The Health of the Teacher.

THE HEALTH OF ’THE TEACHER.

462

until the disease has assumed the chronic form that the signs indicative of destruction of the cartilage become evident accompanied with cartilaginoas and

made will be effectual in placing the nature of the disease beyond doubt and so enable the treatment to be carried out on rational lines. -

stage, too, the grating in the joints and the resulting deformities are characteristic,

osteophytic outgrowths.

At this

being evident both to the physician

and to the

patient.

Dr.

LUFF further drew attention to the existence of Heberden’s nodes, which represent the mildest degree of the disease and are found in the chronic form of rheumatoid arthritis.

Some of the

The Health of the Teacher. called attention last week to the recent plethora. of congresses dealing with medical and allied subjects which have met in our midst we implied no lack of sympathy with the objects of their labours nor undue scepticism as to the

WHEN

we

laid stress on the aid given to diagnosis by the use of the x rays. The necessary apparatus, however, is not available to all practitioners, and hence a conclusion must be arrived at by

speakers

useful results which might accrue. There is, indeed, something to be said for the simultaneous holding of congresses, as it will frequently happen that opinions expressed at one meeting will be confirmed by experiences recorded at another, a consideration of the general and local signs to which we while it is possible for men of wide interests to attend with have alluded. The treatment of rheumatoid arthritis differs the minimum of inconvenience the sessions of several organiin many respects from that adopted in rheumatism or gout, sations. Our only regret is that while so much material of hence again the importance of diagnosis presents itself. interest to our readers is available mechanical reasons The diet must be as liberal and good as the patient can ccmpel us to be selective in what we publish, and we and be of. Stout animal food or may digest freely partaken particularly regret our limitations in the matter of ale may also be given with advantage. The drugs recom- the proceedings at the Congress on School Hygiene, mended by Dr. LUFF are guaiacol and iodide of potassium. for many of the problems which came before this Congress Guaiacol is best given in cachets in the form of the car- have been dealt with from time to time in our columns, and bonate. At first from five to ten grains may be given we have continually urged upon the public and on the variousthree times a day and the dose should be increased authorities concerned the vital importance of the hygienic by one or two grains each week until from 15 to 20 management of our schools. That great good will result grains are taken in each dose. Dr. LUFF insisted on the from the holding of this meeting in London we cannot doubt,. importance of continuing this treatment for at least 12 nor can there, unfortunately, be any question that we in. months. The beneficial effects of guaiacol may be added to have much to make in the field of school

up England leeway potassium, com- management and organisation. It is melancholy tobined with a tonic to counteract its depressing effect. be told that this country is not only behind the principal Iodide of iron has also yielded good results in the nations in Europe, including Russia, but has also been hands of some observers. The mechanical treatment of passed by Chili, Argentina, and Servia, in providing forrheumatoid arthritis was also duly discussed, some of the such an elementary necessity as medical examination of speakers having had the advantage of prolonged experience school children. There are many physical defects which in hydro-therapeutics. Douche-massage when obtainable has render a child incapable of profiting by the instruction yielded good results and so have peat and brine baths. provided for his normal companions and which may even Radiant heat baths have also proved of advantage. When cause school discipline to be a source of actual bodily such measures cannot be obtained, however, much relief injury ; knowing this we cannot doubt that the neglect may be derived from the use of general massage regularly shown by this country to provide for the medical inspecgiven. Local massage of the joints is not so satisfactory tion of school children has caused, and is causing,. and physical exercises may also be of advantage when serious drawbacks to many of the rising generation of properly regulated. citizens who, as they themselves become more instructed We have only alluded to certain points which were raised in personal hygiene, will look back on their school in a discussion the importance of which cannot be well experiences as a period of barbarous mismanagement exaggerated, and we trust that the various opinions which on the pbysical side, counterbalanced perhaps (and perhaps were expressed may be of value to those who are engaged in not) by intellectual gain. If, as we hope, the Congress has. a clinical either from the purely subject point succeeded in bringing home to thoughtful minds the reality investigating of view or in the laboratory. Dr. F. J. POYNTON, whose of the existing evils, we shall, indeed, have cause to conresearches as to the bacteriology of the disease deserve gratulate ourselves on results of national importance. A serious attention, referred to the micrococcus which, work- perusal of the résu11’lé which we give this week of some ing with Dr. A. PAINE, he had isolated from a joint and by of the more important events of the Congress will show from The what varying directions the subject of school hygiene has it had produced rheumatoid arthritis in rabbits. record of this work was published in our columns, but we been approached and what a mass of first-hand knowledge are not certain that its suggestiveness appealed with suffihas been placed through its means at the disposal of the cient force to our readers. Dr. T. J. P. STRANGEWAYS also public. In applying the laws of health to school affairs a legion of stated that he was engaged at Cambridge in a research into the pathology and etiology of the disease, which he problems arise, sufficient to supply material for the condid not regard as a clinical entity but as a type. His results sideration of many conferences. The children’s eyes, ears, will be awaited with interest. The elucidation of the and teeth, their hours of relaxation and of sleep, their food, etiology of rheumatoid arthritis has not yet been accom- and their varying degrees of mental power all demand attenplished, but we trust that the efforts that are now being tion, and it is manifest that all are receiving it. Bat there is.

by administering

at the same time iodide of

.

463

sight of by inquirers in this field. The teachers as well as the taught deserve consideration. They are equally exposed to risk aspect of the matter which is liable

important point dwelt upon by Dr. MACNAMARAA was the incidence of pulmonary tuberculosis on school teachers. Experience of any hospital for chest diseases of ill-health if the condition of the school be in- certainly bears out the extent of the evil in question which sanitary. Light and air, recreation and rest, are as is unfortunately easier to indicate than to remedy. The needful for them as for their charges. Their very efficiency disease is apparently one of indoor life and the teacher’s time must be mainly spent within doors. The actual as teaching machines depends on the preservation of their are in to find faculties the best working order. We glad opportunities of infection within the school building are that at the Congress a special section was devoted to a study not, we should think, serious, since children with tuberof the teachers’ needs and that it was opened with a culosis seldom expectorate and such behaviour in school thoughtful address from Dr. T. J. MACNAMARA, M.P., who would at once be checked. Still, the ventilation of school when he descends from the partisan platform to a con- buildings is not a very easy matter to arrange; it is sideration of matters in which he is an expert, is always a difficult to avoid some closeness of atmosphere during weighty and an interesting speaker. Two main points were lessons, especially in winter. Any lurking tuberculous emphasised in his remarks. The first was the importance infection is thus liable to be stimulated. A remedy to the teacher of conditions favourable for making himself must be sought first in diffusion of the knowledge beard by his audience. The profession of teaching involves of the danger incurred by violation of the laws of an almost continual use of the voice and the resulting strain health and of the value of fresh air in combating the thrown on the larynx is very great. Many members of our malady. Here to be forewarned is to be forearmed, and own profession have opportunities for realising the degree of those who realise the danger of a vitiated atmosphere will be effort involved in delivering even an hour’s lecture when less likely to be seduced by the attractions of shut windows the speaker has to contend against the noise of street or terrified by that domestic bogey, a draught. In the traffic or any similar disturbance. But the duties of a summer classes might be held out of doors with benefit to school teacher are considerably more arduous, inasmuch as both teacher and taught when other circumstances allow, his labours are continued for many hours each day and but in urban schools this cannot often happen. Time out involve not merely the fairly congenial work of delivering of school may be spent in the open air, and ’ open a prepared lecture, but the more wearisome effort of windows at night must be the rule. The cultivation of expounding elementary and therefore uninspiring matters some outdoor pursuit, such as golf or cycling, will be a to immature minds, with much wearisome repetition and great aid to a healthy life on the part of the teacher. We amplification. In addition there is the necessity of main- are brought back again to the principle upon which we have taining discipline among a class often much too large for so often insisted. Since lack of knowledge is still the first convenient handling, since financial pressure tends to cause of those imprudences by which health is endangered, keep down the number of teachers employed to the due instruction of school teachers in the elements of hygiene lowest limits. It, then, owing to the position of the must be insisted upon, not only that they may teach the laws school or to some other defective condition, additional of health to the children but also that they may practise difficulties are placed in the teacher’s way the task b2comes them themselves ; and when these laws are matters of more than normal health and strength can overcome. universal knowledge more will have been accomplished for a distance from busy the happiness of the nation at large than by the most Fortunately, most schools are placed at the if in of attractive scheme of social plunder that has ever beguiled consequence annoyance thoroughfares, only the barbarians residents caused to neighbouring the enthusiastic reformer. by young at play and by the vociferous enthusiasm of their exits. But now and again schools are unsuitably placed as regards traffic, and the teacher has to do his work one

to be lost

A second

Annotations.

amid the rattle of carts and the rumble of heavy vehicles, struggling pitifully to make his voice audible through the tumult which surges through every open window and door.

This unequal struggle of the voice against the outside hubbub must be maintained throughout school hours. It cannot be wondered at that many a breakdown of health is caused by such conditions. Even in favourable circumstances the trial of the vocal powers of the teacher may be considerable and it would be well to arrange for instruction to be given to them in right methods of voiceproduction which may prove a striking boon to an uninstructed speaker. Nor must the general mental strain of

"

THE

Ne quid nimis."

INTERNATIONAL CONGRESS OF AND DEMOGRAPHY.

HYGIENE

THE Fourteenth International Congress of Hygiene and Demography will be held in Berlin from Sept. 23rd to 29th. On Sunday, Sept. 22nd at 8 P.M. there will be a reception of members at the Neues Königliches Operntheater (Kroll). On Sept. 23rd the inaugural meeting will be held in the same place at 11 A.M., after which the exhibition will be opened in the Reichstag buildings, where also the meetings of the various sections will take place. The afternoon of that day

forgotten and the need for sufficient time will be spent in visits to local institutions. The sections will after the day’s work. Medical men have only too meet at 9 A.M. on Sept. 24th, 25th, 27th, and 28th. The after-

teaching

be

for rest noons will be devoted either to meetings of sections or to often to insist that delicate children shall not be made to visits to local institutions on Sept. 24th, 25th, 26th, and 28th. spend their out-of-school hours upon home lessons; the The general meeting will be held on Sept. 26th at 9 A.M., and same rule should apply to the teacher, who needs a fair the closing meeting on Sept. 29th at 10 A.M. In the evening interval of rest to prepare for the labours of the morrow. there will be a reception by the municipality at the Rathaus