PERIOD AND RATE OF GROWTH IN CHILDREN.
In the previous pages the management of children from birth up to a few years of age has been entered into in some detail. It is not necessary to follow 'up that section with one considering the management of children from the earlier years to the age of manhood or womanhood. The lines on which such manage Ment should proceed are practically similar in both instances. For details regarding food, clothing, exercise, &c., reference can be made to the part of the work devoted to Hygiene, from which full information can be gleaned. Investigations undertaken in recent years, however, have shown that parents and guar dians of children have always at hand a simple and reliable means of informing themselves of the general state of physical health and growth of the children under their care, a means of as suring themselves that their method of watch-1 ing over the bodily well-being of the children is attaining its purpose. This means consists in observing accurately, from time to time, the growth of the children in height and weight.
A large number of statistics show, that up to the age of about 22 years in boys and 18 in girls an uninterrupted increase in height occurs in a state of health, accompanied by a regular increase in weight. The rate of increase varies with the year of life, and, indeed, also with the season of the year. Moreover, a multitude of observations has shown that for each year of life there are a certain height and weight and a certain rate of increase which can be set down as the standard for that year. Diseased condi tions, whether apparent or not, seriously affect this normal increase. Any wide departure from the general rule, if not actually in every case indicative of disturbance, becomes at least a signal of possible danger and a warning of the need of careful inquiry into the state of health. Here, then,.is a valuable means, ready to the hands of parents and all who are in charge of children, of assuring themselves from time to time of the general health of their children and of the results of their management of them. For the proper carrying out of the method a register requires to be kept. The name of the child is entered, and opposite each observation the date should be written. At regular periods,
say at intervals of one mouth, the height and weight should be measured and duly noted. The height is measured from the sole of the foot to the crown of the bead ; shoes are there fore, removed. The weight ought not to in clude clothes; and as the amount of clothing varies at different times, it is well to take the weight with clothes and shoes, and then weigh these separately, deducting their amount from the total. Besides the height and weight the measurement round the chest is valuable. It should be taken next the skin—without cloth ing, that is to say. The measuring-tape is placed quite horizontally round the chest. The lower edge in front touches the upper part of the nipple and includes the lower part of the shoulder-blades behind. To ensure that the chest is always expanded with air to the same extent, the person is made to count from one to ten, when the measurement is taken. The arms should, at the time, hang loosely by the sides.
The Value of such Periodical Measure ments is shown by a variety of circumstances. Dr. Percy Boulton gives one instance that oc curred at the Boys' Home, Regent's Park: "In 1875 it was found at that institution that the boys had not increased on an average 2 inches a year, so, in January, 1876, a revised dietary was used, and it was found after one year that, by this simple change, the average increase amongst the boys had been over 2 inches in stature and 6k pounds in weight." In prisons and lunatic asylums the inmates are weighed once a month, and the information given by the scales is taken as an indication of the sufficiency of the diet in quantity and quality. )3ut the information is of further value. If the weight is not satisfactory, and no error in diet accounts for this state of affairs, an examination of the person is made. As a result maladies are dis covered in an early stage, before other signs had made themselves manifest; and thus disease is detected at an early stage, when it may be more easily and successfully treated. It has been shown that loss of weight is one of the earliest occurrences in and may be detected before cough has begun.