Two other "catching" diseases cause city schools a great deal of trouble,--trachoma and pediculosis (head lice). There are probably no two diseases more quickly transmitted from one person to another. Almost before their presence is known, all children of a school or all persons of a group have contracted them. When at college twenty men of my fraternity discovered almost at the same time that they had an infectious eye trouble; yet we thought we were using different towels and otherwise taking sanitary precautions. Last summer a Vassar graduate took a party of tenement children for a country picnic. She returned with head lice that required constant attention for weeks. What then may we expect of children who live in homes where there is neither water, time, nor privacy for bathing, where one towel must serve a family of six, where mothers work for wages away from home and see their children only before seven and after six?
Unfortunately for thousands of children, many parents still believe these troubles will be outgrown. Last summer a fresh-air agency in New York City arranged for several hundred school girls to go to a certain camp for ten days each. The only condition was that the heads should be free from lice and nits (eggs). From the list furnished by school-teachers--girls supposed to have been cured by school nurses--not one in five was accepted. A baby two weeks old, brought to Caroline Rest, had already begun to suffer from this easily preventable scourge. Of 1219 children examined in Edinburgh, Scotland, 909, or 69 per cent, had some skin disease, and 60 per cent had sores due to head lice. Even when neglect has caused the loss of hair and ugly sores on the head, mothers deceive themselves into believing that some other cause is responsible.
Trachoma, if neglected, not only impairs the health of the eye, but may cause blindness. Tears carry the germs from the eye to the face, where they are taken up on handkerchiefs, towels, and fingers and infect other eyes. Of late, thanks to school nurses and physicians and hygiene instruction, American cities have found relatively little trachoma except among recent immigrants. So dangerous is the germ and so insidious its methods of propagation, that a physician should be summoned at once at the first sign of inflammation. Conjunctivitis is due to a germ, and will spread unless checked. Since the board of health of New York City has instituted the systematic examination of the eyes of the children in the public schools, it has found fully one third affected with some form of conjunctivitis. Many of these cases are out-and-out trachoma, others acute conjunctivitis, and a larger proportion are "mild trachoma." This last form of the disease is found to a great extent among children who have adenoids. The adenoids should be regarded as a predisposing factor rather than a direct cause. Therefore sore eyes are given as one of the indexes of adenoids. When we consider that adenoids are made up of lymphoid material, and that trachoma follicles are made up of the same sort of tissue, it is not surprising that the two conditions are found in the same child. The catarrhal inflammation produced by adenoids in the nasal mucous membrane travels up the lachrymal duct and thus infects the conjunctiva by contiguity.