News and Comments
Some Orthogenic Agencies.
The current number of The Psychological Clinic emphasizes some general factors in the treatment of retarded and normal children. Mr. Ayres calls attention to attendance, Dr Martin to preventable physical defects and adverse environmental conditions, and Mr. Johnson to the necessity of playgrounds. These are orthogenic agencies of great importance.
The Schoolroom Thermometer.
It is difficult to give concrete definiteness to the regulations for the enforcement of hygienic conditions in the schoolroom. This may be done with respect to the temperature of the schoolroom through the employment of a thermometer. The principal of every school should receive authority from the Board of Education to hang a thermometer in every room and to require the grade teacher to keep the temperature between 67 and 70 degrees Fahrenheit and to announce that a teacher is liable to discharge if the temperature is allowed to exceed 70 degrees. It is easy enough to open windows and it is better to have a surplus of heat and open windows than to have a deficiency of heat. This regulation would teach hygiene more effectively to pupils and teachers than any amount of text book instruction.
Fresh Air in the Treatment of Disease.
In the February number of Archives of Pediatrics are two good articles on this subject, the first by Dr Edwin E. Graham, professor of children’s diseases in the Jefferson Medical College, Philadelphia, and the second by Dr William P. Nortlirup, of New York.
Dr Graham reports his experience with the fresh air treatment, which he introduced eight years ago in the children’s wards of the Philadelphia Hospital. Before that time the children did not do well. He says, “A frail infant, perhaps premature and under normal weight, would gain for a few weeks at best, then remain stationary in weight, finally gradually lose weight, begin to have diarrhea, and die. Robust infants on admission often did well for three months. The same symptoms after this period began to develop as in the infants admitted in a condition of malnutrition, and in spite of my best efforts, many of these robust children died. The same type of infants in my private practice were almost without exception doing well. Convinced that neither the food, nursing nor general care of these hospital infants was at fault, and that the so-called hospitalism was nothing but lack of fresh air and lack of out-door air, I ordered these children, in the month of January, placed for two hours each day on the fire-escapes.” The infant mortality decreased immediately. For the next two or three years, during Dr Graham’s service in January, February, and March, he had the children placed in small hammocks in the yard for several hours a day, unless it was raining or snowing. Five years ago the children’s wards moved into their new building, where “the infants practically have an abundance of fresh air day and night, and they do as well as could be hoped for.”
In the new Jefferson Hospital, where Dr Graham is on duty all the year round, he has a roof garden for the children, and the results are most encouraging. lie has had great success in applying the fresh air treatment in cases of pneumonia and typhoid fever. The rooms where these cases are kept have large windows on two sides and an open door 011 a third side. The children are well wrapped up and supplied with hot water bags, and the door and windows are kept open night and day, excepting for a few moments when it is necessary to uncover the patients for bathing, etc. Many other diseases have been successfully treated in a similar way.
In private practice Dr Graham has had equally good results. “On my first visit to the child,” he says, “I, if possible, instill into the mother the principle that fresh air differs from impure air as much as fresh milk from impure milk. Once gain her consent, and the treatment is an assured fact. I am more than surprised to see the willingness with which most mothers, no matter what their social status may be, enter into the treatment.” He quotes Wachenheim as authority for the statement, “Indifferent temperature feels neither warm nor cold, and is most restful. In children, indifferent temperature is about 75 degrees F. in summer in summer clothing, and about G5 degrees F. in winter in winter clothing, and varies with age and vitality. Temperatures above indifferent are not sedative, but cause a continuous stimulation that is harmful if prolonged, ending in exhaustion.”
In conclusion he says, “Let is all join hands and preach fresh air; vote for open squares, endorse roof gardens, have adenoids and tonsils removed, and if we are willing as a society [the American Pediatric Society] to endorse and work for the fresh air treatment with the same zeal and enthusiasm as we have worked for fresh and pure milk, our results will be as great a success as has been secured by our milk enthusiasts.”
Dr Northrup would like to see the term “fresh air” made more explicit, and suggests, “If it ever is entered in the U. S. P. [United States Pharmacopeia] and standardized for therapeutic use, it should read something like this, ‘Open air, or cold, fresh, flowing out-door air,? dosage regulated to individual needs.’” He emphasizes the point that in fresh air treatment, “The patients and nurses should be made comfortable all the time,” and tells how they make beds out-of-doors at the Presbyterian Hospital. He concludes by saying, 11 Open-air treatment has hilled no one, has injured no one, has helped everyone, and determined a cure in a few.” The Social Service Department of the Hospital of the University of Pennsylvania.
On January 21, 1909, the committee appointed by the Medical Faculty of the University of Pennsylvania submitted to the Board of Managers of the University Hospital the first annual report of the social work of the out-patient department of the Hospital. The chairman of this committee is Dr J. H. Musser, who procured the funds necessary to carry on the work and first undertook its establishment in the fall of 1907.
This work, following the plan of the Social Service Department at the Massachusetts General Hospital under the guidance of Dr Cabot, was made possible by the contributions of a friend interested through Dr Musser. The services of Miss Mary M. Ogilvie were secured as social worker and director. Miss Cannon, one of the leaders in similar work in Boston, gave two weeks of her time and energy in starting the work in Philadelphia. Miss Ogilvie is assisted by a staff of volunteer social workers. Dr Fussell and Dr Meyer Solis-Cohen are the physicians in charge of this department of the University Hospital. The report is an extremely interesting and suggestive document of nineteen pages. The work of the first year was chiefly taken up with tuberculosis. A tuberculosis class was established and patients were instructed in keeping records of their daily doings, including the character and amount of food taken, the number of hours spent in the open air, the hours of sleep, the amount of exercise or work, the number of bowel movements, the amount and character of the cough and expectoration, their spirits, etc. The patients provided themselves with clinical thermometers and took their temperature three times a day, recording it in a book. They obtained from the hospital at cost price Japanese napkins, paper bags, sputum cups of paste board and holders. The class meets once a week; instructive talks are given by the leader and also by the patients themselves. The records are gone over and are criticised by both the class leader and the members. “The benefits of this method are many. The patients become proficient in giving talks on the prevention of tuberculosis and the management of the consumptive and learn to repeat accurately to their relatives and friends what they have learned in the class, thereby carrying on an active educational campaign.” In some instances the husbands of patients. have repeated the talks heard at second hand to the men at their places of business. This has resulted in the ventilation of the work room and in the admisssion of fresh air to the rooms of fellow workmen. Some of the patients visit other persons known to have consumption or supposed to have a cold or chronic cough and have given them valuable instruction. The influence exerted by these optimistic, enthusiastic, improving tuberculosis patients on the people whom they meet is of inestimable value.
This education of the community alone would be sufficient justification for the establishment and maintenance of a social service department, but the direct result of this treatment is shown in the history of improvement in a large number of cases. “Another case, who, in addition to his pulmonary lesion had two different severe attacks of bone tuberculosis with necrosis, now works eight hours every day and during the summer plays on a ball team every evening and Saturday afternoon.”
In addition to this work Miss Ogilvie visits the homes of the patients, giving instruction in hygiene and the preparation of food; and often discovers new cases, mostly children, while visiting in families of patients referred to the department.
The social work department refers cases to the proper agencies and acknowledges assistance received from them. These include the Society for Organizing Charity, Wayfarer’s Lodge, the Protestant Episcopal City Mission^ the Society of United Hebrew Charities and the Children’s Bureau. Various agencies are beginning to rely upon the social service department for assistance in the medical and social treatment of their cases. The report ends with a plea for a combined effort in solving some of the complex problems of charity and civic life by such agencies as the Medical Department, the Wharton School, the University Hospital, the University Settlement House, and the Psychological Clinic conducted by the Psychological Laboratory of the University- of Pennsylvania. The Application of Modern Methods to Records for Public Schools.
Readers of The Psychological Clinic who have followed the various articles appearing therein from time to time on the subjects of retardation, and elimination of pupils from school, will have formed ft very real appreciation of the necessity for more complete and available records of school data, and will know how to appraise the work reported in Mr. George II. Chatfield’s article in the February number of School Work.
Committees from the Association of Women Principals and from the Principals’ Association of the City of New York have joined forces in an effort to introduce a more satisfactory system of keeping and filing the school data which under the present system are hidden away so securely that they are for all practical purpose lost. Mr. Chatfield, as chairman of the two committees, gives an account of their recommendations.
They have proposed radical changes in the methods of keeping most of the records. The most important suggestion is that in regard to the “Pupils’ Record.” This record is kept on a card 5x8 inches, blue for boys, white for girls. On one side space is provided for the name, address, date and place of birth, and school records in regard to grades, attendance, lateness, conduct, work, special aptitudes and deficiencies for the entire school life of the individual child. The other side is devoted to the record of the physical examination made under the auspices of the Board of Health. Two such cards are filed for each pupil, one set of cards being arranged alphabetically, one according to classes. When a child is transferred from one school to another one card is forwarded to the school and the other transferred to a file of discharged pupils. Thus the record of any child who has ever attended a school may be found at once in the files of that school.
This is only one item in a very comprehensive system of record keeping which aims to present data in reference to pupils, teachers, books, supplies, etc., in such a clear, simple, and available way that their value for practical school use and for statistical purposes will be much enhanced.
The system seems to have been carefully worked out and will doubtless prove of great practical value to the New York schools. The Use of Anatomical Models in Courses in Psychology and Education. The laboratory method of instruction had brought with it a recognition of the importance of models, specimens, and similar demonstration material. When psychology achieved an independent position in our leading universities, the employment of models became a matter of course to demonstrate the anatomy of the nervous system and sense organs, and the comparative development of the human and animal brain. The extent to which large demonstration models, and models for the individual use of students are employed, even in educational courses, at the present day, is scarcely appreciated. In addition to a number of medical departments and eight universities, among them the psychological department of the University of Pennsylvania, using the new Ward model of the spinal cord, this model is to be found in at least seven normal schools, the Philadelphia Normal School for Girls, the State Normal School at Bridgewater, Mass., the Colorado State Normal School at Greeley, Colo., the Idaho State Normal School, the Northern Illinois State Normal School, the Minnesota State Normal School at Duluth, Minn., and the State Normal School at Oshkosh, Wis. The use of these and other anatomical models bespeaks a progressive educational policy in many training schools for teachers, widely distributed throughout the country.
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