204 SECTIONAL ADDRESSES. 
the metropolis and of the larger cities. Sir W. Fordyce *! could write : 
‘I speak within the bounds of truth when I assert that, judging from the 
cases brought to my notice since 1750, there must be very near twenty 
thousand children in London, Westminster and the suburbs ill at this 
moment with the hectic fever, attended with tun bellies, swelled wrists 
or ankles or crooked limbs, owing to the impure air they breathe, the im- 
proper food on which they live, or the improper manner in which their 
fond parents bring them up.’ Within our own memory disease such as 
is described by Fordyce has become unknown ; rickets in mild form still 
reduces stature, but severe deformities are rare in London and the South, 
though as yet to be found, albeit in lessened numbers, in the industrial 
cities of the North. The eviis were checked in part by the various Factory 
and Public Health Acts and by improved sanitation which gradually 
came into force, while other causes of malnutrition, such as late hours, 
lack of sleep, uncleanliness, and premature heavy work, have more recently 
given way before the force of the higher standard of civilisation and of 
personal well-being. 
Modern medical inspection and treatment are fast counteracting the 
chief causes depressing the health and physique of the children, and 
are also dealing with contributory secondary factors, such as defective 
teeth and other foci of chronic sepsis, verminous conditions and unsuitable 
clothing. No one who compares:photographs of present-day children 
with their predecessors of the seventies can doubt the change. It is 
significant that the town is now gaining over the country and that London 
children are now second to none. The treatment schemes did not come 
into force until just before the war, and affected almost exclusively children 
who did not reach military age in time to appear before recruiting boards, 
so that the benefits of the system could not be brought out in the Report 
of the Ministry of National Service. In this direction the future seems 
secure. 
There remains the gap between the school and adult life. An expe- 
rienced Scottish recruiting board reported a falling off during adolescence 
both in the agricultural and the industrial classes. In the former there 
are ‘ the evils of the bothy system, with its lack of home comforts, and the 
tendency to live on canned food’; in the latter ‘the boy goes to the 
factory at fourteen, by sixteen he is earning full wages, indulging in all 
kinds of excesses, not having his due share of sleep and living on unwhole- 
some foods.’ The young artisan, apprenticed to his trade, has far more 
favourable conditions ; ‘ he does not realise his full wage-earning capacity 
so early, his home is better, his social conditions more equable, he has not 
the same opportunities for excesses and lives a more physiological life.’ 
The general impression of the recruiting reports was that the most critical 
period in determining the physical standard of manhood was the age 
from fourteen to eighteen. With any extension of facilities for appren- 
ticeship or trade instruction, with opportunities for the further treatment 
of ailments, even though these be of a voluntary character, much would 
be gained. Moreover—since the use made of these facilities would depend 
41 W. Fordyce, A new Enquiry into the Causes, Symptoms and Cure of Putrid 
and Inflammatory Fever, London, 1773, p. 207. 
“ Report, Ministry of National Service, vol. i., p. 138. 
