"The Medical Examination of School Children," by Dr. A. S. Arkle, a paper read at the North of England Education Conference, January, 1907 (reprinted in _School Government Chronicle_, Supplement, January 12, 1907, pp. 77, 89). As we have already said, the nutrition cannot be determined solely by weight. "In fact," as a School Medical Officer points out, "an ill-nourished child may be above the average weight, or, on the other hand, a healthy child may be much under the average and yet not be ill-nourished." (Report of the School Medical Officer for Leeds for 1910, p. 27.) But when dealing with large numbers of children, the average weight furnishes a reliable index of nutrition. This malnutrition is to be attributed to many causes besides actual lack of food. Improper food and hurried methods of eating account for much malnutrition. So much has been written on the subject of the wrong feeding of children that it seems unnecessary to labour this point. One can, indeed, hardly open a report of a School Medical Officer without finding this evil deplored. In the poorest homes there are frequently no fixed meal times; the children are given "a piece" when they are hungry, and this is often eaten in the street or on the doorstep. Bread and tea figure largely in the dietary. Supper is frequently the principal meal of the day, with resulting indigestion for the children. Employment out of school hours and want of sleep are again important factors. Indeed, in the eyes of some School Medical Officers, malnutrition is due more to want of sleep than to lack of food. The children are almost invariably kept up till late at night, it being a rare exception to find a child being sent to bed at anything approaching a reasonable hour. A still more potent cause, perhaps, is to be found in bad housing conditions. Striking testimony as to the relation between the physique of school children and housing was adduced by Dr. Leslie Mackenzie and Captain Foster, as a result of an enquiry into the condition of 72,857 school children in Glasgow. "If we take all the children of ages from 5 to 18," they report, "we find that the average weight of the one-roomed boy is 52.6 lbs.; of the two-roomed, 56.1 lbs.; of the three-roomed, 60.6 lbs.; of the four-roomed and over, 64.3 lbs. The respective heights are 46.6 inches; 48.1 inches; 50.0 inches and 51.3 inches. For girls the corresponding figures are:--Weights, 51.5 lbs.; 54.8 lbs.; 59.4 lbs.; 65.5 lbs. The heights are 46.3 inches; 47.8 inches; 49.6 inches; 57.6 inches."[462] Footnote 462: Report by Dr. Leslie Mackenzie and Captain A. Foster, on the Physical Condition of Children attending the Public Schools of the School Board of Glasgow, 1907, p. v. At East Ham also the nutrition of the children was found to vary in accordance with the number of rooms:--[463]