EFFECTS OF INANITION ON THE BODY AS A WHOLE 85 



constitutional disturbances. In Munich, even before the war, Oppenheimer and 

 Landauer ('n) found much malnutrition; and at the close of the war, Pfaundler 

 ('19) concluded that the Munich children of 6 years had been retarded by 3 cm. 

 in height and 1 kg. or more in weight. In Berlin, Czerny ('21) states that no bad 

 results among children were visible in the earlier years of the war, but retarded 

 growth became apparent later. Goldstein ('22) among the institutional children 

 of Berlin found 89 per cent subnormal according to age and 50 per cent were 

 10—20 per cent subnormal in weight for height. They were also retarded 1—3 

 years in height. Fuhge ('18) made a study of the metabolism in such retarded 

 children, finding the growth retarded by insufficient food, with relatively small 

 proportion of protein and fats. 



Indices of Nutrition. — In connection with the study of malnutrition, espe- 

 cially in childhood, the desirability of some exact method of determining the degree 

 of undernourishment has been increasingly evident in recent years. A favorite 

 method has been to compare the height and weight with those given in standard 

 tables as normal for the corresponding age, but this is unsatisfactory on account 

 of the great variability even among healthy children of the same age. Since 

 emaciation of the body is the most outstanding symptom of inanition, a com- 

 parison of the ratio between length and weight (independent of age) should 

 be useful. In order to obtain a normal index which is approximately constant 

 for age, however, it is obvious that the simple height: weight ratio (as used by 

 Dreyfuss '06 and earlier authors) is inadequate, since the weight (or volume) 

 of the body in general increases as the cube of the height, assuming the body pro- 

 portions to remain constant. But even the ratio height 3 : weight does not 

 remain constant, since Quetelet (Anthropometric, 1835) demonstrated that 

 between birth and maturity the human body normally becomes relatively 

 elongated, so that a constant ratio is expressed more nearly by height 5 : 

 weight 2 . Not even this ratio remains constant, however, and no completely 

 satisfactory formula or index has yet been discovered. 



Various indices or modifications have been proposed, which are discussed in 

 the papers of Fleischner ('06), Rohrer ('08, '21), Pirquet ('16), Matusiewiez 

 ('14), Pfaundler (/16), Manny ('16, '18), Holt ('18), Davenport ('20), Dreyer 

 and Hanson ('20), Retan ('20), Emerson and Manny ('20) /Gerber (' 21), Wagner 

 ('21), Huth ('21), Carter ('21), Bardeen ('20, '21, '23), Guttman ('22), Clark 

 ('22), Van derLoo ('22) and Davenport ('23). 



It is impossible to discuss the various proposed indices in detail, but a few 

 more important points may be mentioned. The original "Index ponderalis" 



of Livi ('86) was in the form: 100 v ^eig ) gramS ' ) - This was modified bv 



length (cm.) 



weight _. ., . . 



Rohrer ('08) as the " Korperfiillenindex " = 100 -7^. Pirquet ('16) prefers 



the sitting height instead of the total body length in his index "Pelidisi" = 



\/io. weight (grams) . p irquet > s index has been used by Helmreich and 

 sitting height (cm.) 

 Kassowitz ('23) and others. 



