The hygiene of the schoolroom

Front matter

Book g3

GopyiightN"

'1"

Preface

The aim of the author in writing this book is to place in the hands of educators and others interested in child life trustworthy knowledge of the means of conserving the health of those entrusted to their care. Compulsory education, in this country, is almost universal, and it should be the duty of the authorities to see that in the schools which children are required to attend nothing of an unhygienic nature exists. It is the truth, however, that until very recently little attention was given to the physical side of the child's nature, and that in the schoolroom the fundamental principles of hygiene were very little understood — at least were not practised. Some matters, to be sure, that concern the pupil's health, such as the need of proper diet, of proper clothing, and of eye-glasses, are beyond the province of the school authorities, and can be reached only by advice to parents and vi Preface.

guardians. But many of the evils growing out of a common public school system are remediable : there can be, for example, better treatment of the problems of heating, ventilating and lighting. Upon these and kindred topics this book offers suggestions which the writer trusts will be ol value to whoever is interested in improving the physical condition of the children in our schools. A work of this nature is essentially for teachers, superintendents and school governing boards, and aims in all parts to be practical rather than to quote countless pages of statistics usually as various as the individual opinions of the writers. The author hopes to combine the consensus of the best opinion with personal knowledge and investigation and make clearer the much discussed subject of School Hygiene.

Preface to Second Edition

The encouraging- manner in which the first edition of "The Hygiene of the Schoolroom" was received has importance, principally, in showing a lively interest in all that tends to the pupil's physical well being.

School officials, generally, are evincing commendable concern in the modern construction of school buildings, ventilation, heating, lighting, school diseases, medical inspection and kindred subjects.

In many cities through their efiforts medical supervision has been adopted, and, its benefits being so apparent and immediate, it has always found lasting favor.

Teachers have appreciated this volume as a reference book,' as i't makes their duty much clearer in many perplexing points of a scientific nature, which they must decide upon, yet which demand almost an expert's understanding.

As promised in the prospectus at the beginning of the year, the book was to be a practical treatise on all that viii Preface to Third Edition.

pertains to the heahh of the pupil. Upon its appearance it was eagerly taken up by educators throughout the country, many of whom have expressed their gratitude for the helpfulness it affords in the field it covers. Many, too, have added to the value of the second edition by timely suggestions and comment.

It is hoped that this book will help to keep alive the interest that is being felt in the preservation and promotion of the pupil's physical welfare.

The author trusts that it will be received with the same favor and appreciative criticism that was accorded the first edition.

WOONSOCKET, R. I., Nov. I, I904.

Preface to Third Edition

The author is glad of this opportunity to offer an enlarged " Hygiene of the Schoolroom " in the third edition.

In six years school hygiene has taken hfe and energy in such measure as has been accorded no other department of child life study. If this work has been helpful in this impetus, the author counts himself well repaid, and if one child has been spared disease, he feels that his life work has not been in vain.

WooNsocKET, R. I., June i, 1909.

Chapter I Pa !•

The Selection of a Site for a School Building i

CHAPTER H The Construction of School Buildings . 4

CHAPTER HI Ventilation . . . . . .17

CHAPTER IV Heating ....... 30

CHAPTER V School Furniture . . . . -35

CHAPTER VI

CHAPTER VII The Hygiene of ti-ie Eye .... 64

CHAPTER VIII The Hygiene of the Ear .... 82

CHAPTER IX

X Contents.

CHAPTER X

PAGE

Relation of Contagious Diseases to the School 98

CHAPTER XI

CHAPTER XII Modern Education and Health . . . 141

CHAPTER XIII School Diet 157

CHAPTER XIV Physical Training and Exercise . . 163

CHAPTER XV Corporal Punishment 168

CHAPTER XVI

Sickness and Accident in the Schoolroom . 175

CHAPTER XVII The Teacher's Health 182

CHAPTER XVIII.

Defective Children 186

LIST OF ILLUSTRATIONS.

Page

Fig. I. Standard school wardrobes in a school hall 7

Fig. 2. A window ventilator made of glass 26

Fig. 3. Illustrates a desk too high for a child 36

Fig. 4. Illustrates too great space between the seat and desk 38

Fig. 5. Illustrates a very common fault in school furniture 40

Fig. 6. Illustrates a too small " distance " between the seat and desk 42

Fig. 7. Illustrates a desk and chair too small for pupil's size 44

Fig. 8. Illustrates ill-fitting stationary furniture 47

Fig. 9. Chair and desk illustrating proper seating of pupil 52

Fig. id. Shows attention paid to light in schoolrooms built twenty-five years ago 58

Fig. 1 1 . Shows modern school buildings plentifully supplied with windows 60

Page

Fig. 12. Diagram of the eyeball 69

Fig. 13. Shows the muscles of the eyeball in normal position 72

Figs. 14, 15, 16. Show parallel rays entering the eye 73

Fig. 18. Test for examining the eyes for hypermetropia or myopia 77

Fig. 19. Test for examining the eyes for astigmatism. ... 78

Fig. 22. View of the human ear 83

Fig. 23. Photograph of a child suffering from adenoids .... 88

Fig. 24. Photograph of a child from whose throat adenoid growths have been removed- 89

Fig. 25. The larynx and adjacent parts, as seen from above 91

Fig. 26. Sanitary drinking fountain 116

Fig. 27. Sanitary drinking fountain in use 118

DEFINITIONS

Hygiene is the branch of medical science which concerns the preservation of health.

School Hygiene is the application of a system of principles or rules designed to preserve the health of the pupil.

CHAPTER I

The Selection of a Site for a School Building.

The selection of the site for, a school has an important bearing on the hygienic condition of the building. The primary consideration should be the drainage capacity of the soil; if possible, the land should be high and dry. Marshes or springy land must be avoided, else, although the greatest care in construction be taken, dampness in the cellar will most certainly result, and even if all the precautions known to sanitary science are used in all other parts of the building, it will be impossible to overcome the evil effects of this dampness. There are many diseases which, while not due to dampness, are fostered and abetted by its presence, particularly diphtheria, typhoid fever, consumption and rheumatism. Headache and languor also frequently result from living in and breathing a damp atmosphere.

An instance of unwise selection of a site is noted in a New England town, where a schoolhouse was built on a side hill that was notoriously springy. More than twenty years have been spent unsuccessfully in trying to keep a dry cellar. Water forces itself in during the rainy season, filling the cellar bottom and leaving a grimy dampness on the side walls and a perceptible dampness in the rooms above. The result has been numerous complaints of rheumatism in the building and an unnecessarily high percentage of sickness.

Made ground, that is, land that has been filled in with ashes, rubbish, and animal and vegetable refuse, is undesirable school property. The air and moisture arising from such land are impregnated with foul and harmful gases, which are bound to make their way into the cellar ; and, for a number of years, at least until the refuse is entirely decomposed, make such a neighborhood unhealthful. Where possible, a good gravel soil should be secured; if this cannot be had, then, in order of preference, a sand soil and sandy clay. Clay retains moisture very readily, and when a cellar is dug in such soil it is more than likely to be a damp one.

A school should be far from confusing noises, such as those made by railroad trains and certain factories. It is also unpleasant to be located near industrial establishments that constantly give ofif noxious odors. Furthermore, the lot selected for a school building should be

Site for a School Building. 3

large enough to prevent neighboring structures from interfering with the necessary Hght. The building, as a general thing, should not cover more than half the lot. A good rule to follow is that no adjoining structure should be nearer than twice the height of the school building.

In laying out a schoolyard, at least thirty square feet should be allowed for each pupil. For instance, if a sixroom building is to be erected to accommodate three hundred pupils, the playground should contain not less than 9,000 square feet. In the larger cities it will naturally be found difficult to have extensive grounds about the school building; but, wherever feasible, plenty of ground for play and exercise should be planned for.

Too often, however, hygienic conditions are ignored in the selection of a school lot and more mercenary considerations are allowed to prevail. Cost becomes a great factor in the decision, and often a school is located in one particular place because the land is cheap. Or the centrality of a site may determine the selection, or the dislike of property-holders to have a school building too near residences, the school being looked upon as a very poor neighbor. But the importance of a wise selection of land for a school should rise above all other factors in the decision, and the truth should be borne in mind that no lot is too good for school purposes.

CHAPTER II The Construction of School Buildings

We shall consider the construction of school buildings entirely from a hygienic point of view. The general outlines and appearance of the building, and its interior adornment, have received exhaustive attention from architects; the artistic aspect of the subject we shall leave to those better qualified to do it justice. Within the past ten years, it is true, following the trend of other professions toward specialization, some architects have been giving careful study to school construction and have produced schools containing in the aggregate more sanitary improvements than had been worked out previously in as many decades. Experience, however, has shown that many architects have not as yet well handled the subject of school construction, and that too often such considerations as proper lighting and ventilation, proper location of cloakrooms and sanitary closets, are neglected.

The construction of school buildings, indeed, should receive as much attention from the sanitary officer as from the architect ; and when the two shall work together, we may hope to see ideal school buildings. We should bear in mind that such buildings would be as varied as the demands of different communities. The building that would fill the needs of a metropolis would not be suitable for a country cross-roads and vice versa. There are general rules, however, that apply in all cases.

The cellar should be so constructed as to be at all times dry; the top of the foundation should be at least three feet above the ground level, in order that plenty of light may be admitted to the basement. The floors should be of concrete or asphalt, and the walls of cement. The cellar should not be a foul, dark storage room for old rubbish, but a clean, ventilated, and well-lighted room that could be used in stormy weather with safety, as a playground for the children.

It is not vv^ise to construct high buildings for school purposes for two reasons : first, stair-climbing is not a healthful exercise, especially for growing girls; and, secondly, in case of fire the danger is greater than in a low building. Buildings of two stories high should be the general rule; they should never be higher than three stories. The lowest grades should be assigned the rooms nearest the ground floor. In many of the larger cities the cost of land is such an important factor and the school population so dense that it is necessary to erect buildings of a number of stories in height. Of necessity the playground space is very limited, and for this purpose the roof is finished in such a manner as to afford a recreation place for the children. In such cases the sides of the roof are of course well protected by a high fence or wall to avoid accident during play. In many schools much pride is taken in these roof gardens, which are decorated with flowers and plants, affording pleasant places for the children's recreation.

The school entrances should be large and sufficient in number. The corridors must be roomy, and, with the stairs, should be fire-proof, even though the rooms themselves are not so. The stairs should be at least five feet wide, built with a landing near the middle of each flight. The steps should be of uniform box-like shape and of equal width : triangular steps and steps over eight inches high are to be avoided.

The cloakrooms or wardrobes should not be a part of the schoolroom. This latter point should receive particular attention, as there can be no question that the outer garments of the children are a favorite hiding place for disease germs. Personal observation has shown that in houses where contagious diseases exist, the outer garments receive little or no attention, and often form part of the covering of the sick one. When the patient recovers, these same garments, so pregnant with disease, are taken to the common cloakroom and huddled

Fig. 1.

Standard School Wardrobes in a School Hall.

together with dozens of others, which thus become a most excellent medium for transmission of disease.

A model cloakroom should be separated from the schoolroom and connected with the corridor. It should contain individual compartments, or lockers, for each pupil's garments, and windows should be so arranged that a constant supply of fresh air may circulate freely about the clothes and rid them of the disagreeable stifling smell that so often clings to them and fills the schoolroom. The cloakroom should not be kept warm, as germs thrive and multiply much more rapidly in a warm room than in a cold one.

In several schools in England there are drying closets attached to the cloakrooms, for use on damp and rainy days for drying the wet shoes and outer wraps of the pupils. This most excellent arrangement could well be imitated in this country. Along this same line, it would be of great service, especially in times of epidemics, to have a small air-tight closet or room where garments, books, and all other articles brought from home to school, could be thoroughly fumigated. Successful fumigation can easily be done with formaldehyde vapor and with a comparatively inexpensive apparatus.

If at all possible, bathroom accommodations should be provided for the scholars. Recently, six new schoolhouses opened in Boston had well appointed bathrooms. The teachers reported their use to be advantageous, that the daily bath was invigorating as well as cleanly, and stimulated the pupils to better work.

The children coming from the poorer homes formerly were denied these advantages, and often their bodies emitted odors which, taken in the aggregate in the schoolroom, were decidedly unhealthful and made a room difficult to ventilate satisfactorily. The use of the schoolbath obviated this unpleasant feature.

The swimming tank is most to be desired, as in addition to its sanitary advantages- it is helpful as a means of beneficial exercise. The matter of expense often stands in the way of its adoption, and if its introduction is not feasible the ordinary bath tub, or shower bath, is an efficient substitute.

The proper placing of water closets is an exceedingly difficult matter, and even experts differ widely on this point. Some favor placing the closets in the basement or elsewhere within the building; while others find positive objection to having the closet placed any nearer than fifty feet to the main building. Much can be said on both sides. If closets are placed in a cold, bleak part of the lot, many children will refuse to respond to the call of nature, and will suffer the ills attendant on such delay — constipation, hemorrhoids, etc. On the other hand.

lo The Hygiene of the Schooh-oom.

there is difficulty if the closets are in the building. For example : a modern schoolhouse lately examined in a New England town was found to have been most carefully planned — well lighted, well ventilated — and a model school building, save in one respect. On warm days in summer, and in winter when a strong fire was kept in the basement, an odor of urine permeated the whole building. The boys were undoubtedly careless, and the waste pipes failed to carry off the excreta quickly enough. The best plan is to have the closets connected with the basement and yet not in it, and supplied with their own ventilation and light.

The important desiderata in a plumbing system in school buildings are the rapid and thorough removal of the waste, and the establishment, by means of proper fixtures, of a complete barrier to the noxious odors and gases. Where the system is slow in carrying off the waste, decomposition of the sewage takes place and sewer gas forms. School children are noticeably careless in the use of closets, and for this reason many schools, particularly those for children of the younger grades, from first to fourth, have a system that performs automatic flushing of the closets every five, ten, or fifteen minutes during school hours, according as the mechanism is adjusted.

This automatic flushing principle may be applied to the individual closets, or to the latrine system, which is a large trough-like repository filled with water over which a number of seats are placed. The waste products are deposited in these troughs and are washed out automatically every fifteen minutes or half hour, or at the janitor's convenience.

The objection to an automatic flushing device of any description, is that it is very frequently out of order, and that unpleasant odors are about the closet until the flushing takes place.

It can be said, without reservation, that the best closet for all grades of children is the one that flushes every time it is used, either by means of the chain and pull or the mechanism that operates when the weight of the body is taken from the seat. There are many closets that have all the desirable points, but the principal trouble seems to be in finding a satisfactory urinal for the boys. This should be constructed of slate and should be trough-like in shape, with a continuous and strong flow of water through it. The floor should be of slate for at least six feet from the urinal, and this part requires continual flushing and cleansing, as investigation shows that often the floor about, rather than the urinal itself, is the source of the odor.

A system that commends itself to some and is in practical use in American cities, disposes of the excreta by burning. The waste products are deposited on an iron receptacle and at regular intervals a fire is built underneath in a grate, tbe flue of which is connected with the chimney. The heat rapidly consumes the products, which pass up the chimney in smoke and gases. This is not a system to be praised and should be thought of only where sewerage is impossible. In country towns, of necessity, the closet must be the old-fashioned earth closet in a remote part of the lot ; and \vath a very little care in covering in frequently with dry earth or ashes, it serves its purpose admirably. The teacher should never be reticent in speaking of the care of the closets, whether they are in the building or apart from it. Pupils should be taught that nuisances in such places will not be tolerated, not alone from a moral point of view, but from a sanitary one as well.

If possible, there should be in each building a room for gymnastic purposes. A favorite place for this with many architects is the basement, and if this part of the building is properly constructed and is light and dry, it will not be an undesirable location. Here regular gymnastic work and exercises under the supervision of the physical instructor can be carried out. A classroom with its desks and seats provides quarters too cramped for the physical instruction work. The best shape for an exercise room, as for any schoolroom, is an oblong, the longer side being that through which the light is admitted.

Many states have carefully drawn specifications, that must be carried out in school construction to guard against fire and overcrowding. In Massachusetts, "the law requires that a copy of the plans of every public building shall be deposited with the inspector of factories and public buildings of the district in which such building is located before the erection of the building is begun, which plans shall also include the system or m.ethod of ventilation to be provided, together with such portion of the specifications as the inspector may require. The plans usually required are a plan of each floor, including the basement and the attic, if the attic is occupied, and a front and a side elevation, and also plans and sectional detail drawings of the system of ventilation. Further plans may be required by the inspector if deemed by him to be necessary.

"In planning buildings to be used for schoolrooms, or places of assemblage above the first story, provision should be made for at least two stairways, and such stairways should be as far apart as practicable. No such stairway should be less than four feet wide in the clear, and winding steps should be avoided. The height of rise and width of tread of all stairs, measured on the cut of the stringer, should be given on the plans. No flight of stairs should have more than fifteen steps between landings. The main stairways from places of assemblage should have a width of not less than twenty inches for every hundred persons accommodated therein. Such stairways should be railed on both sides. All outside doors to such buildings should open outwardly."

In O'rder to prevent fire, the Massachusetts building law makes further specifications as to the construction details of buildings, as follows :

"All elevator wells and light shafts, unless built of brick, must be filled in flush between the wooden studs with fire-proof materials, or lined with metal, or plastered on metallic lathing, as may be directed by the inspector, and all woodwork inside of such wells or shafts be lined with tin plate, lock- jointed. Where floor beams rest on partition caps or on girders, wall girts, or on wooden sills [the space] between such beams from the caps, girders, girts or sills, to the lining floor above [must be filled in] solid with brick and mortar or other fire-proof material. When floor beams in frame buildings rest on ledger boards, each floor [must be thoroughly fire-stopped] with brick and mortar resting on bridging pieces cut in between the studs, or, where practicable, on the ends of lining floor. In brick buildings the space between the furrings on the outside walls or brick partition should be filled flush with mortar for a space of five inches in width above and below the floor beams of each story. Where basement or other flights of stairs are enclosed by partitions of brick or wood, the spaces between the studs or wall furrings must be so fire-stopped with brick or mortar as effectually to prevent any fire from passing up between such studs or furring, back of the stair-stringers. The soffits of all such enclosed stairs, and also partitions on stairway side, must be plastered on metal lathing. Where a building is occupied above the first floor for any purpose [insert statement of purposes referred to], and the lower story is occupied for stores, or other purposes not connected with the upper floors, the stairways leading to such upper floors must be enclosed with brick walls or with wooden partitions filled solid with brick laid in mortar or other fire-proof material, and plastered on both sides on metallic lathing, and all doors in such partitions lined with tin plate, lockjointed. All long flights of stairs [must] have two smoke-tops in each flight, properly constructed. No pipes for conveying hot air or steam can under the law be placed nearer than one inch to any woodwork unless protected to the satisfaction of the inspector by suitable guards or casings of incombustible material. No wooden i6 The Hygiene of the Schooh-oom.

flue or air-duct of any description can be used for heating or ventilating purposes.' A space of at least one inch [must] be left between all woodwork and the chimneys ; also around all hot air, steam and hot water pipes ; these spaces around chimneys and pipes, where they pass through floors, [must] be stopped with metal or other fire-proof material, smoke-tight. Steam and hot water pipes [must] ha\e metal sleeves and collars. x'Ml channels and pockets for gas, water and soil-pipes [must] be made smoke-tight at each floor. The space around all metal or brick ventilating ducts must be fire-stopped at each floor with m.ital or other fire-proof material, as approved by the inspector. All chimneys [must] be plastered with one good coat of brown mortar, on the outside of brickwork, from cellar to roof. The ceiling of furnace or boiler and indirect radiator rooms must be plastered on metal lathing. The/e should be not less than one foot in height of open air space between the tops of furnace or boiler casing and the ceiling. The entire cellar ceilings of schoolhouses and other buildings used for public purposes should be plastered on metallic lathing."

Chapter III

In spite of the fact that the subject of ventilation has received exhaustive treatment from writers on school sanitation, that the dangers of ill-ventilated rooms have been repeatedly pointed out, and that systems of ventilation have been elaborated and perfected, there are countless schoolrooms occupied daily in which the air is not so pure as in an ordinary stable. Many of these are in buildings constructed long ago, when no one thought of providing any other means of changing the air in the schoolroom than the doors and windows offered. Such buildings are hard to ventilate without causing serious discomfort to those who are seated near the open door or window, and, in consequence, the schoolroom too often goes unaired. But not only in old-fashioned schools is the supply of fresh air inadequate or neglected : even to-day schoolhouses are being built with little or no regard to ventilation.

There can be no excuse, however, for disregarding the dangers of having children live in an impure atmosphere :

sanitary literature teems with warnings. The New York Board of Health estimates that forty per cent, of all deaths are attributable directly or indirectly to bad air. Dr. A. N. Bell, of Brooklyn, N. Y., in a paper read before the Public H'^alth Association of Philadelphia, says : "The depressed state of the organism under the prevailing conditions of a badly ventilated schoolroom not only predisposes to epidemic diseases, but the liability to and the danger of all diseases are intensified ; and vicissitudes of weather, which under favorable circumstances may be encountered with impunity, under these depressing influences become dangerous perils; and doubtless much that is attributed to the season of the year supposed to be predisposing to scarlet fever, measles, whooping-cough, diphtheria, and some other common affections of children, is due to the same cause."

Dr. James Johnson, in his "Diary of a Philosopher," says : "All the deaths resulting from fevers are but as a drop in the ocean when compared with the number who perish from bad air." Nor can there be any doubt of the value of proper ventilation. Prof. S. H. Woodbridge, of the Massachusetts Institute of Technology, in his notes on "Ventilating and Heating," makes clear the effects of the introduction of a system of efficient ventilation when he tells us that b}^ this means "death rates have been redaced in children's hospitals from fifty to five per cent. ; in surgical wards of general hospitals, from forty-five to thirteen per cent. ; in army hospitals, from twenty-three to six per cent., and in prisons, from eighty to eight per cent." ; and Dr. Oliver Wendell Holmes, in his "Medical Essays," is responsible for the statement that "a simple measure of ventilation proposed by Dr. John Clark had saved more than sixteen thousand children's lives in a single hospital."

Between good air and bad there is more difference than might be thought. Chemically fresh air consists of

79 per cent, of nitrogen,*

20.96 per cent of oxygen,

.03 per cent, of carbon dioxide (carbonic acid gas), with traces of ammonia (nitric) acid and watery vapor.

Expired air contains :

79.2 per cent, of nitrogen (very little change),

15.4 per cent, of oxygen (a loss of over five per cent,

of this life-giving element). 4.3 per cent, of carbon dioxide (an increase of over one hundred fold).

Carbon dioxide in excess in the air is not poisonous, as was formerly believed, although when a great deal of

* One per cent, of what was considered nitrogen is another elementary gas, argon.

this gas is present, as in the air at the bottoms of wells, the air is irrespirable.