strategic position to remedy it. The school nurse and the medical inspector, where such are employed, can usually arouse the home to its duty. And then, too, the school, when it works judiciously, usually has a strong ally in the child. Through its health instruction and training and its sympathetic interest in the individual child, the school usually wins the confidence of parents and with it their desire to care for the health of the child. The nurse can go to the home of the child when it needs treatment, or when for health reasons it is kept away, and can make suggestions as to its proper care. Where there is neglect or open opposition, the medical inspector, working through the board of health, can usually insist upon badly needed treatment or even more sadly needed sanitary measures in the home.

But these sanitary measures may be made to benefit others besides the children who attend school. By opening its doors after sessions and in the evenings, the school can become an important centre of instruction not only for its patrons but for the whole community. In fact, each effective modern public school is rapidly enlisting the interest and affecting the welfare of its entire community. As an illustration of this the good work done in connection with the schools for the saving of babies need but be cited. Statistics show that more than one-fifth of the death-roll is made up of babies under one year of age and that an infant life goes out on an average of every 10 seconds day and night. In most places at present one-third of the chil dren born die before they are five years of age. Physicians claim that fully one-half of these deaths could be avoided. By the "baby-saving shows" and careful instruction of mothers in regard to the nourishment and the care of their babies, New York City has been able to reduce its infantmortality from 288.9 per 1000 in 1880 to 120 per 1000. But this is still 50 higher than is the case in Huddersfield, England, which as an industrial centre would naturally be expected to have a high death-rate among its infants, owing to the daily employment of so many of its mothers.

The very fact that problems of health in any community connect themselves with the varied interests found in

the home, the street, and the place of business, emphasizes the need for some organized agency like the school to carry on the work of general health instruction. As this work deals with the wider problems of sanitation and general control of health conditions, there must of course be organized expert health supervision under boards of health possessing full legal power to enforce safeguarding demands. But the school can be made an efficient auxiliary in the spread of health information. And working with the board of health, as it usually does through its medical inspectors, it can furnish excellent assistance in developing in the community intelligent and sympathetic support in all matters pertaining to health. In this way the school can make a very direct and valuable return to the community and to the state not only as an educational but as a protective agency. The health of a community is safeguarded and promoted not by its health laws and health opportunities but by the way in which these laws are enforced and these opportunities used. We are slow to learn that intelligence and desire to do are always more effective than the rigors of the law. Judging from the rapid multiplication of laws, we are even slower in learning that effective health training goes deeper and farther than legal measures ever can go.

The cost and danger to society of preventable disease well warrants the additional expense and effort necessary in using the school for this community instruction. Aside from the way in which health affects economic efficiency is the whole problem of the relation of health to social efficiency. Criminality can often be traced to overcrowded and unhygienic surroundings. Even social vice has been proved to be partly a housing problem; for in a number of large German cities it has been greatly lowered by removing the inmates of houses of ill-repute to more attractive and sanitary homes in the suburbs. While other forces have undoubtedly been operative in these cases, it still remains true that a healthy and inspiring environment is more apt to work toward right living than is a filthy and unwholesome environment. And the school can, both by precept and by example, be a large factor in effecting such salutary transformations in the community.

Recreation and Health.

For the small child the paramount need is physical health rather than progress in studies. But good health promotes the acquisition of knowledge, and where proper opportu nities for games, plays and interesting physical training are given in connection with the school work, the ability to acquire is also almost invariably promoted. And the growth in knowledge is usually attended by a gratifying growth in social and moral development. So ample provision for recreation and a healthy progress along all desirable lines should be characteristic of every well-equipped and well-conducted modern school. But there is not yet the time and attention devoted to well-organized recreation that its importance demands. Too often the demands for intellectual and vocational training are allowed to crowd out entirely the opportunity for badly needed play and recreation. We have not yet learned as we should that the cells of the body need frequent release from the bonds of concentrated, purposeful effort, to refresh themselves in the freedom of undirected, spontaneous expression. We forget that success can be secured at the expense of health and the saving grace of play.

66

It is a fallacy to think that the introduction of the manual arts has removed the necessity for recreation and physical training. On this subject Wm. A. Stecher, director of physical education in Philadelphia, has this to say: Since the introduction of manual training one often hears the argument that pupils having this training need no gymnastics. Now, while it is true that some branches of manual training give to pupils a certain degree of muscular training, it must not be forgotten that this work never was designed nor intended to replace all-round gymnastics. In fact, bodily deformities of students instead of being corrected are in some instances intensified by some forms of manual training. It also is a fact that some forms of this training, at times, are taught under conditions that scarcely can be classed as hygienic." Nor have the after-school play activities of pupils done much to remedy this condition. Where these have been fostered by the school, it has been almost solely for the purpose of getting together and

training school-teams for competition with other schoolteams. This leaves the great mass of the pupils, regardless of their needs, to get this health practice as they will. If they must rely on undirected play during the brief intermissions of the school, or upon the precarious conditions for recreation outside of the school, little will be done in the way of harmonious physical development and the refreshing of the body that comes through wholesome play.

66

Although much has been done within recent years to improve school health conditions, many of these things are largely in the nature of preventive measures. The most sanitary school buildings can only lower the risks accompanying in-door work and the congregating together of large working groups. They of themselves can never remedy the results of physical ignorance or neglect. This is also true of medical inspection, which has no further purpose than the detection and prevention of disease and physical defect. Nor can the health instruction of the class-room do more than furnish the general information in regard to the means of securing and maintaining health, except as it is accompanied by the active measures that tend to remedy defect and to promote vigor and endurance in the body. The present urgent demand is for a greater number of active measures-measures that help to maintain and increase health by giving the pupils an opportunity to indulge actively in gymnastics and in regulated play." But there must also be opportunity for free play-the "unbossed play" which relieves entirely from the tense and exhausting effort that usually accompanies play that has a purpose. This is the complete physical release which the primitive nature, still within us, craves and demands and which nothing else can so fully satisfy. And nature calls for play that satisfies as well as for play that develops. It should be a fundamental aim of the school to inculcate good health habits in respect to play as well as work and to have these habits firmly intrenched in knowledge and desire. Opportunities for play when well utilized by the school can be made the means of developing many of these habits. Well-organized physical training and ample space and time for play, especially in the open air, are invaluable to the growing child and they are also his inherent right.

(The problem of recreation in all of its bearings is so important that it was made the subject of a special chapter in last year's Annals. See "Current Educational Activities," pp. 23-96.)

Sex Hygiene.

The publicity attending investigations and punishments connected with the "white slave traffic "; the increasing number of anti-vice crusades in large cities; and the consideration given at various medical, religious, and educational conferences to the need and possibilities of sex instruction have given the whole problem of sex hygiene unusual prominence within the last few years. Changes in the attitude toward motherhood and toward home duties and responsibilities and a marked increase in the number of divorces have given additional emphasis to the subject. Then, too, the possibilities of such a mating of the sexes as will tend to produce a stronger and more worthy offspring has also received attention in the so-called science of eugenics. Realizing the importance of avoiding the entrance into the young life of wrong thoughts and practices, many are emphasizing the need of early instruction on the subject of sex. According to their thought, ignorance, misinformation, and a lack of proper instruction are responsible for immorality more often than is any moral turpitude on the part of the offender. Secret vice, sex diseases, and all the evils arising from wrong thoughts and desires toward the opposite sex would undoubtedly be placed under valuable restraining influences were the proper knowledge and safeguards thrown around young people at the right time and in the proper manner. there is still great difference of opinion as to what constitutes the best safeguards; whether definite instruction in sex matters should be given and, if so, by whom and how; and as to how early conscious restraining influences should be used.

But

Many maintain that with good health, a proper environment, and wholesome work and recreation sex thoughts and feelings are not apt to arise, especially before the period of puberty. To give definite sex instruction before this period would therefore merely be suggestive of the