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8
As Dr. Robert Hutchison said in his "Sir Charles Hastings'' Lecture,
delivered on March 7th, 1934 . . . "When all is said and done, malnutrition
is mainly a clinical conception, and although an experienced
doctor can say with fair certainty that such-and-such a child is suffering
from it, yet it must be remembered that there is a large personal factor
in his judgment; and this must always be borne in mind when you read
that so many children in, say, a school, are reported to be ill-nourished.''
One of the Council's part-time Clinic Medical Officers who is Medical
Officer of a Day Nursery in another part of the metropolis and who is
also engaged in private practice has, at three of her clinic sessions,
examined children for evidence of malnutrition as far as her routine work
has permitted, and has recorded that severe malnutrition among children
attending the clinics is very rare, but in her opinion a number of cases
showed minor degrees of malnutrition.
A comparison of the children in her Day Nursery with children seen
at the clinics in Poplar gives her the impression that the children under
one year of age in Poplar look better and weigh more than the children
in the Day Nursery, but the general physique of the "toddlers" in the
Day Nursery is better than that of the "toddlers" attending the clinics.
She attributes the latter to the regular, wholesome dietary and regular
life led by the Day Nursery children.
As mentioned above, in the absence of any criteria or standards of
malnutrition, and owing to the fact that there is no time at the ordinary
Maternity and Child Welfare Clinics to devote to research work, it is
difficult to say how much, if any, of the so-called minor degrees of
malnutrition are due to:—
1. Inability of parents to provide a sufficient quantity of suitable
food;
2. Faulty diet;
3. Digestive system of the child at fault rendering it unable to
properly assimilate its food.
Dr. H. K. Waller, in his report on the work of the Royal College
of St. Katharine, page 138, goes more fully into this subject.
Dr. G. O. Mitchell, the Tuberculosis Officer, also refers to malnutrition
on page 105.