Some knowledge of anatomy and physiology is the proper foundation of the lessons which qualify one to shun the dangers to life and health in his surroundings. If the study of physical and political geography be thought profitable to the young, though it concern mostly regions distant from home and never to be visited, how much more interesting and practical is the study of the human body, its parts and their functions, for it is our life-long habitation, and one should feel ashamed to be a stranger in his own house. If an acquaintance with history, particularly of one's country, be thought suitable to both young and old, can our instructors be held excusable for leaving us in ignorance of the dangers which threaten life and health, and of the practicable means for averting them?

It is true that some consideration was given to this subject even before the date of Herbert Spencer's essay; but in amount and quality the instruction now offered to pupils in California is hardly superior to what the present writer enjoyed in 1847 as a school-boy. The time devoted to learning self-preservation is limited to a short period in the grammar school course; the great majority of public school pupils never reach this grade; and the teachers do not receive additional instruction sufficient to qualify them for thorough understanding of the subject, inasmuch as it has heretofore been given by those without a medical education. In my judgment, all who receive their education in our public schools are entitled to a share of this knowledge, according to their capacity, and, like mathematics and language, it should be enlarged in the grammar school and high school grades, and afterward in the university.

It is now two years since a movement was made in the State Medical Society, and a special committee was appointed for the purpose of bringing about a more thorough method, beginning with the teachers themselves. This committee labored, to some extent, with the State Superintendent of Public Instruction, with the Principals of the State Normal Schools, and with the Board of Education of San Francisco. It will be remembered that the Sanitary Convention, at its San José meeting, one year ago, adopted resolutions having the same object. Moreover, the San Francisco Board of Education has been importuned by one of its members, himself a practicing physician, for more than two years to appoint a competent instructor for the City Normal School, to the end that the teachers in the future might be better qualified. This Normal School has recently been reorganized, and now for the first time physiology is reviewed, along with other grammar school studies. The Principal gives some additional instruction, and this is supplemented by a few lectures given by a medical graduate.

In order to learn what is done at the State Normal Schools, the following list of questions had been sent to the Principals: (1) Is any instruction in physiology and hygiene given? (2) If so, is it a review of studies gone over in the grammar school, or additional instruction? (3) Are there any lectures, illustrated by charts, etc.? (4) Is the instruction given by a medical graduate, or by one of the ordinary teachers? (5) Is any attention paid to hygiene further than the effects of alcoholic and narcotic agents? (6) Has this branch of instruction been extended within the last two years?

To the above the following reply comes from Chico: "The instruction given in this school extends over a term of twenty weeks of daily reci

tations, and presupposes a thorough knowledge of the subject as taught in the grammar schools. Microscopic work is done and slides are prepared. The instructor is not a physician. I send you a catalogue."

The catalogue, among other topics connected with this branch, indicates "much experimental work; comparative dissections; study of ventilation." No topic belonging strictly to hygiene is mentioned, except this last.

The reply from Los Angeles states that the instruction is more than a review of the work done in the grammar schools. There are no formal lectures, but the recitations are illustrated as much as possible by charts and casts and by the dissection of natural objects. Heretofore the instruction has not been given by medical graduates, but they contemplate more technical and scientific work, and have made a beginning by a series of lectures on hygiene by a lady physician to the young ladies of the school.

No reply has come from the Normal School at San José.

It is apparent that there is a slowly increasing interest felt in California regarding physiology and hygiene, and there is a hopeful prospect that this branch may become more prominent in education than it has been heretofore. Probably a movement in its favor, started by some members of the medical profession about two years ago, has had some effect, and there is encouragement to the hope that, in time, preventive medicine may be fairly appreciated by directors of public education and by the more intelligent part of the community.

II. ATHLETICS.

In the educational institutions of higher grade throughout the country. there has latterly been no considerable growth in imparting the knowledge of self-preservation; but in contrast we witness a striking and increasing interest in athletic exercises, generally encouraged and promoted by the governing and teaching bodies. It is presumed that these exercises are conducive to health by development of the muscular and respiratory apparatus and by promoting nutrition. This is true while athletics are duly regulated in degree and duration, but the happy medium seems to be impracticable. It is almost impossible to keep athletics apart from competition for prizes, and this has been the case since the institution of the ancient Hellenic games. There always exists a public demand for athletic spectacles, and students cannot resist the temptation offered by the éclat of victory. The name of an ancient Greek has been preserved, who died suddenly of joy for the success of his son in one of the national contests, and here in San Francisco we have witnessed the pride of a whole family in the triumph of one of its members as a pugilist, which might have been fatal to an aged heart structurally defective. Intercollegiate contests in rowing, baseball, and football excite as much public interest as a Sam Jones revival, a lynching affair, or a scandalous divorce case, and young men find more satisfaction over victory in athletic contests than in scholastic acquirements, because the rewards are immediate and conspicuous.

We might be indifferent to the vulgarity of such spectacles were they not inseparable from certain features now to be noted. The betting, juggling of matches, and drunkenness often found are not our concern as sanitarians; but there are dangers which threaten the health and lives of contestants. Pugilists are notoriously short lived, and crippled

hearts among amateur athletes are too common. Many others are so moderately affected that they have observed no shortness of breath, and the discovery of valvular lesion and hypertrophy is first made by the medical examiner. Since January 1, 1895, out of the 250 first examinations for life insurance in the industrial branch I have found 12 defective hearts, and in 7 cases there was no history of rheumatism. Of these last, three were amateur athletes, all under 35 years of age. Of the other four, two had been sailors, one a carpenter, and one was a woman 30 years old. The three athletes and the two sailors clearly incurred the defect from overstrain. Not one of this class complained of dyspnoea, or was sensible of any cardiac defect, and they may, under favorable circumstances, live many years; but, at best, their prospect for longevity is damaged.

The professed object of physical training in education is to furnish needed exercise and to develop the defective muscles of certain individuals. These last are comparatively few, and there is no necessity that all should take gymnastics. Manual training in handicrafts, as practiced in polytechnic schools, furnishes both exercise and skill in the use of tools that is useful to every one. At the same time such discipline is absolutely devoid of the objectionable incidents to athletics just observed. The prevailing fashion is for the latter, on several accounts: (1) They afford opportunity for public display and éclat; (2) they gratify the popular desire for betting; (3) they cannot be stigmatized as work. They are, in short, an ornamental branch of education; and, as Herbert Spencer has pointed out, the ornamental has always taken precedence of the useful, from paint on the body of the savage instead of clothing to the education of the most highly civilized, in which practical acquirements are sacrificed to elegant accomplishments. The above may be illustrated by two recent examples, which stand in contrast. A few years ago the Boston Board of Public Education employed a special teacher in physiology and hygiene, and afterward abolished the position. They have, however, a well-paid professor of physical culture, who is a medical graduate, and it is to be hoped that he governs it within safe bounds. On the other hand, the late Paul Tulane, through whose liberality the university bearing his name at New Orleans owes its high standing, expressly ordained that shops should be provided for the instruction of the students in the useful arts and trades, and that no gymnasium should be attached to the institution. In fact, the former German Turn Halle was purchased and converted into workshops, to carry out his intention.

Large sums of money are expended for physical training in institutions for higher education, but, as a business proposition, the investment is found remunerative. These aids to a liberal education attract students, and what would a college be without them? Consequently we see greater emulation in this particular attraction than in any other academic equipment. If all this expenditure of time and money, all this parade and excitement, were merely an advertising device, it would be no more worthy of our attention as sanitarians than the broadside advertisements of rival sarsaparilla makers; but when the newspapers constantly swell the list of dead and maimed contestants on the field of glory, and unconspicuous testimony is gathered by physicians of hearts organically impaired, I submit the question, whether less of showy athletics and more of plain hygiene in public education might not be advantageous in a utilitarian point of view?

Discussion of Paper Read by Dr. S. S. Herrick.

DR. THOS. D. WOOD: I was one of the committee appointed at the meeting of the State Medical Society two years ago in San Francisco to take under consideration this matter of the teaching of physiology and hygiene in public schools. Not very much was done, I think, by that committee. It was handicapped by the complexity of affairs and committees and red tape which wall about our system of public education. An appeal was made to the City Board of Education in San Francisco, and a thorough effort made to have a reform of some kind instituted, and as Dr. Herrick has suggested, and I think that that effort has been felt in the reorganization of the Normal School at San José. The subject, in the meantime, has been growing in interest. I am practically engaged in the teaching of subjects of this kind. It seems to me, in the first place, that there is a good deal to be done towards reform in the methods of teaching these subjects of physiology and hygiene in the public schools. They, to my mind, have been taught too much as a part of the regular curriculum. They have come into competition with other subjects and studies in the course of study. Physiology has been looked upon as a science study in schools, and I believe it is necessary at the beginning to separate the two branches of physiology and hygiene. Human physiology, it seems to me, and it is the result of the experience of a good many educators, should not be taught to the younger pupils in the schools as such; human anatomy and physiology as a science study is proper, perhaps, in the grammar and high school course. But the subject of hygiene, those who are here to-day will at least admit, I am sure, should be taught from the time the child enters the kindergarten until he is graduated from whatever institution of learning, at least below the professional or technical school, he may enter. Hygiene, it seems to me, should be taught, as Dr. Herrick has suggested, as the science which deals with self-preservation, agreeable to the previous preparation and condition of the children who are being taught. A mistake has been made in trying to teach pathology to children in the first grades of school, in temperance instruction as well as in the teaching of physiology. Injury has been done by the discussing of things which have simply surprised and shocked the nervous system of the child who has never been prepared by any previous training, in the effort to force instruction of this kind. Preparation is needed before the child can understand such difficult subjects as the principles of human anatomy and physiology; there is a preparation needed before entering upon the study of animal physiology, zoölogy, biology, pathology, physics, and chemistry. But the child must not be neglected in the education which he should have in the science of hygiene or health preservation. The first thought that I want to emphasize is that it needs to be differentiated more clearly as a subject, so that it may not come into competition with, or be crowded by, or compressed with other studies in the school curriculum, because it has to do vitally with the child, no matter what he is going to do or how long he is going to stay in school, and the shorter time he stays the more necessity there is that this subject should be sufficiently inculcated.

There are certain things which it seems to me are necessary to the proper teaching, proper consideration, and proper treatment of this subject in the schools to-day. In the first place, a realization of the neces

sity which will come with the better intelligence of people at large. This must be done by education of public opinion, an education which will grow out of this meeting, if this subject be touched upon every year, one year after another; through the discussion of these matters in the newspapers, as well as through the teaching of the younger generation, which will enable them to appreciate the necessity for it.

In the second place, I find from a study of the schools in this State, that practically the most difficult problem to-day to solve in the matter of the development of physiology and hygiene, is lack of preparation on the part of teachers. Dr. Herrick has told us the preparation given in one or two of the normal schools of the State. As a matter of fact the training given in hygiene, in health preservation, is very deficient in most of the State normal schools and universities and public schools throughout the country, and entirely inadequate. It is taught by teachers who are crowded with other work. If they teach it at all, they teach it because they are required to. They have no heart in the subject whatsoever. They teach it as an extra. They feel it an added burden, and they teach it as superficially as they can and retain their places. I have had them admit this to me time and time again. It is possible to arouse an interest in them in this work with reference to this subject, but this has not been done; primarily, because no proper training is given in the training school for teachers, neither in the high schools, in the grammar schools, in the normal schools, nor in universities; and in order that this shall be done, in order that teachers shall have the proper training, there must be better methods for the teaching of this subject. I say this subject of hygiene, which implies enough of anatomy and physiology, as well as the study of disease, to render it intelligible; this teaching, at least in the normal schools, should be done by specially trained teachers, by medically trained teachers, and not simply by physicians. I feel free to speak of this, because in a very humble way am a physician and teacher of hygiene. It does not follow that because a man or woman is a graduated physician that he will be a good teacher of hygiene. It is coming to be an independent subject, and requires careful study in addition to the professional study of medicine. It requires a special study in itself. There are better methods of training needed; in the first place, better teachers; in the second place, a method of teaching the subject which is different from the characteristic method of teaching medicine, or different from the other studies in the schools. It is the teaching of the problem of self-preservation. It is the teaching of mechanics. It is the teaching of the study of a machine which has to be run during a certain time in the best possible way, and there is no figure, no simile which appeals to me so frequently as that of the engineer. The knowledge of the teacher of hygiene and physiology, so far as he deals with this subject in the schools, is comparable to that of the knowledge of the engineer, who must know how to run the engine most economically, perfectly, and successfully to the extent of the work which it shall do. The human body is considered by our school teachers too much as a structure with very peculiar and intricate functions, instead of a machine which must be handled according to its complexity and delicacy in order to get it to do the work which it must do.

After having presumed, in the way I have, as a young man, I am rather hoping that my identity will remain unknown, because I assure