VOL. II. No. 2.

I

School Surgery.

BY ALFRED CARPENTER, M.D. (LOND.), C.S.S. (CAMB.), Vice-President of the British Medical Association.

II.

It

AM frequently consulted as to the duty of the principal of a boarding-school when infectious disease has suddenly appeared among the boarders. To my mind, the duty is clear. The principal should immediately find out which of the children have been recently in contact with the case by sleeping in the same dormitory, or by being in the same class, or in any way in close contact with the sick child. Then find out who among this number have not previously had the disease in question. Put all these in quarantine immediately. Inform the parents of the affected child that the child is ill, and as soon as may be convenient he should give information to the parents or guardians of all the children that such a case has appeared in the school, and that the manager has taken the necessary precautions to prevent the extension of the disease. is a great mistake to keep this fact a secret from those most interested, and if the parents are made aware of the rule of the school when a child is first sent to it, they will be much more content and less suspicious than if they are kept in ignorance of the outbreak, whilst a serious responsibility is removed from the shoulders of the principal or manager, which responsibility he has no right to assume. If the cause for the introduction of the case can be proved to be by means of personal contact, the spread of the disease may be checked at once. If this is not a doubtful point it follows that in all probability there will be no extension beyond that which arises from the danger which those in quarantine may have fallen into. The quarantine must be kept up as long as may be necessary to clear the children from the suspicion of having contracted the disease. If the cause of the outbreak is in the school itself it must be removed, but to do this it becomes necessary to find out from where the cause proceeds. If cases continue to occur in a school in which the course above recommended has been adopted, there is always reason to suppose it may have a local origin. It will be only right to consult an expert as to its possible cause, and especially to get into communication with the Medical Officer of VOL. II.

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Health of the district in which the school is situated. Indeed, it is always right to inform this official of the outbreak immediately it arises, and to take his advice. upon it. It is certain that in the course of a short time this course will become a compulsory duty, and its neglect will involve severe penalties; and as such is sooner or later likely to be the law of the land, it will be best to get into the way of it, and do that from choice which will soon be one of necessity. There is no plan which will be more conducive to the interest of the schoolmaster than this action of the legislature. It will enable the master to know from whence the disease has been imported into his household, and to trace it backwards to its source, and by that means, give him a just ground for complaint against the author of his misfortune, if it has had an origin from without. I press this side of the question very. forcibly upon all who have infectious disease introduced among them; it will be of greater benefit to school managers and school proprietors than to any other class of persons, especially if the case is one of scarlet-fever or small-pox, for these cases do not crop up unless there has been contact with a preceding case of disease; they do not suddenly put in an appearance without connection with some preceding case, and isolation must be immediate to prevent further mischief. This isolation may be carried out by removing the patient to the top of the house and entirely shutting off immediate communication with the rest of the establishment, or, better still, by removing the child to a separate cottage, where there can be the most perfect quarantine. The greatest danger of infection from these cases is during the fever stage, when it is probable that the exhalations from the patients are themselves infectious and incapable of being disinfected with that certainty which can be carried out with the later debris, which is particulate in its character, and is usually wrapped up in some epithelial particles. It is necessary to freely disinfect the excreta which come from the patients immediately upon discharge. This is easily effected by receiving them into a vessel containing a strong solution of Persulphate of Iron (green copperas an ounce to the gallon), or into a bed of dried earth, such as an ordinary earth-closet supplies. It is not difficult to prevent the spread of infection during the convalescent stage, because the breath then ceases

E

in a great measure to be infectious, and our efforts may be directed to the disinfection of the debris and of the articles of clothing which have been worn by the patients as well as of the bedding which has been used. These may be completely purified by exposing them to a dry heat of 330°, or by plunging them into boiling water.

A scarlet-fever patient should have the body anointed daily with pure salad oil in which camphor has been dissolved in the proportion of one dram in two ounces of oil. If the case is one of small-pox it is better to use animal charcoal finely produced instead of camphor. If mixed in such proportions as will make a thin paste, and applied to the patches of eruption, it will prevent the pitting, and probably also prevent the fertility of the germs contained in the secretion of the pox, for I think it is now established on a perfectly sound foundation that these diseases are propagated by the dispersion of minute atoms of perverted protoplasm, which retain their vitality, and are capable of germinating in suitable soil so as to reproduce their kind. These vital germs are allied in character to the fungi on the one side and the algee on the other, and they require for their propagation some of the conditions which belong to both; light and ozone are antagonistic to their reproduction, and with free motion of the atmosphere, are the agents which are antagonistic to the maintenance of their vitality, and it is upon these agents that the principle of repression or stamping out infectious disease depends. Introduce light into the places which have been occupied by fever patients of any kind, ventilate freely with atmospheric air, and supply ozone as abundantly as possible, and it is quite certain that in a short time there need be no danger of the spread of infectious diseases among children or any other classes of persons.

Typhoid fever is much more amenable to repressive measures than either of the two former diseases. It is scarcely infective at all, except under very exceptional conditions. It is sometimes called enteric, sometimes gastric, low or continued fever. It is more often caused by a water supply contaminated by sewage than by any other means. Whenever a case arises in any school it is incumbent upon the managers to look to their source of supply, and inquire narrowly into the possibility of contamination from some one of the many causes which will now and then crop up in the best regulated establishment. Recurring cases must be traceable either to water or milk, or some other article of food, or to a want of sewer ventilation. It is due to these causes more certainly than to personal communication. In any case consult the medical officer of the district. Immediately disinfect the excreta of the patient. In all cases of infective disease remove all curtains, carpets, and every kind of cloth from the room which is occupied by the patient, for those articles absorb the materies morbi, and may give out again to somebody else, and the most perfect cleanliness of all persons who come in contact with the sick must be insisted upon. Daily fumigation of the sick room and of the house in which infectious disease exists should be carried out by burning some brown paper or woody matter and sprinkling carbolic acid with water in the form of spray. A very elegant way of fumigation, and a very efficient means for removing smell, is by burning some ground coffee upon live embers taken from a fire, and held in the

middle of the room upon an ordinary shovel—a few spoonfuls of coffee burnt in this manner give a very agreeable odour, and effectually remove all disagreeable smell in a very few minutes. There is one other important matter which it is well to notice. No attendant upon a sick person should ever take food in the sick person's room. It is running a risk, which it is the duty of the principal to prevent by providing that the nurse shall have a room for feeding in, which shall not be the one occupied by the patient. I must refer my readers to the chapters in the first volume of the PRACTICAL TEACHER on Health at School' for further information upon points more immediately connected with personal hygiene.

ON WOUNDS.

There are many dangers which naturally belong to school-boys, and which, if attended to at once, are not likely to lead to mischief, but which if neglected may lay the foundation for constitutional diseases, and often lead to the loss of limb, or even to life itself.

It is very common for children to bark themselves, as it were, in running, or in any kind of boisterous game; they fall down upon a gravel path or other rough ground, and produce simple abrasions of the skin, or a contused wound may be produced, or the cut may go deeper, and be really incised. In abrasions there is simply the removal of the cuticle; contusions have bruises which extend to a deeper part of the cutis, whilst in incised wounds these cuts are more or less deep, and more or less clean. Lacerated wounds are those in which the parts are more or less torn, and these, with the class of punctured wounds, are by far the most dangerous; and lastly, there is another dangerous kind consisting of poisoned wounds, which require to be considered each in detail.

(1) Abrasions. These require to be cleared from the dirt and gravel which they may contain, and they should then be preserved from contact with the external air as quickly as possible. The simplest way to treat these cases is to cover them up with a slip of lint soaked in Friar's balsam, or Compound Tincture of Benzoin, as it is styled in the Pharmacopedia.' The application produces a slight smarting, which soon goes off, and if the child's blood is in a moderately healthy state, it will heal rapidly. It is not well to bind up too lightly; only apply the lint so that it may be kept in situ.

(2) Contused Wounds. The same treatment is all that is required; it is not necessary to stay until all bleeding has ceased, but as soon as the place is properly cleansed, put on the Frair's balsam, and cover it up from the atmosphere, and allow the dressing to remain on for some days, unless the place should become hot and painful, in which case a poultice should be applied to soften the dressing, and the rules of treatment somewhat altered, as will be described in considering lacerated wounds.

(3) Incised Wounds. The treatment will depend very much upon their extent. The old custom of sewing up cuts of this kind is best when let alone, and not followed. There is seldom any requirement for such an operation. The wounds are frequently accompanied by serious hæmorrhages consequent upon an injury to an artery or a vein. The injury to an artery is a very serious contingency, and the services of a surgeon should be obtained as rapidly as possible. In the mean

time the hemorrhage must be arrested, by pressure applied in the right manner. Hæmorrhage from a vein. is at once stayed by the gentlest pressure; the blood is dark in colour, and flows in a continuous stream. Not so that from an artery; it comes out of the wound in jets, which correspond with the pulse, and has a bright scarlet colour. Hæmorrhage from a vein is easily restrained by the finger pressing gently on the wounded part; or if it be a large vein by a firm pressure or ligature applied below the wound; if the cut is upon one of the limbs it generally ceases in a very short time. The bleeding from an artery is continuous in spite of gentle pressure, and can only be stayed by a ligature tightly pressed upon the artery which supplies the limb, which must be applied above the wound between the latter and the heart. Suppose it is the artery in the wrist which is cut, the ligature must be applied tightly above the wound between it and the elbow, but if it is the vein, then gentle pressure upon the cut will be sufficient to arrest all flow in a few minutes. Sometimes it is necessary to make very steady and strong pressure upon a bleeding artery. This can be effected by tying a handkerchief tightly around the limb, using a cork as a means for obtaining due pressure directly upon the artery, and increasing the pressure by a stick which is inserted between the handkerchief and the limb on the opposite side to the wound, and twisted round so as to completely stay circulation through the artery, and which should be kept up until the surgeon arrives. (To be continued.)

Eminent Practical Teachers.

PESTALOZZI.

BY THE REV. CANON WARBURTON, M.A.,
Her Majesty's Inspector of Training Colleges for
Schoolmistresses.
II.

FROM the breaking up of the establishment at

Neuhof in 1780, eighteen years elapsed before Pestalozzi again attempted to keep a school.

His existence during that period was depressed, poverty-stricken, and at times almost precarious; but afforded him plenty of leisure for thinking out and maturing his ideas, and making them known to the world by his writings. He was the author of several works, but of these three only need be remembered, for it was by them that his reputation was gradually established, and Pestalozzi came to be recognised as the foremost educational thinker and reformer of his time. The names of these works are (1) 'The Evening Hours of a Hermit,' (2) 'Leonard and Gertrude,' and (3) How Gertrude Teaches her Children.' The last of these three will be spoken of in its place later on. The first, which appeared immediately after the collapse of the Neuhof School, was a short paper in the Ephemerides' of Iselin, wherein he states the results of his experience as a teacher, and his views of what education should be. It is neither more nor less than a series of aphorisms, disconnected in form, and altogether destitute of literary skill and arrangement, but bound together by close unity of thought, intention, and subject-matter. They are the fruits of his past experience and reflection, but they contain the seeds of all his future labours and achievements in the cause of education. The Ephemerides of 1780,'

so he writes some twenty years later at the zenith of his fame, 'bear witness that the dream of my desires is not more comprehensive now than it was when at that time I first sought to realize it.' The general tone and character of the Evening Hours' may be gathered from a few extracts :

'All mankind are by nature alike,-they have but one path to contentment,-the natural faculties of each are to be perfected into pure human wisdom.

'The faculties grow by exercise.

'The intellectual powers of children must not be urged on to remote distances before they have acquired strength by exercise in things near them.

"The circle of knowledge begins close round a man, and from thence stretches out concentrically.

'Real knowledge must take precedence of wordteaching.

'As the education for the closest relations comes before the education for more remote ones, so must education in the duties of family membership come before education in the duties of citizenship. But nearer than father or mother is God: the closest relation of mankind is their relation to Him.

'Faith in God is the confiding child-like feeling of mankind towards the paternal mind of the Supreme Being. This faith is not the result of cultivated wisdom, but an instinct of simplicity; a childlike and obedient mind is not the consequence of a finished education, but the early and first foundation of human culture. Out of the faith in God springs the hope of eternal life. Children of God must be immortal.

'Belief in God sanctifies and strengthens the tie between parents and children, between subjects and rulers; unbelief loosens all ties, annihilates all blessings.

'Sin is the source and consequence of unbelief; it is acting contrary to the inward witness of right and wrong, the loss of the childlike mind towards God.

"The loss of this childlike feeling of mankind towards God is the greatest misfortune of all the world; it renders all paternal education on the part of God impossible.

The restoration of this lost childlike feeling is the redemption of the lost children of God on earth.

'The Son of God, who by suffering and death has restored to mankind the lost feeling of filial love towards God, is the Redeemer of the world; He is the Sacrificed Priest of the Lord; His Mediator with sinful man. His doctrine is pure justice, educative national philosophy; the revelation of God the Father to the lost race of His children.'

'Each of these aphorisms,' says one of Pestalozzi's biographers, 'is a text for a discourse; indeed, Pestalozzi's whole life is a paraphrase in act of these texts. We must lay it to the account of human infirmity, if the realization of his grand anticipations turns out but miserably, nay, only too often stands in glaring contradiction with them. The plan of an inventive architect retains its value even if the architect himself lacks the skill to carry out the building according to the plan.'

Up to this time, and indeed after the publication of his Evening Hours,' Pestalozzi appears to have been unconscious of the possession of any literary ability. And even when destitution stared him in the face, and he was compelled to look about for the means of subsistence, it was at a friend's suggestion that he tried his hand at authorship. He composed five or six

stories, most of which have been long since forgotten, on the plan of Marmontel's 'Moral Tales;' but the last of these, to which he gave the title of Leonard and Gertrude,' was the foundation of all his future fame. It was written, as it were, in a vein of inspiration, and without effort. The story,' says he, 'flowed from my pen I know not how, and developed itself of its own accord, without my having any plot in my head, or even thinking of one. In a few weeks the book was there, without my knowing exactly how I had done it. I felt its value, but only as a man in his dreams feels the value of some piece of good fortune. I was hardly conscious that I was awake, and yet a new ray of hope began to dawn upon me when I thought that it might be possible in this walk to improve my pecuniary condition, and to make it

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sympathy by telling him the story of his wrongs. Iselin's opinion and his conduct,' Pestalozzi goes on to say, 'exceeded all my expectations. He said directly he saw the MS. of the work, "There is nothing like it of its kind, and the views which it advocates are an urgent necessity of our time. As for its defective orthography, that is a matter of minor importance and can soon be set to rights. I will arrange for the publication of the book, and see that you are fittingly remunerated." Pestalozzi received a louis d'or per sheet, and a louis d'or per sheet seemed like wealth to him in his then destitute condition. When the book appeared the impression produced by was extraordinary, extending far beyond the borders of Switzerland. The journals reviewed it, the almanacs quoted it; it was discussed in every

more supportable to my family.' A friend to whom he showed his MS. pronounced it interesting, but at the same time so insufferably incorrect in language and unpolished in style that it was out of the question to publish it, and suggested that it should be previously revised by some practised writer. With no more pretension than a child,' Pestalozzi handed over the MS. to the individual recommended, but, 'what was my astonishment,' says he, 'on receiving the revision! It was a regular piece of divinity student's work, which completely changed the real picture of peasant life, simply and artlessly portrayed by me from nature, into something full of formality and affectation, and made the country-folk at the inn speak a stiff, pedagogic language which did not leave a vestige of the peculiarity of my book.' In high dudgeon he betook himself to his former friend Iselin, the Recorder of Bâle, and timidly tried to gain his

society, and the Agricultural Association of Bern presented the author with their great gold medal of honour, accompanied with a letter of thanks. 'Pleased as I was with the medal,' he writes, 'and glad as I should have been to keep it, I was nevertheless compelled to part with it, and sold it at a goldsmith's for its value in money.'

The object of the book was, as Pestalozzi himself explains it, 'to bring about a better popular education, based upon the true condition of the people and their natural relations. It was my first word to the heart of the poor and destitute in the land. It was my first word to the heart of those who stand in God's stead to the poor and destitute of the land. It was my first word to the mothers of the land, and to the heart which God gave them, to be to theirs what no one on earth can be in their stead.'

The chief character in the story is Gertrude, the

wife of the easy-going nonentity Leonard, and the pillar of his house. Gertrude is the embodiment of Pestalozzi's ideal of the housewife and mother, and the way in which she brings up her children is the way in which he would have all children brought up. Her character and her influence are the lights of the picture which, on the whole, is a melancholy one, with the sombre background of a peasant community sunk in the deepest depravity.

It was in the endeavour to raise the labouring classes of his countrymen out of this condition by good elementary instruction, that Pestalozzi now recognised the work of his life. I desired nothing, and desire nothing else as the object of my life, but the welfare of the people, whom I love, and whom I feel to be miserable as few feel them to be miserable, having, with them, borne their sufferings as few have borne them.'

The friends who surrounded Pestalozzi seemed to have welcomed the success of his book chiefly as a proof that he would be able henceforward to earn his bread as a writer of fiction, ignoring altogether the purpose of the work, and the teachings of the experirience which had cost him so dear. But others at a distance showed a deeper insight: invitations reached him from Savoy, from Austria, and from Italy, to settle in those countries, and the offer of a high appointment was made to him by the Grand Duke of Tuscany. The warmest admirer of Pestalozzi will hardly regret that circumstances occurred to prevent his being placed in a position of official or pecuniary responsibility. Lavater, who knew, loved, and appreciated him, is re ported to have said one day to his wife, 'If I were a prince, I would consult your husband in everything that concerns the people and the improvement of their condition, but I would never trust him with a farthing of money.'

Of the other works of Pestalozzi published between 1780 and 1798 it is unnecessary to speak to English readers. During the whole of that period he was a philosopher and a theorist, but in 1798, the memorable epoch of the great French Revolution was to him, as to so many individuals and communities, the turningpoint of a career. The revolutionary armies of France overran Switzerland, sweeping away the existing form of government, and all the Swiss cantons were consolidated into 'one indivisible Republic,' under five directors, after the French model. Of these directors one, who was named Legrand, was a personal friend Pestalozzi, and offered him his choice of an employment under the new government. I will be a SCHOOLMASTER,' was his reply.

On the 9th of September, 1798, Stanz, in Unterwalden, on the Lake of Lucerne, was destroyed by the French, and the whole surrounding district laid waste with fire and sword; in consequence of which a multitude of fatherless and motherless children were left unsheltered and uncared-for in the devastated villages and farms. Legrand now called upon Pestalozzi to repair to the ruins of Stanz, and to create a home and an asylum for the orphans there.

Accompanied by a single woman-servant, he took up his abode in the great Ursuline convent, which was set apart for his use by the authorities, but in a condition quite unfit for the accommodation of a number of children. Gradually he gathered round him as many as eighty wastrels from four to ten years old, 'horribly neglected, infected with itch and scurvy, and swarming

with vermin;' their low-browed and inexpressive physiognomy and malign aspect affording a sure index of the mental darkness, the stubborn temper, the hopeless spirits, and the vicious habits on which the teacher would have to work. Not one in ten of them could say the alphabet. Such were the conditions of this 'educational experiment,'which Pestalozzi regarded as ‘a sort of feeler of the pulse of the science which he wanted to improve'

-a venturesome effort, indeed! 'A man with the use of his eyes would certainly not have ventured it; fortunately I was blind.' Pestalozzi gained much of his unrivalled knowledge of children's nature from the Stanz 'experiment,'which can hardly be called a failure, though it lasted less than a twelvemonth, and though his unsupported and unaided exertions in giving it a fair trial almost bought him to the brink of the grave. He was not only the teacher and trainer of those eighty children, but 'paymaster, man of all work, hospital-nurse, and almost housemaid, all at the same time; all the help,' says he, 'given them in their need, all the teaching they received, came from me; their food was mine, and their drink was mine. I slept in the midst of them; I was the last to go to bed at night, the first to rise in the morning.'

From this slavery he was emancipated just in time to save his life, by a change in the fortunes of war. The French army, hard pressed by the Austrians, fell back upon Stanz, and established a military hospital in the convent of the Ursulines. The scholars of Pestalozzi were dispersed, and he himself went up into the mountains, not so much to rest as to recruit his energies for fresh efforts.

EARING, perhaps, a more grotesque resemblance to the human countenance than either the gorilla or the chimpansee, the Orang-outan (Simia Satyrus) of Borneo and Sumatra, stands next upon our list. Of this animal there are two species, called by the natives Mias-kassar' and ' Mias-pappan' respectively. As the two animals, however, resemble each other closely, both in appearance and habits, a single description will suffice for both.

As regards the actual height of the body of the orang, accounts seem to vary to a very great extent. We read of orangs being slain which measured five, six, or even seven feet from the heel to the crown of the head, while other travellers state that these measurements are far in excess of the real dimensions of the animal. Mr. A. R. Wallace, the well-known naturalist, who devoted special attention to the animal during his visit to the Malay Archipelago, tells us that in no case has he known a mias to exceed four feet two inches in total height, and believes that this is the full limit to which the animal attains. It is cer