1921 Journal of the American Medical Association (JAMA)  
expresses the view that the expensive tuberculosis sana¬ toriums have not exerted so favorable an influence on the mortality from tuberculosis as was expected. The welfare stations for tuberculous patients he thinks have proved of greater value in that an influence has been brought to bear on the patients within the family circle. Likewise, he thinks that infant mortality can be better combated by giving the mother a correct understanding of how to care for her child than by erecting special
more » ... es for infants. But the best and most effective means of promoting the public health is by hygienic instruction in the schools. Attempts to have such hygienic instruction given by the school medical examiner have not proved successful. Hygienic instruction must, therefore, be turned over to the regular teachers. Such a plan presupposes good hygienic training of the teaching personnel. Setter therefore demands that not only the principals of the public schools but also the whole teaching force be required to pursue courses in hygiene. Teachers must present a more thorough knowledge of anat¬ omy and physiology than has been the case in the past. "Of every skilled workman," the writer says, "the demand is made that he must be familiar with the construction of the machine that he operates, but to teachers we turn over our childrenour most valuable possessions-without requiring that they shall be familiar with the human organism." It is well known today that the brain of a child is not an organism of such sim¬ ple construction as was formerly supposed, and that the mental powers of a pupil are to a great extent dependent on the character of his bodily constitution. Instruction in hygiene should be woven into the whole course of instruction. In the upper classes, special lessons in hygiene can be provided. In the case of the girls, hygienic instruction should be combined with instruction in domestic science, and it should take into account their future occupation as housewives and mothers. A New Type of Health Certificate Dr. Crzellitzer, the Berlin social hygienist, has presented to the Berlin Gesellschaft für öffentliche Gesundheitspflege a plan by which the birth certificate, the vaccination certificate, the individual health report of the infant welfare stations and the health report of the school medical examiner may be com¬ bined so as to constitute a single health certificate, which he thinks might follow the child not only from the time of his birth until he enters the continuation school, but, on his entrance into industrial life, might be handed on to the health insurance society (Krankenkasse) in which he is registered, in order that it might serve here, as in the schools, to secure a survey of all persons whose health is such as to require governmental control. From the time the child is 3 months old, at which age all Berlin children must be registered in the welfare station of the quarter in which they reside, the health certificate would remain in the hands of the officials of the walfare station. At the age of 6, when the child enters school, it would be handed over to the school. Thence it would be sent automatically to the vocational guidance bureau, whose function it is to give advice on the choice of one's life work, thence to the continuation school, and finally, to the health insurance society. The entries in the health certificate in regard to physical development, family history, diseases undergone, and the like, would give every physician attending the individual the desired scientific back¬ ground, and every physician called on to pass on disability claims would thus have just the material he needed in order to form an opinion in regard to diet, where the individual should spend vacations, adaptation to various trades and pro¬ fessions ; in fact, he would be in a position to give advice even on marriage. Health certificates, after the death of their holders, would be collected in a central bureau, where they would furnish most excellent material for the study of ques¬ tions pertaining to heredity.
doi:10.1001/jama.1921.02630160065022 fatcat:recnnjsm3fa6xmf7gna6wd35hi