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10 In his opening address to the 1884 annual meeting of the American Public Health Association, Albert Gihon, newly elected as president of the association , observed that he was occasionally approached by parents who wanted to know why as each fall progressed into winter at least one of their children would lose his or her appetite, grow pale and fitful, and suffer recurrent headaches and general lassitude. Gihon explained that his response was always the same: he told the parents to visit the child’s school. Once they had done that, he declared, once they had “breathed the vitiated air it breathes, sat on the racking benches, in the blinding glare, [and] sniffed the latrines that even dogs shun,” they would no longer be mystified why the child “does not eat, why its face is wan, its shoulders rounded, its form bent, its gait peevish, and perverse; why it talks and walks in its sleep, sees ghosts, or does not sleep at all.”1 Gihon made his observation to encourage his audience to pay special attention to a report to be delivered later in the meeting by the association’s Committee on School Hygiene, appointed the previous year and charged with investigating sanitary conditions in the public schools of various US towns and cities.2 But his larger purpose was to galvanize support for organized public health activity aimed at improving the hygienic condition of the nation’s urban schools. While noting that school hygiene was only one of several sanitary concerns to be covered at the meeting, he contended that the preservation of the health of city schoolchildren was of such critical importance to the future health and welfare of the republic that it rightly could have been the sole subject of that year’s gathering. Indeed, Gihon warned, conditions within American schools, and especially within city schools, were so bad that a large proportion Going to School, Getting Sick Mass Education and the Construction of School Diseases Chapter 1 Going to School, Getting Sick 11 of schoolchildren were having their health irreparably damaged. Although conceding that the typical American school was much better than it had been early in the nineteenth century and acknowledging that since the Civil War many cities had constructed impressive stone or brick school buildings, he charged that too often these “stately schoolhouses are crowded beyond every sanitary propriety with hordes of feeble children” whose health was being destroyed, not only by confinement in airless and filthy schoolrooms but also by lack of exercise and a school-day schedule that stunted their growth and development. “Are not their undeveloped plastic bodies distorted on uncomfortable seats, at uncomfortable desks, their eyesight progressively deteriorated by glaring windows and poor type, their physiological necessities opposed by inflexible rules and protracted hours?” he asked.3 Gihon answered his own question, concluding that for far too many American children, especially urban children, gaining knowledge meant losing health; going to school meant getting sick. Although delivered as if revealing a problem that had as yet received little attention, Gihon’s charge that schools and schooling were destroying the health of American schoolchildren probably came as a surprise to very few members of his audience. For the charge was an old one. Since the creation of public schools in the early part of the nineteenth century, criticism of the sorry condition of American school buildings and their furnishings and concern over their ill effect on the health of schoolchildren had been repeatedly articulated, not only in the writings of such nationally prominent educators as William Alcott, Horace Mann, and Henry Barnard, but also in the annual reports of the local school committees who had direct responsibility for and knowledge of their communities’ schools. Common, too, had been the complaint that rigid and taxing methods of instruction, combined with too little opportunity for exercising the body, were making each successive generation of American children less vigorous and more prone to nervous disorders. Indeed, the allegation that schools and schooling posed potentially serious dangers to the health of children served as one of the major leitmotifs of the nineteenth-century American discourse on public education.4 More immediately, for at least a decade the potential health hazards of schools and schooling had also been the subject of a steadily increasing number of papers, talks, and addresses published in medical and sanitarian journals and delivered before state and local medical societies, civic reform associations , and the American Public Health Association itself...

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