The duties of the rural school nurse include prominently the following: a Assisting in the health examinations of pupils

b Explaining to the parents the importance of defects found in children and helping in the arrangements for the medical, surgical or dental treatment required

c Giving emergency treatment in health disturbances and following up treatment, under medical direction, for various conditions

d Providing an important part of the health teaching for the pupils and giving in homes visited, suggestions and advice affecting not only the health interests of the children, but of the home

In many a community, not only in city but in country, the tactful, devoted nurse has made for herself a place of the greatest influence in promoting health and human welfare in general.

Every community should have the service of a nurse whose first, if not sole, duty is to care for the health of the school children.

Here are a few pertinent sentences from a pamphlet prepared by Dr. Thomas D. Wood, Chairman of Committee on Health Problems of the National Council of Education:

One of the appalling revelations of recent years is the conclusion, based on unrefuted evidence, that the rural school children in this country are handicapped by more physical defects than the pupils in the city schools. While several significent causes seem to be responsible for this astounding condition, the present physical inferiority of country children depends in part upon the fact that city children now receive more health care than do those in rural regions.

In the mobilization of our nation's resources for the stupendous task of this war, nothing is more dramatic or impressive than the inspiring spectacle of these young men being trained in preparedness for the intensive, the grim business of war. Records even of men in our great training camps, who have been accepted as fit for military service, show that in multitudes of cases, and within six months after the beginning of training, the improvement in health, in vitality, in physical and general efficiency, has been almost incredible. Shall we not provide as thorough and effective health care and physical education for the children of our country as we furnish for the young men in the army and navy?

The monstrous efficiency of the German Empire in this awful war is due in an important part to the organized health work, the national program of health care and education which has been conducted in that country for the last half century.

Our schools are wasting enormous sums in educating, or trying to educate, the children who are handicapped by ill-health, when the expenditure of much smaller amounts in a judicious health program would produce an extraordinary saving in economy and efficiency.

Another factor vitally influencing the health and well-being of children is the condition of school premises.

While under the operation of the school building code great im

provements have been made in the condition of our school buildings, much remains to be done.

The first offense here is the seating, for in many schools little children are compelled to sit four hours or more in seats too large, and with their feet dangling in the air. The desks are not only too large for health or comfort, but they are poorly adapted for writing or for using books. On the other hand, many large children are compelled to sit cramped in seats which are too small. The conditions are common in some parts of the State-too common for the welfare of children; they are as opposed to health as poor ventilation or bad light.

I recently visited a country school of one room, remote from a railroad, in which every pupil was sitting in a movable adjustable seat; the blackboards were low enough so that all children could reach them readily; the light was from the left and there was plenty of it. The room was clean and the toilets in excellent condition.

If such physical conditions are possible in one rural school, why not in all schools? I affirm that New Jersey ought to lead the country in the physical education of school children. The State is prosperous; there is great interest in education; the constitution explicitly declares in favor of sound and efficient education of children and youth. No education can be sound and efficient, however, that lacks in any sense preparation for physical fitness.

Mere talking about the importance of physical training will not bring it about. Physical training must be practical; health-promoting habits must be established; time must be devoted to it; and above all, the rank and file of teachers and superintendents must work for it and believe in it.

We have, then, a good course of study or exercises in physical training and an excellent course in hygiene. What we need is vitalized teaching. Whether or not we have this depends upon teachers, principals and superintendents.

The following is the law in regard to medical inspection:

Every board of education shall employ a competent physician, to be known as the medical inspector, and fix his salary and term of office. Every board of education shall adopt rules for the government of the medical inspector, which rules shall be submitted to the State Board of Education for approval. The medical inspector shall examine every pupil to learn whether any physical defect exists, and keep a record from year to year of the growth and development of such pupil, which record shall be the property of the board

of education, and shall be delivered by said medical inspector to his successor in office. Said inspector shall lecture before the teachers at such times as may be designated by the board of education, instructing them concerning the methods employed to detect the first signs of communicable disease and the recognized measures for the promotion of health and the prevention of disease. The Board of Education may appoint more than one medical inspector. A Board of Education may exclude from school any child whose presence in the schoolroom shall be certified by the medical inspector as detrimental to the health or cleanliness of the pupils in the school, and shall notify the parent, guardian or other person having control of such child of the reason therefor. If the cause for exclusion is such that it can be remedied, and the parent, guardian or other person having control of the child excluded as aforesaid shall fail or neglect within a reasonable time to have the cause for such exclusion removed, such parent, guardian or other person shall be proceeded against, and, upon conviction, be punishable as a disorderly

person.

Furthermore, the State Board of Education has prescribed rules to be followed by these medical examiners for the examination of children.

The cost of medical inspection, including supplies and all expenses, together with salaries, was as followed by counties: