HE "sickly" child who, in the "good old days," had to be taken out of school, the

tuberculous and pre-tuberculous boy or girl, at one time admittedly destined to abbreviated schooling, ill health and an early grave-these are coming into their own, slowly but surely.

Among the 70,000 school children of Minneapolis there have been the usual alarming percentage who, through tuberculosis, have had to give up their education, at least temporarily, often permanently, who were physically handicapped for life, who in some instances did come to an early grave. To give these boys and girls their chance in life, the city's school and health authorities recently added to the community's anti-tuberculosis equipment the Lymanhurst school for tuberculous children. The Trudeau school for socalled pre-tuberculous children had already been in operation for nearly ten years. These two schools, together with the children departments of the Minnesota State Sanatorium and the Hennepin County (Glen Lake) Sanatorium, constitute the primary opportunities for combatting the White Plague among Minneapolis children.

The State Sanatorium and the Glen Lake Sanatorium are equipped to care for nearly 100 tuberculous children. In these places the children receive excellent sanatorium care, and when able physically, are permitted to attend school there.

The Trudeau School in Minneapolis is equipped to care for 96 children. Most of the children sent to this school are below par physically or give histories of definite exposure to tuberculosis, although they have no demonstrable tuberculosis. These children are given rest periods, nourishment, and an abundance of fresh air along with their regular school work.

The Lymanhurst School for tuberculous children provides care for children with demonstrable tuberculosis. It is equipped with the most modern instruments and apparatus used in detecting the disease as well as those used in the general and special methods of treatment. No provision is made, however, to care for the active, strictly hos

pital case in this school for more than a few weeks. If at the end of that time the children to not respond to treatment, they are transferred to one of the sanatoria. Surgical cases are accepted and are treated by the orthopedist until such time as they can be admitted to a sanatorium if sanatorium treatment is necessary. Otherwise they remain in the school under his care.

Tuberculosis being a germ disease is spread by its hosts. Therefore, its control depends to some extent, at least, upon locating and caring for the hosts. In Minneapolis the school physicians, nurses and teachers carefully observe the children for any manifestations of tuberculosis. To the list of names of children who show symptoms of tuberculosis, they add the names of those children who have been exposed to tuberculous relatives or friends. All of these children are requested to be examined. For such examinations, the nurses take the majority of the children to the special clinics for tuberculous children operated in connection with the Lymanhurst School, the General Hospital Dispensary or the University of Minnesota Dispensary.

In the examination of a large number of suspected tuberculous children many are found whose symptoms are not due to tuberculosis, but to some other condition. Such children are advised to have the non-tuberculous condition corrected and to return to their regular school. Again, there are many children who have recently lived with tuberculous relatives, and others who are below par physically, but in whom tuberculosis cannot be demonstrated. Such children are sent to the Trudeau School where they are given special care in an attempt to prevent the development of tuberculosis in their bodies.

There are still many other children who have demonstrable tuberculosis. The children in whom the disease is obviously of an active and progressive nature are immediately sent to one of the sanatoria. All others are sent to the Lymanhurst School for special study and care.

The consulting medical staff of the Ly

manhurst School consists of approximately twenty physicians representing various medical specialties. Each child is examined by all the specialists and the reports are recorded on one chart. After all examinations are complete, one may find on this record, in addition to x-ray and laboratory reports, the condition of the skin, eyes, nose, teeth, mouth, throat, lungs, heart, stomach and intestine, bones, joints, blood, lymph nodes, as well as general development, mental status, etc. In treating tuberculosis, it is a tremendous advantage to know the condition of the principal organs of the body besides those invaded by tubercle bacilli. If disease is found to exist in any of the other organs, its eradication will aid greatly in treating the tuberculous organs. For example, a high percentage of the children in the Lymanhurst School have been found to harbor infections in the mouth, teeth or throat. The poisons from these infections being absorbed into the blood stream unquestionably reduce their vitality. In many cases, rapid gains have been observed after the eradication of such foci of infection. In other cases, the skin specialist has observed signs of congenital syphilis, and further examination usually reveals the presence of this disease. Such cases generally show rapid improvement soon after anti-syphilitic treatment is instituted. One might cite a great many similar cases, all of which prove that, in the

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treatment of the tuberculous patient, the organs which the tuberculosis involves must not be treated alone, but the entire body must be taken into consideration and an attempt made to correct every condition that tends to reduce the patient's physical fitness.

The children who are advised to enter the Lymanhurst School are without fever or other cardinal symptoms of active tuberculosis. In the school, however, it is not uncommon for such symptoms to occur. The children who develop these symptoms are immediately made bed patients in a small observation ward in the school. The children whose symptoms prove to be due to tuberculous activity are sent to a sanatorium for treatment, while the others are later returned to their usual class work.

The children who attend the Lymanhurst School receive considerable special attention. Upon their arrival at the school building at 8.30 each morning they are given a small amount of hot cereal. At the noon hour they receive a well balanced meal, and before leaving the school in the afternoon, a small amount of cereal is served. Immediately after the noon meal each child rests an hour in bed before class work is resumed. The school day ends at 3.30 and the children then return to their homes for the night.

A considerable amount of time is spent in teaching the children the proper method of using the tooth brush. A brush is then