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94
children examined. This table is included in the appendix
(Table II.B.) where it will be seen that out of a total of
1,767 children inspected the following classification of
nutrition resulted:—
(a) Excellent nutrition 148. 8.4 per rent.
(b) Normal nutrition 1297. 73.4 „ ,,
(c) Slightly subnormal nutrition 309. 17.5 ,, ,,
(d) Bad nutrition 13. 0.7 ,, ,,
It is not an easy matter, owing to the various standards
set, to tabulate a child as of (a) or (b) physique, the
opinion recorded being to a great extent merely the
impression of the medical examiner that a child appears
to be in a particular group on comparison with other
children. In other words where the normal standard of
physique is a good one in an area, one is apt to obtain a
false impression when comparing these tables with those
of other areas. There does not, however, appear to be any
set method on which to base the standard1 of nutrition
scientifically. My general impression in Bromley is that
the nutrition of children attending elementary schools is
good, and when one finds low grade nutrition it is generally
due to either the existence of a debilitating defect, or is
constitutional in the family, that is to say, not due to lack
of nutritive diet, nor does change of diet have any effect
upon this type of nutrition. There are of course cases
where the diet is an inefficient one, and when extra
nourishment is provided either through the scheme of
milk provision at school, or at home, improvement becomes
at once apparent.
Treatment.
The School Medical Service provides through its
special clinics treatment of all those defects discovered at
routine medical inspections. A strict line of demarcation
is made between domiciliary treatment provided by the
general practitioner and clinic treatment provided through
the special services.. The work of the special clinics is
tabulated in the appendix and will be found in Table IV.
(Group I, Group II, Group III and Group IV.) and Table
V.