Scope.

Such an examination need include but a few items of measurement, such as the height standing, height sitting, girth of chest at the level of the ninth rib, weight, and of course a record of name and age. This is a minimum number of items, but it would accomplish much and may be taken by any intelligent teacher. Outfit.

The entire outfit for these items would con

sist of: (1) printed blanks; (2) a scale for weight, which might be borrowed for a time; (3) a measuring rod which can be used for breadths if desired as well as for height; (4) a tape for measuring girths. There should be a number of the latter on hand. The Narragansett Machine Company, of Providence, Rhode Island, can furnish all necessary apparatus for measurements. What to record.

Beside the items mentioned above, the examiner should notice and record everything of the nature of a physical defect, such as crooked back, round shoulders, one low shoulder, flat chest, asymmetry of chest, short leg, bow-legs, knock-knees, rupture, varicose veins, or any noticeable mark or blemish of the skin. The value of such records frequently appears in totally unexpected ways. What is specially needed at present is a large number of measurements taken according to the "individualized method," i. e., measurements of the same individuals taken in consecutive years rather than single measurements of a greater number of individ

uals.

Objections of time required.

But there are objections to these examinations. The teacher has no time in addition to regular duties to do such work, and this is perfectly true. During the period when these examinations are being made the entire time of the examiner would be required or certain hours must be set apart each day.

A special examiner.

This leads to the suggestion of a special examiner.-one who can do not merely the simple things just mentioned, but who can, in addition, make an intelligent examination of eyes, ears, heart, and, if necessary, of lungs also.

arrived physicians who are perfectly competent to do this work, as their time hangs heavy on their hands, and who would be glad to improve such an opportunity for a moderate compensation. In many cases reports should be sent to the child's parents, perhaps with specific instructions, perhaps recommending skilled counsel. As a result, many children would rightly be withdrawn from school for a time at least, and thus the responsibility of the teacher would be lessened and the health of the school as a whole would be improved. Another objection.

An objection of a different sort lies in the reluctance of young girls to be examined, even by a physician. There will necessarily, then, be an examiner for the girls and one for the boys, and the details can easily be arranged so that the more serious cases shall go to the physicians.

Examination only preliminary.

But, examinations made and records taken, what then? Little would be accomplished if nothing further were done; but an intelligent physical examination followed by an intelligent and supervised course of physical training form a logical whole, the possibilities of which for good are beyond estimate. The first without the second is incomplete; the second without the first is illogical. With reference to both, however, the wise teacher will always seek to arouse in the child an intelligent interest in the end desired and in the means and methods used. Without this interest much of the work will be listless, if not useless.

CO-OPERATION OF THE HOME.

How can the home aid in this reform? By wisely and in every possible way supplementing all efforts made in the school for the attaining and preserving of sound bodies; by discussion with teachers and with other parents of cases known, difficulties encountered, and principles involved; by providing for the children both indoors and outdoors, some simple gymnastic apparatus. An adjustable bar can easily be arranged out of doors on which girls and boys alike may turn and suspend themselves. It is a very simple matter to arrange such a bar in a doorway. A pair of rings or a trapeze can easily be suspended from the ceiling. The exceptional grace and gymnastic ability of two

brothers in the University of Nebraska I ascribe largely to the fact that their father provided such simple apparatus for them in their childhood.

When a generation of parents and teachers shall agree to give the bodies of children under their care a tithe of the attention which they now bestow upon their minds, the results will be stupendous. The lesson seems to be a difficult one to learn, that a reasonable amount of time spent regularly in exercise is time saved, not lost; that both mind and body are stimulated by exercise, while simple neglect of physical exercise can result only in defects of body and of failure to attain the best of which the mind is capable.

To review briefly, the defects found among students are largely developments of those found in children, for which latter carelessness and ignorance are largely to blame. School is, for the child, the beginning of new conditions, which, unless controlled, invariably result in physical deterioration.

The plastic child form is easily modified by wrong habits of posture and movement. School seats should be adapted to individual children. Misfit seats result also in numerous deformities and defects of vision.

Wrong positions in standing result in de

An intelligent teacher may make the examination, but a physician is better.

Records are much needed, and when well taken are of great value.

and follow the examinations. Regular physical training should accompany

The home should co-operate with the school in observation and in the providing of proper exercises.

REFERENCES.

1. School Document No. 8, 1894, Boston. Report of the Director of Physical Training.

2. Reprint from School Document No. 4, of 1895.

Report of the Director of Physical Training. 3. School Document No. 9, 1892, Boston. Seating of Children in Public Schools.-Scudder.

4. Habitual Posture of School Children.-Mosher Reprint from Educational Review, November, '92.

5. Flat Chest Produced by Habits of Posture.Mosher. Reprint from Brooklyn Medical Journal, June, '96.

placements of Uterus.-Mosher. Reprint from New 6. Habits of Posture a Cause of Deformity and Dis

York Journal of Gynecology. Book of Statutes, November, '93.

7. The Influence of Habitual Posture on the Symmetry and Health of the Body.-Mosher. Brooklyn Medical Journal, July, '92.

8. Physical Education in the Schools.-Article by L. K. Baker, M. D. Cleveland Medical Gazette, December, '96.

9. Physical Deterioration Resulting from School Life.-J. H. Kellogg, M. D.

10. Scoliosis and Its Treatment by Means of Gymnastics. Dr. T. J. Hartelius.

organs.

Earlier detection of physical defects is of extreme value.

A periodical physical examination is the best way to discover defects.

11. Notes on the Examination and Measurement of nal, January, '96. 12. A. A. A. P. E. Reports.

N no way have been better shown the results of the science of the child than in that of ascertaining the condition of hearing in school children. For the past few years over this country and Europe much attention has been paid to the hearing of school children. Tests of the hearing of many children have been made. One can hardly believe that Reichard, in 1878, among the school children of Russia, was the very first to investigate and test this important sense. But such is the case. Even as late as in 1893 there had only been twelve reports of investigations made in this country

and in Europe,-3 in Russia, 3 in Germany, 2 in France, 1 in Denmark, 1 in Scotland, and 2 in America,-as far as I can ascertain. Since that time investigations have become much more common, yet even now there is very great neglect in looking after the powers of hearing among school children. Importance of testing.

The important part that the ear plays in edu cation requires that it be kept in prime condition and that all shall be done for a defective hearing child that will aid him in his work. Un

less careful investigation is made it will be almost impossible to learn of the extent of the defect and in most cases the defect will not be discovered. At least ten out of every fifty children show some defect in one or both ears. Those who have not tested have never thought that such is the case. This is because the badhearing child hears better at some times than at others and also because usually he intuitively turns the good-hearing ear towards the party speaking, and so such will cause the teacher to think the child is inattentive at other times. Also in this sense as in the others, there is latent power which is brought into play at moments of great interest and so gives the child the appearance of a good-hearing child. Just recently this fact has been impressed upon me. In one of my classes is a young lady who has been counted very dull. I kindly told her one day that she had better not remain in the class, as I considered it really a waste of her time as she seemed to be making no progress. She told me (and honesty was depicted on her countenance) that she worked very hard and at her room knew she had the lessons well prepared, but in recitation she could not answer my questions for some reason unaccountable to her. More than ever I was convinced that she was quite dull. Lately a friend of hers, a member of her class in my room, informed me that this lady is quite deficient in hearing and tries in every way to conceal it. Thus, of course, she did not answer my questions, as she did not hear them. Since learning of her defect I have given her a seat quite near my desk and I take special pains to speak slowly and distinctly and watch to see that she knows what I want, and so now she is doing fair work. I hope to see her yet a good student.

Causes of this defect.

There are many causes for hardness of hear ing. It may be congenital. It may come from affection of the auricle, the closing of the audi

tory canal, and from disturbances of the drum

and drum-head. It may have arisen from diseases of childhood. One of the most frequent causes, and the most dangerous in its results, comes from the condition of the naso-pharyn geal cavity. In this cavity the eustachian tube. opens and is ever ready to carry fetid matter to the ear. This means almost incurable troubles. Effects upon school work.

trous to the schoolroom. One can almost with certainty say that every dull child, every vicious child, every stupid, staring child has defective hearing in light or strong degree. One very careful investigator is so impressed with the results of his investigations that he demands that "every inattentive child should have his ears examined." To show that I am not overstating this some of the results will be given, reported prior to 1893, so no one can say that these are overdrawn pictures of childstudy enthusiasts. Sexton, in New York, found 78 defective hearing pupils among 570 examined, only one of whom was known to be deaf by his teacher. She said that this pupil was a little deaf, and being a mischievous boy, he was required to occupy a back seat. The boy was found by Sexton to be quite deaf. Worrell, in Terre Haute, Ind., in 98 cases of hardness of hearing among 391 pupils examined, states that only one was known to the teacher. Worrell says that the defective hearing ones were, for the most part, the oldest ones of each grade, also generally the largest in size, and they usually occupied the back part of the room. Barr, in Glasgow, had the dull pupils pointed out to him after his investigations had been made and he found in many cases that he had recorded such pupils as defective of hearing. Gelle, in Paris, found that in most cases the hard-hearing children were designated by their teachers as lazy, absent-minded, and remaining behind their fellow-pupils. Weil, after examining the hearing of 5,905 children of Stuttgart, states that the sufferers are often misjudged and considered inattentive, and so treated, while they are simply hard of hearing. Bezold, in Munich, by careful investigations and calculations found that the rate of progress in the grades at school corresponded to the degree of Petersburg, says that among pupils hearing the the hearing defect present. Zhermunski, in St. whisper in both ears from 24 to 12 meters the ratio of the satisfactory to the unsatisfactory was 4.19 to 1; in those hearing from 12 to hearing from 8 to 0 meters the ratio was 1.7 to 1. Thus the ratio changes as the defective

8 meters the ratio was 2.6 to 1; and in those

(whisper) of below 2 meters, 36 from 2 to 4 meters, and 28 only exceeded 4 meters. So about two-thirds of the poorly-gifted had very defective hearing.

Defects might be cured.

The investigators mentioned above are specialists of hearing, and of the ear, and not only tested the hearing but also very carefully examined the ear and the nose and throat. They are unanimous in claiming that much of the bad hearing could have been avoided or improved. One investigator states that at least 500 of the 616 defective hearing children found in school by him could be cured, if properly treated; but if left to themselves, at adult age they will be more or less deaf. Another one claims that 41.7 per cent of the defective ones of his investigations could be cured, or very greatly benefited, if they could receive appropriate treatment.

Need of examination.

Since the extent of bad hearing is so preva lent among pupils something must be done. Some day we shall have reached such a high place in our school work as to have competent physicians and specialists examine the child physically just as we examine him mentally today. But as such is far off, something else must be offered. I would suggest that every child be carefully observed by the teacher and some of the simpler tests at least be used to ascertain in regard to the hearing powers. The child should be observed carefully whether opportunity can be had for testing or not. case tests cannot be made, the worst cases of defective hearing may be ascertained by observation and inquiry. Bear always in mind that no child likes to be scrutinized too closely and that many are very sensitive as to their physical and mental defects. Hence the teacher must use great care and forethought in taking observations and in making inquiries.

The teacher should make, from day to day, a note of all the dull, vicious, lazy pupils in the class. Notice if such pupils are in the habit of keeping one side of the head always turned to the one speaking or reciting, and if at times when this side is turned away if the pupil comprehends so well and so quickly as at the other times. Notice these pupils when deeply interested in something being told if they can with draw their attention to something else as

quickly as can the other pupils. Observe if a child has a dull, expressionless face, and if he keeps his mouth open, and if his face is flat, as though deformed, with almost an idiotic stare upon it. If so, inquire of parent if the child's sleep is disturbed by bad dreams, if he snores at night, if he sweats at night, or addicted to nightly bed-wetting. If such are the facts the child can be pretty well determined as a sufferer from adenoid growths and needs the care of a surgeon, for the dullness will continue till the adenoids are removed, which removal will also give increased hearing power. In dictation exercises and the like the teacher should note particularly what children make poor work and just wherein the failures are. Such children need careful attending to in order to ascertain the extent of the hearing and the condition of the naso-pharyngeal region. Thus can observations be made.

Means of testing.

No perfect test for hearing has been devised. The watch, voice, acoumeter, phonograph, tuning-fork, and other things have been tried, but none prove altogether satisfactory. Yet for most purposes the watch, whisper, and tuningfork will answer.

The following tests are simple and are easily made, and in most cases will give the teacher a fair idea of the reach of hearing of the pupils examined. These tests should be made several times in the year, if at all possible, so as to ascertain the hearing condition at the different seasons and during the various stages of weather.

An ordinary watch may be used, although a stop-watch will be found the best and easiest. Fasten a tape line on one wall at the height of the pupil's head. Fasten the tape at the same height on the opposite wall. Place the child with the back of his head to the tape line. Note at what point on the tape line is his ear towards you. Let him close his eyes and the opposite ear, or better, bandage his eyes and close his opposite ear with fresh, pure (medicated) cotton. Place yourself near the tape line with watch in hand. Move the watch up and down the line, but see that the watch or any part of your person does not touch the tape line. Request him to tell you when he hears the watch. A good plan is to say "Now" and

let him answer "Yes" or designate by raising finger. Test until the farthest limit is found at which he distinctly hears the watch. Note this point on the tape line. Test the other ear in the same way. A much quicker way, perhaps, is to let the child hold the tape line just in front of his ear, placing the end of it on the face, and let him close the other ear with a finger. The investigator holds the other end of the tape line with one hand and with the other moves the watch back and forth.

II. The whisper.

One must practice till the whisper will be the same at all times of the test. Uttering the word as the breath is being expired will give the best results. Use simple words which are well known to the child, or, it may be, the best results will be obtained by using the names of the numbers from 1 to 99. Watch carefully if certain sounds, or certain combinations of sounds, bother the child.

Placing the tape line and the child, as in the test with the watch, whisper to the child, moving up and down, as in the other test. Let the child repeat what he hears; or without being blindfolded, let him write on paper or on blackboard what he hears. Note the farthest point at which he correctly gives or writes down what is whispered. Test the other ear.

III. The tuning fork.

Instead of the watch or the whisper a moderately low-sounding tuning fork can be used as in the foregoing tests. Strike the tuning fork a certain number of times and let the child tell how many strokes he hears. By placing a rubber cork on a stick a good thing to strike with can be made. Strive to strike with the same force and same intervals at all times.

In these tests the average reach of hearing the watch, or the whisper, or the tuning fork may be found. All pupils hearing at this distance, or above, may be counted as having normal hearing. All pupils hearing at points below this may be placed among the defective in hearing.

Children who are found defective by the above method should be tested as follows, so that it may be known just how well they may hear the speaking voice.

IV. The voice.

In the same manner as in the other tests, ascertain at what distance the child can hear the

speaking tones of the voice. Use words or numbers as before. Also, it may be well to use simple sentences. Speak with the out-breathing voice. Strive each time to use the same pitch of voice, degree, etc. Avoid explosive tones.

The two following tests may be found helpful in further investigation of hardness of hearing, but it is presumed that the methods already given will be sufficient: V. Weber's test.

Let the child close one ear. Strike a tuning fork and hold it on the child's head (on vertex). See how long he hears it. Let him close both ears. Strike the tuning fork again and place on his head and see how long he hears it. Test the other ear in the same way. (Strive to strike the tuning fork with the same force at both times.)

The normal ear hears the tuning fork louder and longer when the ear is closed than when it is open.

VI. Rinne's test.

Strike a tuning

Let the child close one ear. fork and place it upon the child's head. Note how long he hears the tone. Strike the tuning fork as before and hold it before the open ear of the child. Note how long he hears it. This test can be made by striking the tuning fork and placing it on the child's head and letting it remain till he no longer hears it. Then bring it before the open ear. Reverse this order.

A normal ear hears the tuning fork by air conduction longer (in front of ear) than by bone conduction (on the head). Helpful suggestions.

A few suggestions may be helpful:

As has already been stated, the dull, vicious, and lazy children should be carefully observed and if possible tested for defects in hearing. All the children ought to be tested for limit of hearing, and ears and throat examined.

All children with defective hearing should be seated as near the teacher as possible, and so placed that the better hearing ear may easily be kept toward the teacher and without causing too much turning about on the part of the pupil.

If a child is found so deaf as not to be able to do the work of the schoolroom, it should be so reported to the parents and the parents advised and helped to send the child to a school suitable.