Castle. Even its storied ruins could not replace in my mind the thoughts and impressions which I had carried away relative to the school. Wandering about in the Great Court of the ancient feudal fortress two reflections were uppermost in my mind; first-the narrow line of divergence between this school and those of our own country, and second-the unquestionable excellence of this school situated in a remote spot in Northern Wales.

THE SECOND INTERNATIONAL CONGRESS ON

SCHOOL HYGIENE.

By ANNA J. MCKEAG, Wellesley College.

The second triennial Congress on School Hygiene, which met in London, August 5-10, brought together physicians, educators, health officers, architects, engineers, and members of educational administrative bodies from all parts of the world. The interest of the present government in the purposes and aims of the Congress was shown by the presence of the Earl of Crewe, Lord Fitzmaurice, and other members of the Council at the opening meeting. The sessions of the Congress were held at the University of London and adjacent institutions. Sir Lauder Brunton was President of the Congress and among the presidents of the eleven sections into which the Congress was divided were Sir James Crichton-Browne, Professor William Osler, Dr. T. J. Macnamara, and the Earl of Crewe. English, French and German were the official languages used.

Four general meetings for set discussions were held. At the first of these, which was devoted to the discussion of the subject, "Methods for the first and subsequent medical examinations of school children," Dr. Leslie MacKenzie, of Scotland, presented a clear statement of the objects, method, and extent of medical examinations. Dr. MacKenzie believes that the medical examination ought to be "limited to the health conditions that fit or unfit the child for his school work." He would exclude details of purely scientific interest, relegating these to special investigations. He includes, however, certain facts in the social history of the child: occupation of the father or mother, housing conditions, and out-of-school occupations of the child. The schedule of examination includes, besides the points already mentioned, attendance, mental capacity, physical exercise, personal appearance, cleanliness, height and weight, chest measurements, eyes, ears, nose, throat, teeth, and deformities and diseases. Several of these are filled out by the teacher. There should be three examinations, one at admission, one at eight or nine, and one at eleven or twelve. A skilled physician requires only about five to ten minutes per child for such an examination. Professor Mery, of Paris, who followed Dr. MacKenzie, advocated an examination three-fold in its purposes: Anthropometric (weight, height, thoracic

measurement, respiration); physiological (sight, hearing); medical (organic-anatomical: general condition, teeth, skin, circulation, lungs, spine). Children found to be physically defective should undergo a subsequent examination by the specialist needed in their individual cases. Measurements should be made each semester by the teacher under the direction of the school physician.

At the general meeting on the subject of "The Lighting and Ventilation of Classrooms," the paper presented by Sir Aston Webb was largely a report on the regulations now enforced by the Board of Education in regard to the hygienic requirements of proposed school buildings.

The third general meeting was given up to the discussion of "The School in relation to Tuberculosis." Dr. Arthur Newsholme showed that tuberculosis is relatively uncommon at school ages, since the reports of the Registrar General show that it is the cause of death of only seven children per year in every 10,000 children between the ages of five to fifteen, and of these seven only three are pulmonary cases. Comparing these figures with statistics of examination of children in schools, and assuming that there are ten non-fatal cases to every fatal case, Dr. Newsholme reaches the conclusion that not more than one in 300 children in schools shows diagnosable pulmonary tuberculosis. These tuberculous children are not probably to any great extent, a source of infection. It is important that family history as to tuberculosis should be included in the medical schedule card of each pupil. General hygienic improvement of schoolrooms operates to retard the development of latent tuberculosis.

At the general meeting on "School Work in its Relation to the Duration of Lessons, Sequence of Subject, and Seasons of the Year," the papers presented were by Professor W. H. Burnham, Clark University, Professor Chabot Lyon, and Dr. Leo Burgerstein, Vienna. In Dr. Burnham's paper, which in the absence of the author was read by Dr. Luther H. Gulick, the discussion of the concrete questions of period of study and the like was prefaced by a critical estimate of the results thus far obtained in experimental investigations of the nature and laws of fatigue. The methods of the ergograph and æsthesiometer were shown to be valuable only in the hands of a skilled experimenter, working under laboratory conditions. The socalled mental tests of fatigue are really tests of work, but have a hygienic importance. The problem of the physiological basis of fatigue is not yet solved: but whether or not Weichardt has really found an anti-toxin capable of neutralizing the toxin which was apparently demonstrated by Mosso to be the cause of fatigue, Weichardt's theory is one which does not misrep

resent the problem of fatigue. "The nervous system can adapt itself to new conditions, and healthful habits of work can be developed." The problem of fatigue "is in part the problem of adaptation or immunity." "No student of hygiene can ignore the problem of developing resistance." "The studies of muscle fatigue and of the character of the child's physical organism, indicate that short periods of hard, even violent activity, are normal, and likely to foster development and relative immunity to fatigue; but, on the other hand, that there may be extreme danger in prolonged periods of work without rest. "The outcome of investigation seems to emphasize the pace of work rather than the time spent in study."

Professor Chabot pointed out the difficulty of arranging a programme based on a theory of the rhythm of effort, since the order of subjects has less to do with fatigue than has certain other factors, such as the method and personality of instructors. It is safe, however, to regard abstract subjects as being the most fatiguing. If there are five lessons, three should be in the forenoon. Lessons for children from 7 to 10 years of age should not exceed 15 to 30 minutes; for those of 10 to 14 years, not over 30 to 45 minutes; and after 14 years, not over an hour or an hour and a half.

Dr. Burgerstein suggested the desirability of utilizing, in the study of fatigue, not only the scientific experiments of laboratory workers, but also the results of "empirical trials made in schools by experienced teachers, with lessons of different duration and different sequence of subjects, under careful observation of scholarship." There is a certain danger in shortening the lesson-period where there are many teachers, since each tries to get as much done in a half hour as in the former hour. Lessons requiring exact memory should come in the early morning; lessons requiring good light should not be placed late in the afternoon; two lessons in foreign script should not be given in succession. Physical drill is followed by diminution of aptitude for mental work.

Each of the eleven sections into which the Congress was divided applied itself to a particular department of school hygiene:

Section I dealt with "The Physiology and Psychology of Educational Methods and Work;" Section II with "Medical and Hygienic Inspection in School;" Section III with "The Hygiene of the Teaching Profession;" Section IV with "Instruction in Hygiene for Teachers and Scholars;" Section V with "Physical Education and Training in Personal Hygiene;" Section VI with "Out of School Hygiene-Holiday Camps and Schools, the Relation of Home and School;" Section VII with "Contagious Diseases, Ill-Health, and other conditions affect

ing attendance;" Section VIII with "Special Schools for Feeble-minded and Exceptional Children;" Section IX with "Special Schools for Blind, Deaf and Dumb Children;" Section X with "Hygiene of Residential Schools;" Section XI with "The School Building and Its Equipment."

It is impossible in this brief notice to attempt a review of all the noteworthy papers read at sectional meetings. The United States was represented by several important papers-on Medical Inspection by Dr. Cronin and Dr. Darlington, of New York, and by Secretary Martin, of Mass.; on Scoliosis, by Dr. Lovett, of Harvard; on Folk-Dancing as an Agency in Physical Training, by Dr. Gulick; and on Hygiene for Teachers, by Dr. Wood, of New York. Special mention should be made of the Presidential Address in Section I, by Sir James CrichtonBrowne, which was a scholarly and adequate summary, from the standpoint of the physician, of the ways in which psychology and physiology bear on education. The work of Preyer, Hall, and Sully was commended as enabling the teacher "to watch the building of the mental fabric in its various tiers and stages." The question of the nature of the establishment of associations between neurones was discussed. Though the physical substrate of associations is not fully understood, these associations exist, and it is "to control and regulate these intercommunications, so far as not organically preordained, that education is still somewhat blindly groping its way." The opening up of association routes may be expedited by nutrition and exercise, or retarded by malnutrition or overfunction; it is usually a very gradual process, interrupted by certain cataclysmic upheavals, such as the advent of adolescence.

Dr. M. C. Schuyten, of Antwerp, presented in Section I some results of his paidological investigations, during the last ten years, in the laboratory at Antwerp. Among these may be mentioned the fact that the child's power of giving concentrated attention decreases from January to July and increases from October to December; that fatigue increases from October to July; that a period of slackening in development comes at about six years of age; that in March the muscular force is at its lowest ebb. It is encouraging to know that the recommendations of the laboratory are carefully considered by the Alderman of Instruction.

Miss Alice Ravenhill, Fellow of the Royal Sanitary Institute of London, presented statistics of an investigation into the hours of sleep of 10,000 London school children ranging in age from four to sixteen years. Miss Ravenhill finds that girls sleep more than boys; that all children sleep more in winter than in summer; that the average child sleeps from one to three hours less than he should; that insufficient sleep is due