VOL. II. No. 1.

School Surgery.

BY ALFRED CARPENTER, M.D. (Lond.), C.S.S. (CAMB.), Vice-President of the British Medical Association.

I.

T is proposed to consider this part of our subject under three heads, all of which are connected with a departure from a proper condition of health, and may be common to all schools, and which require immediate attention on the part of those in authority. These departures may be general or particular, may apply to considerable numbers of children at one and the same time, or be personal only to one or more as being caused by one's own or another person's act. The measures to be taken by the teachers have reference to the prevention of disease or accident, as well as to the removal of their incidence when they do arise. They separate themselves into School Hygiene, or measures connected with the subject of infectious disease; School Surgery; and a less important division, which includes simple instruction upon Medicine, and is connected more directly with disturbances of health, especially those which are trivial and do not require medical attendance.

School Hygiene includes a consideration of the measures requisite to prevent the admission of infectious diseases, to prevent their extension when they are unfortunately admitted, and to remove them from the precincts of the school as soon as possible after admission, so as to avoid the necessity for closing the establishment altogether.

Under the head of School Surgery we shall consider the accidents which more properly belong to school life; and also the emergencies which are of frequent occurrence, and which render a knowledge of the principles which ought to be followed absolutely necessary on the part of those in authority, so that no mischief may be done before the surgeon, who may have been summoned, can possibly appear upon the scene; and lastly, we have the simple principles of household medicine, which should be known to all men and women who are heads of establishments, and especially to those who have a number of young people under their care.

Nimia cura medici, which some people are supposed to require, and which uneducated people too often indulge in, does more harm than good. A knowledge

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without prudence, a zeal without discretion, and a theory without practice, are all bad; but they are especially so in the arena which belongs to the properly educated medical man. It follows, therefore, that nothing is put forward here which is intended to supersede the necessity for medical advice when it can. be obtained, but only to provide for emergencies when. no doctor is at hand, and when attention is wanted immediately, or in which it is important that the school authority should know how to act when such emergency does arise, and when action must be immediate.

These rules are based upon those which every properly educated medical practitioner will be sure to follow upon his arrival on the scene, and there will be so much time gained, either in preventing mischief from accident, in arresting the progress of infectious disorder by taking time by the forelock, and preventing altogether the necessity for further medical aid, "Prevention being better than cure" on all hands, and no body of men recognise this more fully than the honest-hearted medical practitioner.

School Hygiene.-The conduct of masters regarding infectious diseases requires more consideration than it gets at present. The difficulties which are daily arising in all parts of the country from a neglect of proper rule is such as justifies early attention to this part of our subject.

No child should be allowed to come to school who is personally suffering from any of the ordinary infectious diseases. They are Measles, Scarlet fever (or scarlatina, as it is often called), Diphtheria, Whooping-cough, Mumps, Small-pox, Chicken-pox (or glass-pox), Scald head (or ringworm), Purulent Ophthalmia, and Scabies (or itch).

If the school be a boarding-school, any child suffering from any of these diseases must be at once removed from the school, and all those who have been in contact with that particular child for the preceding twenty-four hours should be put in quarantine-that is, to be kept separated from the rest of the school. No person should be allowed to return to school after recovery from any of the above diseases until after they have been thoroughly disinfected, and after the lapse of a certain period, which should date from the termination of the fever stage. This disinfection must include a proper bathing of the whole body in some disinfecting fluid, such as a weak solution of Condy, or

A

water in which some chlorinated soda has been mingled. If the whole body is well sponged over with some water containing 1 per cent. of Condy or chlorinated soda, and then well scrubbed in a bath with some oatmeal, the whole of the infecting matter on the body may be rapidly removed. It is requisite to cut the hair, and then to wash the head first with the disinfecting solution, and then with some water, to which a little borax has been added; half an ounce of borax in a quart of water is a cleansing solution which will dissolve particles of epithelium, and prevent them from clinging to the hair to the danger of the child's fellows. The nails, both of fingers and toes, should be cut, and the ears washed out, and if the process of washing is repeated every day for a week there will be but little chance of danger to other children from that particular cause, provided there are no eruptions and no discharging abscesses or other sequences of the disease itself upon any part of the body; these are generally found at the alæ of the nose, behind the ears, or near to one of the orifices of the body. These should be all cured before the child is readmitted to the school.

Where possible, a medical certificate should be produced, which should state that the child is free from infective power: but if no certificate is forthcoming, a child should not be admitted into school until three weeks after recovery from measles, a month after scarlet fever, at least six weeks after diphtheria, three weeks after mumps, a month after smallpox, provided all scabs have disappeared in that time, and nearly as long for chicken-pox. No definite time can be fixed for whooping cough, and it is doubtful whether, if it be in a given neighbourhood, it can be excluded from a large school, but no child actually whooping should be allowed to stay in the school.

Ringworm or scald head arises in the majority of instances from want of washing. If such cases appear in any school, all the children should have their heads well washed with soap and water, and afterwards well sponged over with a solution of borax-an ounce to a gallon of warm water should be about the strength of the solution-whilst those children who have the disease manifestly present should be kept at a distance until the places are perfectly well. It is right, however, to state that a large number of cases which are called ringworm are not the true disease. The real ringworm is characterised by the presence of a vegetable growth in the epidermis. A microscopical fungus, styled the 'tricophyton,' produces one form of true ringworm. They are either isolated spores or jointed filaments, which attack the scalp and grow in the hairs and their sheaths, and also amongst the epidermis of the scalp and other parts of the body. There are several of these parasites which produce disease in the hairy structures. They can only be cured by plucking out the diseased hairs, cleansing the patches first with soft soap, then with solution of borax, and lastly applying equal parts of sulphurous acid and glycerine. The diseases are various forms of tinea, and are at first scarcely to be distinguished from harmless patches of tetter or simple lichen, except by the expert. The worst form of infectious ringworm is that which is styled 'tinea favosa.' It is produced by a fungus called 'achorion,' an dit is at once known by the presence of yellow, cup-shaped crusts on the scalp; it is highly infectious, very difficult to cure, and on no account should a subject of it be admitted into the society of other children. It is always a mark of

badly-nourished, badly-fed constitutions, and associated with filthy habits.

Cleanliness of head is a necessary contingency in all schools, so that the chance of infection may be avoided. All large schools should have a place in which the hair should be combed and the head properly cleansed as frequently as may appear necessary. The operation should be superintended by a monitor or person appointed to see its due execution; a senior child in turn should take this duty under the control of the teacher. The brushes and combs in use must be kept clean, and each child restricted to his own articles. In elementary day schools it would be good practice to have occasional inspection drill as regards the children's heads. I am sure it is far more important to teach children the necessity for clean heads than for nine-tenths of the tasks which are done in the school hours, and yet I am not aware of a single day school in which such an inspection drill exists. It would assist the master or mistress very materially in their work by checking irritation, and will assist very much in diminishing the incidence of infection at any rate as regards diseases of the scalp.

Purulent or infectious Ophthalmia is a very troublesome disease, and when it has obtained hold in a school it is very difficult to eradicate; personal attention to each case and rigid isolation will alone effect its removal, whilst it often happens that much injury is done to eyesight in consequence. The disease which is called Scabies or Itch is not uncommon in some elementary schools; it is not usual to take much notice of it, but a child who is the subject of it ought not to be admitted into any school until he is cured. This is not a difficult matter; it can be effected in three days if the disease be vigorously attacked. It is due to a small insect somewhat like a cheese-mite, which burrows in the epidermis and lays its eggs, the hatching of which gives rise to the itching from which the disease is named. Sulphur is fatal to the insects themselves, and if used by inunction, so that the canals leading to the nests of the insect get filled with the sulphur itself, the young brood are destroyed as soon as they change their state from ova to developed acari, whilst all the insects which have been previously hatched, both male and female, are at once destroyed by contact with the sulphur.

The preceding observations apply to children who are suffering or have suffered from disease, but it may be that the child is not himself affected, but is living in a house in which some one else is suffering from infectious complaint, and that child may convey the disease to his school-fellows. No child should be allowed to attend school under these circumstances. The rule, however, may be somewhat relaxed in the case of children who have already had an attack of the same kind of disease at some anterior period, say in the preceding year, provided they are kept from all immediate contact with sick persons until the recovery and disinfection are complete. It may also be relaxed in the case of those children who, not having themselves had the disease, have not been in contact with the case and have been at once removed to an uninfected house; or if they have been in contact with the case, then a fortnight's quarantine should be established, which will clear them all from the possibility of becoming the subject of infectious complaints if they have escaped infection on that occasion. Children are frequently sent to school whilst suffering from an in

fectious disease, which had not been recognised because it is extremely mild, or in its very early stage, or, as too often happens, because the parents are careless as to other people, and won't take the trouble either to verify their suspicions or even to prevent mischief when they know that it is likely to happen. The teacher or director of every school should, therefore, give immediate personal attention to any one who may appear ill or complains of feeling unwell. Feverishness should lead him to suspect the presence of infectious disease, and if the teacher could be provided with a thermometer, such as is now in common use among medical men, he need never be in doubt upon this head. If the feverishness is combined with any kind of rash upon the skin, or with any appearance or complaint of sore throat, or with both, he need be under no difficulty as to the advisability of that child leaving the schoolhouse as soon as possible. The thermometers are provided by all the surgical instrument makers, and are of very simple construction; they have an index which registers the highest temperature. If this is placed in the axilla or armpit of the child, so that the mercury in the bulb is kept in contact with the skin at the deepest part of the axilla for five minutes, it will register the highest temperature. If this exceeds 100 (the normal being 98.5) it is evident that the child should not be at school at all, and should be sent home at once, or if it be a boarding-school, the child should be put in quarantine.

(To be continued.)

Eminent Practical Teachers.

PESTALOZZI.

BY THE REV. CANON WARBURTON, M.A., Her Majesty's Inspector of Training Colleges for Schoolmistresses.

JOHN

HN HENRY PESTALOZZI* was born as long ago as 1746, but he lived to be past eighty years of age, and many of those who knew him, and some of those who were taught by him, are still alive.

Quite apart from his reputation as a teacher he was a remarkable man, and his history is well worth studying and laying to heart; there is much in it to be admired-admired perhaps, rather than imitated, much to be avoided, perhaps, rather than to be condemned. He was not a very wise, certainly not a very practical man, but he had in him something of the Divine gift of Genius, a heaven-sent conviction that he had found a new truth, and a passionate yearning, which no difficulty could deter or failure dishearten, to turn it to account for the benefit of mankind.

His father, who had been a doctor, died when Pestalozzi was only six years old, and the boy was brought up in narrow circumstances, but still 'as a spoilt darling,' so he tells us, 'by one who was the best of mothers,' but too much absorbed in household cares to attend much to the development of her son's character. Many of the errors and weaknesses of his manhood are undoubtedly traceable to his want of masculine example and discipline as a boy; but, on the other hand, the tender affectionateness which he learned from his mother is the keynote of his life, and

Pronounced Pest-a-lot-zy. He was, of course, a Swiss, but the name is of Italian origin, and in the Italian language the first of two 'z's' coming together is pronounced like a t.'

has coloured the whole system of education of which he was the originator.

His birth-place was Zurich, the capital of the Swiss Canton of that name, and there he went to school. 'In all school games,' he says, 'I was the clumsiest and most helpless of all the boys, yet always trying to excel them. They used to call me "Wonderful Harry from Foolstown." They liked me for my good nature, though they were always laughing at my awkwardness and thoughtlessness about everything that did not particularly interest me. Though one of the best of the scholars, my flightiness led me to commit faults of which the worst of them were never guilty. Generally seizing with quickness and accuracy upon the essentials of the subjects taught me, I was indifferent and careless as to the form and method. At the same time that I was far behind my classmates in some parts of my work, in others I surpassed them in a remarkable degree. The wish to be acquainted with some branches of knowledge that took possession of my heart and imagination, even though I neglected the best means of acquiring them and of exercising myself in them, was strong in me to enthusiasm ; and it unfortunately happened that the tone of public culture in my native town was at this time eminently calculated to foster the ambition of taking an active interest in affairs, long before one had had sufficient experience or training for such an attempt. Freedom, beneficence, self-sacrifice, and patriotism were the watchwords of our education; but the means of attaining to all this which was especially commended to us, namely, cultivation of the intellect, was left without that solid and efficient training of the practical ability which is the essential condition of its success. imagined, whilst yet in the position of school-boys, that by a superficial school acquaintance with the great civil life of Greece and Rome, we should eminently prepare ourselves for the little civil life of a Swiss canton.'

We

In his holidays Pestalozzi frequently paid long visits to his uncle, the pastor of a rural village three miles from Zurich, where he became much attached to, and beloved by the country folk. A strong antagonism existed at this time in Switzerland between town and country, aristocracy and poor, and Pestalozzi took part, enthusiastically, as was his wont in everything, with the latter; and conceived a strong prejudice against the higher classes, by whom he believed his humbler neighbours to be oppressed-a prejudice which largely and, it must be added, injuriously affected both his character and his career.

He had no sooner emerged from boyhood than he fell under the influence of the famous Jean Jacques Rousseau, whose ideal scheme of liberty, with its visionary speculations on philosophic education and contempt for established scientific methods, had at this time taken hold of the imagination, and deeply tinged the ideas of the younger generation. Rousseau's educational treatise 'Emile' appeared when Pestalozzi was sixteen, and had before long run the round of all the European languages, and was regarded almost in the light of a new revelation. The young enthusiast found something which went straight to his own heart in Rousseau's fervid and tender love for humanity, in his sympathy with the sufferings of childhood, and his profound feeling of the political and social corruption of the times. No sooner had Pestalozzi read 'Emile' than the whole home and public education of the

world at all previous times and in all ranks of society appeared to him as one gigantic blunder, which could be rectified only by the realization of Rousseau's ideas. As yet, however, he had not awakened to a consciousness of his vocation and destiny as a practical teacher of children. The first effect which the study of Rousseau produced upon his mind was to induce him to abandon the preparation which he had already begun for the clerical profession; in the hope that by devoting himself to jurisprudence he might find a career more adapted to procure for him a position in which he might exert an active influence on the social condition of his native land. One of his biographers, however, tells us that he abandoned theology, because he broke down twice in his first sermon, and found himself incapable of committing even the Lord's Prayer accurately to memory.

Among the friends of his youth who exercised an influence in the formation of his ideas and character were the celebrated Lavater, of whom we shall hear again, and a gifted youth named Bluntschli, who died of consumption at an early age. In his last moments Bluntschli sent for Pestalozzi, and said to him, 'I am dying, and when you are left to yourself you must not rush into any career which might be dangerous to you from your easy and confiding disposition. Try to find some quiet tranquil line of life, and unless you have by you a friend who will faithfully assist you, with a calm dispassionate knowledge of men and things, by no means embark in any undertaking whose failure would be disastrous for you.' Such was his friend's estimate of his character, but that no one knew its defects better than he did himself is sufficiently proved by the extract which follows from a love-letter to his betrothed, the beautiful and high-minded Anna Schulthess.

'Dearest Schulthess, those of my faults which appear to me the most important in relation to the situation which I may occupy in after-life are improvidence, flightiness, and want of presence of mind to meet unexpected emergencies. I cannot tell how far these faults may be diminished by my efforts to counteract them by calm judgment and experience. At present I have them still in such a degree that I dare not hide them from the maiden I love; they are defects, my dear one, which deserve your fullest consideration. I have other faults arising from my irritability and sensitiveness which often refuse to submit to my judgment. I very frequently let myself run into excesses in praising and blaming, in likings and dislikings. Whenever my country or my friend is unhappy, I am myself unhappy. Direct your whole attention to this weakness; there are times when the cheerfulness and tranquillity of my soul will give way under it. . . Of my great and even culpable negligence in all matters of etiquette, I need not speak; any one can see all that at the first sight of me. I also owe to you the candid confession, my dear one, that I shall always consider my duties towards my beloved partner subordinate to my duties towards my country, and that though I shall be the tenderest of husbands, nevertheless, I hold it to be my duty to be inexorable to the tears of my wife, if she shall ever attempt to restrain me by them from the performance of my duty as a citizen. My wife shall be the confidante of my heart, the sharer of all my most secret counsels; a great and honest simplicity shall reign in my house. And one thing more: My whole heart is my country's; I will risk all to alleint the need and the misery of my countrymen.

What consequences may the undertakings to which I feel myself impelled draw after them! How unequal to them am I and how imperative is my duty to show you the possibility of the great dangers they may bring upon me!

'Decide now for yourself, whether you can join your heart to a man with these faults and these prospects in life-and be happy. I love you so dearly from my heart, that this step has cost me much. I fear to lose you, my darling, when you see me as I am. I had often thought, I will be silent'; but at last I have conquered myself, and I rejoice at what I have done.'

Bluntschli had scarcely been a month dead when Pestalozzi fell so dangerously ill that he was on the point of following his friend to the grave. His physician told him that he must give up all scientific study and rest his brain. His sympathy with Rousseau's anti-scientific ideas made this abandonment of methodical study only too easy. He sold his books, burned his MSS., and betook himself to a farmer of considerable reputation, named Tschiffeli, in the Canton of Bern, and sought his instruction and advice as to the best means of realising his dreams for the amelioration of the condition of the poor. It was an unfortunate selection of counsellor. 'I came to him,' says Pestalozzi, 'a political visionary, and left him an agricultural visionary, full of enthusiasm for my gigantic schemes fresh awakened by his plans, which, though difficult of execution, and in the main impracticable, were bold and original in conception.'

Tschiffeli had become famous by his plantations of madder, and Pestalozzi's first practical essay was in the cultivation of this plant. He induced a wealthy firm, in Zurich, to become partners with him in the purchase of one hundred acres of chalky heathland for this purpose, on which he immediately proceeded to erect an Italian villa. To this house and estate he gave the name of *Neuhof, and there he settled at the age of twenty-four with his fair wife, Anna Schulthess, who had ventured, in spite of the warnings of the love-letter above quoted, to throw in her lot with his.

The madder plantation proved a failure. The Zurich firm which had advanced the money for the undertaking, withdrew it at a sacrifice rather than risk the whole in such incompetent hands. Pestalozzi now found himself thrown upon his own resources, but with extraordinary courage, or extraordinary imprudence, he determined not only to go on with his agricultural speculations, but to combine with them a school for the gratuitous education of poor children. He drew up and made public a scheme for the establishment of this institution, and his plans and principles commanded such general approbation that, in spite of a growing distrust in his practical ability, he received offers of assistance from several of the principal towns of Switzerland. The 'Neuhof Poor School' opened in 1775, with fifty scholars. It was what we should now call an industrial school, for the children were to help out their expenses by their earnings, working in summer on the farm, and in winter at weaving, spinning, and other indoor occupations. The plan was a good one, and such a school has since then many and many a time proved almost self-supporting in competent hands, but it failed in those of Pestalozzi. Discipline never existed; the children would not work while they stayed with him, and ran off when they got new clothes,

* Pronounced Noy-hofe.

the civil authorities declining to interfere. These, however, were difficulties which time and patience might have overcome. The real cause of failure lay in the fact that he tried to carry out his experiment on a scale quite disproportioned to his skill, capital, and experience. It was an undertaking which required and presupposed a thorough knowledge of manufactures, men, and business, in which, to use his own words, he was deficient in the same proportion as such knowledge was indispensable to him in the direction which he had given to his undertaking.' 'I who so entirely disapproved of hurrying on to the higher stages of instruction before a thorough foundation had been laid in the elementary stages, looking upon it as the fundamental error in the education of the day,—allowed myself to be carried away by illusions of the greater remunerativeness of the higher branches of industry, without knowing even remotely the means of teaching, or even of learning them, and to commit the very faults in training up school children to spin and weave, which I so strongly reprobated and denounced, and which I considered dangerous to the domestic happiness of all classes.' There never was a more candid confession of incapacity, but still he struggled on, his noble wife assisting his endeavours, determined to share his last crust with his children rather than turn them adrift. He lived like a beggar to teach beggars how men live.' He laboured night and day to raise others from the misery into which he had himself fallen. At last, however, all was spent, and, in addition to that, he became deeply involved in debt; his own small fortune and his wife's considerable one had melted away. In 1780 the Neuhof School was closed, and Pestalozzi found himself in 'his elegant country house' all but penniless, with a wife whom trouble had thrown into a lingering illness, and the wolf at the door. 'When my experiment went to wreck,' he writes, 'the blind confidence which people had reposed in me changed into just as inconsiderate a distrust. All belief in the qualifications which I really possessed was now lost, along with the belief in those which, in my self-deception, I gave myself credit for, but had not. My friends now only loved me without hope, and in the whole of the surrounding neighbourhood it was everywhere said that I was a lost man, and that nothing more could be done for me.' (To be continued.)

Anecdotal Natural History.

BY REV. J. G. WOOD, M.A., F.L.S.

Author of Homes without Hands,' 'Nature's Teachings,' etc.
AND THEODORE WOOD,

Joint Author of 'The Field-Naturalist's Handbook.'
No. XIII. THE MONKEY TRIBE.
PART I.

THE
HE grotesque resemblance borne by the larger
apes towards the human form has given rise to
various conjectures regarding the relationship between
man and the monkeys. Without, however, touching
upon these speculations, with which we need not con-
cern ourselves, we will examine the chief points of
structure in which the two beings resemble, and also
those in which they differ from, one another.

As a type of the tribe we will take the Gorilla (Troglodytes gorilla), as standing first in the family, and compare the respective skeletons of that animal and of a human being.

No second glance is needed to see the wonderful difference which exists between the bony framework of the man and that of the beast. The clumsy, brutal head of the ape, with its low, receding forehead, protruding cheek-bones, and massive jaws, is quite unlike the rounded skull of the man, with its upright forehead and small jawbone. Then the almost total absence of neck; the long, ungainly arms, with their enormous hands; the short, bowed legs, all insufficient to support the body upright; and the peculiar structure of the feet, suffice to prove, even without entering into further details, the immeasurable distance which separates the two beings.

As we proceed in our examination, this conviction is still more strongly forced upon us, every part of the frame bearing witness to the nature and habits of the beast, as opposed to those of the man.

Let us now examine the structure a little more closely.

We notice, in the first place, the great size and strength of almost every bone in the body, which at once informs us that the muscular power is proportionately developed.

This is the case to a singular degree in all the larger apes, the strength, more especially of the arms, being perfectly astonishing. M. Du Chaillu tells us that a gorilla has been seen to bend a gun-barrel double by means of the hands alone, grasping the weapon in the huge paws, and bending it without apparent exertion. He also remarks that, unlike most wild animals, the gorilla possesses scarcely more tenacity of life than man. The surest mode of killing this ape is, when it has turned to bay, to allow it to approach within two or three yards, and then to aim at the centre of its breast. It succumbs at once to the shot, and falls dead on its face, almost without a struggle.

The hinder limbs, too, are powerful in their way, the grasp of the foot, in particular, being very great. But when called upon to sustain the weight of the animal upon level ground, they are of comparatively

little use.

This is not so much owing to the want of the requisite strength, as to the structure of the opposite extremities of the body, namely, the head and the hinder paws. Both of these are formed in such a manner that an upright carriage is impossible, the animal, even when at rest, being quite unable to assume a perfectly erect attitude.

When the structure of the head and feet is examined, this inability is easily accounted for.

In the former, the 'occipital foramen,' or in plainer language, the orifice in the base of the skull through which the spinal cord passes to the brain, is placed so far back that the whole weight of the head is thrown forward, tending, of course, to overbalance the body. In man, this orifice is placed almost in the centre, so that the head is evenly poised upon the spinal

column.

With regard to the feet, the cause is evident without the need of dissection, for these organs are formed almost exactly like hands, being provided with thumbs and fingers instead of toes. They are, in fact, almost identical in form with the hands themselves. Naturally, as they can possess no heel, and as there is no 'calf,' ie.,