Popular Science Monthly/Volume 33/August 1888/Teaching Physiology in the Public Schools

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IT will not be amiss at this time, when many of the States have decided that "physiology and hygiene, with special reference to the effects on the human system of alcoholic stimulants and narcotics," must be taught in their public schools, to glance at the reasons for such teaching, at some of the books and methods in use, at some of the results already obtained, and at what might reasonably be expected to result from proper teaching and proper study.

Those who study the causes of infant mortality, especially in large cities, of intemperance among the laboring-classes, of the crimes which thrive in the hot-bed of tenement-house life, of the increase of nervous disorders and insanity in this country, can not but see that dissipation (using the term in a general sense) and a disregard of the requirements of health are responsible in a large measure for the evils named, as well as for others which afflict mainly the so-called higher classes of society. The fact that much of the dissipation and the disregard of health laws is due to ignorance rather than to want of thought is sufficient reason for the study of health laws. But, as the health of individuals is closely related to the health of the village, town, or city in which they live, and as "public health is public wealth," another reason is apparent for the popular study of hygiene. Says Dr. H. P. Yeomans, of the Provincial Board of Health, Ontario, Canada: "Practical experience has demonstrated that the work of educating the people in all that pertains to public hygiene is a most important factor in the successful accomplishment of our objects as sanitarians. At every step in our legislative halls with local health authorities, in communities, and in our experience with individual citizens, we encounter more or less opposition arising from a lack of intelligent comprehension of the causes of disease, the best method of preventing the spread of epidemics, and generally of the preservation of public health. ... It is a well-recognized principle, especially in a free country, where the sovereign power is lodged in the body of the people, that popular sentiment must proceed in advance of legislation in order that the successful enforcement of law may be secured."

The instruction of the adult population in Health matters must be, in the main, through the current literature of the day and by popular lectures. The children who are to be the future molders of the country's welfare should be systematically and properly taught in the schools physiology and hygiene, with only enough anatomy as a foundation for the study of physiology.

If Dr. Hammond's statement be correct that many school children of the present day are oppressed mentally and physically by too many and too hard studies, it is imperative that parents, teachers, and even pupils should know what work the child's brain and body can and ought to bear. But this statement of Dr. Hammond will cause the introduction of the studies of physiology and hygiene to be objected to by some on the ground that any additional studies will weigh too heavily upon the children. This objection is a valid one if the prescribed lessons are to be merely memorized by pupils, and if the children are to be rigorously marked for not remembering. Improperly taught, as these subjects too frequently are, they become distasteful to the pupil, discouraging to the teacher, and are calculated to do more harm than good. Properly taught, they will not be merely additional studies for the pupil to grind out with tears and labor and vexation of spirit, but will be welcomed because they lighten the work imposed by the routine of school-life.

Until very recently, in order to obey the precept, "Know thyself," the teaching has been almost altogether anatomical, dry descriptions of the position, shape, and use of bones, muscles, and the various tissues of the body. Unfortunately, much of this sort of teaching still prevails, even for young children, and some of the books in use foster such teaching. Fortunately, many of the books devote more space to physiology than to anatomy, but a few only give much attention to hygiene, which is the most practical of the three studies, but its study should be associated with that of the other two.

Says Dr. Parkes, the eminent sanitarian: "Hygiene aims at rendering growth more perfect, decay less rapid, life more vigorous, and death more remote." Information that will help to effect these ends is what is needed by all who wish to enjoy and accomplish most during life. While it is of interest to know what bones are, and how many there are in the body, where the location of the heart is, and what are its functions, it is of more practical importance for all of us to know what will keep the bones in sound condition, and what we should or should not do in order that our hearts may serve us faithfully many years. The practice of hygienic laws, as well as the study of hygiene, is needed both in and out of schools much more than mere anatomical and physiological knowledge. Dr. Stephen Smith, as President of the American Public Health Association, voiced the opinion of many sanitarians when, in 1873, in an address before the association, he said: "Were a well-digested system of education in hygienic matters, which so vitally concern the well-being of every person, adopted and put in practice with anything like the vigor with which we insist upon the study of the common and useful branches, like geography, arithmetic, and grammar, and the uncommon or ornamental branches, as French, music, etc. within one generation the whole mass of the people would be so enlightened on subjects relating to the hygiene of every-day life that our average longevity would be immeasurably increased." Not only would life be prolonged, but better mental and physical work would be accomplished by the prevalence of health, which to many a worker is more than half the battle, and the poor quality of which holds many an earnest soul down in the toils of poverty and despair.

Since Dr. Smith's address was delivered, efforts have been made to systematically teach in the schools the principles of physiology and hygiene, but the results have not been as good as we had a right to expect. This has been owing to the character of many of the text-books in use, to the short time allotted to the study of physiology and hygiene in the schools, to the unsatisfactory education of the teachers in hygienic matters, to the undue teaching of anatomical details and the use of hard technical terms, and, finally, to the preponderance of so-called temperance teaching to the exclusion of other and weightier matters.

We can not coincide with the view of the distinguished editor of the "Sanitarian," as set forth in an editorial, June, 1877, that "with such a multiplicity of studies the teacher never (italics ours) goes beyond the text-book." But we do agree as to much that follows. He says: "The pupil learns that muscles are not bones, that the liver is a gland, and that the heart is a muscular organ, that the food in some way or other is turned into blood. Beyond this there lies a nebulous mass of learned names, barbarously pronounced and ignorantly applied, which the first contact with the world dissipates, as a summer sun does the mist of the morning. . . . The text-books. . . are mere table-books and catalogues of names, or else their familiar style is so gelatinous that the student is unconscious of swallowing anything. One author treats the subject from a chemical standpoint, another from an anatomical standpoint, while the third combines the two with an unprofitable result."

The following extracts from some of the books now in use in the schools indicate how anatomy, physiology, and hygiene are being taught in certain quarters, for there are many teachers who will not know anything in regard to any subject outside of the text-book used by them:

One book says in its preface: "Technical terms have been avoided, and only such facts of physiology developed as are necessary to the treatment of the effects of alcohol, tobacco, opium, and other truths of hygiene." A careful perusal of this book will show that the physiological facts developed have little or nothing to do with the treatment of the effects of alcohol, tobacco, etc. Much is said in the book as to what the effects are, but nothing as to the treatment of these effects. And why should there be? Such information should be confined to medical works. On one of the pages of this book is the following: "Children's bones have more gristle than those of older people; so children's bones bend easily. I know a lady who has one leg shorter than the other. This makes her lame, and she has to wear a boot with iron supports three or four inches high in order to walk at all. One day she told me how she became lame. 'I remember' she said, 'when I was between three and four years old, sitting one day in my high-chair at the table, and twisting one foot under the little step of the chair. The next morning I felt lame, but nobody could tell what was the matter. At last the doctors found out that the trouble all came from that twist. It had gone too far to be cured.'"

The writer of this account would have the reader believe that the hip-joint disease which the lady had, and which caused the shortening of three or four inches in one leg, resulted because there is more gristle in the bones of children than in those of adults, and because on one occasion a child between the ages of three and four years twisted its foot under the little step of a high-chair. This twisting, it is presumed, injured the gristle somewhere in the leg, and so caused deformity. How many little children are there who do not twist their feet under the little steps, as they sit in their high-chairs? In how few does hip-joint disease result. If a child runs the risk of such an affliction every time the foot is twisted under the little step, then the children of nowadays are puny folk. The truth is, such a result is rare, if it ever happens with a healthy child. Still, if a child can be taught to sit straight in its chair, with feet on a level and side by side, well and good. Most physicians, I take it, would be apt to say in regard to this reported case of deformity: "If such a result followed such a twisting, in all probability the child was not strong and healthy, but of a rachitic or rickety tendency. In such children the bones and ligaments are unusually soft and quite easily bend out of shape."

On another page of this book is a pretty picture of a mill, which the text tells us is a snuff-mill. The writer says that after entering the mill "the smell of the tobacco was so strong that I had to go to the door many times for a breath of pure air. I asked the man if it did not make him sick to work there. He said: 'It made me very sick for the first few weeks. Then I began to get used to it, and now I don't mind it.' " Then the writer adds: "He was like the boys who try to learn to smoke. It almost always make them sick at first; but they think it will be manly to keep on. At last they get used to it." Who will say that the average boy will not try to get used to tobacco after being told that he can do so if he will?

The book dwells, wherever there is a chance, upon the evils of alcoholic drinks, but gives, in all earnest, the following bill of fare as suitable for the dinner of a child: "Roast beef, potatoes, squash, bread, butter, salt, water, peaches, bananas, oranges, grapes," but no where is there any advice as to how much of these things should be eaten at one meal. Intemperate eating is considered a matter of small account.

In one place is the following saying: "A good cook has more to do with the health of the family than a good doctor." It might, perhaps, have been well for the writer to quote this saying if it said, "poor doctor" or "many a doctor." A good cook is surely a blessing, but there are good cooks and good cooks as the opinions of different families go, and, while food that has been cooked by a "good" cook may taste well, it may not digest well. Good doctors at the present time not only know what good cooking is, but are able to choose digestible food as well. The above motto is a fair specimen of the sayings which are recklessly put into text-books.

A second book in use states in its preface as one of the reasons why the book should appeal to teachers, "The adaptation of the text to oral instruction, the teacher's work being already arranged." The italics were used to emphasize the fact that the teacher's work has been made easy, and that no particular effort on his or her part will be necessary. This book, with about two hundred and twenty-five pages of text, devotes thirty-seven pages to bones, giving numbers and names in detail, while three and a half pages only are devoted to the subject of food, and twelve to digestion. The front and rear views of the normal skeleton depicted in the book are pictures of deformed skeletons, with lateral curvature of the spine and ill-shaped skulls. An accurate picture for a school-book is evidently not a matter of importance.

This book has pictured, as do other text-books, to magnify the evils of tight-lacing, the skeleton of a well-formed chest with an outline of the body and the skeleton of a contracted (corset-laced) chest with no such outline. The outline in the one case gives the appearance of much expansion, and the absence of it in the other exaggerates the contraction. This method of representation is considered by reliable artists as tricky, and was pointed out to me by an excellent lady teacher of physiology and hygiene, as an unfair way of showing the evil effects of tight-lacing.

A third book, intended for the use of primary schools, is made up of questions and answers; nothing left for the teacher to evolve, nothing for the pupil to imagine or solve. Both teacher and pupil are machines to grind out so much material in an allotted time. Five or more pages of this small book are devoted to bones, especially the location and number, but nothing is said as to what is necessary to keep bones in good condition.

The subject of alcohol is fully treated of, but intemperate eating, exercise, sleep, bathing, etc., are not even referred to. We doubt whether pupils who use this book could answer correctly if questions upon the various subjects were put to them in a different way from those they have been accustomed to.

A fourth book endeavors to teach the truths of anatomy, physiology, and hygiene in an allegory. The preface presumptuously compares the allegorical teaching of the book with the parables of Christ, and says: "If the great truths of Christianity could be taught in allegory, may not less difficult subjects in the same manner be made interesting and instructive." The preface further states that the authors have "shun abstruse and technical phraseology," have aimed "to give correct and scientific views in simple language with correct illustrations."

On looking over this book, we notice many poor pictures and the fact that a number of the pictures, though lettered, have nothing about them to indicate what the letters stand for. It is noticeable, also, that technical and abstruse terms are not infrequent, such, for example, as "perimysium," "quadrangular papillary clumps," "sebiparous glands," "germs of absorbent vesicles," etc. A third feature of this book are the attempts to be facetious. For the most part these attempts are ridiculous and out of place in a school text-book.

A fifth book, which has a large sale and is in the main excellent, has at times evidences of careless teaching; for example, "When milk produces an unpleasant effect upon the stomach, it should be mixed with a little lime-water." Italics are ours. In the list of antidotes for poison from fish-eating, appears the following: "Ether with a few drops of laudanum mixed with sugar and water may afterward be taken freely." Again italics are ours. In the use of mustard as an emetic not a word is said as to the importance of mixing it thoroughly with the water used, lest suspended in mass it may inflame or irritate the stomach.

We may judge somewhat of how a study is in general taught by the oral or written answers given by a number of pupils, in various schools, in reply to questions upon the study. About a year ago there appeared in the London "Architect" the following: "If instruction in sanitary matters is to be continued in schools it will be necessary to supplement the lessons with visits to some such place as the Parkes Museum of Hygiene, unless the school boards are satisfied if the children get hold of a lot of hard words, or rather of sounds resembling them. At present it is supposed that sanitary science may be taught as easily as morality. by listening to a teacher read from a book. The children fail to catch the words, or they attach no meaning to them. Here, for example, are verbatim copies of the exercises in one of the Greenwich schools:

"'Infections are brought on by bad smells, such as small-pox, measles, scarlet-fever, glass-pox, s. c., they are brought on by bad drainerges suers; they must be well ventalated. Infection disease are caught by touching such as charcoal, chloride of lime, etc. Measles, feaver are called disinfectionous because they are catching.—Fainted. If a person as fainted, take her out in the open air lay her down with her head. And do the clothing round the neck and dashed cold water the face and hand and put smelling salts to her nose. Degestion is paines in the head, paines in the stom-ach, bad tempers. From degestion comes consumption, information, head-ache, neuralgia.'

"These exercises may be thought amusing, but it should be borne in mind that every word represents more or less pain to some unhappy child, in endeavoring to recall ponderous words which were without meaning. Education in sanitary matters is desirable, but, as it is conducted at present in public schools, it must injure children's minds by habituating them to the use of words which they can not understand."

In the English official reports we read that "an examination of girls in board schools for prizes offered by the National Health Society, revealed some curious items of information. One reply to Mention any occupation considered injurious to health' was, 'Occupations which are injurious are carbolic acid gas, which is impure blood.' Another pupil said, 'A stone mason's work is injurious, because when he is chipping he breathes in all the chips, and then they are taken into the lungs.' A third says, 'A bootmaker's trade is very injurious, because the boot-makers press the boots against the thorax; and therefore it presses the thorax in, and it touches the heart; and if they do not die they are cripples for life.' With a beautiful decisiveness, one girl declares that 'all mechanical work is injurious to health.' A reply to a question about digestion runs, 'We should never eat fat because the food does not digest.' Another states that 'when food is swallowed it passes through the windpipe'; and that 'the chyle flows up the middle of the backbone and reaches the heart, where it meets the oxygen and is purified.' Another says, 'The work of the heart is to repair the different organs in about half a minute.' One little physiologist replies: 'We have an upper and a lower skin; the lower skin moves at its will, and the upper skin moves when we do.' One child ennumerates the organs of digestion as 'stomach utensils, liver, and spleen'"

In the clever little book compiled by Miss Le Row, entitled "English as She is Taught" appear the following genuine answers by pupils in reply to questions upon physiology and hygiene. Presumably most of these answers are from American pupils in American schools:

"Physillogigy is to study about your bones, stummick and vertebry." "When you have an illness it makes your health bad as well as having a disease." "The body is mostly composed of water and about one half is avaricious tissue." "The body has an infinite number of bones joined together by the joints." "The spinal column is made of bones running all over the body." "Digestion belongs to the lower animals." "Digestion is the circulation of blood." "Digestion is reducing our food to plump." "Digestion is when food is taken into the stomach." "The gastric juice keeps the bones from creaking." "The eyes are set in two sockets in a bone which turns up at the end and then becomes the nose." "The three coverings of the brain are the diameter, the perimeter and the trachea." "The growth of a tooth begins in the back of the mouth and extends to the stomach."

As an additional contribution to answers, we add the following, taken by the writer from the note-books of pupils of one of the high-schools of this country:

"Anatomy is dissecting of bodies generally lifeless." "Anatomy is study of parts of the body, physiology study of action of parts, hygiene is application of these parts" (italics are ours). "Kinds of bathing, adapted to the age, quantity, quality and health of the person." "Supernator are the muscles about the back." "The hygiene of a muscle should have proper rest and exercise." "Hygiene is the study of the time and manner of the action of the muscles and large blood-vessels." "The mouth is the commencement of the alimentary canal, and it extends through the throat, œsophagus into the stomach." "The extent of the mouth helps the digestion of food." "Nervous system a decided part of the body." "A young person who goes to parties and has great excitement has generally some brain trouble, such as St. Vitus dance." "It is far more reliable to drive out the fire of a room and put on extra clothing than it is to put on no clothing and sit in front of a burning fire." "Soap is important in carrying off the fat of the body." "What is eaten by the body has sometimes been taken as food." "The third cavity is the pelvis, which contains the vital organs." "In a diet of twenty-four hours a man should eat some of all the nutritious articles." "The first step in digestion is mastication and insalivation. Second, the muscles of the gullet." "A person is in fair health when he has the affinity to accommodate himself to change of climate and the ability to endure." "Respiration is the exchange of carbolic acid for oxygen." The substitution of carbolic for carbonic acid is frequently met with." The times for "bathing depend on the age of, location of and heat of the individual."

The bad spelling so frequently found in these note-books shows, of course, ignorance or carelessness, either being reprehensible. Œsophagus is spelled "esofergus" "ecophagus," "sasofagus," "esolpusgult," "sarcophagus," "desophagus." The pancreas is spoken of as "the pangueous," or "the pantheis"; the parotid or salivary glands as the "perodic," "the galviatory and savilary glands," "the spiratory glands." The cerebrum is "the big brain, or celebra"; the cerebellum, "the little brain, or sedula." Suture-joints are "sucher-" joints. Hygiene is "hygine" or "hygene." Adipose is "adicose"; sweat is "swett"; osseous is "oscius"; cancellous tissue is "tenselous"; thoracic duct is "carasse duck," and so on.

Enough illustrations have now been given of the ignorance and carelessness of pupils in regard to anatomical, physiological, and hygienic knowledge to warrant us in saying, when taken in connection with the character of some of the text-books in use, that in many schools these subjects are improperly taught. But it will be said by some: "The fact that such and such text-books are unreliable in pictures and text does not prove that the teachers using them are guided by the unreliable material, and also the fact of faulty and absurd answers by pupils does not prove that these very pupils do not have a very fair general idea of the subjects they were questioned upon." Our answer is, that until teaching becomes, with the majority of female teachers especially, something more than a mere makeshift till marriage looms up, very many teachers will be guided solely and absolutely by the book they are using, and as long as favoritism and cupidity prevail in school-book committees, books will be adopted by school boards which are unreliable, mere compilations, written by persons who in some instances have confessed their incompetency as authors.

In regard to the second assertion, the answer is, after an experience of over twelve years as a teacher, and after conversation with many excellent educators and the examination of many hundred note-books, the number of pupils who have correct views as to the truths of physiology and hygiene is comparatively small. Ask some of the boy and girl graduates of your schools why it is that a certain amount of carbonic-acid gas in a well, cellar, or cave may be injurious to human beings in contact with it, and not injurious to persons in a room or hall, or which is the most nutritious food, or what produces and maintains the animal heat of the body, and notice how few give even reasonable answers. Yet a goodly number of these girls will be the future teachers. Listen to the curious and absurd statements of what should and should not be used, eaten, worn, tasted, looked at, touched, etc., which are rehearsed by little children to their parents as coming from the primary teachers or the heads of primary departments, and then it will be perceived that the teaching of physiology and hygiene is not what we have a right to expect. What are the remedial measures?

1. Encourage the sale and use only of reliable text-books written by physicians or sanitarians who have had experience as teachers. The mere compiler will magnify the importance of what may be considered by comparison as the non-essentials, and will endeavor to perpetuate absurd and untruthful statements simply because they sound well.

2. Health boards, health societies, and sanitary associations have instructed by this time a goodly body of physicians in sanitary matters. These men and women may well be called upon to outline hygienic teaching, if not to be practical teachers themselves. In addition to instruction in normal and model schools by such special teachers, there should be a sanitary supervision of schools. The physicians appointed to do this work should look after the ventilation, lighting, and cleanliness of the school-buildings, the spread of contagious disease, the condition of wardrobes and closets, the vaccination of school-children, etc. In some cities the attempt is made to do this work through the health authorities, but it is unsatisfactory, as the physicians doing the work are, for the most part, political appointees, and not chosen for their knowledge of health matters. The work should be done by sanitary officers of boards of education. With proper teaching and proper sanitary supervision of the schools, hygienic subjects would be real to the pupil, and the value of hygienic knowledge would be so apparent that interest instead of apathy would be the rule. In 1873, at the annual meeting of the American Public Health Association, President White, of Cornell University, said: "First, as regards public schools, I would make provision for simple instruction in the elements of physiology and hygiene, either by the use of some short and plain text-book, or, what is still better, by lectures from some competent resident physician. I confess that I greatly prefer the latter method. Not only theory but experience leads me to prefer it. Were it not that we have made a great mistake in our systems of public instruction by severing our common-school instruction from advanced instruction, we should by this time have a body of teachers in our common schools abundantly able to lecture to the pupils without a text-book." It is now seventeen years since these words were uttered, and what do we find in regard to the teaching of physiology and hygiene? Just this, that the number of physicians who teach in the schools is very small, that the average teacher of these subjects on duty has her teaching warped by her hobbies in regard to food, air, or some other hygienic measure, that she does not seem to be able to distinguish between essentials and non-essentials, and is carried away, it may be, by the dress or alcohol question. It has been found by experience that something else than the ability to lecture is necessary in order to get children to have correct ideas of the subjects taught. The daily drill, the "line upon line and precept upon precept," the bringing of the pupil up to the level of the teacher by the teacher's coming down to the level of the pupil, are all necessary. It is probably because these were deficient that we are able to record the answers to questions in the earlier part of this article. It is not a question of how much such and such a child ought to comprehend, but how much does the child understand.

All honor to the teachers who do make the subjects they teach understood as well as interesting.

3. What to teach. The teaching should be reliable, interesting, practical, in order "to inculcate sound national views regarding the necessity of obedience to laws of health, to secure willing obedience to the enforcement of sanitary law, to correct social and personal habits which are constantly operating as causes of disease." If the evils of alcoholic drinks are to be portrayed, as they undoubtedly should be, let the teacher show the relation between intemperance, crime, and immorality, and how intemperance results from imitation, habit, disease, and poverty, rather than spend her time in endeavoring to detail the dire effects of alcohol upon every tissue of the body, and to picture upon the child's mind what a drunkard's stomach looks like, or what a hob-nail liver is. Let her not forget to teach about intemperance in eating, exercise, bathing, study, etc., and to have an eye upon the evil effects of opium and cocaine intemperance, which are not uncommon. Let her encourage self-control, mental, emotional, sexual, physical. Have her dwell on the advantages of "lend a hand" societies, rather than on prohibition measures. The teacher can show how "health is wealth," what are the advantages of a healthy home and surroundings, how disease tendencies can be overcome, what "filth diseases" are and how they can be averted, how economical and nutritious food can be obtained and how prepared for eating. "In the personal habits of pupils, in the ventilating and heating of school-buildings, in the location of wells, in the character of the out-building, in the construction of school-houses and laying out of the grounds, in a proper observance of the purity or impurity of the water-supply, in the enforcement of laws for preventing the spread of contagious and infectious diseases, and in many other things practical truths may be instilled into the minds of pupils, and impressions made that will never be effaced in after years." These are some of the subjects that should be taught, but in order to insure such teaching, the teachers, especially in the primary grades, should have some definite plan and instruction given them by competent and practical physicians. Were this done there would be less overloading of pupils with technical and unnecessary anatomical knowledge.

4. How to teach. Now that the study of psychology is fashionable we may hope, perhaps, for a better knowledge on the part of teachers of what is and is not necessary for healthy mental activity and development, what are rational methods of teaching; but as long as text-books are ground out, in questions and answers, just so long will memorizing be the rule for pupils, and the encouragement of observation and originality be the exception. Yet the child can be taught by practical methods and appliances about the admission of light and air to a room, simple tests for the purity of water, about filters, what soils obstruct drainage, why sewerage and drainage are necessary, what to do in accidents and emergencies, etc. The desire of the average child to observe and ask questions can be turned to good account instead of being stifled by rigid routine work. The energy born of observation and the intelligent application of what is learned by observing is healthful. As Herbert Spencer puts it, "Success in the world depends on energy rather than on information, and a policy which in cramming undermines energy, is self-defeating."

If the teaching of physiology and hygiene is to be of service in strengthening the growth and development of individuals and communities it is a matter of moment that these studies should be properly imparted.