GROWTH. 49 



ous factors which affect growth, nationality, environment, and social 

 status and the quantity and quality of the food are the most important. 

 Environment and social status influence the quantity and quality of 

 the food and also determine largely the medical care which a child 

 receives. This latter factor in itself is becoming an increasingly 

 important one in the element of growth, for defects in both anatomical 

 and in dietetic conditions are recognized and corrected by early medi- 

 cal attention. 



Influence of nationality on growth. The well-recognized influence of 

 nationality on growth must be taken into account in the consideration 

 of the normality of our children. Owing to the cosmopolitan character 

 of the American people and the large influx of European blood, nation- 

 ality undoubtedly plays an important role in the establishment of the 

 American standard, but for comparison with our curves the use of 

 standard growth-curves representing nationalities other than American 

 is, strictly speaking, precluded. Certain nations are known to be 

 tall and well-developed, while others are typically short. Thus, the 

 Anglo-Saxon race and certain branches of the Chinese race are pro- 

 nouncedly taller than other nationalities, while the Japanese race is 

 characteristically short. A superficial comparison of the data from 

 different countries reveals the fact that the growth-curves for different 

 races of men are by no means identical; indeed, this may be said to 

 be true even for similar races inhabiting different localities. Even 

 in Japan there are localities where the people are much taller than the 

 general run of the inhabitants, while in England it has been found that 

 the average weight of infants, both male and female, in London is 

 much higher than that of infants in Leeds and slightly higher than the 

 average weight of infants throughout the whole of England. Con- 

 sequently, in comparing the growth-curves of our children with other 

 growth-curves, emphasis has been laid upon the American data, as 

 American data alone may properly be used in this study of normality. 



Influence of environment and social status on growth. It has been 

 shown by various authors that environment and social status play a 

 part in the growth of children. Those children who live much of the 

 time out of doors and whose families can afford to supply them with 

 good and sufficient food obtain better growth than children of the same 

 nationality and locality who have not the same opportunities. 1 As 

 early as 1829, Villerme 2 concluded that stature is greater and growth 

 sooner completed, all other things being equal, in proportion as the 

 country is richer and the comforts of the inhabitants more general. 

 Robertson 3 reports that "increasing unfavorability of environment 

 results in a parallel increase of deficiency in weight and stature." 



1 Burk, Am. Journ. Psychol., 1898, 9, p. 272. 



2 VillermS, Ann. d'Hyg. Pub. et de M6d. Legale, Paris, 1829, 1, p. 351. 



3 Robertson, Am. Journ. Physiol., 1916, 41, p. 553. 



