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(c) Delicate Children.—Lastly we come to the sub-heading of
Table III., "Delicate Children"—which is perhaps the cause of
more confusion and misunderstanding than all the other
categories together.
What exactly is a "delicate child"? The definition given
in the table is "pre or latent tuberculosis, malnutrition,
debility, anaemia, etc." What is "pre or latent tuberculosis"?
We have learned that a large proportion—up to 90 per cent.—
of adolescents undergo the process of tuberculisation or infection
with tubercle bacilli. Every such child who is not manifestly
suffering from tubercular disease may, in a sense, be regarded
as in the state of "pre or latent tuberculosis." But clearly
that is not the intention so far as Table III. is concerned, otherwise
a majority of the children in the elementary schools
would be suitable candidates for special schools. It is now
generally considered that "pre or latent tuberculosis" is a
meaningless term which should disappear entirely from the
literature of medicine as did "struma" and "scrofula," two
terms in common use before Koch's discovery of the
bacillus of tuberculosis in 1882.
Almost equally vague and indefinable are the terms
"malnutrition, debility, ana?mia, etc.," although, in practice,
it is not difficult to detect the unsatisfactory state of health
which these terms are intended to indicate. The important
thing to recognise about this considerable group of children is
that the causes of their condition are chiefly inadequate rest
and insufficient or improper food. If these causes were
removed the condition of a majority of the "delicates" would
be satisfactory. Therefore, to classify them as "physically
defective" is misleading. It is true that the term "physically
defective" may be used in the wide sense to include all children
the subjects of physical defect or defective physique. But
the meaning usually attached to physically defective is the
condition of being handicapped or crippled by some obvious
physical deformity. It would be less confusing to classify this
group in a separate table as physically sub-normal children.
I have referred to them as a considerable group of children
—they represent from 5 per cent. to 10 per cent. at least of