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19
Children in northern latitudes appear widely to undergo vitamin shortage,
especially during the winter months. This can be no new thing, yet the inhabitants
of these very countries have proved in the past to be the most virile of human races.
Perhaps periods of alternating saturation and unsaturation are stimulant. Of this
there is no certain knowledge.
Here is a field for exploration and discovery. The time may be near when new
methods of examination and diagnosis must be installed in schools and treatment
centres. Meanwhile, it is not surprising that clinical assessments differ in this
shadowy state between definite health and definite disease.
The Board of Education syllabus provides for every child to be marked during
routine inspection as "1," "2," "3," or "4"; 1 being exceedingly good nutrition,
2 normal, 3 subnormal, and 4 definite pathological malnutrition. Bearing in mind
the above considerations in regard to the limitations of the clinical assessment of
nutrition, the figures for London give astonishingly consistent results. From year
to year the fluctuations are minute, and each year each age group preserves its own
distinctive features. Thus the 7.vear.old boys always present the greatest proportion
of subnormal cases, which is in accordance with physiological expectation. Leaver
children always present the lowest proportion of subnormality, and girls are always
better nourished than boys in each age group. While the groups differ in their characteristics,
fluctuations from year to year in each group are, like the total figures, exceedingly
small (see percentages in table 10). These facts give grounds for placing
reliance upon the returns for the purpose of assessing nutritional state and for
comparison from year to year.