ery therefrom, and surgical operations.

Some further characterization of this group is indicated by the age limits ranging from 16 to 22 years; further, 15 of the 266 were young men, and 17 of the total number were Afro-American.

First, anthropometric defects were read off in terms of marked departures from our own growth and development norms, assembled from typical and similar groups of Chicago second generation young Americans. In this regard a defect meant not less than three times the average variation of the group. Sensory defects of vision and hearing were recorded from readily ascertainable comparative tables and our own norms.

The gross summary of total number of defects noted shows that 247 candidates of 266, or 92.8%, had defects of one kind or another as indicated, noticeable, moderate, or extreme in degree. The slight departures were remediable or correctable, either at once or before examination was completed, such as of vision, and the like, or during the two-year term of study in compliance with the program outlined for each student. The extreme defects, or rejected candidates, set the problem before us in a frank, sharply outlined picture. But this is not by any means all there is to it. It has been usually said that negative cases always set the problem, but I believe that a close survey of the whole of which those rejected form a part will more adequately bring out their implications and bearings, especially for educators.

The detailed study of the defects noted shows that among these high school school graduates, in such a simple co-relation as height-sitting and weight, 8 were too heavy and 23 were too light. Ten students were deficient in strength, 5 below age-size requirements in lung capacity, 57 students, or 21.5%, showed a visual defect equal to or greater than the standards outlined by industrial insurance requirements, and 5 students were handicapped by hearing defects. In regard to the integumentary system, 18 had some

dermal or skin affection, superficial or constitutional; only 23 had defective teeth needing attention; only 3 had affections of nails, and 4 had symptomatic disturbances of hair health.

Within that subtle field of the nervous system, 32 gave evidences of hyper- or hypo-excitability, even making allowances for the circumstances incident to examination. With respect to the respiratory system, 13 showed findings of obstructions, hyper-tensions and immobilities over and beyond mere functional bad habits. Within such observable and measurable features of the glandular system, as could be investigated, the most striking and significant signs and symptoms were obtainable. Only three students had palpable cervical glands, 38 had tonsillar involvement in addition to the 33 students that had tonsils excised; 152, or 56.4%, had a noticeable or marked enlargement of the thyroid gland.

More important still than those characteristics of the glandular system, though in many respects related thereto, were the findings in the vascular system. Fourteen of these students showed involvement of heart function, some of them grave and organic, others only accidental or incidental to constitutional characteristics, nervous malfunction and glandular impairment; 47 candidates had abnormal blood pressure, of which 16 only showed hypertension, while 31 were subfunctionating either due to systematic overdrain or slow accumulating disorders, and 19 of these had too low or too high pulse pressure. In the genito-urinary system only 3 gave a symptomatic record of slight functional impairment that resisted remedial measures or were undetected.

In the list of diseases of childhood or early life, it is well known that infantile paralysis must be reckoned as one of the most dreaded, disabling and deforming. Among one group, 5 of these young girls had the misfortune to suffer its ravages with resulting impairment of form and function. Moreover, 6 had deformities of

obscure origin and slow development, more or less marked as scoliosis. An equal number of lordosis cases were found, and seven additional cases had deformities of trunk or of extremities.

as

Does it appeal to you or appear to you successful education in secondary schools that young people must graduate, presenting such an array of defects as I have outlined-defects that are preventable or correctable to a very large degree? Or that which is a still worse arraignment, to pass out students from the molding of your hands, with incapacitating defects that are unknown to the students in the vast majority of cases and undetected or not pointed out by their teachers?

The situation evidently requires more than the care and treatment of the family physicians, and even of the surgical specialists, as the health records of these young applicants evidence, for it is noted that 99 of 266, or 37.2% of the group, had experienced surgical operations, of which tonsillectomies numbered 55, adenectomies 22, 1 thyroidectomy, and 3 for excision of cervical glands, I each for hernia, mastoiditis, tumor, and the like, up to the quota mentioned.

Objections may be raised at at this point that this group of high school graduates is not worse off than the general population of the same ages in any community, an implication which I doubt, and an apparent justification of neglect, which I condemn, for the simple reason that no one, to my knowledge, has yet produced a valid argument to show cause why a system of education should not improve conditions-in other words, should not edu

cate.

Moreover, if we appeal to our further data, we find in regard to the additional 49 candidates, other than high school graduates who passed the same examinations on the same dates, that age and maturity alone do not cause defects to be outgrown or evanesce, while on the other hand, additional physical care certainly does tend to minimize or lessen these handicaps.

Of 29 college graduates or students with at least least two years of college education, 23 of the number had comparable defects, or 79.3%, as against 92.8% of high school graduates, while 19, or 95%, of the 20 former teachers who entered the class to renew their certificates, had pronounced defects as compared with 92.8% of all high school graduates. Thus maturity of years without a record of physical care increases the number of defects, whereas additional education and slight advance in age, with recorded physical care and physical health education, diminishes the numbered defectives. Why then wait for an examining board to find defects that may debar or disqualify high school graduates who seek to qualify for any particular vocation, or expect time unaided to minimize or assist in the correction, to say nothing of the prevention of, defects? Why not rather correct imperfections in the process as it goes on? In short, why not educate instead of neglect?

As a further argument for the value of detection of defects and the efficacy of simple correctional programs of procedure, we may appeal to our statistical records again, which incidentally gives us a brighter picture.

From the records of re-examinations of a recent graduating class from the Normal College, who took the same examinations two years previously and who were informed of their physical status and deficiencies, it is seen that of the 189 candidates, two had no program of correction indicated, 107 were noted as having grave or noticeable handicaps or defects, of which 91, or 85% of the number, followed the recommendations outlined in advance or benefited by directed physical education by their instructors, and health guidance by a school committee on health.

The foregoing outlined facts indicate the desirability, nay, the necessity, of adequate physical examinations at periodic intervals of high school students to prevent misfortunes in vocational selections,

tribute to the growing scientific attitude on the part of people.

We are emerging from plain superstition. Our advertising abounds with such expressions as "discovered by an eminent scientist", "triumph of science", "endorsed by leading physicians". But this incident also shows that mankind is still very easily mislead. Education already has a heavy task, but it would seem that it is the only way by which we can learn to distinguish the true from the false in those matters that affect our health.

There is a method of learning truth called the scientific method. By it we have discovered that the phenomena of our physical universe occur according to laws. As we discover these laws we are able to control our environment to an extent never before possible. From our knowledge of these laws we have developed our radio, telephones, railroads, automobiles, aeroplanes, and the thousand and one things that make this the greatest mechanical civilization ever known. But it seems that the mass of mankind is slow to appreciate that the biological laws are just as definite, and in some cases as well known as physical and chemical laws. At any rate, people seem to be very easily misled by pseudo-science in the realm of health and the cure of disease.

We teachers must first be thoroughly convinced that the scientific method is the means by which the truth should be learned about health, that it is the only method that produces results. And we need further to learn how this method is used so that we can distinguish that which is scientifically sound from that which is not. This task is not easy.

We can, for convenience, divide this method into separate steps, although these are not necessarily separate and distinct in actual practice. First, is the collection and observation of facts; second, the classification of these facts observing likenesses and differences and casual relationships; third, formulating hypotheses to account for the facts; fourth, testing these

hypotheses by further facts; and fifth, deducing the laws which govern our facts. A very large part of our laboratory and research work comes under the fourth step. Let us illustrate this by a brief story of the discovery of the cause of yellow fever, for this is a brilliant chapter in the history of disease control.

Certain facts concerning this and other similar diseases led to the mosquito theory of its cause. But further proof was needed. A commission on yellow fever in Cuba, composed of four doctors, undertook the proof. These men were Reed, Carroll, Lazear, and Agrimonte. Protecting themselves from mosquitoes they tried other probable means of infection. They slept with yellow fever patients, wore their clothes, and ate from dishes used by them. But they did not contract the disease. Then Carroll and Lazear allowed themselves to be bitten by the suspected mosquitoes. The result was that Lazear died of yellow fever and Carroll was near the same end. To make the proof more certain, soldiers of the American army in Cuba volunteered to undergo the same risks. And then came the benefit of knowing nature's laws. Armed with certain knowledge, the Sanitary Commission, under Dr. William C. Gorgas, exterminated the stegomyia mosquito in the Canal Zone, and with it yellow fever, thus making it possible to build the Panama Canal. But it is interesting to note that it took an epidemic in 1905 to convince the people in the Canal Zone that the scientists were right. After this, however, Dr. Gorgas and his Commission were given full reign in sanitary matters.

The scientific method is based on determinism. This merely means that we assume that nature acts according to law, and not capriciously. We expect that certain conditions produce certain results and if we duplicate these conditions we will get the same results. This method is further based on logical thinking as opposed to emotional thinking, and here is where many of us get into difficulties. We

are biased by what we would like to be true, by views we have held for a long time, or by what we get from those who seem to us "authorities." It is hard to be open-minded and unprejudiced. We are prone to draw conclusions and base our judgment on insufficient evidence. The average man has little idea of the rigorous proof and abundant evidence that must be obtained before scientists will draw general conclusions. And even then the scientists must be open-minded in the face of new evidence.

We are very apt to mistake cause for effect, and vice versa. When two things happen simultaneously, or successively, we are not justified in the conclusion that one causes the other. Many of our physiology texts have taught that cigarette smoking causes low mentality because these phenomena often occur simultaneously. It is at least possible that the smoking is caused by low mentality or that both come from a remoter cause. These are some of the errors of logic into which we fall. But even after we recognize these errors and guard against them, we are often at a loss to know what to believe in health matters. Authorities themselves disagree and the layman is puzzled.

Here are a few suggestions. Beware of the "secret" discovery, or the exclusive method. One may patent an invention and derive financial benefit, but not with honor may a discovery of benefit to the health of mankind be kept secret. One must give such a discovery to the medical world. Thus did Dr. Banting with his insulin treatment for diabetes, and so must all reputable doctors and scientists. Use your critical judgment on the "authority" who would gain financially if you took his advice or accept his ideas. Just as you should guard against emotional bias in your own thinking, so be on guard for bias on the part of the other fellow who has a financial ax to grind.

Let us understand that very many things about health and disease are not settled and we have to educate this judg

ment of ours to take the side of the "more probable." There are degrees of scientific soundness varying from the certainly proved to the very doubtful. For instance, it is known that certain diseases, like typhoid fever, are caused by bacteria; for others there is strong presumptive evidence of the same cause, but definite proof is lacking. For still others the cause is doubtful or unknown.

A word about authorities: The standing of men with others of their profession and the schools in which they were trained are guides. The science of our leading universities and medical schools, both State and private, is as sound as we can find. We have to exercise our judgment, however. There is no substitute for our brains.

Finally, here are some questions upon which we can exercise our thinking powers. To some, the answers are definitely known. Others are still matters of dispute. Every teacher interested in health training should be able to give an opinion or definite answer to them. You may have to search for facts or data or opinions of others, but beware of emotional bias. If you feel strongly or get a little "warmed up" in considering or discussing them, mistrust your conclusion. 1. Do drafts cause common colds? 2. Do you ever suffer from lack of oxygen?

3. Is night air injurious?

4. Do drugs usually cure disease?

5. Under ordinary circumstances are you ever poisoned with carbon dioxide?

6. Is a healthy person, unvaccinated, likely to take small-pox after exposure to

the disease?

7. Does the perspiration contain poisonous waste matter?

8. Will salts in bath water remove fat? 9. Is the science of the Physical Culture Magazine sound?

10. How about that of Hygeia?

11. Which magazine would be the better authority on mental health: The New