d or actual epidemic.

HEALTH AND SCHOOL PROGRESS

But medical inspection does not confine itself to dealing with
contagious disease. Its aid has been invoked to help the child who is
backward in his school studies. With the recent extensions in the
length of the school term and the increase in the number of years of
schooling demanded of the child, has come a great advance in the
standards of the work required. When the standards were low, the work
was not beyond the capacity of even the weaker children; but with
close grading, fuller courses, higher standards, and constantly more
insistent demands for intellectual attainment, conditions have
changed. Pupils have been unable to keep up with their classes. The
terms "backward," "retarded," and "exceptional," as applied to school
children, have been added to the vocabularies of educators.

School men discovered that the drag-net of compulsory education was
bringing into school hundreds of children who were unable to keep step
with their companions, and because this interfered with the orderly
administration of the school system, they began to ask why the
children were backward.

The school physicians helped to find the answer when they showed that
hundreds of these children were backward simply because of removable
physical defects. And then came the next great forward step, the
realization that children are not dullards through the will of an
inscrutable Providence, but rather through the law of cause and
effect.

EXAMINATIONS FOR PHYSICAL DEFECTS

This led to an extension of the scope of medical inspection to include
the physical examination of school children with the aim of
discovering whether or not they were suffering from such defects as
would handicap their educational progress and prevent them from
receiving the full benefit of the free education furnished by the
state. This work was in its infancy five years ago, but today
Cleveland has a thorough and comprehensive system of physical
examination of its school children.

Surprising numbers of children have been found who, through defective
eyesight, have been seriously handicapped in their school work. Many
are found to have defective hearing. Other conditions are found which
have a great and formerly unrecognized influence on the welfare,
happiness, and mental vigor of the child. Attention has been directed
to the real significance of adenoids and enlarged tonsils, of swollen
glands an