be made. The question may be properly asked, "Does the school board have the power to exempt from vaccination?" Legally, no, but to a certain extent it is done where physicians certify that the health of the child is such that vaccination at the time would be injurious. Yet unfortunately this opinion is taken advantage of by anti-vaccinationists and children in perfect health are given this certificate. This is not right and makes much trouble; why should your child be excused because you have a "political pull" and my child be compelled to be vaccinated? In Pawtucket I introduced a special blank in which the physician is obliged to give the reason why the child is excused, and for what length of time. That this was necessary is evidenced by the fact that over 150 pupils were vaccinated who never had been, and that of 4,000 school children only thirty had used these special excuses, and to my knowledge only four or five have left school.

This question naturally follows, I think: Are there diseases which make it detrimental to the health of the child to be vaccinated? If so, what are they? A leading physician very aptly replied that a child who was physically unable to be vaccinated was physically incapacitated from attending school, and should not be allowed there. Personally I have excused children in whom I was afraid of a scrofulous outbreak as suppurating cervical glands. More especially am I afraid of trouble in thin, light-complexioned, fair-haired children; in exaggerated cases of eczema, and after any severe debilitating illness as typhoid, scarlet fever, diphtheria, etc.

I hardly believe that the physicians understand that they are practically evading the law when they excuse patients from vaccination, and I think if they did so understand the law they would be much more careful to whom they gave such certificates. And now I am led, trembling, to the old, old, time-worn, threadbare question, Do you believe in vaccination? I hope that the society will forgive me, because I am young and inexperienced, for introducing this subject, but the repeal of the vaccination law in England has again aroused the anti-vaccinationists the world over to renewed life and vitality.

Because a political deal could not be worked in any other way the home of vaccination has renounced the teaching and wonderful results of the discovery of Dr. Jenner.

Should we not, as true physicians, as teachers, show to our patients, if only by statistics, what vaccination has done and is doing in overcoming smallpox ?

With the voluminous statistics of the day, it seems impossible for one not to believe in the efficacy of vaccination properly performed.

It would hardly seem necessary in an assembly of this kind for a member of the school board to ask for less criticism and a little more charity towards the introduction of physical culture in our schools, yet the harshest critics that we have are the physicians themselves. It is true that physical culture under any system as it is taught at present is not all that could be wished, yet I think it is a big jump in the right direction.

It is in the high school, I believe, that the greatest good can be done, especially at the age of puberty, and we notice the round shoulders, the loping gait, the spinal curvature, the prominence of one hip with the corresponding depression of the other combined with the limping gait, and, last but not least, signs of the tubercular diathesis. Then I believe is the time that proper calisthenics and gymnastics will do its greatest work and save many a boy and girl to a life of better influence and greater ability because they have a good and firm physical condition. Medical inspection can do its best work in the primary and grammar grades, while physical culture should be prominent in the high school instead of discontinued, as is done, I believe, in some cities. One objection, I believe, is the danger of overheating the body from active physical exercise and the liability of "taking cold" from sitting in garments wet with perspiration.

Yet in our city we have been able to give the Robert's dumbbell drill and light work on the horse and parallel bars without much trouble and any such danger. I think, however, that better results could be obtained at a comparative small cost, so that the ordinary clothing could be changed for a

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light gymnasium suit, and then after the work a shower bath could be taken. Physical culture exercises should be given at least twice a week in order to avoid lameness and stiffness. In work of this kind a physical examination of the pupil is necessary, and thus avoid any trouble from weak hearts or lungs, and, if necessary, special gymnastic work can be given. It will not be many years, I believe, when such work will be done in every high school throughout our land, especially if the medical men will support and agitate the subject. not, I beg of you, excuse a pupil from gymnastic work unless there is some physical infirmity, and do not be browbeaten into excusing this child because the parent objects to anything so undignified. What applies to boys should in a certain sense be applied to girls. Calisthenics, exercises, drill with wands, etc., do an immense amount of good towards building up a firm and elastic carriage, and gives a good physique. Show to your patient the advantage of having his son and daughter do these exercises, however simple; tell him what is being done along that line, and the hue and cry about "fads" in public schools may still continue, but physical culture will be considered an essential.

And now, if you please, I will refer briefly to the third subject, in which I think every physician will be vitally interested; I refer to medical inspection of schools. I believe the time will soon come, if it is not now at hand, when every child upon entering school shall undergo a physical examination. This should include testing both the eyesight and hearing, the condition of the throat and nasopharynx, examination of the lungs, heart, and spine, and observing at the same time the mental aptness of the pupil. We should also observe any tendency to tuberculosis, scrofulous glands, the presence of extensive lesions as eczema, claimed by some writers to be contagious; syphilitic eruptions or manifestations, tinea favosa, circinata, or tonsurans, the itch, or any other conditions not as common but considered transmittible by contact. This may seem to some of you as though it was giving too much liberty to the medical inspector, but in case a pupil should present a certificate from

the family physician of good standing giving a clean bill of health, so to speak, it should be accepted. The plan is then suggested, and is now carried out in some of the large cities, for the teacher each morning to have the children who do not seem well, kind of "dumpish," so to speak, or suffering from a headache or sore throat, to wait in an anteroom until the inspecting physician arrives, when he shall decide by suitable examination whether the child shall remain at school or not. There is no treatment given whatsoever; the physician only decides instead of the teacher whether the pupil should continue at school that day.

At these visits the inspector can observe how the ventilation of the room is being cared for and see if the building is being kept in a clean and sanitary condition. Such inspection, especially if it could be combined with a physical exam. ination upon entering school for the first time, would have a great influence in preventing epidemics of scarlet fever, measles, whooping cough, and diphtheria, but it would have a much greater benefit in giving the myopic, the deaf, and the deformed child an opportunity not only to become mentally equipped, but also to attain a better physical education and condition. I thoroughly believe that this work could be done if the State, city, or town would properly pay a respectable physician for so doing. If the physicians as a body, instead of bemoaning the abuse of medical charities, would compel civil authorities and hospitals and public institutions to pay them a fair and just fee for services rendered, there would not be so much complaint throughout the land in regard to such abuse. Why should the city expect a physician to give his time, experience, and labor for practically nothing any more than they should expect coal and fuel to be supplied gratis? Yet I think if a medical inspector could be fairly paid and removed from political controversy, it would be a great help and influence in the public schools of this or any State.

In conclusion allow me to sum up this paper as follows: If I have awakened in your hearts any interest in the welfare of the public schools I shall have done well. Do not get pro

voked with the teacher if your vaccination certificate is returned as not satisfactory; the teacher did not make or pass the vaccination law.

Do not excuse this pupil from physical culture exercises because her father is afraid that dancing or hopping around on one foot may make a "premier danseuse" of his "pride and joy," or that little Johnny's back was strained from a few Swedish movements, while undoubtedly he has been "scrapping" with the neighbor's young hopeful.

Show to your patients the need and advantage of vaccination. Show to your patients the advantage, even if slight, of physical culture, and if you can conscientiously advise medical inspection of schools, do so by agitating the subject among your clientele. However, if I have interested you. enough this afternoon so that you will take the trouble to visit the school round the corner from your office and see what is being done, I shall feel amply repaid for my trouble in preparing this article.

UNNATURAL DEATH. Dr. Hill, master of Downing College, Cambridge, read a paper at the recent meeting of the Sanitary Institute of England, with the above title. He told his hearers that about one million babies were born annually in England. Thirty thousand of the million would die violent deaths from accident, 30,000 would die unnecessarily from tuberculosis, and 120,000 more from other absolutely preventable causes, such as smallpox, measles, and scarlet fever. Only 45,000 would be allowed to live out their natural lives, and nearly one in twenty would die because the machine was worn out. One fourth of all the diseases which destroy life are absolutely preventable, and fifteen years would at once be added to its average duration if the practice of hygiene were placed on a level with its theory. Dr. Hill attributed the greater number of the diseases over which the individuals affected by them have personal control to mistakes in eating and drinking. - London Times.