The first work of this kind in Cleveland is described in Superintendent Jones' report for 1900. In that year the schools became greatly interested in the question of defective vision. Tests were made by teachers in different grades, and as a result over 2,000 children were given treatment.

In 1906, an agreement was reached with the Board of Health, so that each alternate day a health inspector communicated with the principal of every school. Teachers were warned to be on the alert for symptoms of illness, and children showing signs of measles, whooping cough, scarlet fever, or other common diseases of childhood, were reported to the principal, and through her to the Board of Health. Contagious cases were excluded from school as soon as detected, and a systematic campaign started against the waves of disease which were sweeping one after another through the schools.

In the same year Drs. L. W. Childs, J. H. McHenry, H. L. Sanford, and other members of the medical profession volunteered their services as school physicians, to detect not only cases of possible contagion, but also the existence of physical defects. What was probably the first school dispensary in the United States was opened at the request of Dr. Childs by the Board of Education in 1907 at the Murray Hill School. The value of school dispensaries was so immediately evident that by 1909 seven others were established for the use of these three physicians.

Coincident with the dispensaries came the school nurse. When the first nurse was appointed at the Murray Hill School, a remarkable change was observed among the children. Absences became less frequent. Skin diseases were rare. Children began to take an interest in health matters, and there was a marked rise in standards of neatness and cleanliness. Teachers and principals united in their demand for more nurses, until within a year after the movement started there were six nurses appointed by the Board of Education and regularly employed in school work. In the same year, December, 1909, the Board of Education formally voted to establish a Division of Health Supervision and Inspection as part of the regular school system.