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96
Annual Report of the London County Council, 1914.
These malnourished children are considerably under the average height and weight for their age.
By taking some 150 cases that fall in the age group 7—9 and comparing the actual height and weight of the
child with the height and weight of a normal child, of exactly the same age in years and months, it was
found that the difference was in one instance as much as 22 centimetres in height and 10 kilograms
in weight. The height is not so frequently below normal as the weight, and 40 of these 150 children
were above the normal height for their age. Many of the children in this class are overgrown and thin,
in fact, this type of child is fairly frequently met with when dealing with ill-nourished children. The
average of the divergence of these 150 children from the normal for their individual ages shows them to be
48 centimetres below normal height and 3.9 kilograms below normal weight; the boys are 59 and the
girls 3-7 centimetres below normal height, but in weight both groups are 3 9 kilograms below normal. The
yearly increase of normal children between 7 and 9 is 4.6 centimetres in height, and in weight for boys
1.7 and for girls 1.9 kilograms, so that this group of 150 children approximated in height to normal
children a year younger and weighed less than normal children two years younger than themselves.

It will be seen that while more than half the children were either above normal height or less
than 5 centimetres below it,in regard to weight the large majority were over 3 kilograms below the normal.
The effect of the treatment received is apparent in the records of the measurements taken at reinspection,and
where there is no organic disease and the child is suffering only from lack of proper food, the
change to a suitable diet makes a marked difference in both height and weight. The record of the height
and weight of some 250 children seen at re-inspection was compared with their height and weight at the
inspection, and the increase or decrease in each case was shown as a yearly increase at the same rate.
The average yearly increase of all the cases of which there are records of height and weight, both at
inspection and re-inspection, works out at 5.5 centimetres in height and 2.5 kilograms in weight, which
is slightly over the normal increase in height, and considerably over the normal increase in weight per
annum. Among children of the 8—9 age group the increase in weight was at the rate of 3 kilograms a year.
The interval between inspection and re-inspection of this group was as a rule about 5 or 6 months. In a
general average are included those cases which do not gain in weight and also those which actually
lose weight, owing often to organic disease which does not yield to treatment. In individual cases the
increase during the period the child was under observation would, if the same rate had continued for a
year, have amounted to the growth of a normal child in 4 or 5 years, but it is not safe to assume that
a child who makes rapid progress for six months will continue at the same rate in the following six
months. The yearly rate of increase must be looked at in connection with the time that elapsed between
the two series of measurements.
Among all the children fifteen were recorded to have grown at a yearly rate of over 10 centimetres
during the interval between the measurements, which, on the average, was a period of just over six
months. Twenty-three children were recorded as having increased their weight at the rate of over 5
kilograms a year, i.e., the growth of a normal child in 3 or 4 years.
The most striking instances recorded were :—
(1) Girl, 8£, in poor, neglected condition, was given milk and the home was visited ; at re-inspection,
9 months later, weight was found to have increased 7.8 kilograms.
(2) Boy, 68/12, had early illness, home poor, milk at school; attended tuberculosis dispensary
gained 6.6 kilograms in 7 months.