board of health is a question that it is
impossible to decide without knowledge of local conditions. So far as
state and county organizations are concerned, it is clear that whatever
the boards of health may do, it will be necessary for state and county
superintendents of education to equip themselves with the machinery
above recommended. In cities it is quite clear that a board of
education should be responsible for all of the machinery suggested,
excepting the three divisions that have to do with work hitherto
considered as protection against transmissible diseases, namely,
inspection, examination, district visiting. In Cleveland these are
school duties. In New York they are duties of the health department.
Boston has school nurses and health department physicians. The state
law of Massachusetts provides that where health boards do not examine
school children, school boards may spend money for the purpose.

As to inspection for transmissible diseases, it seems quite clear that
health boards should not delegate their authority or responsibility to
any other body, for they alone are accountable to their communities for
protection against contagion. It is clear, too, that in the interest of
community health, departments of health are justified in pointing out
in advance of contagion those children most likely to become a menace.
Similar grounds of public interest justify the health boards in sending
nurses and physicians to the home as a means of getting things done.

Dr. Biggs feels that responsibility for the physical welfare of school
children will strengthen health work in all cities, and, given proper
interest on the part of school officials, should make possible
universal cooeperation in a constructive programme. On the other hand,
he believes that division of responsibility between school and health
boards will weaken both in their appeals for funds and for support of a
constructive programme. I have heard principals and superintendents
maintain also that the moral effect of a visit to the school by a
representative of the health board vested with powers of that board was
much greater than a visit by a representative of the school board. They
further allege that a physician coming from the outside is more apt to
see things that need correction and less apt to accept excuses than an
inspector who feels that he belongs to the same working group as the
school-teacher. Because the follow-up work in the homes incident