C. HEALTH EDUCATION AND SCHOOL HYGIENE

1. Horace Mann on schools and children as the medium for health education of the community, 1842

Horace Mann, "The Study of Physiology in the Schools – Dissertation Upon the Subject; Report for 1842," Annual Reports on Education (Boston, 1868), pp. 131-144.

The study of human physiology. . . by which I mean both the laws of life and hygiene, or the rules and observances by which health can be preserved and promoted, – has claims so superior to every other, and, at the same time, so little regarded or understood by the community, that I shall ask the indulgence of the Board while I attempt to vindicate its title to the first rank in our schools, after the elementary branches.

In civilized communities, where the rates of mortality have become a statistical science, it is found that more than one fifth, almost a fourth part, of the human race die before attaining the age of one year. Instead of filling the number of threescore years and ten, – the period spoken of by the Psalmist as the allotted life of man, – almost one-quarter part of the race perish before attaining one-seventieth part of their natural term of existence. And, before the age of five years, more than a third part of all who are born have died.

After the age of two or three years, however, the annual proportion of deaths rapidly diminishes. Those children who have inherited feeble constitutions from their parents have been thinned off, and the rest have escaped the terrible slaughtering of that ignorance which presides over the nursery. Nature then seems to take them under her care; she prompts them to activity, and even counsels disobedience and stratagem to secure for them the oft-prohibited boon of exercise and outdoor air. Still a vast majority of mankind die before attaining one-half of that age at which the faculties of body and mind reach their fullest development and vigor. Before the age of twenty years. . . one-half of the human race are supposed to have died. Nor is this all, or the worst; for a vast portion of those who survive suffer pains which it is frightful to think upon. The sick and valetudinary, instead of being here and there an individual, are a countless host; and it is rare to find any person entirely free from all ailments, organic and functional. Instead of contributing their share to those productions and improvements by which life is sustained, and the arts of life and the resources of wellbeing supplied, these classes are grievous burdens upon their friends or upon society. The worldly prosperity of thousands of families is destroyed by the diseases or infirmities of one, if not both, of their heads. Children are made orphans, or mainly deprived of parental nurture and supervision; or, on the other hand, parents are bereaved of their children. And further, although it is most true that the calamity of sickness, or even of death itself, is nothing, compared with crime, yet it is also true that sickness induces poverty, which is one of the tempters to crime; and that a deranged condition of the physical system often urges to vicious and destructive indulgences by the unnatural appetites which it creates, and thus ill health becomes the parent of guilt as well as of bodily pains.

Should anyone think that this view of the subject refers too much of human suffering and delinquency to an ignorance or disregard of the physical laws, let him learn what the most obvious and palpable of those laws enjoin; and then let him go through society, and see how systematically and flagrantly they are violated, and he will be in haste to retract his former opinion. I have the concurrent authority of many of our most eminent physicians for saying that one-half of all human disability, of the suffering and early death inflicted upon mankind, proceeds from ignorance, from sheer ignorance, of facts and principles which every parent, by virtue of his parental relation, is as much bound to know as a judge is bound to know the civil or criminal law which he undertakes to administer, or as a juror, in a case of life and death, is bound to understand the evidence on which his verdict is to be rendered. When we reflect that every child in the community, before he arrives at the age of twenty years, might and should become acquainted with those organic laws upon which the Creator of the body has made its health and vigor to depend, how worthless in the comparison becomes a knowledge of algebra, of ancient mythology or history, or of all the Grecian and Latin lore which has come down to us from author or commentator!

I see no way in which this knowledge can ever be universally, or even very extensively, diffused over the land, except it be through the medium of our Common Schools. All other instrumentalities for instructing mankind reach but a small part of them, and, of course, must fail extensively in accomplishing any general purpose. Only a comparatively small portion of our youth attend the higher seminaries of learning; and, while this species of knowledge is every way as important to females as to males, the latter only enjoy the benefits of our colleges or universities. Besides, the course of studies in these higher seminaries is already so full as almost to forbid the introduction of more; and those branches which have general usage and prescription in their favor will not readily yield to others, however much more intrinsically important. And hence it is that students are instructed in languages, and in the recondite truths of mathematics and astronomy; they are taught all the motions of the planets, and even the librations of the moon, as carefully as though those mighty orbs would fly from their paths or lose their balance if their course and equipoise were not prescribed anew from year to year, and to class after class; while the structure of their own bodies, and the simple and beautiful laws on which life and all our capabilities of usefulness are dependent, are almost universally neglected.

There is a frightful extent of ignorance on the subject of the physical laws, as they appertain to the human constitution (and in this sense only I use the phrase), pervading the whole community. Even educated men, who are not physicians, are rare exceptions to this remark. The graduated of colleges and of theological seminaries, who would be ashamed if they did not know that Alexander's horse was named Bucephalus, or had not read Middleton's octavo volume upon the Greek article, are often profoundly ignorant of the great laws which God has impressed upon their physical frame, and which, under penalty of forfeiting life and usefulness, he has commanded them to know and obey.

An accurate knowledge of a few great physiological principles, together with a sound judgement or discretion in applying them, will suffice to ward off an inconceivable amount of human suffering, and to confer an ability to make great additions to the public welfare, instead of subtracting from it. The Creator assures us that "he doth not afflict willingly nor grieve the children of men;" and if, in all things, the race should obey the physical laws of God, they would no more suffer physical pain, than they would suffer remorse, or moral pain, if in all things they would obey the moral laws of God.

This subject has its merits, which should command the attention of the statesman and political economist. All investments to preserve or increase the public health would be reimbursed many fold, in an increased capacity for production. One of the most important items in a nation's wealth consists in the healthfulness and vigor enjoyed by its people. All agriculturists and manufacturers must feel the force of this remark in regard to their own workmen; and they would feel it still more if they were obliged, at their own expense, to support those workmen during all periods of sickness or incapacity to labor; and this is the relation in which the State stands to its citizens. . . Omitting all considerations of personal and domestic suffering, of the extinction of intellectual power, and of those moral aberrations which originate in physical derangement and disease, – and considering the race under the mere aspect of a money-making power, – in this respect it is clear, that the health and strength of one community, if set in opposition to the debility or infirmity of another, would be sufficient, not only to determine the balance of trade, but to settle all other points of relative superiority. Let such information be diffused through the public as all the children in our schools might easily acquire, and a single generation would not pass away, without the transfer of immense sums to the other side of the profit-and-loss account in the national ledger. . .

2. Massachusetts recommends the teaching of physiology and hygiene in public schools, 1850

"An act requiring physiology and hygiene to be taught in public schools," 1850 – ch. 229, Acts and Resolves Passed by the General Court of Massachusetts, 1850 (Boston, 1850), p.419.

Physiology and hygiene shall hereafter be taught in all the public schools of this Commonwealth in all cases in which the school committee shall deem it expedient.

All school teachers shall hereafter be examined in their knowledge of the elementary principles of physiology and hygiene, and their ability to give instructions in the same.

This act shall take effect on and after the first day of October, one thousand eight hundred fifty-one.

3. Sanitary science as a branch of education, 1850

Massachusetts, Sanitary Commission, Report of a General Plan for the Promotion of Public and Personal Health, Devised, Prepared and Recommended by the Commissioners Appointed Under a Resolve of the Legislature of Massachusetts, Relating to a Sanitary Survey of the State (Boston, 1850), pp. 178-179.

This report, prepared by Lemuel Shattuck (1793-1859) and two other commissioners, and usually known as the Shattuck Report, included fifty specific recommendations for promotion of public and personal health.

We recommend that measures be taken to ascertain the amount of sickness suffered, among the scholars who attend the public schools and other seminaries of learning in the Commonwealth.

It has recently been recommended that the science of physiology be taught in the public schools; and the recommendation should be universally approved and carried into effect as soon as persons can be found capable of teaching it. Sanitary science is intimately connected with physiology, and deserves equal and even greater commendation as a branch of education. Every child should be taught, early in life, that, to preserve his own life and his own health and the lives and health of others, is one of his most important and constantly abiding duties. By obeying certain laws, or performing certain acts, his life and health may be preserved; by disobedience, or performing certain other acts, they will both be destroyed. By knowing and avoiding the causes of disease, disease itself will be avoided, and he may enjoy health and live; by ignorance of these causes and exposure to them, he may contract disease, ruin his health, and die. Every thing connected with wealth, happiness and long life depend upon health; and even the great duties of morals and religion are performed more acceptably in a healthy than in a sickly condition.

1. Poor ventilation in public schools, 1845

John H. Griscom, The Sanitary Condition of the Laboring Population of New York (New York, 1845), pp. 11-12.

The necessity for breathing space was among the cardinal tenets of mid-nineteenth-century "sanitary science." John H. Griscom (18091874), a pioneer sanitarian of New York City, found overcrowding of rooms and inadequate ventilation as characteristic of schools as of tenements, factories, reformatories, and jails.

An inquiry into the amount of air allowed to children in schools, to the inmates of prisons, and to laborers in work-shops, will exhibit a degree of neglect, or ignorance, in relation to this vitality important subject, in individuals having the training and guardianship of these classes, truly lamentable, as well as surprising. For examples.

One of the Public Infant Schools of this city, having an average attendance the year round, of 200 children, was for a long time, and until recently, kept in the basement of a church, the dimensions of which were 46 X 30 X 8½ feet, equal to 11730 cubic feet. The proximity of the adjoining buildings rendered it so dark in a sunny day, it was difficult to see to write on a slate a short distance from the windows. A large stove warmed the room in winter. These children had about sixty cubic feet each, for the six school hours, equal to ten cubic feet per hour, when each child should have ten cubic feet per minute. Ventilation was un-thought of, until recently, and now in consequence of the position and arrangement of the building, it is very imperfect.

The dormitories of the House of Refuge have each an area of less than 200 cubic feet. When the door is closed on the inmate, his bed, which is about eighteen inches from the floor, is extended nearly across the cell, diminishing by so much its atmospheric area, and intercepting almost wholly the communication between a very small opening at the bottom, and another at the top, and one in the middle, of the door. Those openings were intended, but are wholly inadequate, for ventilation, even if no bed were there. For the perfect decarbonization of the blood, the air in each dormitory, at the lowest proper estimate, will remain sufficiently pure for the space of thirty minutes only, yet the youthful inmates are locked in from 8 P.M. till 5 A.M. nine hours, with no other ventilation than what I have described. Their work-shops cannot be said to be much better supplied with air. The effects of this privation are plainly marked upon the countenances, and general physical development, of the children.

The general arrangement of the cells in the City Prison is but little if any better. Besides the small window near the ceiling on one side, air is admitted only through five auger holes in the door on the opposite side, and these latter are of no service at night, when the inner door is closed.

2. Public schools in Louisville, Kentucky, 1849

L. P. Yandell, "Sanitary Condition of Louisville, Kentucky," Transactions of the American Medical Association, II (1849), 615.

Early public schools often met in converted houses, hotels, or stores rather than in buildings specially designed and constructed as schoolhouses.

The public schools, twenty-four in number, are open to children at the age of six years, and all are crowded. The system is one which calls for reform in several particulars. Too many scholars are congregated in a room, either for health, or for mental or moral improvement. In some, there are as many as 130; and in none, less than 60. The largest rooms are not forty feet square, and many are of much smaller size. The children are kept in them from three to four hours in the morning, and two and a half to three hours in the afternoon. The long vacation is in summer, and lasts six or seven weeks. The health of the children is good. The number of teachers in the several schools is too small. It is not possible for the children to take exercise in the small yards connected with the schools, and they are consequently forced into the streets to enjoy it. Louisville, by a fatal oversight, neglected to provide grounds, when she might, for the exercise and recreation of her children, and now the opportunity has passed away. Fortunately, her streets are so wide that, planted as they are with fine trees, this evil will not be so sorely felt as it would be in cities less happily constructed. Broadway, when graded and set with trees, according to the plan which has been commenced, will afford a promenade as beautiful as could be desired.

3. "Are our public schools injuring the bodies of our children?" 1855

The American Medical Monthly, IV (1855), 411-412.

There is not a more important interest in the State than the Common School. Occupying the exclusive attention of those who are to be the men and women of the next generation, for many hours of each day, its influence upon society can scarcely be overrated, and any error of physical training that by implication or by constitution it circulates becomes a serious wrong.

We have often queried whether there were not something decidedly wrong in the amount of time that the Common School demands of our children for study, and in the still greater amount that it spoils for recreation.

Our city schools require – and it amounts to about the same thing throughout the State – that the scholar shall be on hand from 9 o'clock to 12, and from 12½ to 3. Now 5½ hours would not be too much for any healthful child, if with the ringing of the dismissal bell there came a season of relaxation until nine of the next day. But when we meet our boy of ten years old returning from school, we find him always loaded down with books – geography, astronomy, physiology, and half a score of the sort beside – in several of which he assures us that he must get a lesson before morning. And upon further inquiry, we find that except exercises in arithmetic, reading, spelling, and writing, all his studying is to be done out of school hours! Of course, if he is bright, he soon learns how to make short work of his lessons, and by hurried or stolen reviews in school to "stuff" for recitation. But if he is dull, he has a harder lot. Coming home from school he is jaded and weary. He loathes the sight of a book. He longs to put his old "trowsers" on and kneel in the gutter or on the crossing to have one good game of marbles, or he agonizes for a game at ball, or "tag." He wants to expand his lungs and stretch his legs, and shake himself unhampered by a nice coat and out of the sight of grumbling teachers or guardians.

The prudent parent may consent to this in the summer time, but in winter there is no larger margin for play between the last hour of school and the first of night than a supper of proper length should entirely occupy, and none like to have their children out rioting after dark. Then, with the coming dark, the lad must sit down to his books. Under the most favorable circumstances he shares a light with the other members of the family, and while they talk of new dresses and gossip of the day's affairs, he must keep his attention on problems that he abominates, or strive perpetually to commit to memory dates, names, figures, in which he can have no mortal interest. He is three times as long about it as if he had learned the same lesson in school; has acquired a habit of studying lazily, or rather has fallen into a habit of "mocking" over books and calling it study, besides finding his temper soured, and his spirits broken by the constant repetition of rebukes that really kind parents and sisters inflict upon him for listening to their conversation rather than attending to his business. But with the end of his labors it is bed-time, and with the end of breakfast it is school-time again. So whatever of recreation, whatever of physical training, whatever of development of muscle or exercise of body he gets, is stolen during the week or lumped together upon Saturday, when there is no school.

Our Board of Education and excellent corps of teachers could scarcely adopt a more ingenious device to secure a generation of puny people. They inject great quantities of elementary knowledge into the mind, and surfeit it where they should feed it with the greatest care. The body is ignored – its organs recognized only as things to be mortified. They struggle vigorously to crowd boys into the Free Academy, but take very feeble measures to prepare them to face the world and take part in its stern conflicts. Our own impression is – perhaps it may be a crude and undigested one – that the five and a half or six hours a day are an ample time to detain young children upon any intellectual exercise that is not positively alluring to them. We are not alarmed lest our children should study too much – they and nature conspire to prevent any such evil. But nature and the child together are incompetent to prevent the wrong that our system imposes in abbreviating the hours of physical exercise.

We are aware that some of the order and fine show of the school-room must be sacrificed if this doctrine is adopted. But, we think, neither the health of the scholar nor the convenience of families can afford to construe our school-rooms into mere recitation-rooms, or halls in which to parade the military precision of classes. Let the school hours be divided between recitation and study, and the scholar will have time enough for necessary exercise. The body will be encouraged to keep pace with the growing intellect. The winter evenings will come to be envied seasons of rest, of and for pleasant reading. What is now a drudgery and a bore to so many – the Common School – would become a pleasure, and of course a most certain profit.