and hygiene with "special instruction as to the effect of alcoholic drinks and of stimulants and narcotics on the human system." Much of that instruction was provided in the grades of the elementary school, but the study of physiology and hygiene also had its place in the secondary school. Data concerning the study of the subject in the public high schools from 1895 to 1915 are presented in the following table:

TABLE CLI. PUBLIC HIGH-SCHOOL PUPILS ENGAGED IN
THE STUDY OF PHYSIOLOGY, 1895–1915*

* Report of the United States Commissioner of Education (1916), vol. ¤, p. 487.

On the whole it may be said that up to recent date instruction in physiology and hygiene both in the elementary school and in the secondary school has been a conspicuous failure, though reforms of the past decade give promise of betterment. For this failure it is not difficult to find reasons: (a) the study was inaugurated in the schools as part of a propaganda and became preaching rather than instruction; (b) teachers were either apathetic and merely conformed to the letter of the law or were reformers whose enthusiasm led to well-meant but ignorant teaching; (c) as far as temperance instruction was concerned much that was taught was demonstrably false and obviously untrue even in the knowledge of the pupils, while much more was not demonstrably true; (d) apart from the temperance propaganda the physiology which was taught, especially in the high school, concerned itself with anatomy and scientific classification of parts and organs of the body rather than with the application of hygiene knowledge; (e) textbooks in physiology until

within recent years were most unsatisfactory, either tending to exaggeration and falsity when designed as a part of temperance propaganda or tending toward too much scientific classification and organization and neglecting practical hygiene.

Within the past few years and especially in the high school there has developed a tendency to provide instruction in physiology and hygiene not only through courses in that subject proper, but also in connection with biology, general science, domestic science, and community civics. Further, textbooks in the subject and methods of teaching have been adapted to the real ends of instruction in physiology and hygiene - the imparting of health knowledge and the development of health habits which will have practical and fairly general application in the lives of the pupils.

303. Place of physiology and hygiene in the program. It must be recognized that instruction in physiology and hygiene has its legitimate and necessary place in the school. Some of that instruction is and should be provided in the elementary school throughout its course (grades one to six). Before entrance to the junior high school the pupil should have acquired considerable physiological and hygienical knowledge. Instruction in those fields should be continued throughout the junior high school. In the seventh grade (first grade of the junior high school) that instruction may well be given as a separate study. In the eighth and ninth grades (second and third grades of the junior high school) it may be made a part of the general science courses. In the ninth grade also it should be related to the course in community civics. Throughout the junior high school all instruction in physiology and hygiene should be conducted primarily from the viewpoint of its application to the lives of the pupils and to social needs. The study of physiology and hygiene as a science has no place in the junior high

school. As a science physiology and hygiene should be reserved for study as elective in the senior high school. Recognition of the phenomena of retardation and elimination should guard us against the suggestion made by some that a high-school course in physiology and hygiene (to be engaged in by all pupils) should be deferred until the pupil may have studied biology, chemistry and physics.1

304. Direct importance of physiology and hygiene. There is no possible way of determining exactly the importance of some knowledge of physiology and hygiene to the secondary-school pupil during the school period of his life. A few facts are worthy of attention, however, in that connection.

(1) In 1914-15 the United States Commissioner of Education reports that 585 cities in the country having each a population of 10,000 or over had a total enrollment of 643,957 high-school pupils with an average daily attendance of 540,603. So many factors affect attendance or nonattendance that it is impossible to determine the amount of absence from high school that is due to illness or to estimate the effect of poor attendance on the pupil's work, retardation, and sometimes elimination. It is known, however, that one of the most potent causes of retardation, even in high-school pupils, is irregular attendance. The amount of non-attendance due to illness or poor health is greater than is sometimes thought. This may in part be remedied by proper health inspection and attention, in part by the dissemination of health knowledge and the development of health habits among high-school pupils.

(2) Careful investigation of the physical conditions of

1 Cf. Berry, C.S., p. 357 of Johnston, C. H. (Editor), High School Education. 2 Report of United States Commissioner of Education (1916), vol. I, p. 47. 3 Cf. Ayres, L. P., "The Relation Between Physical Defects and School Progress," Proceedings of the Fourth Congress of the American School Hygiene Association, pp. 99-105; Rapeer, L. W., School Health Administration, pp. 31-50.

secondary-school pupils has indicated that more than one half of the high-school pupils suffer from more or less serious physical defects. While the correction of many of those defects demands the care of the specialist the health instruction of the school can at least impress on the pupils the recognition of their defects and the importance of immediate attention to their correction.

(3) Children of secondary-school age in alarming numbers suffer from preventable diseases. Some conception of the importance of this factor may be gained from figures presented in the following table.2

TABLE CLII. ESTIMATED PREVENTABILITY OF DEATHS OF CHIL DREN OF AGES FIFTEEN TO NINETEEN FOR TEN MOST NUMEROUS CAUSES OF DEATH IN 1910

These and other considerations render imperative and effective program of health instruction, inspection, and care in the secondary school.

1 Small, W. S., pp. 500-03 of Rapeer, L. W. (Editor), Educational Hygiene. 2 Arranged from data given by Rapeer, L. W., School Health Administration, p. 17. Cf. Department of Commerce, Bureau of the Census. Mortality Statistics (1911).

305. Sex hygiene and sex pedagogy. Modern civilization is in many points in direct conflict with nature; nowhere is it in greater conflict than in matters related to sex. Modern conventions and the conditions of modern life make necessary and desirable the postponement of marriage until a date considerably later than the development of strong sex instincts and the maturity of physiological functions related to sex. Sex maturity begins to appear during the period of secondary education, and the development of sex instincts during that period is as inevitable as the daily rising of the sun. Sex indulgence, normal and perverted, among secondary-school pupils is by no means the rare exception that trusting and optimistic school authorities would believe. For every case that becomes known there are many cases which remain undiscovered.

The importance of measures which may help to diminish the ravages of venereal diseases in society need not here be rehearsed. The prevalence of such diseases and their effects have been discussed ad nauseam in modern literature, both scientific and unscientific. The problems of education in this connection are not those of need, but rather of ways and means. According to Crampton: 1

The problem resolves itself into two parts:

1st. Shall instruction in sex hygiene be given in the schools? 2d. When, how, and by whom shall it be given?

The situation is bristling with difficulties. It may be questioned whether knowledge is more protective than ignorance, and the answer may be that knowledge from a worthy source is better than that which comes from vicious companions.

It may be firmly held that this instruction should come from the father and mother, the physician or other sources; to this the reply must be given that these sources are ineffective, for the situation still demands a remedy.

1 Crampton, C. W., "The Teaching of Hygiene," Proceedings of the Fourth Congress of the American School Hygiene Association, pp. 137–42.