disease, and not be under the necessity of stopping all school-work because a few children are sick.

It is possibly too much to say that with a careful system of inspection every child is as safe in school as in his own home, but for the children of the middle and poorer classes, whose home is the crowded tenement and whose play-ground is the street, that point has already been reached.

THE EYES OF SCHOOL CHILDREN.

HENRY S. Miles, M.D.,

BRIDGEPORT,

THE EYES OF SCHOOL CHILDREN. Although always interested in this subject, I had done no work in the schools until March, 1897, when our Superintendent of Schools, through the Physical Director, asked me to examine the eyes of all the pupils in Bridgeport. I promised to give what time I could toward doing so.

Blanks were provided that the pupils' name, age, grade, vision of each eye, error of refraction, if any, and amount, whether pain in eyes or headache-if wearing glasses and other notes could be recorded. I found that, with a secretary to record results of the examinations and no loss of time in getting pupils, I could thoroughly examine only from fifteen to eighteen an hour or, with the time at my disposal, about six hundred in a term; as there were then over eight thousand pupils in all the schools and seven hundred new ones coming in each year, it was soon seen that we had undertaken too large a task, single handed, and the following year made a new arrangement whereby most of the normal eyes were eliminated. During that year, the teachers in the various schools were instructed to send to the Board of Education rooms only those scholars who complained or ap peared in some way to have defective eyes. By this method I was able to examine the suspicious cases from every school in the city. The total number of pupils notified to appear was ten hundred, sixty-seven; nine hundred twenty-two, presented themselves and the eighteen hundred forty-four eyes were examined. these, two hundred sixty-four (28%) were found to have defects sufficiently marked to require further treatment

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by a physician. They were reported back to the teachers and their parents or guardians were advised to have them attended to. A summary of defects is as follows: One hundred and two were hyperopic (far-sighted), fortyone were near-sighted (about sixteen per cent. of those defective); this is less than reported by most observers that have examined school-children in American and European cities. One hundred sixty-two had astigmatism without going into details of amount, kind of astigmatism and mixed cases. One hundred fifty-three, or 58% of those defective were girls, and one hundred eleven boys; in addition to these, two hundred ninety-eight had slight defects, leaving three hundred and sixty with eyes practically normal, 39%. This is very near the percentage found in other cities.

Thirty-two scholars had normal vision still with marked defects in eyes.

Forty-one were wearing glasses, seven of whom did not need them, and eight were wearing glasses not suited to their eyes. The remainder gave relief or helped to a certain extent. There were twenty boys that squinted and fourteen girls; this proposition is at variance with records in private practice, for among the errors of refraction found in four thousand eyes, which I reported to this Society in 1894, from the cards of Dr. Wilson and myself, there were fifty-five squinting girls and twentythree boys. Thirty-nine of the school children had diseases of eyes or lids sufficiently severe to call for treatment, mostly some form of conjunctivitis or blepharitis. The teachers helped us in a careful, prompt and thorough manner, and the parents almost without exception expressed themselves as grateful for the knowledge of the condition of their children's eyes. In 1899, a special committee of our State Society went to Hartford, and we secured the passage of a law which reads as follows:

SECTION 1. The State Board of Education shall pre

pare or cause to be prepared suitable test-cards and blanks to be used in testing the eye-sight of the pupils in public schools and shall furnish the same together with all necessary instructions for their use, free of expense, to every school in the State.

SECTION 2. The superintendent. principal or teacher in every school, sometime during the Fall term in each year, shall test the eye-sight of all pupils under his charge, according to the instructions furnished as above provided and shall notify in writing the parent or guardian of every pupil who shall be found to have any defect of vision or disease of the eyes, with a brief statement of such defect or disease and shall make written report of all such cases to the State Board of Education.

In 1900 the teachers of Bridgeport thus examined eight thousand, eight hundred and nineteen of the nine thous and two hundred and forty-eight pupils enrolled, and notified the parents of thirteen hundred and nineteen with defects, about 164; six hundred eighty-nine had vision less than half normal. In the entire State with 122,940 scholars enrolled 108,657 were tested and blanks sent to parents in 15,970 cases, a little more than fourteen per cent. of those tested.

In 1901 the law was amended so that the examinations will only be made every three years hereafter instead of yearly.

The eyes of school-children have received quite some attention since Beer published a work entitled "Healthy and Weak Eyes," in the year 1800, and James Ware first mentioned "The relation of myopia to the demands of civilized life," in 1813. Physicians in various cities here and abroad have examined and published records of over 300,000 scholars in all grades, but Connecticut is the first State, and so far as I have been able to learn the only State having a law which requires a regular uniform examination of all pupils. Some States and cities sanction an examination.

We realize that these examinations by the teachers cannot give the best results, for many errors must of necessity be made-pupils with far-sightedness may have normal vision and be overlooked and those with disease of the fundus of slight degree or in a position not interfering with sight will not be discovered. On the other hand, an expert would detect why vision was not perfect in some cases and so avoid notifying parents-quite a number have poor vision for which there is no remedy, as where caused by scars upon the cornea, etc., but certainly much good has been done and will be done by carrying out the provisions of our law. Some time in the future perhaps all eyes can be examined by opthalmol. ogists, and ears examined for defective hearing and adenoids will be ferreted out and their removal advised. Possibly we may live to see medical supervisors for every school district as at present maintains in Asbury Park, New Jersey. I will read you Section 255 of the New Jersey school laws:

Every Board of Education may employ a competent physician to be known as the Medical Inspector, fix his salary and define his duties. Said Medical Inspector shall visit the schools of the district in which he shall be employed at stated times, to be determined by the Board of Education, and during such visits shall examine every pupil referred to him by a teacher. He shall at least once during each school year examine every pupil to learn whether any physical defects exist, and keep a record from year to year of the growth and development of such pupil. Said Inspector shall lecture before the teachers at such times as may be designated by the Board of Education, instructing them concerning the methods employed to detect the first signs of communicable disease and the recognized measures for the promotion of health and prevention of disease. The Board of Education may appoint more than one Medical Inspector.

Dr. John Taylor fills this position at present and has