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153
Report of the County Medical Officer—Education.
Z.159 Sex, male. Age, 7. Height, 95 c.m. Weight, 10.8 kilograms.
Number in family, 5. Number of rooms, 2. Condition of home, poor.
Cause—Tuberculous peritonitis, dental caries.
Action—Excluded from school, medical treatment, referred to Invalid Children's Aid Association.
Result—No improvement.
X.316 Sex, male. Age, 8. Height, 121 c.m. Weight, 22.4 kilograms.
Number in family, 2. Number of rooms, 1. Condition of home, poor. No father. Mother works.
Cause—Poverty, tuberculosis.
Action—Dinners and milk at school. Treatment at dispensary.
Result—Considerably improved, phthisis now better, weight increased.
X.415 Sex, male. Age, 8. Height, 110 c.m. Weight, 18.5 kilograms.
Number in family, 9. Number of rooms, 3. Condition of home, poor. Insufficient sleep.
Cause—Pulmonary tuberculosis.
Action—Excluded from school, referred to Invalid Children's Aid Association.
Result—No improvement, lost weight.
Z.126 Sex, male. Age, 8. Height, 106 c.m. Weight, 17 kilograms.
Number in family, 8. Number of rooms, 3. Condition of home, poor. Sleep prevented by fleas.
Cause—Pulmonary tuberculosis, necessity.
Action—School meals, oil from hospital.
Result—No improvement.
Z.88 Sex, male. Age, 8. Height, 106 c.m. Weight, 17 kilograms.
Number in family, 6. Number of rooms, 2. Condition of home, poor. School doctor advised milk and oil.
Cause—Tuberculosis, rickets, carious teeth.
Action by Care Committee, not fed at school, but malt and oil obtained from dispensary.
Re-inspection—Slight improvement, weight increased (19.3 kilograms.).
Z.101. Sex, male. Age, 8. Height, 116 c.m. Weight, 20 kilograms.
Number in family, 4. Number of rooms, 3. Condition of home, "fair." School doctor advised milk and
oil. Bad family history of phthisis. Father died of "chest trouble."
Cause—Poverty, tuberculosis.
Action taken—Out-relief, Guardians giving malt and oil. Not fed at school.
Re-inspection—Slight improvement.
Y.39 Sex, male. Age, 8. Height, 107 c.m. Weight, 14.5 kilograms.
Number in family, 5. Number of rooms, 3. Condition of home, "fair." School doctor advised milk
and oil.
Cause—Tuberculous glands, insufficient food. Father dead.
Action taken—Dinners and milk in school, attendance at tuberculosis dispensary.
Result—Improved, weight increased 17.4 kilograms.
Z.79 Sex, male. Age, 8. Height, 108 c.m. Weight, 16.4 kilograms.
Number in family, 9. Number of rooms, 4. Condition of home, "fair, but stuffy." Oil advised by school
doctor.
Cause—Tuberculosis, mother starved before birth, intermittent poverty, verminous.
Action taken—"Will not take milk," "cannot take oil"; attends dispensary.
Result—Slight improvement.
X.297 Sex, male. Age, 12. Height, 148 c.m. Weight, 35 kilograms.
Number in family, 9. Number of rooms, 6. Condition of home, good. Mother died of bronchitis.
Cause—Pulmonary tubercle.
Action—Medical treatment (Mount Vernon).
Result—No improvement.
X.240 Sex, male. Age, 12. Height, 144 c.m. Weight, 31 kilograms.
Number in family, 8. Number of rooms, "whole house." Condition of hume, "very superior."
Cause—Phthisis.
Action—Sent to country, medical treatment, cod liver oil.
Result—Improving.
X.367 Sex, male. Age, 12. Height, 126 c.m. Weight 27 kilograms.
Condition of home, "good."
Cause—Phthisis.
Action—Tuberculosis dispensary.
Result—Slight improvement.
In connection with the causation of malnutrition, lack of parental care should be taken
into consideration. The family histories obtained have been very carefully scrutinised with the
following result:—
Good homes (266)—Mother dead, 15 cases; mother seriously ill, 5; mother works, 5; father dead, 11; father
seriously ill, 6.
"Fair" homes (240)—Mother dead, 14 cases; mother seriously ill, 7; mother works, 21; father dead, 17;
father ill, 9; father drinks, 2; mother drinks, 7.
Poor homes (379)—Mother dead, 10 cases; mother ill, 10; mother works, 64; mother blind, 1; mother epileptic,
1; father dead, 47; father ill, 27 cases; father in infirmary, 4; father a lunatic, 1; father deserted
home, 6; father drinks, 6; mother drinks, 8; in inebriates' home, 1.
It may be assumed, therefore, that maternal care was lacking in the homes in 10 per cent. of
the good homes, 20 per cent. of the fair homes, and 25 per cent. of the poor homes.
In 30 cases one parent had died of phthisis, and in 26 further cases one parent was reported to
be suffering from phthisis. Of the other main conditions mentioned as antecedent or concomitant in
cases of malnutrition it is only recessary to mention that rapid growth as a cause is found only
amongst boys and girls of the older age group, and that want of sleep is mentioned chiefly in older
boys, and is associated with out of school work, the majority of cases being in Jewish boys, who are
required in addition to ordinary school work, to apply themselves to religious instruction in the evenings.
Action taken.—The measures taken by care committees in cases reported as "malnutrition"
may be divided into four groups:—(i.) School feeding with or without medical treatment; (ii.) medical
treatment alone; (iii.) convalescent or institutional treatment; (iv.) other actun, such as home
visiting and advice.
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