84 INANITION AND MALNUTRITION 



burgh. A somewhat smaller, but still alarming, amount of malnutrition among 

 New York school-children was found by Chapin, Baker, Mitchell, and others. 

 In a recent investigation by the Bureau of Child Hygiene (Baker '18a, '18b), 

 171,691 school-children in the Borough of Manhattan were classified according 

 to the Dumferline scale as follows: No. 1 (normal) 17.3 per cent; No. 2 (passable 

 61. 1 per cent; No. 3 (distinctly undernourished) 18.5 per cent; No. 4 (pro- 

 nounced malnutrition or marasmus) 3.1 per cent. As to age, of the children 

 up to 6 years, 22.5 per cent were undernourished. The percentage increased 

 to a maximum of 25.2 per cent at 9 years; then decreased to 12.1 per cent at 

 16 years. Similar conditions probably exist in one million school-children in 

 New York City. Nationality was not found to be an important factor, although 

 the percentage of undernourished varied from 19.8 in children of Russian and 

 Polish origin to 28.7 per cent among those of Italian parentage. Among 

 894 New York school-children, Mitchell ('19) found 69 "special" and "open 

 air" cases; of the remaining 800 children 16.8 per cent were 7 per cent or more 

 subnormal in weight according to height, in comparison with norms based 

 upon data of Holt, Burk and Boas. As an example of conditions in a smaller 

 city of the Middle West, Brown ('20) found that 41 per cent of the children 

 in the Lowell School of Kansas City were more than 10 per cent underweight 

 (compared with the standard table of Dr. Wood). 



From a large series (172,000) measurements of American children in 1918-19, 

 Woodbury ('21) concluded that 4.4 per cent were notably deficient in stature, 

 and 15.7 per cent were deficient in body weight. The largest proportion of 

 deficient cases occurred in infants below one year of age, the deficient group 

 at this age averaging almost 25 per cent below normal in weight. These data, 

 from material secured in the "Children's Year" measurements, indicate a lesser 

 extent of malnutrition than those above mentioned. 



It seems probable that the percentage of undernourished children was 

 increased by the scarcity and high price of food during the recent war period, 

 (Chapin, et al. '18) even in countries not directly involved; although this was 

 not found evident in Amsterdam school-children by Lubsen ('17). In Belgium 

 Demoor and Slosse ('20) state that children of 6-14 years at the end of the war 

 were retarded at least one year in height and weight. Calmette ('19) found 

 even greater apparent retardation in Lille, amounting to 4 or 5 years in the 

 older children. Newman estimates that fully 10 per cent of the English school- 

 children are seriously malnourished. 



In Vienna, evidence of marked undernourishment of the children is given by 

 Gribbon and Paton ('21) and Gribbon and Ferguson ('21). Among children 

 from 1-14 years of age, the worst effects were found in those from 2-3 

 years of age, which averaged 13.6 per cent below normal in height for that age, 

 and 26.5 per cent subnormal in weight. 



In Germany, numerous observers have described severe malnutrition and 

 retarded growth in childern as a result of the war conditions (Fuhge '18; Addams 

 and Hamilton '19). Beninde ('19) found conditions progressively worse since 

 191 7. Schlesinger ('20) presents extensive data and concludes that malnutri- 

 tional effects of the war appeared later in children than in adults, consisting in 

 (1) retardation (average of 2 cm.) in growth in length; ^2) loss in weight; (3) 



