A discussion, in a recent number of the British Medical Journal,2 on "The Claims and Limitations of Physical Education in Schools," has many valuable hints which should be followed by educators in this country. Dr. Carter, in the leading paper on this subject, makes the pregnant remark: "If the hope is entertained of building up a science of education, the medical profession must combine with the profession of teaching, in order to direct investigation and to collect material essential to generalization. Without such co-operation educational workers must continue to flounder in the morasses of empiricism, and be content to purchase relative safety at the cost of slow progress, or no progress at all." In other words, an advisory medical board should coexist with our board of public education, to try to hold in check or prevent a further "cruelty in trying to be kind." Private institutions of education recognize the importance of physical training and development, and in such institutions the deterioration of vision is in proportion less than in institutions where physical training is not considered.

In one school of over 200 middle class girls, Dr. Carter found that, during a period of six years, no fewer than ten per cent. of the total number of girls admitted during that time have been compelled to take one or more terms' leave of absence, and of the present number twenty-eight per cent. have medical certificates exempting them from gymnastic exercise and 10.25 per cent. of the total present number wear eye glasses of some kind or other. From my own experience the same number of students in our schools would show about the same percentage of visual defects. These questions are of such growing importance that not only instructors, but the medical fraternity, should not rest until these evils are eradicated.

Dr. J.W. Ballantyne, of Edinburgh, in a lecture3 on diseases of infancy and childhood, says: "The education of the young people of a nation is to that nation a subject of vital importance." The same writer quotes the startling statement made by Prof. Pfluger, that of 45,000 children examined in Germany more than one-half were suffering from defective eyesight, while in some schools the proportion of the short sighted was seventy or eighty per cent., and, crowning all, was the Heidelberg Gymnasium, with 100 per cent. These figures, the result of a careful examination, are simply startling, and almost make one feel that it were better to return to the old Greek method of teaching by word of mouth.

Prof. Pfluger attributes this large amount of bad sight to insufficient lighting of school rooms, badly printed books, etc. One must agree with a certain writer, who says: "Schools are absolute manufactories of the short sighted, a variety of the human race which has been created within historic time, and which has enormously increased in number during the present century." Granting that many predisposing causes of defective vision cannot be eliminated from the rules laid down by our city fathers in acquiring an education, it would be well if the architects of school buildings would bear in mind that light when admitted into class rooms should not fall directly into the faces of children, but desks should be so arranged that the light must be sufficiently strong and fall upon the desk from the left hand side. My attention has repeatedly been called to the cross lights in a school room. The light falling directly into the eyes contracts the pupil which is already contracted by the action of the muscle of accommodation in its effort to give a clearer picture to the brain. This has a tendency to elongate the eyeball, and as a permanent result we have near sightedness.

Where the eyeball has an unnatural shortness this same action manifests itself by headaches, chorea, nausea, dyspepsia, and ultimately a prematurely breaking down of health. The first symptom of failing sight is a hyper-secretion of tears, burning of the eyelids, loss of eyelashes, and congestion either of the eyelids or the eyeball proper.

The natural condition of aboriginal man is far sighted. His wild life, his nomadic nature, his seeking for game, his watching for enemies, his abstention from continued near work, have given him this protection. Humboldt speaks of the wonderful distant vision of the South American Indians; another traveler in Russia of the power of vision one of his guides possessed, who could see the rings of Saturn. My recent examinations among Indian children of both sexes also confirm this. While the comparison is not quite admissible, yet the recent investigations carried on by Lang and Barrett, who examined the eyes of certain mammalia, found that the larger number were hypermetropic or far sighted. With all the difficulties which naturally surround such an examination they found that in fifty-two eyes of rabbits, thirty-six were hypermetropic and astigmatic, eight were hypermetropic only, five were myopic and astigmatic, and others presented mixed astigmatism. In the eyes of the guinea pig about the same proportion of hypermetropia existed. The eyes of five rats examined gave the following result: Some were far sighted, others were hypermetropic and astigmatic, one was slightly myopic and one had mixed astigmatism.

Of six cows, five were hypermetropic and astigmatic and one was slightly myopic.

Six horses were also examined, of which one had normal sight, three were hypermetropic and astigmatic, and two had a slight degree of astigmatism. They also examined other animals, and the same proportion of hypermetropia existed. These gentlemen found that as an optical instrument the eye of the horse, cow, cat and rabbit is superior to that of the rat, mouse and guinea pig.

I have for the last five years devoted considerable attention to the vision of the Indian children who are pupils at two institutions in this city. I have at various times made careful records of each individual pupil and have from time to time compared them. Up to the present there is a growing tendency toward myopia or short sightedness, i.e., more pupils from year to year require near sighted glasses. The natural condition of their eyes is far sighted and the demands upon them are producing many nervous or reflex symptoms, pain over the frontal region and headaches. A good illustration of the latter trouble is showing itself in a young Indian boy, who is at present undergoing an examination of his vision as a probable cause for his headaches. This boy is studying music; one year ago he practiced two hours daily on the piano and studied from three to five hours besides. This year his work has been increased; he is now troubled with severe headaches, and after continued near work for some time letters become blurred and run together. This boy is far sighted and astigmatic; glasses will correct his defect, and it will be interesting to note whether his eyes will eventually grow into near sighted ones. I have several cases where the defective vision has been due entirely to other causes, such as inflammation of the cornea, weakening this part of the eye, and the effect in trying to see producing an elongation of the anterior portion of the eyeball, and this in turn producing myopia. The eye of the Indian does not differ materially from that of any deeply pigmented race.