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Ward is continued conscientiously by the mother at home (it nearly
always is), it becomes impossible in a little while to detect any traces of
the former wasting.
The Malnutrition of older children, usually between the ages of
one and four years, is due to a variety of faults in their environment.
When the children are taken in the faults are removed, and it is really
wonderful to see what progress they make. Plenty of fine food, fresh
air, sunlight (natural or artificial), any medical treatment that seems
necessary, and, especially, good nursing work, work wonders in a short
space of time. They usually put on weight very fast, their colour
becomes healthier and their vigour improves in a remarkable way. Similar
very good results are obtained in Debility after Illness, and in Rickets.
In the latter we have the pleasure of seeing crooked limbs grow straight,
in addition. It might be supposed that when the child was returned to
its old environment the former symptoms would recur; but this is not
the case. Once got into a sound state he will withstand adverse conditions
that he could not before.
Of the remaining cases, Food-refusal and the other, Neurosis, yield
well to institutional treatment, although the former is rather apt to recur
unless the parents are both willing and intelligent in their co-operation.
Both cases of Coeliac Disease made complete recovery.
The results of treatment in the Wards may now be shown
Recovered 37
Improved 6
Removal by Parents 2
Transferred to Hospital 2
47
These results seem to speak for themselves. It should be noted that
the cases marked 'improved' were left to make a complete recoverv at
home, it being regarded as morally certain that they would do so. Two
were removed by their parents after a stay of only four days: they were
twins. One of the cases transferred to hospital was the intractable and
dangerous form of wasting called Marasmus; the other was the rather
uncommon internal deformity known as a Diaphragmatic Hernia. The
exact nature of this was not diagnosed with certainty until the child was