One of the effective agencies in this health movement in the schools is the open-air school. These schools are intended for anaemic chil dren and for those who have a predisposition to tubercular troubles. New York city also has the of having organized the first school of this type. In 1904 the board of education of that city organized an open-air school in connection with the Seaside Home for Children at Coney Island. In the same year a school of this kind was organized in Charlottenburg, a suburb of Berlin. Other schools were organized thereafter in some of the German cities and one was established in London in 1907. The school at Coney Islana has been in continuous operation since it was first opened. In 1908 an open-air school was organized at Providence, R. I. Nearly all the leading cities of America now have established in their school systems an open-air school and additional schools of this type are being estab lished in each city in the expectation that all amemic children and predisposed tubercular children shall ultimately be afforded the ad vantages offered this type of school. We have not exact figures on the number of children in the public schools who are tuber cular but reliable estimates show that there are at least 100,000 enrolled in the public schools of this country who are in the incipient stages of tuberculosis and that there are more than 100,000 others who have been so exposed to this disease that they should be excluded from attendance in the regular grades of the schools. These 200,000 children should be segregated and provision made for their care and instruc tion in outdoor or open-air schools. These schools provide the three essentials which are necessary in the proper treatment of tuber cular cases, which are fresh air, rest and proper nourishment. In some cities an entire building is set aside for the tubercular chil dren. In other cities the open-air school is built upon the roof of a school building or in one of the upper corner rooms. A school physician or nurse must be supplied, diet must be furnished and the necessary wraps and clothing must be provided.
The best medical authorities of our time say that many diseases such as rheumatism and infections of various organs including the heart, kidneys, appendix, etc., come from foci of infection. A great proportion of the foci are abscesses at the apices of the roots of teeth or pyorrhea pockets about the teeth. Uncleanliness of the mouth causes the teeth to decay, to be broken down and unfit to properly masticate the food. This results in the food not being broken up into small particles nor mixed with the saliva, the first function of di gestion. The stomach and other organs of the alimentary canal are thus called upon not only to assume a burden, but must also receive more or less decayed food, pus and germs from the decaying teeth. Thus unclean mouth condi tions result in improper assimilation of the food and nutrition of the body and may cause a poisoning or breaking down of the system.
Considering that not more than 15 per cent of the people make any pretense of taking care of the teeth, that fully 80 per cent of all school children have decayed teeth and 20 per cent of them have dental abscesses which are likely to become foci of infection, it is evident that people as a whole have very little conception of the value of proper mouth conditions. It
is strictly an educational problem to bring about a better understanding of Oral Hygiene. No child should leave school who has not been taught to take proper care of his teeth and mouth. No system of health instruction will be effective and complete without a dental clinic.
It is known that in many cities and even in other parts of the country children are sent to school who have not had their breakfast. It is also known that large numbers of children are not provided with the kinds of food which afford the nourishment for the proper physical development and growth of children. This too is a subject which is receiving careful at tention in the best school systems of the coun try, and no general plan of health education will rest upon a sound basis which does not take into consideration instruction in nutrition. When'the health examination of a pupil shows that such pupil is under-weight, inquiry will be made to ascertain if the child is also under nourished. The value of food and economy in food should be considered.
On the question of health, the public, the medical profession, the home and the school have not only been too conservative but have been guilty of gross negligence. All of these agencies have possessed false notions of the propriety of the consideration of certain health and physical conditions on which the children of the country should receive sound, direct, discreet, scientific instruction. This failure in the performance of a sacred duty has resulted in shocking conditions which affect the whole social and moral fabric of the nation. The statement is made by reliable authority that the tests made in certain typical States show that of the 10,000,000 men subject to draft, in the enrollment of the War Department, more than 3,000,000 were afflicted with venereal diseases. This condition is a reflection upon our civili zation. There should be great satisfaction and encouragement to those who bear responsibility in this matter in the fact that of the more than 2,000,000 American soldiers serving in France less than 1 per cent was afflicted with these diseases. This fact exemplifies the power and influence of scientific instruction, of publicity and of discipline in dealing with this problem. Surgeon General Gorgas of the United States army recently stated that the army suffers a greater loss in service from its men who have venereal diseases than from its men who are wounded. He further stated that in his judg ment very little success will be achieved in cor recting this evil until the people generally are educiated to believe that it is individual action and individual judgment that are finally going tcs control in establishing proper standards of in this respect.