INTRODUCTION TO SCHOOL HYGIENE

This text examines the institutionalization of norms for proper physical and mental status of Bulgarian school youth at the beginning of the 20th century. The analysis focuses on two interrelated issues: how certain cultural images of fit body and normal mind reasoned the introduction of professional (medico-pedagogical) roles in the Bulgarian secondary schools, and how such images prescribed “health selection” in the production of individual and collective identities.

Within the general historical and cultural framework of the period school held a priority place in the state politics of modernization. Bulgarian schools were regarded as the “mirror of the people’s soul” and their multifarious cultural function was defined as missionary. They had to provide not only general education but also civilian and moral training of the youth. In compliance with the state agenda schools were to compensate the deficits of other institutions and social agents. The state school politics of preserving and improving the health of the “young generation”, in turn, were legitimized with the medical ignorance of the family environment and the physical unfitness of youths entering the army, among other things.

During the period under review the common notion “school hygiene” was regularly used in state-official, expert and popular-scientific texts to signify the professional activities of school medical officers and teachers regarding the health-sanitary status of the educational system. School hygiene in Bulgaria may be defined as a hybrid institutional phenomenon situated in the interdisciplinary border zone of sanitary and medical services, anthropology, educational training, social, moral and national pedagogy. Their fusion resulted in multiple meanings of the “hygienic” which were complementary to the sanitary one. The sanitary-epidemiological tasks were of primary importance for the emerging institutional field of school hygiene in Bulgaria.

The practices of introducing basic sanitary rules in schools and the urgency of coping with school epidemics, however, will not be the subject matter of this article. It will focus on other, seemingly more marginal aspects of school social hygiene which were however not less representative for the professionalization of the medical knowledge on students’ health, and for a certain level of medicalization of the school teachers’ roles in this respect.

Methodologically, the text refers to the Foucauldian concepts of “anatomopolitics” and “biopolitics”. The former signifies a number of disciplinary technologies for differentiating, arranging and supervising individual bodies, while the latter indicates the technologies of regulation exercised by modern states over man as human species — such as birth control and statistically valid instruments for coping with global biological processes and threats, “bio-power” over life and death. In the terms of Foucault anatomo- and bio-politics are chronologically consecutive and strategically overlapping technologies, articulated one through the other from the lot centuries onwards. Two series of phenomena were thus formed: [body - organism - discipline - institutions], on the one hand, and [population - biological processes - regulatory mechanisms - state], on the other. Biomedicine provided the link between the individual body and the mass population, and produced considerable disciplinary and regulative effects. From the end of the 19th century onwards modern medicine was functioning increasingly as a form of public hygiene which was preoccupied with the prevention of collective normality and with the medicalization of the deviations from socio-moral norms. The medico-psychiatric discourse, especially since the 20th century, revealed a tendency of replacing “illness” as a form of organic or physiological pathology, with “abnormal” as a medicalized form of unhealthiness.

Our hypothesis is that it was at the beginning of the 20th century when the Bulgarian school started getting “medically disciplined” while the state presented initial claims for “etatisation of the biological”. The first institutional steps of school hygiene, which, in view of the small number of school physicians, would otherwise seem a negligible historiography problem, were invested with important discursive meanings. These referred to the will of the state to modernize its institutions by means of biomedical knowledge, as well as to consolidate the population in the professionally validated terms of folk-, nation-, and even race-building. School hygiene, in turn, served as a common denominator for utopian projects of a “bio-pedagogical” imagination and turned into a zone of socio-medical prophylactics.

Immediately after the political establishment of the modern Bulgarian state in 1878 the health-sanitary supervision over schoolchildren was assigned to the state medical officers at local level. The ministry, however, often acknowledged the weakness of the feedback, as regards the fulfillment of their obligation to watch over the health state of the students. The inclusion of school hygiene in the competence of the general sanitary authorities was claimed to be out-of date, ineffective and therefore discarded to a certain extent by countries such as France, Germany, Hungary, and Sweden, among others.

The fundaments of school hygiene as a special field within the educational system, with institutional agents of its own, were established in 1904. The role of the school physician, officially called “teacher-physician”, was introduced by the minister of education, Prof. Ivan Shishmanov, “for the present time only in high schools and vocational ones, and later on, in the rest of the schools”. In compliance with the 1904 “Law on National Education” the ministry adopted special “Rules on Teacher-Physicians and Lady Teacher-Physicians at the Secondary and Vocational Schools” that regulated the new expert position. The official name of the new institutional role was revealing in itself — it was “teacher-physician”, or “school physician”. Although the position could be occupied only by medical doctors, their professional and legal status was equalized to that of teachers. They had certain pedagogical obligations which will be made subject of further analysis in this article. All things considered, the name emphasized the strategic affiliation of medical services with the complex goals of Bulgarian education.

The 1904 Rules outlined several areas of the teacher-physician’s duties, namely: 1) in the field of school buildings, furniture and campus; 2) with regard to students; 3) relating to the functions of “teacher-supervisor”; and 4) competences derivative from his membership of the school administration. In the process of programme implementation school physicians had to monitor the “healthy condition” of schools and students, to make anthropological and ambulatory examinations, to give medical aid only in urgent cases and to poor students, to teach in hygiene and popular medicine, as well as to manage the school sanitary administration.

These large-scale activities were put into practice in the same year when the Rules were adopted. Twenty one teacher-physicians were appointed in all secondary schools and their number increased proportionally to the growing number of secondary schools.

With regard to primary schools, the institutional activities in the field of hygiene and medicine remained very limited during the pre-war period. In general, the education laws repeated the requirement that the health-sanitary inspection in the villages and in towns having less than 1000 pupils should be performed by representatives of the respective local sanitary authorities. In towns with more than 1000 pupils the health-sanitary control was legally assigned to special school physicians. In this case, however, the state delegated the discretion of their appointment to the municipalities. During the pre-war period this legal instruction to municipal authorities remained to a great extent an unimplemented project. By reason of financial difficulties there were no school medical officers in charge of elementary and junior high schools.

In general, the performance of the healthcare and hygiene policy in the primary educational system was officially assessed as rather unsatisfactory. The local medical officers inspected schools mainly during epidemics. As minister of education Ivan Shishmanov declared with bitterness that the “institute of teacher-physicians serves the middle class children rather than those of the poor classes”.

The institutional birth of school hygiene in the secondary school system was accompanied by the issuance of a special journal with the same name. “School Hygiene” was an official edition of the Ministry of National Education which was aimed at popularizing the tasks and practices of teacher-physicians. Therefore, the official discourse on the newborn school discipline could be represented to a great extent via a reconstruction of the texts published in the ministry periodical during the period of its existence (1905-1908).

A number of publications legitimized the new medico-pedagogical figure. It was presented by state officials and experts as an indisputable cultural achievement that has reached its optimal development in Europe. Hence, the institutional benefits of its practical adoption in Bulgaria were regarded simply a matter of time. Even among the critics of the official policy of school hygiene the role of teacher-physicians was welcomed as an ideal that has been cherished for years, as a very expedient idea and an undertaking that should be supported in general.

The programme article in the journal’s pilot issue in 1905 was written by Dr. Velichko Georgiev (1872-1924), Chief Medical Inspector on School Hygiene and Medical-Hygienic Education in the Secondary Schools at the Ministry of National Education. The text offered a comparative review of the organization of the school medical service in different states as an inspiration of the Bulgarian institutional acquisition. Furthermore, minister Shismanov noted with the undisguised pride of a statesman that “what is a dream for much more civilized countries than ours has become a reality in Bulgaria”. This strategy of legitimization through references to imported cultural models, however, was not indisputable in the expert debate on the institutional logic of school hygiene. For it was well known that many undertakings borrowed from foreign countries, when being applied in ours, came across many obstacles and failed to produce any results. The arguments pro et contra the legislative regulation of teacher-physicians developed into a discussion over the adaptive capacity of the “interior” Bulgarian models of institutional life and regarding the foreign, “external”, models of publicity.

The apologetic rhetoric of endorsement and it’s opposite, the skeptic one, confronted on a broader “front” than this of school hygiene. Thus the evaluation of the institutional adequacy of the teacher-physician’s role became part of the critiques on the negative effects of the modernization processes in Bulgaria. Next, it got involved into a central debate — that on the “phoney” Bulgarian cultural identity in the “wonderland” of modernity.

Some statements in the press could be read as a more radical version of the rhetoric of “mistaken civilised countries” argument. The need of sanitary-hygienic supervision in the schools was so obvious, that there was no need to prove it. It was important that the fundaments of something useful were laid and that from a completely Bulgarian viewpoint that should be long lasting. The reasonable claim for practical relevance of any institutional form was on the other hand mixed with a suspicion towards cultural “otherness”. Its alleged falseness was experienced as threatening the superiority of the “immanent” national needs. Thus the ignorance of the Bulgarians regarding social hygiene along with the declared need to rectify the defects of what was considered unhygienic and anti-hygienic provided the basic reasons for the institutional mission of teacher-physicians and traced the agenda of school hygiene.

Hygiene in its basic sanitary meaning was promoted in the medical press as one of the most obvious and urgent prime causes for the introduction of the new institutional role. Under the 1904 Rules the sanitary inspection was pointed out in the first place when defining the scope of school physicians’ competences. The advisable “cleanness” was not reflected; it met the eyes of the observer in its physical objectiveness and self-evidence. But precisely the taken for granted meaning of the hygienic became problematic in the aspirations of the “medical perception” — articles in the press attacked the official concept of hygiene as unprofessional and superficial on one more ground, the “narrowness” of its usage. In support of this hygienic theory its proponent addressed the medical assumptions of the so called constitutional infirmities as fundamental for the understanding of both the limits of hygiene and its mission. This image of a preventive technology with corrective functions within the frames of body “constitution” marked a transition of the “hygienic” in schools from a “simplistic” sanitary project towards a professionalized version of social hygiene and preventive medicine.

Medicine in its therapeutic mode was not welcomed in school. School physicians carried out examinations, but students who were found “more seriously ill” were not to be cured, unless they couldn’t afford paid medical treatment by general practitioners. The rest should be sent to their parents at home with a notification on the character of their suffering.

Thus “being hygienic” appeared to be not so “one-sided” in the usages of the state official discourse, as some of the critics argued. The model foreign history of school hygiene revealed, according to Chief Medical Inspector Georgiev, a gradual shift in the competences of school physicians: when the initial call for coping with the unhygienic state of schools had accomplished its mission to a certain extent, the efforts were directed to the improvement of students’ physical and mental state. And as a further step the “institute of school physicians should be based on principles that not only prevent the deterioration of students’ health, but also create them as a sound and powerful generation with strong hygienic and medical knowledge, worthy of a better destiny in life”. The trajectory of hygienic expansion from material cleanness to medicalized versions of social purity reached the peak of a bio-political imperative. It was articulated with a nationalistic pathos: hygiene in school was “for the welfare of our people”. If the “main interest of a nation is to provide healthy offspring and healthy generations, who will continue the deed of their fathers”, then the “Ministry of National Education is directly interested in the maintenance of the future generation”.

Referring to health-sanitary reports, the official discourse of the Ministry ascertained that many of the district physicians were “taken aback” during their school inspections by the “weak, handicap and degenerated students” who were “called upon to carry on their shoulders the future of society”, that was to fulfill the “supreme historical tasks of the Bulgarian people at the Balkan Peninsula”. Fighting degeneration, therefore, was a concern over the heredity of future generations who were expected to “inherit the supreme goals” of ethno-national consolidation.

It was during that period when the Bulgarian public debate on childhood and youth intensified due to a large number of statistical and expert publications on children’s high mortality and morbidity rates (compared to those of the “civilised European countries”) and on the basis of data proving medical unfitness for military service. Not only were primary schools reported being in an “awful anti-hygienic sanitary state”. The teacher-physicians in the secondary schools declared that they had to exercise their duties under miserable conditions. The work was much and the doctors were few; special cabinets and instruments were often unavailable. The press and the annual sanitary reports of the school doctors that were submitted to the Ministry of National Education drew scientific conclusions and their political implications were put on the agenda of the public debate.

The role of teacher-physicians on the stage of physical and mental hygiene had to guarantee the state administration of generational health — to contribute to the discipline of individual bodies and to the regeneration of the collective social/national body. The models of biological health and physical training served the implied moral image of the youth’s collective which was projected as a military corpus. With the help of biomedicine and the agency of school, youth was expected to gain back the “genuine” wholeness of the “torn” body of the ethnic collective, to “rebuild” its utopian Balkan integrity.

Therefore, the “stigmata of degeneration”, which the discourse on students’ health ascertained, “threatened” even more the humanistic trouble which left the “pure” empirical field of bio-medical knowledge and entered the area of bio-(pedagogical) politics. The latter was inspired by the belief that physical weakness might “weaken our chances in an eventual war for defense of the Fatherland”. The goals of nation-building shared by the school policy required energy, and that should be kept concentrated and built up.

In order to answer the widely-spread warning that the “students in our schools as a whole are pale, skinny, feeble and subject to frequent serious illnesses”, the 1904 Rules required from teacher-physicians to carry out anthropological examinations and measurements at the beginning and at the end of the school year. The list of examined characteristics included — circumference of the head, height, weight, capacity of the chest, strength of arms, eyesight, hearing, condition of teeth, and colour of the skin, eyes and hair. The collected data on all registered “anomalies and illnesses” had to be registered in a “special health book” of each student, a sample of which was published as an Annex to the 1904 Rules. These health records were meant to provide a uniform standard of health surveillance.

The establishment of physical norms presumed the combination of individualizing and statistical approaches, which developed into practices and debates over the so called “anthropology of the Bulgarians”. The most representative example of a mass anthropological investigation of students from the primary and secondary schools was the one carried out at the end of the century by the Bulgarian pediatrician and anthropologist Prof. Stefan Vatev (1866-1946). During his specialization in Germany, Vatev had adopted the anthropological methods of Rudolf Virchow and Felix von Luschan. Thus data on the colour of the skin, hair and eyes of 225 000 students in the whole country was gathered, including also examinations of schoolchildren from the European territory of Turkey, which was an indication of the ethnic presumptions and aspirations of the research itself.

The study was initiated by a non-governmental organization called Bulgarian Homeland Committee. Special instructions and tables were printed by the Committee and circulated by the Ministry of National Education to schools where teachers performed the measurements. The published results raised critiques regarding the racial aspirations of the survey. Prof. Stefan Yurinich from the "Department of Comparative Anatomy and Zoology" at Sofia University argued that children were not a stable anthropological type; hence, their examinations could not serve as a reliable source of data for defining the characteristics of the “Bulgarian race”. During the ongoing disputes Vatev stated that he had not made “even probable conclusions about the Bulgarian race” — first, because he did not want to evoke needless criticism; and second, by reason of his positivistic argumentation in favor of the exact anthropological science. Although Vatev considered his own studies a neutral contribution to the pure empirical knowledge, he did not discount the possibility of its further usage for pro-racial generalizations.

In general, such ideas and investigations did not face the confrontation of the state. The opinion of inspector Georgiev stated in 1906, that the anthropometrical measurements aimed to provide evidence on the physical development of students, instead of to burden the teacher-physicians with scientific anthropological tasks. The Circular declared that the medico-anthropological observations had a double aim — first of all, they were of scientific interest and could be used to study the growth and development of our race; their practical relevance to the healthy condition of students was outlined in the second place.

In the period before the WWI racial concepts appeared with growing frequency in expert and media discourses. “Race”, however, had rather fluid definitions, which did not turn it into a subject matter of overall theories and state ideological politics. In texts relevant to school hygiene the Bulgarian “race” could be identified as a version of the “native”, “indigenous”, the latter being articulated as a synonym of “people”, “folk”, “nation”, or “nationality”.

In line with this, V. Georgiev defined the urgency of keeping school health books in which to register the illnesses that have “degenerated the organism”. Furthermore, Georgiev argued that such health books must exist from a child’s birth and be in use after finishing school “further in life” and even after the person’s death, to “shed light on the health conditions of his offspring”. The accumulation of data provided by the health records of several generations was expected to contribute to the medical knowledge on hereditary diseases. Thus the links in the chain of heredity “tightened up” the institutional links in the disciplinarian continuum which had to embrace the whole life of individuals. By spreading backwards — to the ancestors, and forward — to the inheritors, the hereditary traits were to construct the collective body of the community.

In respect to the hereditary eye diseases, for example, the ophthalmologist Prof. Konstantin Pashev (1873-1961) regarded school as a “fertile ground for hygienic propaganda”. As early as in 1905 he recommended that blind people and those having eye defects, such as shortsightedness and especially high myopia, should not marry. Along with this, Pashev pointed out the importance of the “material and mental condition of the tribe” for the state of eye health in the country. A curious example of the influence, which the theories on heredity exerted at institutional level, represented the instructions on the methods for collecting data about stammering and other speech defects of schoolchildren. The instructions were sent by the Ministry of National Education to the directors and the teacher-physicians of all high schools and the pedagogical ones in 1909. The directions emphasized on the hereditary origin of this suffering and added that “in relation to this certain family peculiarities are significant, for instance: father-alcoholic, ex-prisoner often goes to law, cruel money-lender takes part in elections, etc”. The key concept of “predisposition” implied that not only concrete illnesses could be inherited, but a general common inclination towards getting ill. Moreover, hereditary diseases were believed to be subject of possible transformations into moral vices and even into crimes of future generations or vice versa — vices and crimes might be “inherited” as diseases. Thus entire vicious-criminal-ill clans could originate.

According to the instructions of the education Ministry school physicians were called upon exercising “constant and competent supervision” not only over the physical state of schoolchildren, but over their “high spirits” as well. Doctors should counteract students’ nervousness which was regarded as a high price of their intellectual advancement.

The issue of “abnormal children” was discussed by the “School Hygiene” journal as socially significant, though still “untouched either theoretically or practically”. In a review of an article written by Alfred Binet (1857-1911), it was commented on the author’s definition of the “abnormal” person, precisely “any subject who clearly deviates from the average type and represents undoubted pathological anomaly”. For the purposes of school hygiene abnormal students were specified as those who were not able to take advantage of the “ordinary methods of training and education”. In an addition to this criterion V. Georgiev pointed out that such children were often bullies and broke the school-rules. The author differentiated between “poor students” by reason of “pedagogical” reasons — most often meaning the social and/or economical incapacity of parents — and, by reason of “pathological disorders”, who were the “abnormal” ones per se. In the classification of V. Georgiev, however, the line between both groups was not that clear-cut. In an article called “Mentally Abnormal Students”, he examined the group of “seemingly talented” schoolchildren with “perverse impulses”, including “thieves, liars, masturbators, pederasts, fire raisers, murderers, poisoners, etc”. Furthermore, mental hygiene had to address also pupils like those and not only “physically or mentally underdeveloped or handicap children shall be exempted temporarily or for life from the obligatory primary education; this fact being subject of proof before the inspectorate via a certificate from the school trustees based on a medical certificate that shall be issued free of charge”.

In order to cope with both the obvious pathologies and the marginal cases of mental unhealthiness, teachers and teacher-physicians had to integrate medical and pedagogical surveillance together. Thus in 1905 the Chief Medical Inspector recommended that school doctors should visit the homes of students with poor marks or poor behaviour, and seek the reasons for these from a “medical point of view”. The success of the newly founded school medical service at the Military Cadet School and at the Seminary was judged by the higher school marks of their students”. In discussions over the contents of the health books medical experts promoted the idea to record the students’ marks and data on their behaviour in separate columns of the books; in this way the medical intervention would “mark” its inscription into the technological register of pedagogy”.

Under the framework of the discourse on school hygiene in Bulgaria, teachers and teacher-physicians reported on the large spread of onanism among school youth and warned against its harmful effects. The alarm was based on statistical data according to which the percentage of the masturbating students varied between 80 and 100 per cent. Petar Nedevski, who was a teacher- physician at the male high school in Gabrovo presented statistical data on the masturbation among the students of the same school. In support of his conclusions he referred to analogical data collected by his colleagues at the male schools in Varna, Shumen and Sofia, as well to the opinion of Dr. Chavov, senior medical officer at the Alexandrovska Hospital in Sofia. The school institutional agents, therefore, prescribed “moral treatment” — i.e., elimination of the medical ignorance regarding the disastrous results of masturbation, as well as compensation of the malign influence of the inadequate social environment, especially the family one.

Thus school hygiene acted as a moralizing discourse which was endorsed and sanctioned by the medical science and the agents of school surveillance. It was not by incident that the big campaign against masturbation in France and in Germany at the second half of the 19th century coincided with the claims for state-controlled education. In the case of Bulgaria the school fighting against onanism provided additional arguments in favour of the medical supervision (having specific disciplinarian and “pedagogical” effects in the educational system). Thus stabilized, the expert medical power, in turn, supported the state imperative for regulation of the population.

What linked the “symptoms” of neurasthenia, masturbation, laziness, poor marks, etc., was “fatigue”, which marked a deficit of productive energy. The above-described issues of school mental hygiene were part of the debates on the so-called “school diseases” and vices meaning those which were characteristic of the school life or caused by it. Similar to European debates, the “over-pressure” and mental fatigue of students was a regular topic of the Bulgarian medico-pedagogical discussions. The professional criticism derived from an overall “political economy” of the individual and collective body: mental over-fatigue dissipated neural energy and what was more important, it weakened the whole organism.

The issue about opening special schools for mentally defective children was raised before the commission that was assigned by the ninth congress of the Bulgarian Teachers’ Union with the task to elaborate a new school curriculum for the primary schools. The commission reasoned its refusal to provide a final decision with the missing data on the level of mental development of the children entering school as well as on the changes of this development in the course of school life. Moreover, it stated that “there are no data on the average mental power of the Bulgarian child” and without it the “selection and allocation of students would be unfounded”. The commission’s refusal to make a decision, however, was not equal to a rejection of the initiative itself — recommendation was made to the Teachers’ Union to inquire into the matter. Still, the unimplemented project remained open.

The introduction of the physician as a medical expert and teacher in the system of the Bulgarian secondary schools marked a level of professionalization of school physical and mental hygiene. Under the framework of the ongoing institutional modernization teacher-physicians, assisted by regular teachers and pedagogues carried out health prevention on different levels. The role of the school doctor mediated the rhetorical and practical usages of the medical discourse that was patronized by the state for the purpose of constructing a healthy “social organism”. School hygiene itself was involved into the project for consolidation and restoration to health of the collective “national organism” by means of control and prophylactics of the “school youth”. Cultural images of social and moral irregularity “populated” the institutional environment of the school, thus providing for medicalized images of physical and mental, individual and collective health. The metaphor of the “degenerating people’s organism” corresponded to the metaphor of its regeneration by the youth — brought up by the political will of the state with the disciplinary cooperation of the school and the instruments of medicine. Thus a resource for the nationalistic rhetoric was accumulated.

This discursive potential, however, remained to a certain extent latent in the first two decades of the century. The limited social effect of school bio-politics was due to a number of reasons. Firstly, the financial and expert resource which the education ministry had at its disposal in the processes of medicalization of the “school nation” was insufficient. Secondly, the need for providing a health-sanitary minimum in schools in order to cope with mass epidemics preoccupied the efforts of the authorities; it was still too early for more radical and practically effective forms of bio-politics. And yet, the symbolic and institutional register of school hygiene, as a hybridization of medicine, education and state power, was set at the beginning of the 20th century. Its more intensified usages and misusages were forthcoming at the eve of the World War.

Addendum: The presentation on the theme of school hygiene is a ledger — that means, no isolated subject matter could be rendered without linking it to commensurate themes. For example, school hygiene in Bulgaria as a meta-analysis should consider in its reference list also topics from the fields of basic hygiene, child demography, physical anthropology of the child, mother and child welfare, etc. which in their logical association will give a more comprehensive picture on the debate at hand. Thus the review material procuring this addendum, which in its essence has been a CAS study from the international literature, could as well benefit from including a wider reference canvas than simply the subject of school legislation in its rudiment, reported from Dr. Velichko Georgiev on the pages of the journal "School Hygiene" (1905-1908).

As good as this and not considering to write another essay on child and school hygiene, we should advance a step further with giving some additional titles that will enhance the presentation — altogether, good for the scanty dimensions of literature in English language on Bulgarian topics in general. Here is what our research have admonished mostly from private sources:

1) Basic Hygiene — should include mainly the writings of Prof. T. Petrov, which in themselves numerous but have always a separate chapter on school hygiene. The doyen of hygienic science in Bulgaria did also separate studies on body typology in children (colour of the skin, eyes and hair), published in the periodical literature of the time;

2) Child Demography — besides the various indices presented in semi-bound textbooks from Bulgarian demographers in the first half of the 20th century (G. Danailov, D. Mishaykov, Z. Chankov, etc.), we recommend for the agenda a firstly published and mostly unknown book. Nikola Hristov's "Procreation Policy of Bulgaria" (1914) was published right before the years of WWI; sadly, it remained largely unreported in time despite its bulk volume of 328 pages and staunch neo-Malthusian philosophy;

3) Physical Anthropology of School Children — again this is another underreported study from Dr. M. Mihailov, published on the pages of "Periodical Journal of Bulgarian Literary Society /vol. LXIII, fasc. 1/, 1908, 82 pp". Mihailov's paper is the first published report on the subject, with data on 3620 pupils from primary schools in Sofia-city. Measurements are made on height, weight, head and chest circumferences. International comparisons are made (Quetelet, Liharzik, Roberts, etc.), and original data is regressed per unit change in the dependant variable;

4) Mother and Child Welfare — already reported elsewhere on consulting stations "Mother and Child" in Sofia, with exposition on Child Hygiene (1927). The principal patron of those stations was Prof. S. Vatev, but his efforts would have been vain without help from midwives and auxiliaries. A total system of prophylaxis and surveillance of child health was administered, with milk delivery plus vaccinations and immunizations, on the territory of greater city of Sofia;

Thus in short terms we have reached the years of the mid-1930s, when the "Union pour la Protection des Enfants en Bulgarie" was created and its "Medico-Pedagogical Journal" was published for five consecutive years (1935-1939). Editor-in-chief was Dr. Vasil Shumanov. Most of the materials were written by competent authorities from Bulgaria and abroad. It is here that the future Acad. Dragomir Mateev made in print a long cycle of articles on child hygiene and physiology, ditto.

(i). This figure illustrates the proportionality assumption in child growth; if after the 2nd year the thoracic circumference does not exceed the cranial, there is something wrong with the child's normal development — i.e., possibility for hydrocephaly, rickets, etc.