of all the cases. About 1500 "truant or incorrigible," one-third of whom are in special schools, are enumerated, and 3000 “backward," one-tenth of whom are in special schools, are reported. The number of defectives thus listed aggregates about 5000, or approximately 3 per cent of the public elementary schools enrollment. The census is an under rather than an over estimate of the number of defective children in the city. If the same percentage obtains in parochial as in public schools, about 1500 more must be added, while many not attending school at all would also swell the total.

Such provision as has been made for the subnormal children is both crude and inadequate. The buildings are, as a rule, in poor condition and not well adapted for the work. While many of the teachers are doing admirable work, they have not, as a class, been specially trained nor selected for it. Separate institutions are needed for the permanent custody of the feeble-minded. A considerable proportion also of the truant and incorrigible class are of such a character, or have such home environment that they should be cared for in a parental school, and at least 100 additional special classes for the backward should be established. It is evident that the problem of the training of the defective child is a serious one. It is to be hoped that the report of the census by the Bureau of Health will arouse the public to an appreciation of its importance and result in adequate provision being made by the educational authorities.

At the conclusion of Dr. Cornman's address, Dr. Witmer introduced Mr. Otto T. Mallery, who read the following paper on:

Playgrounds as a Municipal Investment in Health, Character and the

Prevention of Crime'

There may be some misguided persons, of course not among the membership of the Academy, who are under the impression that play is something trivial, something incidental, something unimportant done between hours of work.

Such a person may be converted to the Gospel of Play by observing a small boy standing on his head. Every muscle is under orders. His attention is concentrated and his will issuing peremptory commands to all parts of the organism. The whole boy is very much alive, keen, alert. His head, both outside and inside, is undergoing quite as great a strain as though he were studying a book. A moment's wool gathering at his books is possible without serious mental prostration, but a moment's wool gathering with his feet above his head results in physical prostration of the most ignominious sort. Play is a great mind as well as muscle builder. Self-control under stress; loyalty, obedience and fair play in team games and a sense of subordination of the individual to the welfare of the team, are all not only ideals of the playground, but ideals of character as well.

If our misguided person needs to be reinforced by observation of the other sex, he will find an unconscious missionary of the Gospel of Play in a girl of six, seated upon a pile of builders' sand in the street. The little girl has found the sand plastic. She is molding the sand, impressing her character With acknowledgments to Mr. Joseph Lee.

upon it. Most of the things of the street-its filth, its standards, its diseases -impress their character upon her, whether she wishes it or not. Over the sand she is the commanding purpose, the arbiter of its shape. She is exercising her creative, her formative instinct. The child is making something, perhaps the first thing she has ever consciously made, and making things is an important part of being alive. Wherever children are gathered together, on the sands of the sea or the sands of the street, this universal creative instinct comes into action. Creation and recreation are closely allied.

The first commandment in the Gospel of Play is: "Thou shalt play with all thy mind and with all thy strength, and with thy neighbor as well as by thyself." This is implied in "Thou shalt love thy neighbor as thyself," for psychologists and experience alike tell us that in group play our social affections are first developed. So in many other directions the influence of play upon the normal growth of the character and health of a child is traceable. Play is as necessary to a child as light and air to a growing plant, and yet modern industrial conditions have deprived the majority of city children of the exercise of this universal instinct in its proper form. "In the planning of our cities the children have been left out," and as a result American municipalities have serious social problems to solve.

One hundred and seventy-seven American cities have opened supervised playgrounds, and the playground movement has gained its impetus upon the sound argument that playgrounds are a good municipal investment in health. character and prevention of crime.

Chicago has spent $11,000,000 upon a system of playgrounds which Theodore Roosevelt describes as "the greatest civic achievement of the age." Onetenth of the area of the city of Boston is devoted to parks, playgrounds and bathing beaches. The administration has undertaken the development of the children with the same care upon the physical as upon the educational side. New York demolished a block of tenements at a cost of nearly $2,000,000 and established a playground upon the site. Where once several murders were committed each week, now a thousand children are playing each day. New standards have been set up and the influence of the playground is felt throughout the neighborhood. Other smaller cities have made great strides towards an adequate playground system, which shall offer healthful organized activity to every child.

The influence of playgrounds upon civic health is obvious. The International Tuberculosis Conference has placed playgrounds as an important plank in its platform. Backward children are often found to be handicapped solely by lack of physical development. The increase of vitality gained upon the playground shows itself in increased efficiency in the school room. In Philadelphia it is estimated that 20 per cent of the school funds are spent upon children who are going over the same work for the second or third time. The cost of the repeater is great. The playground reduces the number and cost of the repeater.

When England underwent an industrial transformation at the end of the eighteenth century the population flocked to the towns and were herded in unsanitary and deteriorating congestion. No municipal care was undertaken.

According to the individualistic theory, the fittest would survive. The submerged tenth, however, had its origin. Breeding took place from lower and lower physical and moral levels. As a result, when the debilitated city dwellers marched upon the plain of South Africa, they dragged out the Boer War and threatened the fall of the British Empire. The same city congestion is an American problem to-day. Playgrounds provide a means of raising the average vitality of the community. Hospitals will always be necessary, but a playground opened to-day saves the opening of a hospital to-morrow. On the score of economy of money and industrial efficiency playgrounds are a good municipal investment.

The games of the street teach shrewdness and cunning. Every boy is for himself. There are no rules except to win at all costs. On the playground, under proper supervision, new standards are inculcated. In team games a boy learns to work for the welfare of the team, rather than for himself. It is a great step forward to fight as a member of the team for the honor of the neighborhood, rather than for oneself against every one else in the neighborhood. The ideals of the playground are fair play and self-government. The relation to the ideals of good citizenship is not difficult to see.

When a certain playground was first opened the bats and balls began to disappear, leaving that many less for use. Searching parties were formed and one by one recalcitrant offenders were rounded up and the bats and balls ferreted out. Now the community sense has so far developed that the bats and balls are guarded as community property with a greater vigor and success than transportation and lighting franchises are retained for the community's benefit by those who have lived longer in this world.

So much of a human being's character is formed in play that it is quite to be expected that much character is deformed, degraded and twisted and perverted where wholesome play is prevented. A boy is much like a boilerfull of restless energy which must find an outlet. The boy's safety valve is play, and much of what we call juvenile crime is merely play energy gone wrong. Give the boy the game to play, give him exciting feats to perform on the flying rings and trapeze and the juvenile court will be deserted for the public playground.

The boy in the street who throws most energy into knocking out a window or a policeman is the same boy who on the playground throws the most energy into knocking out a home run. The boy who most successfully steals a cabbage from the corner grocery is the same boy who most successfully steals a base in the ball game. The stolen cabbage is a test of wits and legs against the policeman, who in his capacity of catcher is apparently provided for that very purpose. The stolen base is a test of wits and legs, with no after effects on the runner or catcher in the juvenile court, reformatory or prison. The boy who leads the gang of hoodlums against the blue-coated symbol of the law is the same boy who, under other conditions, leads the playground to order and fair play. The personal force is the same. The difference lies in the direction of its application.

In a certain district in Chicago the number of cases in the juvenile court

decreased one-half after a playground had been established. Everywhere the testimony of judges, supervisors and social workers is to similar results.

The test of economy again holds good. A playground is cheaper than a jail. Play is more attractive than vice, and the prevention of crime by the provision of a preferable substitute is a demonstrably sane and practicable municipal investment.

When public opinion intelligently and forcibly demands, the funds are always forthcoming. The cost of an adequate playground system is a large item in the budget, and agitation must now concentrate upon this phase in order that the foundations may be laid for a robust motherhood and a vigorous citizenship for the next generation of city dwellers.

Dr. Witmer introduced Miss Ogilvie, head of the Social Service Department of the University Hospital, who said:

This hospital service is very new, so new as not to be known by many of the other hospitals in this city. It was started three years ago in the outpatient department of the Massachusetts General Hospital, and has become almost indispensable and so popular as to be established in at least fifteen of the large hospitals in the East. I do not know of any of the western hospitals, except one in Chicago, which has it.

We started the work in the University Hospital just eighteen months ago, as an experiment, and after twelve months we decided it was of sufficient account to be made a permanent department of the hospital. During the first twelve months we spent most of our energy in what was most important to us, the tuberculosis work. Nearly a third of our patients were cases of tuberculosis. We gave instruction in hygiene, arranged for home treatment where we could, and where it was possible and the cases were suitable we sent them to sanatoria or hospitals.

Another department of that work was securing proper employment for people who have tuberculosis. Just this morning I had a letter from a certain sanitarium asking if I could not send them a probationary nurse who might have tuberculosis in an incipient stage. They wrote that the nurse we sent three months ago had done such good work that they wanted another. While the work along this line seemed at times rather hopeless, we have accomplished a good deal.

We have a great many neurotic cases and a great many cases with the simple request that we cheer them up. Sometimes the doctor could find no reason for the symptoms they had. Only yesterday we had a case of hysteria at the office. We tried to give her some good cheer.

We have not really established that part of the work known as social therapeutics, in the way that Dr. Worcester is doing it in Massachusetts in the Emmanuel Church Movement, and yet I may say that we do a great deal of good right along the line of suggestion. It is of course impossible to state just how much good we have done, sitting in the office and giving advice to the people, instilling some hope into them and helping them along in the journey of life.

To me the most interesting part of the work is the "steering" or conducting patients through the dispensary, sent from other sources. Last year we

had only 366 cases altogether, but 131 of them were patients sent in by other agencies to be conducted through, with the request that we send a report back. A good many were children and came mostly from the University Settlement House, the Society for Organizing Charity and Dr. Witmer's Psychological Clinic. There were also some cases from the S. P. C. C. Perhaps you do not know, most of you, what it means to take a child so sent in, make a special case of him, and see that he gets the very best medical attention. I always try to see that the chief of a medical dispensary examines the child and gives the treatment. It is a little hard to get hold of the chief. He is always busy, but if possible I have Dr. Fussell see the child. We get his very expert diagnosis, treatment and advice, and we then take the child to the next dispensary, if necessary. For a long time doctors dealt with these cases with a feeling of hopelessness, because there was no one interested in them. Now that there are several persons interested in these cases, the doctor is willing to do his best, with the assurance that he will have intelligent co-operation, whereas before this bureau was established he had no means of knowing whether his orders would be carried out or not. If the patients were able to pay $25.00 for the advice of a specialist they could not be better attended to than they are at the dispensary.

Last year a boy was sent to us by Dr. Witmer. Like most of the cases he sends us, this boy was about twelve years old. We sent the boy through five dispensaries, four in one day. It took a good deal of work to see that he was examined first at one dispensary, and in the last he waited a little later and was seen. After he had been examined in five dispensaries, it was found in four of them that he had some positive defect or ailment, for which he received treatment.

This boy had quite a remarkable propensity for lying and stealing, and it is hardly necessary to say that his morals have improved to a great extent. As for this little girl Fannie, I cannot tell you how many dispensaries she has been through, but I went with her to many.

She has a sister (Rose) sixteen years old. From her attitude and the hopeless expression on her face you would think her a woman of 60 or 65, that she had a dozen diseases and had lost her last child. When she came into the dispensary people remarked about her, saying, "Who is that poor girl?" She had been through at least five dispensaries and is always talking about her ailments. I found her living in the rear of a squalid tenement house, with no open space excepting an alley about eighteen inches wide. Her family might have a little air, but they keep the windows almost hermetically sealed, and three, four or five people sleep in one room. They have three rooms, one above another.

We succeeded in enlisting the interest of the Jewish Young Women's Union, and one of their workers is now arranging to place this girl, if the consent of the parents can be obtained, in a country home for a term of years.

Unless we go into the homes, in most cases we do not accomplish much. When we are asked either by the patients or by the doctors to go into the home we go, sometimes co-operating with another agency. Only yesterday I secured groceries from another agency for a destitute family.