day by day during the year, but upon the amount of "stuffing" that can be done at the end of the term, and is one of the greatest of educational blunders. The teaching test is a careful diagnosis at frequent intervals for the purpose of discovering the disease in its incipiency, in order to apply the proper remedies and save the patient. The promotion examination is a blundering post-mortem to learn the cause of death.

The importance of an entrance examination of the acuity of vision has been referred to. The requirement should be presented to parents. If by them neglected, it may be made by teachers, or especially qualified persons, to whom this duty is assigned. Provide school principals with simple apparatus and necessary directions. No more than in the detection of color-blindness is the physician required unless there is found to exist defective vision or asthenopia. Little is needed except a card with standard test-type to be used at twenty feet and one of diamond-type for near vision. The correction of visual defect, not due to ocular disease, by the wearing of glasses during school-life, means increased ability to study and diminished liability to progressive myopia and astigmatism. Would it not be better to have the examinations made by an expert in ophthalmology? No doubt it would. Let us so advise parents. Whenever possible let the pupil bring a certificate that he is free from ocular disease and defect. But all cannot command the best of guides. Such examinations must be made at the schools, and to bring the expert there for such purpose, on account of the time and labor required, involves the payment of large salaries.

Because perfection is not at once attainable, shall not the existing order of things be improved? For the instruction of teachers in this work, the best thought in our profession will be everywhere given as freely as to hospitals and to the training-schools of the hospitals.

For those found by the school-examination to have diseased or defective eyes, a reëxamination by a competent physician should be secured. Why not refer those unable to pay for medical advice, having been found with defective eyes in the school-examination, to the free dispensaries of the larger cities? Why not let them go to opticians? Such questions we must answer, as matters pertaining to school hygiene are publicly discussed. They can be best answered from the results of experience. The examination in cases of defective vision due to refractive errors requires an amount of time out of all proportion to that needed for the routine treatment of the more common eye-cases presenting at a free clinic. It is accordingly impossible that this labor be performed to any great degree by the responsible chiefs of such clinics. It is hastily and imperfectly done, or else referred to students and "under studies" who are often more benefited by the experience fhan is the patient who must after all, in case glasses are prescribed, visit the optician. Such is the experience in Baltimore where clinics have been overcrowded since examination of the pupils' eyesight has been undertaken by the Educational Board.

Reference to opticians remains for a moment's consideration. To us this is like sending the sick to a wellstocked drug-store, there to find the remedy under the guidance of an affable clerk with well-cultivated commercial instincts. But in the city of Minneapolis, under a system of school inspection similar to that adopted in Baltimore, a large proportion of the defectives have resorted directly to the optician. Poor eyes, whether due to disease or refractive error, have been assumed always to mean glasses which a vendor can supply. A community so civilized as to establish educational standards for medical practitioners, nevertheless entrusts its wellbeing and in a measure the future usefulness and happi

ness of its children, to those who claim no knowledge of medicine, and this in a special department which involves minute study of the anatomy, physiology and pathology of the eye, its nerves and muscles, as well as a mathematical and technical training acquired by few physicians.

No doubt the facility with which elder people find magnifying glasses that are useful, as the accommodative power declines, fosters the delusion, that if optical appliances are needed for the young the optician can choose from his stock. The matter is, however, unworthy of serious debate. To practice medicine until certain requirements have been met is illegal. The imposition of glasses upon the eyes of children with whom no physiological requirement for their use can exist, is to practice medicine in one of its highest and most intricate branches. Correcting the blunders of such unlicensed and uneducated practitioners of ophthalmology, constitutes a large part of the work of every physician who treats diseases of the eye. The subject is well presented in the Review of Reviews for June, 1897, by Dr. Allport, Superintending Oculist of the public schools of Minneapolis.

At no previous time has the public, the reading and thinking people of this country, been so interested in educational problems and reforms as to-day. Magazines and popular journals teem with discussion. That the coming army of citizens, to be made from the graduates of our schools and colleges, may possess good eyes has engaged the attention of Educational Boards in Baltimore, Minneapolis, in Brookline, in Bridgeport in our State, and many other cities.

As deductions from the facts presented, the following recommendations are offered:

The modification of educational methods now in vogue so as to restrict and often to interrupt the use of the eyes, especially by young pupils, and the removal of

all incentives to periodical cramming, such as term or promotion examinations.

The appointment by Educational Boards of a qualified physician, whose duty it shall be to advise concerning the construction and lighting of school-houses, and in the selection of text-books with reference to type, paper, etc., to make provision for the examination of the eyes of children upon their admission, and to instruct teachers or school principals in the routine of such examination.

[President's Address at meeting of the New Haven County Medical Association at New Haven, Conn., October 21, 1897. For Resolutions concerning this subject see Proceedings, p. 30.]

PHYSICIAN, HEAL THYSELF.

W. H. DONALDSON, M. D.,

FAIRFIELD.

If an excuse is to be offered for the introduction of such an old subject, it is simply because the times demand it. The theme is of an ethical, rather than a therapeutical, nature, and is chosen because the present state of our fraternal relations seems to call loudly for a remonstrance.

A recent perusal of the Code of Ethics, brought out so vividly the rank violations of its tenets in our present-day practice, that this opportunity has been taken to bring before you an exhortation to halt and consider.

While our profession has been flushed with brilliant achievements in medicine and the glorious advances of surgery of the past decade or two, its ethics have been allowed to drift into the dim shadows of past memories. To such an extent is this true, that we are now awakening to a realized sense of neglect and forgetfulness, and find ourselves in a sad state of disorder, and our journals filled with the remonstrances of an outraged profession.

The daily press, as well as the scientific and popular periodicals, have entered into the discussion until the public at large are as well informed in many of its phases, as the profession itself. Medical men of high standing have contributed lengthy articles for the reading of the laity to such an extent that it may well be questioned whether they have not been prompted by mercenary rather than charitable or patriotic motives. The seductive temptation of public advertising in the disguise of such methods calls for decided condemnation on our part. We are living, and practicing, in strange times! The rapid multiplication of our numbers, out of proportion