Sooner or later serious difficulties are bound to arise from an administratively unsound arrangement in which a school official in charge of a most important division of work is responsible to two entirely independent chiefs. The opportunities for honest but irreconcilable conflict of views are so numerous that they will surely arise in time. One chief may favor vaccination and the other be opposed to it on principle. One may deem it the duty of the schools to have the doctors and nurses give instruction in sex hygiene while the other may be utterly against anything of the sort. One may hold that the only useful physical exercise is that gained through games and athletics, while the other may favor formal gymnastics. One may believe in school gardens, and the other deem them a waste of time and money. One may believe that courses in infant hygiene should be provided for the girls in the upper grammar grades, while the other may hold that such instruction should be reserved for continuation classes for young women. All of these are matters on which educational authorities are sharply divided in opinion and there are many more of the same nature. The present director of schools, the present superintendent of schools, and the present chief medical inspector have so far worked successfully under the present arrangement of divided duties and responsibilities, but a reorganization along sounder administrative lines should be made before, instead of after, serious trouble arises. Eventually, if not now, Cleveland must realize that health work in education must be placed under the direction of the city's highest educational official who is the city superintendent of schools. SUMMARY 1. Cleveland employs 16 school physicians, one oculist, and 27 nurses. It spends $36,000 a year on salaries and supplies for these people, and maintains 86 school dispensaries and clinics. 2. Through medical inspection, the educator and the physician join hands to insure for each child such conditions of health and vitality as will best enable him to take full advantage of the free education offered by the state. It recognizes the intimate relationship between the physical and mental conditions of children. It realizes that education is dependent upon health. It betters health conditions among school children, safeguards them from disease, and renders them healthier, happier, and more vigorous. 3. The first work of this kind in Cleveland started in 1900 when tests were made of defective vision. In 1906 the Health Department provided inspectors for contagious diseases in the schools. In the same year inspection for physical defects was undertaken; the first dispensary in the United States was established at the Murray Hill School, and school nurses were appointed. In 1909 the Division of Health Supervision and Inspection became part of the regular school system.