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19
It may be said at once that, from a close analysis of the measures of height and weight of
roughly 1,000 children at these homes, the effect of the diet has been beneficial and, in fact, both
the height and weight have increased in excess of the expected gain.
This expected gain in height and weight was derived from the standard figures for the
growth of elementary school children used in the department. The measurements of the children
from whom the standard was prepared are, however, given at yearly intervals, and do not,
therefore, offer a strictly accurate basis for comparison with the measurements of the children
at the residential schools, since these latter measurements only cover a period of six months.
This will be seen to be important when it is remembered that children do not gain in height and
weight equally throughout the year, but tend to increase in height at one period and in weight at
another.
Furthermore, during the first six months of operating the new diet it was necessary for the
superintendents of the homes (or those responsible for ordering the daily menus) to become
accustomed to the various features of the new dietary tables. This, in some cases, took a little
time, and any early errors or misunderstandings of the schedules may possibly have affected
in either direction the heights and weights taken at so short an interval as six months. A more
thorough estimation of the value of the new diet could be made over a period of a year instead
of six months, and it has been arranged to have the heights and weights taken again in March of
this year in order that a report on the whole of the first year's working of the diet may be made.
The weights of the children, about 1,000 in all, at four representative schools have been
analysed. The schools selected were Anerley, Hornchurch, Hammersmith and Stifford and
Grays, three of which are large schools, while Hammersmith is smaller. The results show that,
on the whole, the children have generally gained weight in slight excess of the expected gain.
The measurements show that, at the beginning of the new dietary the children in the residential
schools were already up to the expected weight of elementary school children, reflecting credit
on the previous care of the children. A point which is not shown in the analysis is the fact that
at Anerley school, of 391 children, 50 showed a slight loss in weight, although taken on the
whole the children at that school showed an average increase. The superintendent of Anerley
has reported that the new dietary worked very well indeed. He states that the children have
enjoyed the greater variety, the better breakfasts, and the increase in the amount of food ; while
the medical officer also reports that the diet is satisfactory. It is possible that a few of the
weighings may have been incorrect, and it should be possible to establish whether this is so or
not when the weighing is repeated in March of this year. It is also possible that the children
in question were previously too fat to be really healthy. This is definitely stated to be the case
in three girls who lost weight at Banstead school. The gain in weight at the other three schools
has been wholly satisfactory and there are no figures in them for loss of weight comparable with
those at Anerley.
The heights of the children at the four schools already mentioned have also been analysed.
During the visits of the medical officers to these homes it has often been the impression that the
children, though robust and in good condition, were nevertheless somewhat stunted in height.
The analysis now made confirms this impression, for it shows that at all ages from three to fourteen,
at the beginning of the new diet, the average height of the children was below standard by
an amount varying from one to three inches. During the six months of the new diet there has
been a very satisfactory average increase in height. Children at the age of six have increased
in height according to the expected normal increase, but at all other ages up to fourteen the
increase in height has been greater than the expected increase, and children of three, five, eight
and thirteen have reached the expected height for their ages.
A review of the reports of the superintendents of the residential schools shows that they
are all satisfied with the new diet and many of them are enthusiastic. They welcome the variety
afforded by the schedule, especially the increase of fruit, and many of them remark that the
variety is particularly appreciated at breakfast.
Practically all the schools mention with regret that the dietary does not provide for the giving
of an egg as such once a week, and consideration is being given to the possibility of providing
for this, at all events during the summer.
The medical officers echo the superintendents' reports in stating the diet has been beneficial,
and they point out that the health of the children has been maintained at a satisfactory level.
Sufficient information, has already emerged to show that the dietary is a suitable one and
it has been recommended that, with the slight modifications suggested, it should be approved
provisionally for another year.
That nocturnal incontinence is one of the most troublesome complaints
afflicting children in the residential schools was pointed out in last year's report.
In the issue of "The Practitioner" for December, 1932, Dr. Langdon Brown,
the Regius Professor of Physic in the University of Cambridge, drew attention to the
suggestion of G. W. Bray that some cases of enuresis are due to allergy. Dr.
Langdon Brown gave reasons for supposing that the drug ephedrine might be of
special use in such cases. Following upon this, the medical officer of the Shirley
schools reported that he had tried ephedrine hydrochloride upon children suffering
from the complaint in that school with encouraging results.
Enuresis.