SPEAK FOR

Patri's: A SCHOOLMASTER OF THE GREAT CITY

WILLIAM WIRT, Superintendent of Schools, Gary, Indiana :

"I have read the book with great interest and find it a vivid picture of the difficult problem of actually doing in the school what we all know should be done there. But the story does a great deal more than show the difficulty of the problem. The successful way in which the difficulties have been overcome is an inspiration and should convince any teacher that the effort is worth while. The great problem for us as teachers today is to actually put into practice what we preach."

ALBERT SHIELDS, Superintendent of Schools, Los Angeles, Cal.: "It is a delightful thing to find a practical administrator who can. see in the school organization not the end of education, but a necessary yet ever changing device for securing that end; whose understanding of the larger problems is so real that he will not permit rules or traditions or habits, however sanctified by long custom, to deflect his attention from the real objects of true education-the welfare of children. It is a book full of help and suggestion."

JOHN MARTIN, Board of Education, New York City, N. Y. :

"Were I an educational czar, I should issue an edict that every City Teacher read this book three times during the vacation. If its spirit could take possession of every school, a revolution would be effected more fundamental than the glorious Russian Revolution."

A Schoolmaster of the Great City, by Angelo Patri, $1.25

Devoted to the Science, Art, Philosophy and Literature

I

E. BOSWORTH MCCREADY, M. D., PITTSBURGH, Pâ.*

T has not been many years since children, from the pedagogical standpoint, were divided into those who were up to grade and those who were not. The more thoughtful members of the teaching profession were, however, not content with a classification so crude nor with the acceptance of any classification which did not, at least in some measure, explain factors of causation. It was at about this time that psychology was emerging from the mysticism and obscurity of the middle ages and taking its place as a more or less exact science. From the intimate relationship that modern psychology bears to pedagogy, it seemed that the former might lend the aid desired in solving the problems involved in the study, treatment and education of that large class of children who fail to conform to a more or less arbitrary standard of normality. It was not long, however, before the limitations of psychology, per se, were apparent to many, who realized that the psychic factors involved are dependent upon anomalies, deviations, variations, and irregularities in physical structure and function. Thus psychology came to depend more and more upon physiology and pathology, and the psychologist to draw more and

• Director, Wildwood Hall; Paedologist, South Side Hospital, Juvenile Court of Allegheny County, Eastern District Associated Charities and Gusky Orphanage and Home.

more upon the resources of the physician. To some it seemed, since the problems involved in the management of exceptional. children were so largely medical, that this were a legitimate field of occupation for the physician, who would qualify his medical training and experience with knowledge gained through the more highly specialized function of the psychologist, and particularly of the clinical psychologist, who, as Haberman says (J. Victor Haberman: The Intelligence, Examination and Evaluation, J. A. M. A. July 31, 1915, footnote 3.) "must first and foremost be a physician."

It is not to be expected that the busy general practitioner, pediatrist, or neurologist will have the time, inclination, or facilities to study and treat effectively the numerous classes of physical and mental variation with which he may meet. Hence the necessity for a branch of practice which will combine some of the functions of the pediatrist and neurologist with some of those of the psychologist and pedagogue. This is not entirely a new idea, for upon the pages of medical and pedagogic history stand out prominently the names of physicians who have filled these joint functions with credit to themselves and benefit to humanity. Guggenbühl, Itard, Séquin, though pathfinders who sometimes lead their followers through devious ways, left to posterity a legacy which will never be. dissipated. In our own day the name of Dr. Maria Montessori stands out as perhaps the best known, though there are many others--both in this country and abroad-who, approaching the subject from a somewhat different angle, are accomplishing much in this field of endeavor by adding to our knowledge and stimulating interest.

It would seem that the field is sufficiently comprehensive and important to warrant a distinctive appellation for those who confine their practice to this medico-psychologico-pedagogical function. I have for some time made use of the term "peadology." According to Dr. Henry W. Cattell (Dr. Henry W. Cattell, Personal Letter, Sept. 26, 1913), the editor of Lippincott's Medical Dictionary, the term "paedology," first used synonomously with "pediatrics," later made to designate "child study," may now be defined, in a' more restricted sense, as "that branch of pediatrics in which the physical and mental defects of child development are especially studied and treated by the physician.”

The South-Side Hospital of Pittsburgh has recognized "Paedology" as a branch of medical practice by creating a staff position of "Pædologist," which it has been my honor to occupy during the last few years. A clinic conducted in connection is known as the "Paedological Clinic." The Juvenile Court and other agencies coming into close contact with children have given similar recognition, and sufficient interest has been shown in various parts of the country to warrant the assumption that both specialty and term are destined to have a place in the sun. As in other fields of medical endeavor, the first step toward accurate diagnosis and rational treatment is thorough study of the individual patient. Notation of gross physical abnormalities with superficial examination of eyes, ears, and nose, and the application of the BinetSimon, Healy or other tests is not sufficient, except for the purpose of selecting suitable cases for further study and as a prelude to more thorough investigation. These tests merely allow us to determine faulty functionating of one of the body's most important organs the brain. They do not inform us regarding the cause of the disorder of function, any more than does the clinical thermometer tell us the nature of the pathological process behind an elevation of temperature. The paedologist is not independent of other branches of medical practice but, among others, must call to his aid specialists in diseases of the eye, ear, nose and throat, in X-ray diagnosis, in blood analysis and in biologic chemistry, He must, to an extent, direct the line of their investigations, interpret their findings and correlate them with his own observations. Information gained from such sources must be amplified and extended by examinations and investigations undertaken by the paedologist himself. The family history should be as complete as it is possible to obtain, though as often elicited is of little practical value. In the large mass of institution cases we would expect to find-and do find--a history of alcoholism, insanity, tuberculosis, etc., in immediate and remote ancestry, though we find these conditions also in the ancestry of the supposedly normal inmates of orphan asylums and of industrial homes. In private practice it is not always so easy to find a scape-goat, as defects are usually either less frank in expression, or are more carefully glossed over, and require either

observation, or else intimate knowledge of the individual family members for their detection. Of more comparative value, to my mind, is the developmental history; especially when this is made to date, as it should, from the earliest moment of conception, and also from the pre-conceptional period. Birth conditions, digestive disturbances, convulsions, age of sitting up, of walking, talking, etc., are all of diagnostic importance, and are worthy of detailed study, as are all facts connected, in even remote ways, with the mental and physical development of the child. The physical examination should be thorough, from the top of the head to the soles of the feet-careful note being made of stigmata of degeneracy, of gross and minor abnormalities, and also of variation from the commonly accepted norm or type in any degree.

In this day of so-called "standarized" mental tests, I may be considered iconoclastic in stating that in the matter of the mental examination not so much depends upon the method of testing employed as upon the individual equation of the tester. It is upon his interpretation of all the collected data, and the almost intuitive. recognition and selection of essentials that the proper evaluation of psychic factors, with their complex physical interrelations, rests. For purposes of classification, for rapid or routine determination of approximate mental capacity, such tests are indispensable. The surest knowledge, however, is gained through prolonged observation of the child's reaction to a given environment, his adaptability to new problems and conditions, aided by such tests as the experience of the examiner may select. In private practice I make it a rule in all except evident cases to give nothing except a tentative opinion without at least a three months period of such study and observation. It not infrequently happens that I find it necessary to revise early impressions almost completely and to differ radically with the "snap-diagnoses" of previous ob

servers.

It is now generally conceded by medical men that the chain of ductless glands composed principally of the pituitary, pineal, thyroid, thymus and adrenals are of the utmost importance in physical and mental development. While our knowledge of the normal action of these glands is still somewhat hazy, yet they are found to preside, in some manner, over certain correlations of the body.