes," by
"No," by
“Uncertain," by


Of those who answer "yes,” many add "for girls,” and it is evident that nearly all have the same limitation in mind.

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