“3124. You have been good enough to attend here in consequence of certain evidence that we received the other day in which it was stated by Dr. Eichholz, on the authority of other medical men, that if people are going to have children, they will have healthy children as though Nature were giving every generation a fresh start, and he went on to say that healthy births were about 90 per cent in the poor neighborhoods, and he suggested that we should go to the London Obstetrical Societies to ascertain how far their experience bore out this statement. What are you able to say on this point?—What I have to say at the present time is more a matter of observation and of opinion. We have not the figures at present to prove the accuracy of it, but I think the testimony of experienced observers would be in accordance with the views expressed by Dr. Eichholz, though perhaps not to such a large extent. I should say that from 80 to 85 per cent of children are born physically healthy.

“3125. Whatever the condition of the parents may be? Whatever the condition of the mother may be antecedently.

“3126. And you think the deterioration sets in later?—I do, materially so. The weight of children at birth as far as I know—and I have weighed a great many—is generally not below the average; the average keeps up very much no matter what the physical condition of the mother may be for the time. Since receiving this information we have instituted at the Obstetrical Society of London, in connection with Lying-in Charities and Hospitals in London, a tabulated form for ascertaining these facts—what the weight of children is at birth; their physical condition, and whether there is an increase or otherwise during the time a woman is under observation. That time is not very long, not more than 10 days or a fortnight generally.

“3127. Will you be able to furnish us with these facts when collected?—Certainly. I will give the information later on, but I think there is a general consensus of opinion, at all events irrespective of figures, which I am not able to give, that the average is kept up no matter what the condition of the mother may be.

“3128. That proves what you say in your précis,—that Nature intends all to have a fair start?—Yes.”

II
MALNUTRITION

“One of the most striking things about children suffering from malnutrition is their vulnerability. They ‘take’ everything. Catarrhal processes in the nose (adenoids), pharynx, and bronchi are readily excited, and, once begun, tend to run a protracted course. There is but little resistance to any acute infectious disease which the child may contract. One illness often follows another, so that these children are frequently sick for almost an entire season. Their muscular development is poor, they tire readily, are able to take but little exercise, and their circulation is sluggish. Mentally, they are usually bright, often precocious. Many would be called nervous children.”—The Diseases of Infancy and Childhood, by L. Emmet Holt, M.D., LL.D., p. 231.

“General malnutrition is the commonest pathological feature of infant life. Probably 50 per cent of all infants in this country (England) suffer from a greater or less degree, and this large proportion is caused undoubtedly by the extremely unsatisfactory methods of substitute feeding at present in vogue. Illness, in the usually accepted sense of the word, is not present. No specific disease can be diagnosed, and unless the indications are realized, the degeneration is allowed to proceed until marasmus or some acute disorder supervenes....

“Marasmus represents the extreme result of gradual and long-continued malnutrition. Extreme wasting is the cardinal, and indeed only, specific symptom. The term is not applicable to those cases where the wasting is the result of exhaustion due to the incidence of specific disease, such, for instance, as tuberculosis....

“The most striking and perhaps the commonest result of impaired nutrition is the disease generally known by the name of rickets. Though some of its most obvious features are those associated with changes in the osseous system, those are by no means the only effects of the disease. Rachitis is the expression of profound pathological changes occurring in practically all the tissues of the body.