/::'J!;: r-:: -.1- jn,»Jffi;;* ^'jy..,;.', , ...,,M-- ' •■'■^- ■■ jV:-;:.,!;;';;,',;,^ • i:/!J.J.,....^. • -i; ';ifi)f,,-t,-;;^)>;i';; •;;; ; . I ■ 7Jj:;i:(^n;l;fn: ,■:.'.,;■•■;,;; ."■'•;':;,;::!:;; j'/'rl?-;', ^ .... i,f.;vf)..' v...; -- •''-,■>./.■■'■■ ■- ■ l.'»•.^ Class L^LAl^i % fl l^ld-SKXTED BY j ^ f <^ SCHOOL FEEDING ITS HISTORY AND PRACTICE AT HOME AND ABROAD THESIS PRESENTED TO THE FACULTY OF THE GRADUATE SCHOOL OF THE UNIVERSITY OF PENNSYLVANIA IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY BY LOUISE STEVENS BRYANT PHILADELPHIA, PENNSYLVANIA 1914 i J SCHOOL FEEDING ITS HISTORY AND PRACTICE AT HOME AND ABROAD THESIS PRESENTED TO THE FACULTY OF THE GRADUATE SCHOOL OF THE UNIVERSITY OF PENNSYLVANIA IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY BY LOUISE STEVENS BRYANT PHILADELPHIA, PENNSYLVANIA 1914 ^ ^<^^ V -^o:: "^ SCHOOL FEEDING ITS HISTORY AND PRACTICE AT HOME AND ABROAD BY LOUISE STEVENS BRYANT Of the Psychological Clinic, University of Pennsylvania WITH AN INTRODUCTION BY P. P. CLAXTON United States Commissioner of Education l6 FULL-PAGE ILLUSTRATIONS AND 6 CHARTS IN TEXT J. B. LIPPINCOTT COMPANY PHILADELPHIA AND LONDON COPYRIGHT, 1 9 13 BT J. B. LIPPINCOTT COMPANT PUBLISHED, FEBRUARY, I913 mm m y fail PRINTED BT J. B. LIPPINCOTT COMPANT AT THE WASHINGTON SQUARE PRESS PHILADELPHIA, U.S.A. TO DR. LIGHTNER WITMER IN APPRECIATION OF HIS WORK FOR "ORTHOGENICS," THE NORMAL DEVELOPMENT OF EVERY CHILD THE STATE, THE SCHOOL, AND CHILD WELFARE The main principle which should guide us in discussing the question of the State and Child Wel- fare, I consider, is that the State looks after the child primarily because he is a child, and not because he is destitute or sick or criminally inclined. There- fore it behoves us not to wait until one or more of these calamities overtakes him before we super- vise his upbringing. This principle was half con- ceded by the establishment of an Education Author- ity. Half only, for until lately the child's parents still had to be destitute before the State concerned itself in any way with his bodily needs. Years of experience, however, in the teaching of underfed children have brought home to our people the fact that we cannot separate mental and bodily welfare. The prolonged controversy over the feeding of school children has led to the acceptance of a second principle of action: that the welfare of the child should be looked after by one authority only — i.e.^ that the necessary feeding should be undertaken by the School Authority, and not by the Poor Law Guardians. It seems to me that the adoption by the Legislature SCHOOL FEEDING of these two principles makes it both inevitable and desirable that all public provision for children of school age, whether destitute or not, should be en- trusted entirely to the Education Authority. It has become impossible to defend the practice of allowing the responsibility for a child's welfare to shift auto- matically from the shoulders of the Education Authority to those of the Destitution Authority and back again, according as the parents' means sink below a vaguely defined line or rise above it. I would add a reminder that the only way of enforcing the natural and proper responsibility of the parent for the general welfare of his child is to set up a definite standard of mental and bodily nurture and to insist that no child shall receive less upon any excuse whatsoever. Without such a stand- ard it is impossible for the State to make any clear demand upon the parent to do his duty. With it* the State can really insure the health and efficiency of its future citizens. Finally, let me repeat the first principle th*at the child must be looked after because he is a child, and must never be sacrificed for the sake of " improv- ing " the moral character of his parents, however much they may need it. If sometine must suffer,' it is but common-sense to urge that it should be the present generation, not the future one. — Beatrice Webb, in "The Child," January, 191 1. PREFACE This book deals, first, with the history and present status of legislation concerning and administration of meals in public elementary schools in all coun- tries, and, second, with the physiological aspects of malnutrition during the growing peripd, its causes, classification, results, the basis of school dietetics on the food needs of the growing child and the scien- tific construction of menus to fulfil these. , Most of this is brought together for the first time and the presentation is non-technical. The §ources were many, for the most part answers to letters of inquiry and official documents and reports. Material on high school lunches has been omitted because this presents quite different problems in education and administration and because the sub- ject has already been widely exploited. The treatment is primarily informational, con- troversial matter having been eliminated as far as may be. During the course of the work, which occupied nearly three years, I had the most cordial co-opera- tion of many people. My thanks are especially due to the following individuals : Dr. Leonard P. Ayres, Dr. Luther GuHck of New York, Mr. H. H. Bon- nell, Miss Alice C. Boughton, Miss Mary Leeds of PREFACE Philadelphia, Dr. Mary Schwartz Rose of Co- lumbia University, Dr. Ira S. Wile, Miss Kittredge and other members of the New York School Lunch Committee, Miss Haisler and Superintendent Pearse of Milwaukee, Dr. Meyerding of St. Paul, Miss Small of Buffalo, Mrs. Hotchkin of Roches- ter High School, Miss Cook of Syracuse; and in foreign countries to Miss Helene Simon of Berlin, Dr. Gastpar of Stuttgart, Dr. Tonsig of Padua, Dr. Erismann of Zurich, Mr. Alexander Schiavi of Milan ; and to the following organizations whose officers' responses to requests for assistance often involved the special gathering of material and pho- tographs at obvious cost of time and effort: The American Institute of Social Service, The Nutrition Laboratory of Columbia University, The Sheffield Scientific School of Yale, The Boston Home and School Society, The Philadelphia Home and School League, The British Institute of Social Service, the Education Committee of Bradford, England; the London County Council, Zentralstelle fiir Volkswohlfahrt, Berlin; to the Prefects of the Departments of France and to the French Consulate of New York City, Det Sociale Sekretariat and Bib- liotek, Copenhagen; Centralverein zur Bekostigung armer Schulkinder in Wien (Vienna), Austria-Hun- gary; Central Bureau voor Sociale Adviezen, Am- sterdam ; Centralforbundet for socialt arbete, Stock- holm, Sweden, and to Zentralstelle fur Soziale Lit- eratur, Zurich, Switzerland, CONTENTS PAGB Preface v Introduction 9 I History and Present Status of the School Feeding Movement 13 II Physical Deterioration and Malnutrition in England 22 III Provision of Meals in the Public Elementary Schools OF Great Britain 43 IV The Cantines Scolaires of France 77 V School Meals in German Municipalities 99 VI School Feeding in Other European Countries 130 VII Lunches in American Elementary Schools 147 VIII Provision of Meals in Open Air Schools 184 CONTENTS PAGE IX Investigations of Underfeeding among Abierican School Children 196 X Malnutrition in Childhood: Its Symptoms, Causes, Results and Classification 211 XI The Food Needs of Growing Children 233 XII School Menus 248 Bibliography (Annotated) 261 Appendices, A, B, C, D, E, F, G 299 Index 333 TABLES PAGE Investigation of Ill-Nourished Children, Manchester, 1904. 37 Number of Children Attending Meals and Number of Meals Served in Years from 1907-08 to December, 1910 62 Provision of Meals in English Schools, Financial Summary, 1908-1 1 64 Causes of Malnutrition I25 Sample Recipe Card Showing Constituents and Fuel Values of Ingredients 156 Monthly Account Sheet in Use for Philadelphia Lunches. . . I57 Daily Record Card Kept by Saleswoman at School Lunch. . 158 Average Gains of Children Attending Lunches Voluntarily for Six Months Compared with Average Gains of Chil- dren Not Attending the School Lunches 161 Average Gains During Three Months of Children Fed Reg- ularly Compared with Average Gains of a Similar Group of Children Not Fed Regularly 162 Showing Comparative Marks in Lessons and Conduct at Three Months' Interval of Fed with Unfed Group of Children 162 Food Used in One School Month— Syracuse Open- Air School — Showing Money-Cost and Food Value. Twenty Meals, Twenty-five Children 192 Investigation of Underfeeding in Chicago 203 Relation between Income and Underfeeding in American Workingmen's Families 206 Incomes of Families of Underfed Children 207 Housing of Underfed School Children 209 Average Height and Weight of All Children from 5-18 Years, According to Housing 220 Relation of Nutrition and Vulnerability to Disease 228 Daily Food Needs of the Average Child, Age 10, Weight 27-29 kilos 243 TABLES Showing Amounts of Various Foodstuffs Considered Neces- sary at Different Meals for the Average* School Child Weighing 27-28 Kilos 245 Comparison of Distribution of Food Constituents and Values in the Three Daily Meals Under Conditions of Good Home Feeding with Distribution When School* Meals Supplement Poor Home Feeding 246 Comparative Food Value of Lunches Purchased by Children 249 Food Values Purchased by One Cent 250 ILLUSTRATIONS PAGE Rochester High School Students at Lunch « . . . . i8 Full Tables. Bristol, England 46 School Dining-Room. Bristol, England 46 Charging Oven. Bradford, England 58 Interior of Motor Wagon. Bradford, England 58 Filling Food Vessels with Soup and Rice Pudding. Bradford, England 66 Cutting Bread and Mincing Parsley. Bradford, England 66 Washing up After New York School Lunch 148 Preparation of New York School Lunch 148 Serving and Waiting in Line. New York City 150 Three-Cent Dinner in Philadelphia Schools 154 Lunch Room Equipped and Supported by Mothers' Club, Philadelphia 160 Just to Show How it Looks. Three-Cent Dinner, Philadelphia 162 Kindergarten Children. Three-Cent Dinner, Phila- delphia 162 The Principal Eats Dinner Each Day with the Chil- dren in this Philadelphia School 166 The First School Lunch in Pittsburg 166 Special Class of Mentally Defective Children at Lunch 174 Ready TO Serve Rural School Lunch. Minnesota 176 Cooking Corps in Minnesota Rural School 176 Warm Lunch Equipment of One-Room Rural School, Minnesota 178 Children at Lunch. Open-Air School, Orange, N. J. 190 Open- Air School, Syracuse, N. Y 190 The Waiting Line, Buffalo, N. Y 200 A Happy Boy. A Big Meal. Indianapolis 200 Noon Lunch in Two Buffalo Schools 206 CHARTS AND DIAGRAMS PAGB I Diagram: Average Increase in Weight of Children in Bradford School Feeding Experiment Dur- ing 25 Weeks 52 II Chart: Average Weights of One-room, Two-room, Three-room and Four-room Children at each Age from Five to Fourteen 221 III Table: Relative Weight and Height Table, Boys. American Standard Measurements 223 IV Table: Relative Weight and Height Table, Girls. American Standard Measurements 224 V Chart: Daily Food Needs in Grams of School Children of Varying Ages and Weights 241 VI Chart: Average Purchasing Power of One Cent Spent for Unplanned Lunch, Contrasted with Pur- chasing Power if Spent for School Lunch . . 251 INTRODUCTION More and more are we coming to understand that education is for life, and that physical health is essential to full mental and moral development and effective living. To the extent that the body fails to serve the will, the will is paralyzed and the best emotions rendered usekss. Mere good wishes can not accomplish much. Little service can be rendered by him who stands forever "shivering on the brink of action." The establishment of the physical health of children has therefore come to be regarded as a most important part of their edu- cation. To a very large extent this must depend on right habits of eating. Children must have food in proper quantities and of the right kind, and must eat in the right way at right times. There must always be doubt as to the value of the results of a school day for the child who is listless from want of food or from eating large quantities of indigestible or non-nutritious food. The custom of providing meals for children at school has, in recent years, become well established both in America and Europe. In America at least the work was begun first in the high schools. For several years mid-day meals have been provided 9 10 INTRODUCTION for high school children in many of our cities and larger towns. It is only recently that the more important task of providing meals for the smaller children has been attempted, except in a very few places. At present meals are provided in one or more elementary schools in nearly a half-hundred cities. In Europe, this work was begun earlier than here— in Germany a century and a quarter ago — and the school luncheon is now part of the daily program in the elementary schools of many of the most progressive countries. There is little doubt that the school 'luncheon idea, now well rooted in this country, will spread very rapidly, especially in our cities. The reasons why it should are easily understood. In our large cities and smaller industrial towns, many children come to school having had little or no breakfast. Many have eaten their breakfast at a very early hour, some as early as 5 or 6 o'clock, and so become hungry and faint before the noon hour. These children should have a light, wholesome luncheon in the middle of the forenoon. For many there is nothing to eat at home if they return there at the noon hour. Many who find food at home at the noon hour find it cold and must eat it alone. Father and mother and the older children of the family are in the shops or in the mills. In the smaller towns and in country communities many INTRODUCTION 11 children live so far from school they can not go home for luncheon and return within the time allowed. They must therefore go without luncheon, or eat cold, unsuitable food brought from home in baskets, buckets, or paper bags. Others who do go home for luncheon can do so only by running home, bolting their food and hastening back to school. In many places in which the parents and older mem- bers of the family return for the mid-day meal, it is very inconvenient to adjust the meal-time to the convenience of the children in school. In some cities and towns the school day begins at 8.30 or 9 o'clock, and continues until 1.30, 2, or 2.30, with one or two brief intermissions, usually of only fifteen minutes each. Where this practice obtains, many children go without food until the school day is over, and then go home to a cold luncheon, eaten rapidly and in such order as it can be had, losing altogether the social value of the meal. I have known many school children whose daily schedule of meals consisted of a very light breakfast at 6 or 7, a cold dinner bolted at 2 or 3 o'clock, and supper at 6« Again, many parents, instead of providing a luncheon for their children at school, give them small amounts of money with which to buy food, and which the children spend for unwholesome and unnutritious stuff sold at large profits from push carts and at corner stores. n INTRODUCTION These conditions should not — must not — con- tinue. The remedy seems to He in the well-managed school luncheon, which can be made wholesome, educative, and saving in money, in time, and in the health of children. Because the movement already started will prob- ably continue with accelerated speed, there is all the more reason for a book like this which Mrs. Bryant has prepared after a long and careful study of the subject in all parts of the world. In her painstaking correlation and interpretation of the facts concerning this great new movement, she has rendered a distinct service to the children of America and to all who are interested in their welfare. The book is practical. The information in re- gard to what is being done in various countries and cities is reliable. Problems not yet solved and difficulties not yet overcome are frankly admitted and pointed out. The book is not dogmatic. In its fuU descriptions of experiments and clear state- ments of results it is illuminating. P. P. Claxton. Washington, D. C, February, 1913. SCHOOL FEEDING History and Present Status of the School Feeding Movement School feeding is an educational movement a century and a quarter old, national in scope in many of the important countries of the world and at the present time spreading and developing with wonder- ful rapidity. The object of the school feeding move- ment is to supply such facilities as will make it possible for every child to secure an adequate, whole- some noon meal despite the fact that he is attending school. The necessity for special provision to se- cure this end arises where many of the pupils live so far away from the school as to make it impos- sible for them to return home at noon, or where there is no adequate warm noon meal awaiting them if they do return. One or both of these con- ditions may result from any one of a most varying range of causes. 13 14 SCHOOL FEEDING They exist in connection with forms of educa- tional administration which are otherwise most admirable, such as the consolidation of rural schools, and single sessions in high schools in sparsely settled districts. They are found in densely settled portions of great cities, where many mothers are absent from home all day at work. At the other end of the social scale they occur in the homes of the cultured and well-to-do, where parents are frequently absent during the mid-day hours engaged in social and civic work. It is but rarely that these conditions exist in any very large proportion of the children's homes, but while the proportion is not great, the actual number of children affected in each school system is frequently very large indeed, and the necessity for alleviation then becomes imperative. Society's machinery for meeting this need is school feeding. GERMANY The first provision of school meals of which .we have record was made in Munich in 1790, when municipal soup kitchens were started by Count Rumford as part of his international campaign against vagrancy. The kitchens were designed to SCHOOL FEEDING MOVEMENT. 15 meet the needs of the people of all ages, and from the start the school were encouraged to send groups of children to them for a warm meal at noon. This work was long unorganized but never discontinued, and in the seventies the obligation of providing meals was put on the school authorities. From this ancient beginning the school feeding movement spread throughout the German Empire until now it is national in scope, and about half of the cities contribute to support wholly or in part school break- fasts or dinners. FRANCE School feeding in France began in 1849, when the National Guard of the Second District in Paris presented to the city the unexpended balance in their treasury with the request that it be used to help poor children get a schooling. This was the beginning of the " Caisses des Ecoles " or school funds which were made obligatory throughout the country in 1882 and are employed among other purposes in maintaining the " Cantines Scolaires " or school restaurants that are now universal in France. ENGLAND The founder of school feeding in England was Victor Hugo, who in the early sixties provided 16 SCHOOL FEEDING warm meals in his own house in Guernsey for the children attending a nearby school, and so gave the initial impetus which led to the establishment in London in 1866 of " The Destitute Children's Din- ner Society." During the next forty years similar charitable societies were formed, until in 1905, when the Provision of Meals Act was under considera- tion, there were in London alone no less than 158 voluntary organizations for school feeding and a total of 360 'in England. For the most part these societies were conducted by teachers in the differ- ent schools with little attempt at central organiza- tion and no aim beyond the immediate relief of acute distress. The Provision of Meals Act, passed in 1906, gave the Local Educational Authorities permission to instal school restaurants as part of the regular school equipment. This resulted in the rapid de- velopment of a system similar to the French Can- tines, which by March, 1909, had extended over 100 towns and cities. WIDE EXTENT From these early beginnings in Germany, France, and England, and with the various objects of char- itable relief, promoting hygiene and encouraging SCHOOL FEEDING MOVEMENT 17 school attendance, the work of school feeding has spread, until now, grown beyond the local issue, it has received national recognition and been made the subject of national legislation in France, Switzerland, Holland, Great Britain, Denmark, and Bavaria. It is national in scope with support by the municipalities in Germany, Italy, Denmark, Sweden, Norway, Finland, Austria, and Belgium. It has been started in Spain, Russia, and the United States. PROMINENCE OF MOVEMENT The movement for school feeding is by no means an obscure one, and during the past two decades has been the subject of serious and extensive in- vestigation in most of the countries mentioned. In England the Provision of Meals Act came as a crystallization of public opinion that had been shap- ing for forty years and had been tremendously stimulated by the activities of four Parliamentary Commissions appointed to investigate the physical condition of the people. In Germany the problem was first given wide publicity in 1890 when a National Congress was held to discuss problems concerning vacation colonies for school children. At this convention it was 18 SCHOOL FEEDING agreed that if children were to receive permanent benefit from their country outings they must be assured good food all the year round. In 1897 the Social Democrats introduced a bill in the Reichstag providing for school feeding in cities, but this was defeated on the ground that such a measure would increase the migration of the people to the large cities. Recently, however, since England has passed her national act, the subject has been extensively studied in Germany, and there is now serious and widespread agitation for national legislation. BEGINNINGS IN AMERICA As in the case of many other educational ad- juncts, the United States has been slow in following the lead of the European countries in adopting school feeding. Long after it had passed the ex- perimental stage in Europe, it was still regarded as a startling innovation here. Purely charitable work was undertaken as early as 1855, when the Chil- dren's Aid Society in New York City began to furnish free lunches for the children of the Industrial Schools. Almost from the beginning of his superintendency of the New York schools, Dr. William H. Maxwell SCHOOL FEEDING MOVEMENT 19 has urged the installation of lunches in the ele- mentary schools, where all who wish may buy at cost a warm, nourishing noon meal. Since 1908 lunches in the elementary schools have been con- ducted by the co-operative efforts of the educational authorities and a committee of social workers, physicians, and teachers. The Starr Center Association started penny lunches in two Philadelphia schools over fifteen years ago; a work that with the co-operation of other societies has continued and grown until at present there are more than ten schools with some form of school lunch. After two years of agitation and investigation, the Board of Education in Chicago in the fall of 1910 appropriated $1200 for the experiment of installing lunches in six city schools. It is too early to speak of results. Recent reports show that the meals are a success so far as they may be measured by the attendance and the children's interest. In twenty-seven other cities in fourteen differ- ent States, women's clubs, teachers, and school doc- tors have organized to introduce lunches in the ele- mentary schools, and in at least twenty other places the matter is being considered. W SCHOOL FEEDING Though there have been no legislative enact- ments providing for school lunches in American cities, at least one important step in this direction has been taken in Massachusetts. This takes the shape of a bill favorably reported by the Com- mittee on Education of the Lower House in the Session of 19 12 and provides that school boards shall be empowered to expend school funds for the support of lunches in elementary school systems. SUMMARY 1. School feeding began in Germany. It is a century and a quarter old in Europe and more than half a century old in America. 2. It is a movement national in scope in fifteen important countries. 3. School feeding is provided for in the national legislation of six countries. 4. The movement has attained great momentum in America in the last twenty years, and school lunches now constitute a part of the elementary schools systems of thirty American cities. There is no longer any question as to whether or not we must seriously face the school lunch problem. School lunches already constitute an important part SCHOOL FEEDING MOVEMENT 21 of the systems of elementary schools in our largest American cities, and nothing is more certain than that the movement will rapidly extend in the next few years. The problem confronting those who have at heart the welfare of American public schools is no longer " Shall we have school lunches? " but rather, " How may we best guide this movement so as to develop all of its potential benefits and at the same time avoid possible dangers ? " II Physical Deterioration and Malnutrition in England The children of a country are the capital of a country, and it is in the use and value of its capital that we may discern a nation's wisdom. — Earl Beauchamp, 1902. Shortly before the close of the Boer War, Major-General Frederick Maurice of the British Army startled his countrymen by announcing that only two men out of every five who' wished to be- come soldiers were physically fit for army life.-^ In Maurice's own words, it was " a vital matter . . . to enquire what is the meaning between the five and the two. Does it mean that the class which neces- sarily supplies the bulk of the ranks in our army consists in this large proportion Oif men physically unfit? If so, what are the causes of this fatal con- dition of things, and are they remediable? " This roused the country to an eager considera- tion of its blood and brawn, and a series of search- * Maurice, Sir Frederick, The National Health, in The Contemporary Review, January, 1902. See also A. Watt Smyth in his " Physical Deterioration, its Causes and the Remedy", ch. i. 22 DETERIORATION IN ENGLAND 23 ing investigations into the physical make-up of the nation followed. Attention was first turned to the schools. Im- mediately after the publication of Maurice's state- ment the king appointed a commission to find out what means of physical training was provided in the schools and what further education was needed to improve the national physique and to build up the national army. The Royal Commission on Physical Training ex-^ amined the opportunities for physical education in all grades of institutions from the universities down. They came to the conclusion that, so far as the elementary schools were concerned, the trouble was not with the lack of gymnastic drill, but with the bodily condition of the children themselves. In many cases they were simply too weak to be trained physically. In Edinburgh, for example, where no less than 30 per cent, of the children in certain districts were under-nourished, it was found that the method of gymnastics followed was not only doing no good, but actual harm. In contrast to the conditions in the regular public schools came reports of the rapid development of army and navy recruits in the training schools where £4 SCHOOL FEEDING full regular meals were as prominent and important a feature as was military drill. Surgeon-General Don submitted evidence showing that young boys gained from five to seven pounds in weight and an inch in chest girth after seven weeks of army life. Wherever food was provided as in the case of special schools for the physically and mentally de- fective, or in industrial schools for truant or neg- lected children, physical training was reported to have good results. Indeed the children in the in- dustrial schools were in many ways the physical and mental superiors of children of the same social grade in the regular elementary schools. Comment- ing on this fact, the Commission said : " These institutions certainly give to the boys or girls who come under their influence advantages as regards physical conditions which are not open to the chil- dren of independent and respectable though very poor parents." ^ The difference between these two classes of children was both marked and painful. With this and a mass of similar evidence before them, the Commission became convinced that, " among the causes which tell against the physical 'Report of the Royal Commission on Physical Training, p. 30, par. 164. DETERIORATION IN ENGLAND 25 welfare of the population, the lack of proper nourish- ment is one of the most serious " ; and that " the question of the proper and sufficient feeding of children is one which has the closest possible con- nection with any scheme which may be adopted for their physical and equally for their mental work." They accordingly recommended the general estab- lishment of school lunches for which the children would pay a small fee as they had formerly done for their instruction. Though the evidence presented by the Commis- sion on Physical Training was valuable and sug- gestive so far as it went, they did not even try to answer the question the British public was asking, which was, " Is our race deteriorating, and if so what are the causes ? " A year later a new in- vestigating body, known as the Interdepartmental Committee on Physical Deterioration, was ap- pointed to study the general social and economic causes for the alleged deterioration of certain classes, and to point out means of diminishing it. The new commission consulted sixty-eight wit- nesses, men and women from all parts of Great Britain, who were either officially connected with the government in school, factory, or town adminis- 26 SCHOOL FEEDING t ration, or else members of well-known institutions of charity and education, and all of them were intimately acquainted with the daily lives of the masses of the people; thirty-seven were physicians. The first hopeful finding was that there was no hereditary taint apparent that might cause a progres- sive degeneration of the people. Each new gen- eration started life with a new lease of energy. But shocking conditions of life were found, that for large numbers more than counterbalanced the strength at birth. It was upon these conditions and the possibility of their betterment that the Com- mission dwelt. Bad as were the other destructive factors, such as congestion of population, unsanitary dwellings, involuntary unemployment, infant mortality, drunk- enness, etc., none was more prominent than the chronic malnutrition, found at all ages, in town and country. This malnutrition was specially marked among school children, although the decrease in breast feeding and the absence of a good milk supply were responsible for much bad feeding earlier. Never- theless people seemed to understand the feeding of infants and little children better than that of older DETERIORATION IN ENGLAND 27 ones. When the children began to go to school they were left tO' shift for themselves at meal times, and usually adopted the adult habits of tea and coffee and highly seasoned canned food. Dr. Eichholz, one of the most prominent wit- nesses, declared that the following was a fair de- scription of the dietary of thousands of city chil- dren: "Their breakfasts are nominally bread and tea, and the dinner nothing but what a copper can purchase at the local fried fish shops, where the most inferior kinds of fish are fried in reeking cot- ton-seed oil." Milk and fresh vegetables were un- known quantities, while meat was almost lacking, except perhaps at the Sunday dinner, when it was of a poor quality. In short, the Commission found that the food was bad for three reasons: first it was insufficient; second it was irregular; third it was entirely unsuitable in quality, and was specially lacking in cell-building elements. At the same time the strain of school work, added to the demands of rapid growth, made the subject of food during the school period of intrinsic impor- tance. Indeed, Dr. Hutchison, the well-known Eng- lish dietitian, gave as his opinion that the most critical time of a child's life, so far as its nutrition 28 SCHOOL FEEDING goes, is the school period — ^between ten and fifteen years. This being the case, Dr. Hutchison added that " looking at it purely scientifically, it would be an extremely important thing to ensure to every child at school a sufficient and proper meal." Few figures were given to- show the precise number of children in the schools who' were mark- edly affected by bad feeding. Dr. Eichholz made the statement that in London there were not fewer than 122,000 children who were underfed, that is, 16 per cent, of the entire school population. In Manchester 15 per cent, were reported underfed. Dr. Kelly, Roman Catholic Bishop of Ross, asserted that, '' In the South of Ireland it is commonly the case that children come to school underfed." There was a good deal more similar evidence, mostly in the form of general remarks about the wide extent of malnutrition in the schools. With one exception, the witnesses were agreed that bad food was the most serious of all the factors making for degeneracy, particularly juvenile de- generacy. They agreed with Dr. Eichholz that '' food is the point about which turns the whole problem of degeneracy," and with Dr. Mackenzie, that "of the three selective agencies determining DETERIORATION IN ENGLAND 29 national development, housing, occupation, and feeding, unquestionably the most important is feed- ing." Although the poverty and ignorance at the bot- tom of malnutrition and other evils might be com- bated only by widespread social legislation and reform, nevertheless the Commission v^as convinced that the problem as it touched the school might be directly attacked, and, like the earlier commission, they proposed that school lunches be introduced. " We have got to the point," said one witness, " where we must face the question whether the logical culmination of free education is not free meals in some form or other, it being cruelty to force a child to go and learn what it has not the strength to learn." The members of the Commission, however, were not in entire agreement with this witness, and they therefore suggested that the lunches be maintained wherever possible by private funds, and that the school authorities should be allowed to interpose where these failed, to supply the meals from the public funds. The situation before the public now was this: The two commissions which had started out to 30 SCHOOL FEEDING answer Major General Maurice's question had shown that the physical condition of the people at large was in need of careful attention. This applied most of all to the food of the people, and to that of the children in particular. Both commissions had recommended school meals as a partial remedy, and as a step in the larger campaign against the forces of deterioration. It remained to find out just what was the exact need for school feeding and what was being done already by private individuals in the matter before proceeding to organize meals on a public basis. A special Commission was appointed to look into the matter of medical inspection of schools and the voluntary provision of school meals throughout the country. The bulk of their attention was devoted to the subject of school feeding. They sent in- quiries to all the local school authorities through- out the country to find out just how many schools were equipped with the lunches, and how these were run. In addition they examined thirty-five wit- nesses, all of whom were actively engaged in the work of school feeding, most of them being school officers as well. The report of this Commission was published in DETERIORATION IN ENGLAND 31 November, 1905.^ It was found that there were no less than 355 separate organizations for school feeding in 146 places, town and country, that were serving meals of some sort anywhere from three weeks in winter to four months, to about 100,000 children. Some of these organizations were old — the earliest one dating from 1866 in London. The Committee on the Medical Inspection and Feeding of Children did not attempt to find out how many children were in need, nor to estimate the efficiency of the existing organizations in meeting the need. This was left for the Select Committee that considered the Provision of Meals Bill, presented in Parliament a few months later, which was de- signed to give the schools direct responsibility for feeding the children when necessary. The Select Committee on the Provision of Meals Bill went over the reports of the three earlier com- missions, and examined besides twenty-eight Avit- nesses, all of whom had had experience with school meals either as teachers and superintendents, school doctors, members of charitable societies, the Society for the Prevention of Cruelty to Children, etc. * Report of the Interdept, Com. on Med. Inspection and the Feeding of Children Attending Public Elementary Schools. 32 SCHOOL FEEDING As the final passage of the Bill came as a result of the findings of this Commission, especially in regard to the inadequacy of the existing provisions, we shall consider them somewhat in detail. VOLUNTARY FEEDING SOCIETIES The work of the private societies may be illus- trated by the following description given before Parliament by Dr. Airy, who had had charge of the Birmingham Free Dinners Association for twenty years.* " We began with the idea of giving penny din- ners to children who could pay for them, thinking, in our ignorance, that that would suffice for the need of the poor population. We speedily found that we were doing a rapidly declining business among the wealthier classes, and that there were thousands of children who could not pay a penny under any circumstances. We therefore reduced the price to a halfpenny, still intending them to be self-supporting or nearly so. We were then con- fronted with the revelation that there were hundreds of children in every district in Birmingham who * Minutes of Evidence before the Select Committee on the Educational (Provision of Mbals) Bill, 1906, p. 132. DETERIORATION IN ENGLAND 33 could no more pay a halfpenny for a dinner than they could find change for half a sovereign. We therefore at once determined to give up all idea of self-support, and we resolved to make it a charity and devote it, until we saw our way a great deal further, to keeping alive (I think that is the best expression I can use) the very poorest children who either got nothing at all for dinner, or, if they got anything, only got a bit of bread with a little grease, perhaps, scraped on it. We made a careful census of the city, and in Birmingham at that date (1886) we reckoned that there were from 2,500 to 3,000 children who were in a normal state of semi-starva- tion. In addition to that we had to reckon for the margin that there always was from any excep- tional cause of unemployment. We did our best to (satisfy is hardly the word) meet as far as we could the needs of those children." The dinners were given only to those children who could expect practically nothing at home. The relief was further limited by the character of the meals which was purposely designed to discourage any children not in desperate straits. Besides this there was a careful inquiry into the home circum- stances of each child. Only those children might 3 34 SCHOOL FEEDING receive the meals who were passed on by the head teacher, the class teacher, and the visiting attend- ance officer. In spite of all this, the society normally fed 2,500 children in ten different centres each day. Some idea of the pressing need may be gathered from this additional comment by Dr. Airy: " We were much distressed at the fact that the children would come a mile or a mile and a half to eat this poor dinner, and they would come through slush and snow and wet. ..." EFFECTS OF THE MEALS The work of the voluntary societies, limited though it was, had shown good results, as was everywhere asserted by the teachers who volun- teered to help in the selection and service of the children. In Birmingham, for example, the teachers were " unanimous that the system pursued enabled the children to do their ordinary school work, and they reported that the difference was perfectly ex- traordinary.*' Even where the meals were continued only a few weeks, the effect was good. One teacher testified: " Yes, after a week, I can see difference in a child. She becomes less listless, and less fidgety. You can DETERIORATION IN ENGLAND 35 see a much more healthy tone about the skin after a fortnight. It is most marked." The teachers' in- terest in helping the children was often increased by the fact that they found the children so much easier to teach after the breakfast or lunch at school. Dr. Hall of Leeds, who had for years examined children for admission to the factories, and had also charge of school feeding in certain schools, gave most interesting testimony as to the effect of regular meals on children who were seriously under- fed. He took fifty-five children, between seven and eight years old, all considerably below the normal weight, and fed them for a fortnight, weighing them carefully before and after. In that time they gained an average of eighteen ounces (one pound, two ounces) apiece. These children were not " hungry " ; they had to be persuaded to eat at first. Dr. Hall says : ^' I tell you the slum child is not hungry, and will go without food if he cannot have his stale food, his pickles, liver, and onions and blood made up into a sort of pudding. These children are evidently to a medical expert underfed. Look at them. You have at once the evidence of it. You have the ill-nourished skin, the ill-nourished 36 SCHOOL FEEDING hair, the stunted growth, the light weight. Lift up the clothes. When I went amongst them first of all I thought they were flea-bitten. Nothing of the sort. They suffer from purpuric petechias. I took the children and I fed them well. At the end of six months there was not a flea-bite. It had all disappeared." ^ INADEQUACY OF VOLUNTARY SOCIETIES: NUMBER OF CHILDREN BEING FED VERSUS NUMBER IN NEED But societies such as those described were not able to feed anything like the number needing to be fed. For example, in London there were 158 sepa- rate organizations feeding something under 30,000 children, for four months in the winter. This was not a quarter of the 122,000 reported to be underfed and probably in need all the year. In Manchester, Dr. Brown Ritchie examined 10,180 children taken from all grades in twenty schools over the city. The results are shown in the following table: 'Minutes of Evidence Before the Interdept. Com, on Medical Inspection and the Feeding of School Children, pp. 203, 204. DETERIORATION IN ENGLAND 37 Table I . Investigation of Ill-Nourished Children, Manchester, 1904* Number Badly Very Badly Examined Nourished Nourished 7 worst schools 2,031 610—30% 367—18% 13 remaining schools 8,149 i,379— 17% 806—10% 20 schools 10,180 1,989—19% 1,173—11% It will be noted that 1,989 were badly nourished and 1,173 were very badly nourished. That is to say 3,162 or nearly a third of all those examined were below par as to their nutrition. The marked cases formed over 10 per cent, of the whole. At the time of the investigation only about a fifth of the children needing it were being fed at school, although there was a well-organized private society in Manchester. In Bradford, 6,000 children were found by medi- cal inspection to be underfed, that is to say, 11 per cent, of the total school enrolment, while the private society was able to feed only 2,000 at most. Similar figures were reported from other places, but not in sufficient detail to warrant a specific numerical statement for the whole country. A summary is given by Dr. Crowley of the Lon- " Minutes of Evidence Before the Interdept. Com. on Medical Inspection and the Feeding of School Children, p. 250. 38 SCHOOL FEEDING don County Council as follows : " These children of poor nutrition are very common. . . . Speaking for our large towns generally it has been said that they constitute approximately lo to 15 per cent, of the whole school population." "^ VOLUNTARY FUNDS SPORADIC AND INSUFFICIENT The real trouble with the voluntary societies was that their funds were entirely uncertain. It was impossible to raise them steadily enough to plan ahead. Several witnesses called attention to the fact that people seemed willing enough to give at Christmas, or when the weather was very bad, but they did not seem able to grasp the fact that the children's hunger was not an affair of the weather, or even of the time of year. One man, whose busi- ness it was to gather funds for several London societies, said : " When wage earning people on small wages are thrown out, the pinch comes. They have no reserve to fall back upon. Then you come to February, when the better class of people who have larger reserves are beginning to sell parts of their furniture, to pawn, and so on. They begin to feel the pinch then. By that time the stream ' Crowley, Dr. Ralph H., The Hygiene of School Life, p. 16. DETERIORATION IN ENGLAND 39 of charity is very difficult to tap ; it has really ceased to flow. It is at Christmas time that you hope to get people quickened. A fortnight's really bad cold weather will bring money, but when the bright or mild muggy weather comes, you may as well appeal to the air." The difficulty of raising funds was well shown in the case of Birmingham, where it was decided in 1904 that a yearly income of 4500 pounds was needed to provide a meal every school day for the 4500 children in need. The man who out of his own pocket had been supplying breakfasts to about a thousand very poor children, was asked if he con- sidered that there would be any difficulty in raising the 4500 pounds *' if an appeal were made to the people of Birmingham by duly constituted persons." He replied : "I think there would be more than difficulty; I think there would be an impossibility. As a subscriber, I have seen the last published accounts of the Birmingham Free Dinners Asso- ciation. This charity has been in operation from fifteen to twenty years, and has had among its officers and subscribers some of the most influential people in the district. Its total list of subscriptions and donations is under 300 pounds per annum, and even this includes 75 pounds contributed by teachers 40 SCHOOL FEEDING in the council schools. To raise a sum of from 4000 pounds to 5000 pounds a year by these means seems to me quite hopeless." It was obviously unjust to expect that the teachers should contribute to the support of the meals especially when they were already giving their ser- vices, and yet they often did so feeling strongly the children's need. ADMINISTRATIVE DIFFICULTIES Not only were the voluntary societies thus hampered at every turn by lack of funds, but there were administrative difficulties nearly as bad. Ow- ing to the lack of funds the societies were not permanent in many cases, and the meals were stopped during the summer, though the provision was often just as necessary then. Again, because of the lack of official regulation, there was frequently considerable overlapping of effort in certain districts, while others remained neg- lected. A third difficulty was that the voluntary societies had no means of prosecuting delinquent parents on the one hand, nor on the other of assur- ing that provision was made for the most needy children. DETERIORATION IN ENGLAND 41 SCHOOL FEEDING BY PUBLIC CHARITY An attempt was made, shortly after the publica- tion of the report of the Committee on Physical Deterioration to relieve some of these administrative difficulties by means of the " Relief of School Children's Order." This was a national order which provided that children found to be underfed at school were, on application by teachers or super- intendents, to be put in charge of the public poor officials, and fed free for a month, the cost being chargeable to the father as a loan. Where the father failed to pay, he was prosecuted for vagrancy or cruelty, or else, if he could not pay, he was dis- enfranchised as a pauper. The results of this order were as clumsy as its name, and it soon became a dead letter. The school authorities objected to the harsh methods of the " Guardians of the Poor," and declared that they served no good end to education. Parents objected even more decidedly and refused to allow their children to be fed. Voluntary subscriptions fell off at once and as the order limited the relief to the absolutely destitute, a great many children not technically destitute, but who had been helped be- fore, were left unprovided for. 42 SCHOOL FEEDING The order served the purpose, however, of shovvr- ing that the provision of meals was a school prob- lem and of establishing the principle that to be efficient, the provision of meals must be carried out under the direction of school authorities. This prin- ciple was recognized in the Provision of Meals Act, passed December, 1906. We have now considered the growth of public opinion on the subject of malnutrition of children, the awakening of the public conscience by the re- ports of the Commissions on Physical Training and Physical Deterioration, the careful investigations by two other committees on the existing voluntary provisions for school feeding, their findings as to the inadequacy of these, the unsuccessful attempt to deal with the problem by public charity and the final crystallization of ideas and opinion in the Provision of Meals Act, passed after four years of discussion and inquiry. The working of the Act, and the present con- dition of school feeding in England will be taken up in the following chapter. Ill Provision of Meals in the Public Elementary Schools of Great Britain The Provision of Meal Act, passed in December, 1906, virtually transferred the obligation of feeding hungry children in the schools of England and Wales from charity, public or private, to the local educational authorities. It did more than provide for the children in ab- solute need, and who, in the words of the Act, were " unable by reason of lack of food to take full ad- vantage of the education afforded them." These children, about ten per cent, of all, did not exhaust the number who might be benefited by a wholesome school lunch. Many more were dependent on hasty, cold and irregular meals, snatched at home, or bought with pennies at noon at small shops nearby. This was bad, not only because these children furnished ready recruits for the malnutrition ranks, but be- cause bad habits and low standards of food were being formed to work future ill. The Act was designed to combat the kind of 43 44 SCHOOL FEEDING ignorance that gave little children tea and bread for breakfast, pickles, fried fish and pastry for lunch, and tea, jam and bread for supper. To do this required more than sporadic '' relief work." It meant careful and continuous education of parents and children. As a step in this needed education, the Act pro- vided that school funds might be used in the estab- lishment of regular school restaurants, where warm, wholesome meals might be served daily tO' all those wanting them, at cost to those able to pay, and free to those found to be unable to pay. All classes of school children might thus be benefited and the pernicious small food shops supplanted. This object of the Act and the spirit in which it was conceived are shown in the following statement made by the National Board of Education in the circular sent with the Act to each Local Educa- tional Authority: The Act, which is purely permissive, and imposes no duty where a Local Educational Authority think it unnecessary to bring it into operation, is primarily oi an educational char- acter. Its object is to ensure that children attending public elementary schools shall, so far as possible, be no longer prevented by insufficiency of suitable food from profiting by the education oflFered in our schools, and it aims at securing that for this purpose suitable meals shall be available just as MEALS IN SCHOOLS 45 much for those whose parents are in a position to pay as for those to whom food must be given free of cost. There are five general provisions for the conduct of such school restaurants which may be briefly summarized as follov^s: 1. The meals are tO' be controlled by special committees known as School Canteen Committees, on which the local school board must be represented. 2. The entire cost of equipment and service may be borne by the school. 3. The cost of the food is to be met wherever possible by the parents of children receiving the meals, or by voluntary contributors. Where money from these sources fails, a local tax, not to exceed a rate of j/zd. on the pound, or 2 mills on the dollar, may be raised tO' cover the cost of food. 4. Wherever a parent, though able, fails to pay the cost of the food, this is to be collected sum- marily as a civil debt, but its non-payment is never to be made a cause for disenfranchisement. 5. Teachers are never to be required to take any part in the organization or service of the meals. The Act includes no further details of administra- tion. The texts of the Act and that of the circular of information above referred to are given in Ap- pendices A and B. 46 SCHOOL FEEDING HOW THE ACT HAS WORKED The experience in Bradford, a manufacturing town with a homogeneous population of 300,000 and about 60,000 school children, may be taken as typical of the way in which British towns generally are availing themselves of the provisions of the Act. School feeding was not new in Bradford .when the Act was adopted. The experiment had been tried before of supplying the very poorest children with food, first through private, and then through public charity, but unsuccessfully, because of lack of funds, and general administrative difficulties. Before attempting to start meals on a large scale, therefore, the authorities waited until they had de- * termined, by definite experiment and investigation, first the extent to which the problem of malnutrition was immediately pressing, and second, what sort of meals should be provided, and what was the best method of serving them. THE EXTENT OF MALNUTRITION IN BRADFORD IN 1907 The first thing was to find out the number of children in the Bradford public schools who were in absolute need and because of lack of food were FULL TABLES. BRISTOL, ENGLAND SCHOOL DINING-ROOM. BRISTOL, ENGLAND. THE USE OF UPPER STORIES FOR LUNCH ROOMS IS A HAPPY IDEA MEALS IN SCHOOLS 47 unable to take full advantage of the education pro- vided for them. After an examination of the physical condition of all the children in the schools, Dr. Crowley, the head medical officer, declared that from a personal examination of 2000 children he estimated that there were at least 6000 children in the city who were underfed. This means that 11 per cent, of the total school enrolment were suffer- ing from malnutrition. PRELIMINARY EXPERIMENT The next step was to determine the probable effect of merely feeding these children without alter- ing their manner of living in any other way. It was important to find out whether the school could help matters in the only way open to it — that is by pro- viding food of an assured good quality and served under wholesome and pleasant conditions, it being obviously impossible to enter the homes and change the construction of the buildings or the lives of their inmates. By way of preliminary experiment it was decided to feed about forty of the most needy children for three months with two daily meals carefully planned to meet the needs of growing children. Before the 48 SCHOOL FEEDING meals were started, the children were weighed three times in five weeks to ascertain their average rate of growth. They were fed from April 17 to July 24 and during that time they were weighed and meas- ured once a week and a general account was kept of their physical condition. At the same time careful records were kept of the growth in weight and height of a group of 69 " control " children who were of the same age and general development as the experiment children and of the same social class. The meals at school constituted the only difference between the two sets of children. GENERAL CHARACTER OF THE MEALS AND SERVICE Breakfast and dinner were provided daily except Sunday. The two meals were so planned by the school doctors and the director of domestic science as tO' furnish about three-quarters of the total daily ration required by the school child. The elements of fat and tissue-building protein were emphasized, as it was in these expensive elements that the home meals were usually lacking. The children were suf- fering not so much from a general lack of food as from *' protein starvation." MEALS IN SCHOOLS 49 The menus of seventeen dinners were made out to fulfil the special requirements of the case and provided such a variety that it was three weeks before any given meal was repeated. The break- fasts were not varied from the general scheme of oatmeal, milk and bread and butter or molasses. Among the seventeen dinners, four were made up of substantial soups and boiled or baked jkn or ginger puddings made with milk and served with a sweet sauce ; there were six " vegetarian " dinners made without meat, though butter and other animal products were used in baked puddings and wholemeal cakes. There were six dinners with meat and vegetable pie, stew, etc. One dinner was especially elaborate, with fish and potato pie, green peas and lemon sauce, blancmange and jam. Bread was served with all the meals and milk, the most valuable source of protein for children, was used in nearly all. These menus proved so satisfactory in the preliminary test that they are in permanent use in the schools of Bradford. The cost of the breakfast, including preparation, was 2j^ cents; the average cost of the dinners was not quite 3 cents. In addition to this care in the choice of food, it 4 50 SCHOOL FEEDING was served in such a way that the whole effect should be educative. There were tablecloths and flowers on the table; monitresses were chosen from the older children in the school who waited on small groups of ten at a table. These monitresses wore clean white aprons and sleeves, and received their dinners free in return for their services. Most of these children had never had any experience in the etiquette of the table and yet there was little trouble about their behavior, " for children soon respond to orderly and decent surroundings." TRAINING THE APPETITES It was not enough that the meals should be nourishing and attractive to the normal palate. The children were quite unused tO' normal food, having subsisted largely on canned and fried food, coffee and baker's bread. They had seldom tasted milk. They had to be taught to like the new tastes. They were watched individually from the first. Dr. Crowley says : " This is an especially important point, and if it be not attended to no system of feed- ing can give fully satisfactory results. With a little encouragement, by starting with small helpings, by not at first unduly pressing what is distasteful and MEALS IN SCHOOLS 61 in other ways, children whom at first it is difficult to get to eat can soon be made to do so. These children it was found advisable to group together at one table, thus permitting of ready supervision." When the meals started, only one child of the entire group had ever before eaten oatmeal. This was a Scotch child. The first day thirteen refused to eat it ; by the next day curiosity or imitation had conquered all but two, and after that all ate with apparent enjoyment and there was much complain- ing when the oatmeal was omitted for variation. New dishes in the dinners were adopted in the same way. RESULTS Certain good results of the experiment were apparent to all. The children brightened up, their general carriage changed from one of listless de- pression to alert interest. The teachers reported a corresponding improvement in the lessons. Aside from these results that cannot be expressed in quantitative form, the actual gains in weight are shown in graphic form in the following diagram in which the fluctuations in weight of the children receiving meals are shown by the solid line and the total gain of the *' control group," by the dotted line. 5^ SCHOOL FEEDING The results may be summarized as follows: I. Before the meals began the average weekly rate of growth during five weeks was a little over LBS 3i 3 MARCH APRIL MAT JUKE JULY AUOUST IE 19 IS 2 9 16 21+ 1 ^ 16| 21 27 1* 11 19 26 JL 10 jj] J5 1 t Ji 22 ^ ' tj ' e e Si p. n. ) y .> / p. o (/I /^ ^ r N \ 2i 2 m 4 V ,, ' 1 4 4 1 1 / /■ """^ J \ \ i- """ / V cc / 1 i /" ^ f \ a 'a / ( ,■» .•^ ' -xa o > o u / ' — V , --• -'' ^^•* , •* ■ ^ — a a 1 r ^* ... ♦ * ,»• • •' ^ * .• ♦ ■ ■' ' • — p,^- =f- ^, :^^ J . ' « - m^ ^ <: ^ — I 1 ■ . Diaeram showing average individual Increase in weight of children in Bradford school feeding fxpSiS during twenty-five weeks. Solid line shows average increases and decreases of chUdrenrrcTv^ngmSfJ Dotted line shows average increase of control children not receiv- ing meals. (Adapted from Crowley.) an ounce apiece. This was about the average weekly gain of the control children during the experiment, and represents a yearly gain of three pounds and five ounces. MEALS IN SCHOOLS 5S 2. The children who were fed gained on an aver- age of six ounces a week in the first four weeks of the experiment. The greatest gain came in the first week, when the average was one pound and four ounces. After this sudden rise the weights remained nearly stationary for a week. The weekly gains of the third and fourth weeks were 5J4 and 4j4 ounces. 3. During a holiday of eleven days, from May 16 to May 2y, after four weeks of feeding, the chil- dren were not fed, with the result that they lost a pound apiece in weight, which it took two weeks to regain. 4. During this same holiday the control children, relieved from the strain of school work, gained on an average of eight ounces apiece, as opposed to a gain of }i ounce in the next eleven days after the vacation. (These variations not shown in chart.) 5. The net average gain of the experiment chil- dren from the beginning of the feeding till the end was two pounds and eight ounces. 6. The total average gain of the control children during the same period was one pound and four ounces. 7. At the end of the summer holidays all the 54 SCHOOL FEEDING children were about the same again. An increase in weight was again shown in the case of the control children, who gained at the rate oi 2}^ ounces a week instead of one ounce. This experiment showed that the single factor of good food could do much even while other con- ditions hostile to healthy development remained un- changed. Without hesitation, therefore, the school authorities made plans for the development of meals on a much larger scale. PRESENT ORGANIZATION OF SCHOOL CANTEENS IN BRADFORD To-day the equipment for school meals in Brad- ford is probably the finest in the world. The work is in the hands of the Canteen Committee, which is a sub-committee of the city school board, and com- prises head teachers, medical inspectors, visiting nurses, and attendance officers. SELECTION OF CHILDREN All the children may attend the meals, but special attention is given to those who are to receive the meals free. As a rule the teachers recommend chil- dren from their classes who they think are in need MEALS IN SCHOOLS 55 of food. Sometimes the parents apply to the head teachers directly. In any case where free meals are asked for, the child is immediately given food, while the Canteen Committee makes careful inves- tigation of home conditions, and on the basis of what is found, determines whether the parent shall be required to pay the cost of the meal in full or partially, or whether the meals are to be given free.^ THE POVERTY SCALE Wherever it is found that the total weekly in- come of a family falls below 75 cents per head after the rent is deducted, the children are considered eligible for the free list. Exceptions are made to this rule, and the scale is raised in the case of a small family, where the expenses are proportionately heavier than in a larger one, and in cases where there is illness or irregular employment. Children of all social grades attend the meals, and pay various prices for them, anywhere from threepence to halfpenny, according to their ability. But no distinction whatever is made between those who pay, and those who do not, and the children themselves are entirely unaware of the differences. ^Appendix B 56 SCHOOL FEEDING PREPARATION AND SERVICE The preparation of the meals is under the direc- tion of a man who is a professionally trained chemist, as well as a first class cook. He has five helpers, and together they prepare the meals at one central kitchen where there are facilities for prepar- ing 10,000 meals a day. Only the most approved modern appliances are used, and there is no waste either of time or materials in the Bradford kitchen. There are large hundred gallon steam- jacketed boilers, porcelain baths for washing vegetables, potato peelers, dish washers, and other labor-saving devices. The city bakes its own bread in large steam ovens, heated like the other stoves by the same boiler that is used in the heating of the school baths nearby. This means that the cooking of the food does not cost a penny extra. COST OF THE MEALS IN BRADFORD The initial cost of the equipment described above was $20,000. During the year 1908-09 the total expenditure for the meals was $39,600, including the salaries for cooks, caretakers, and supervisors, the up-keep of the equipment, the cost of administra- MEALS IN SCHOOLS 67 tion and the food. In this year about a million meals were served, a quarter of them being break- fasts. The total cost of a dinner was 3 cents, the food costing 2 and the administration i cent. In all about 5,500 children attended the meals some- time during the year, while the average daily attend- ance summer and winter was 2,700. Of these a daily average of about 240 children paid either the whole cost of the meal or part of it. EDUCATIONAL FEATURES OF THE MEALS AND SOME OTHER THINGS The most important educational feature of the meals is that they tend to raise the standard of food above that found in the children's homes. This is true not only of the food itself, but of the way the meals are served. The dining halls are painted in fresh, light colors. Tablecloths and napkins are provided and the chil- dren are encouraged to, bring flowers and plants for decoration. The teachers eat with the children, and are paid for the service of supervision for which they volunteer. Children from the older classes, particularly from classes in domestic economy, wait on the table. The 58 SCHOOL FEEDING aprons and sleeves worn by the " waiters " are made and mended by children in the sewing classes. The children must wash their hands and faces before each meal and other lessons in practical hygiene and cleanliness are given at the same time. The food values and the cost of food are taught to some of the older children, but this work is not confined to the school. Members of the Canteen Committee visit the homes and talk to the mothers about their children's food and health and encourage them to visit the dining rooms at meal time. The Education Committee has also published little pamphlets which are distributed among the mothers giving the recipes of the dinners used at school, with the cost of the ingredients, and directions for preparing them for families of seven. So far the results reported have been favorable, not only as regard the children's health and physical development, but their manners and conduct as well. When asked after one year if in general and in any or all of these particulars the teachers had seen an improvement, answers were forthcoming from 214 teachers as follows : One said the improvement was physical only, not mental; Thirty-seven said they had not had enough experience to give an opinion; CHARGING OVEN. HEAT SUPPLIED BY SCHOOL BATH FURNACE. BRADFORD, ENGLAND INTERIOR OF MOTOR WAGON. SHOWING DEVICES FOR RET.A.INING HEAT. BR.A.DFORD, ENGLAND MEALS IN SCHOOLS 59 Thirty-three thought no improvement was visible; and One hundred and forty-three reported that the meals had improved the capacity of the children. The work with the parents has been remarkably successful. Miss Margaret MacMillan, the well- known English educator, in a lecture in New York City in 191 1 asserted that the institution of school feeding has " enormously increased the responsibility of parents, because they are profoundly impressed with the need of studying their own chil- dren, when they learn things about them they have never thought of before." For example, a mother brought her little girl tO' the School Clinic for ex- amination. The doctor found nothing the matter and inquired why she had brought her and if she had noticed anything wrong. The mother said, '' Oh no, I just wanted an opinion." Such a thing as a woman seeking an opinion about her child was unheard of ten years ago, while it is now quite common. Another account of the work in Bradford closes with this significant statement : " The doctrine that child feeding would undermine parental responsi- bility has received a rude shock, as scores of letters in our possession show that when circumstances improve, parents are the first to report this to the 60 SCHOOL FEEDING committee, are often most grateful for what has been done for them, and are anxious to make way for the children of those less fortunate than them- selves." PRESENT EXTENT AND STATUS OF SCHOOL MEALS IN ENGLAND Beginning with the spring of 1909, annual re- ports have been issued by the Board of Education on the workings of the Meals Act from the time of its passage. The first report, covering the period through March, 1909, showed that in 113 places, out of a possible 328, the Act had been put into operation. Five places were not heard from and in 210 places the local authorities stated either that there was no need or that voluntary organizations were sufficient to meet it. Many of these organiza- tions receive substantial support from the city, although not through the medium of the school bud- get. If we include all forms of organizations, it may be fairly said that there are not fewer than 200 towns in England and Wales where meals of some kind are served at school. With these differ- ences in mind the experience in Bradford may be regarded as typical of what is taking place else- MEALS IN SCHOOLS 61 where in England though not perhaps on such an elaborate scale. Some idea of the rapidity with which the organ- ization of school canteens progresses may be had from the following figures taken from the reports of the Board of Education referred to above. By the end of the year following the passage of the Act, forty-one Local Educational Authorities had received permission from the central board to use school money to pay for the food. In the year 1 907-1 908, eighty-five authorities received permis- sion and during the school year 1909-19 10, their number was raised to ninety-six, and in 1910-1911 to one hundred and twenty-three. So far as returns were available as to the number of children fed, it appears that in 1 907-1 908, in fifty-six places excluding London, 44,000 children (in round numbers) attended meals and among them consumed about 3,000,000 meals. In 1908- 1909 about 118,000 children in 109 places visited canteens and consumed over 9,600,000 meals. In 1909-1910, 119,998 children in 122 places con- sumed between them over 8,760,000 meals, again excluding London. 62 SCHOOL FEEDING If we add to the figures already given the returns from London for these years, we have the following grand totals for England and Wales: Table 2. Number of Children Attending Meals and Num- ber OF Meals Served in Years from 1907-08 to Dec, 1910 Year England and Wales Excluding London London Total No. Fed No. Meals No. Fed No. Meals No. Fed No. Meals 1907-08 1908-09 1909-10 1910- 44.213 117,875 19,998 13,084 2,751,326 9,671.789 8,766,635 7,160,201 37,979 39,632 55.000* 115,000* 143,962 166,766 7,335,609 9,138,755 82,192 157,507 174,998* 228,085* 2.895,288 9,838.555 16.102,244 16,298,956 ♦Estimates only, based on average number of meals per child consumed in preceding years. London did not avail herself of Section 3 of the Act until January, 1909. After this date the can- teen service was increased enormously till, during the single week ending March 11, 191 o, 55,554 children attended the meals in 842 centres, and be- tween March and December, 19 10, a total number of over 9,000,000 meals was consumed. MEALS DURING VACATIONS In London and in forty-four other places the meals are served every school day, and during the school holidays. In thirty-four places provision is MEALS IN SCHOOLS 63 made for the meals all the year round, even though the attendance is somewhat smaller in the summer. The reason for this practice is because experiments have shown that the children tend to lose weight during the holidays when the school meals cease. FINANCIAL SUMMARY There are four different sources for the money used in support of the school canteens. First there is the amount spent on equipment and service. This is drawn from the local taxes, the amount being voted on by the City Council as part of the Educa- tional Budget. Second, there is the local tax (at the rate of J^d. on the pound) specially levied to cover the cost of food. This is first voted on by the City Council but must be submitted for approval to the National Board of Education before it may be used. The third source of funds is in voluntary contributions, which are mainly used to pay for food. Finally there is the money collected from parents, either in payment for meal tickets, or as a civil debt in cases where they have neglected to pay. The total amount spent on school canteens in 112 towns of England and Wales during the years 64 SCHOOL FEEDING 1 908- 1 909, and 1 909-1 9 10, is shown in the accom- panying table, which indicates also the sources of the funds used. Table 3. Provision of Meals in English Schools Financial Summary, 1908-1911 1908-09 1909-10 I9I0-ZI 1. Money raised by local taxes for focd $205,445 $408,640 $448,045 2. Expenditure on equipment and service 132,175 218,220 256,330 3. Total cost to local taxes for food and service (from i and 2) 337,620 626,860 704,375 4. Expenditure on administration. 24,045 43,665 63,465 5. Total expenditure from local taxes 361,665 670,525 767,840 6. Money provided by voluntary contributions 89,155 49,065 37,685 7. Money contributed by or recov- ered from parents 1,675 4,530 6,850 8. Total expenditure on meals (5 and 6) 450,820 680,455 748,910 In this table the amount contributed by or recov- ered from parents is small for the reason that the meals have so far served the needs of only the poorest children whose parents, as shown by the use of the " Poverty Scale," are actually unable to pay even the bare cost of the food-stuffs. The significance of this is emphasized by the considera- MEALS IN SCHOOLS 65 tion of the fact that the average price asked for a dinner is 3 cents and for a breakfast 2 cents. The restriction imposed by law on the amount that may be spent for food has caused considerable trouble, because in several places it has been found absolutely impossible to keep within the halfpenny limit. For example, in Bradford in 1 908-1 909, $22,650 was spent by the school for food instead of $14,425, which was the amount covered by a J^d. tax. This was partly owing to the fact that the meals were continued during the summer months, and because, in addition to the dinners, it was found necessary to have breakfasts at a time when there was an unusual amount of unemployment. An at- tempt is now being made to remove this restriction, which is felt to be illogical and not in keeping with the spirit of the Act, which was designed to benefit as large a number of children as possible and at least to provide for all children in actual want. The amounts provided by voluntary contri- butions show a tendency to decrease from year to year, as the work becomes more and more recog- nized as part of the school responsibility. But this does not imply a lack of public interest, since this is being shown in other ways, especially by the en- 5 66 SCHOOL FEEDING thusiastic volunteer service of Canteen Committees in doing follow-up work with the parents and chil- dren. FURTHER LEGISLATION AFFECTING THE CANTEEN SERVICE AND RESULTS SO FAR The Provision of Meals Act was the first of a series of legislative measures passed in favor of national conservation and growing out of the fear of national deterioration. The most important of the laws which were passed later and have affected the canteen service was the Education Act oi 1907, making Medical Inspection compulsory in the schools throughout England. The National Board of Education almost at once placed the general supervision of the Meals Service in the hands of their Medical Department and beginning with 19 10, the annual report has been made by the Chief Medical Officer. This Act requires that an account be kept of the nutrition of each child and that this be made the basis of the general report on his physical condition. In most places the medical inspector is a member of the committee in charge of the canteen work, and frequently it is he who makes the final decision of whether or not a child is to receive free meals. FILLING FOOD VESSELS WITH SOUP AND RICE PUDDING. BRADFORD, ENGLAND CUTTING BREAD AND MINCING PARSLEY. BRADFORD, ENGLAND MEALS IN SCHOOLS 67 In the spring of 1909 an amendment was pro- posed to the original Meals Act which was designed to place the final responsibility of saying whether or not a child is underfed on the medical inspector, who might be required at any time by the school board to examine a child for this purpose. The amendment further provides that wherever a child should be found to be underfed, it should be the duty of the school authorities to see that it was fed. SCHOOL MEALS IN SCOTLAND This amending bill was defeated in Parliament. If passed it would have virtually made compulsory the provision of meals by the educational author- ities. In its terms it resembles closely Section 6 of the Education Act passed in Scotland in 1908 whereby medical inspection is made compulsory and the school board in any town is obliged to see that children are fed who are declared by medical in- spection or otherwise to be " unable by reason of lack of food to take full advantage of the education provided.'* The school board may make immediate provision of food but must interview the parents as soon as possible and find out why the child is not fed properly. Then if it is found that it is be- 68 SCHOOL FEEDING cause of the poverty or ill health of the parents, the school may provide meals for the child as long as it is necessary during the school year. Where the case shows wilful neglect or cruelty the cost of the meals is collected summarily as an " alimen- tary debt," and the parent may be punished under the Prevention of Cruelty to Children Act. FEEDING AS A PREVENTIVE MEASURE Partly because of the excellent results obtained in the open air ^ schools for tuberculous and anaemic children, where full regular meals form an impor- tant and prominent part of the treatment, British school physicians are now proposing that children showing tuberculous or anaemic tendencies shall be given meals at school as a preventive measure. In this connection, Dr. Lambert of Brighton suggests that " it is frequently advisable to recommend all members of a family known to be tuberculous, irre- spective of their stature." ^ In many places, the medical inspectors have begun keeping records of the physical development of the children from year to year. The records thus made ^ Ayres, Leonard P., Open Air Schools. ' Kelynack, T. N., Medical Examination of Schools and Scholars. MEALS IN SCHOOLS 69 are turned over to the British Association for Anthropometric Investigation, v^hose aim is to have available at any time material showing the exact physical condition of the nation.* Special attention is given to the children who are underfed and in attendance at the school meals, as this is a convenient and reliable method of testing the value of the canteens. The following experiment in Northampton, which corroborates the experience of Bradford, shows what may be expected from school meals. During a period of fourteen weeks, forty-four children were given breakfast and supper, and weighed each week. At the beginning of this time they weighed on an average nearly four pounds less than normal for their ages. At the end of the period they had gained so that they weighed only two pounds less than normal, while forty control children, whoi had not been fed, were as much below weight as before. Where such measurements of weight have not been made, bodily improvement has been shown in other ways. From Halifax comes the report that the meals have " increased vitality, both as regards * Report of the Committee on Anthropometric Investigation in the British Isles. London, 1909, The Royal Anthrop. Institution. 70 SCHOOL FEEDING work and play," and from Bristol that " In a fort- night after the commencement of the free dinners to necessitous children, the improvement in their physical condition became quite apparent." One of the chief reasons for having the canteens was that certain children were found to be unfitted to do mental work properly because of their physical weakness. Therefore it is significant that so far the reports show that the meals have had a good effect on the children's mental ability as well as on their bodies. This has been particularly noticeable in the case of those distinctly underfed. Where the meals have been given as a relief from temporary distress, the results have not been appreciable, as they have simply maintained the children's normal efficiency. A few quotations from the official re- ports will illustrate the general tenor of opinion. Birkenhead : " The general testimony of the head teachers of the various schools ... is that the chil- dren were brighter, more regular, and better fitted for their work." Birmingham (Breakfasts) : " Beyond question a distinct improvement has taken place in the ability of the children to take full advantage of the educa- tion given." Bristol : " The children's general appearance is MEALS IN SCHOOLS 71 brighter, and they enter into their work with more zest." Wallesey : " Most of the teachers report that the children show an increased interest and a greater abihty in their work ; and they also note an improve- ment in the regularity of the attendance. One teacher says : ' In several cases the dull, tired, and frequently bored look about the children has dis- appeared, giving place to a brighter manner and keener interest in their work.' " Only a few exceptions to this general opinion as to the effect of the meals on the learning ability of the children were found. Thus, one teacher in Gillingham stated that " the increase in ability was very slight," and in Coventry it was reported that many cases showed no apparent difference in capacity. children's care committees Just as it has been found that for medical in- spection to be effective, a great deal of '' follow-up " work must be done with parents and children, so it has been with school meals. To make them effective and to really strike at the root of mal- nutrition with its complex causes, much more must be done than merely feeding the children once a day. Parents must be visited, shown what good 72 SCHOOL FEEDING food is, and taught and urged to spend what they have wisely; bad sleeping habits must be broken up, and the aversion to fresh air combated, and child labor discovered and stopped ; finally the little children not yet going to school must be cared for if they are not to be unfitted by malnutrition for their future work. To do all this is so obviously beyond the limit of the teachers' time and strength that Children's Care Committees have been established in many English towns. These are sub-committees of the local school board and the members are elected from managers (superintendents), principals, and volunteer laymen. They have charge of all the extra-academic activ- ities of the school, especially those relating to physical welfare. While not obligatory, the forma- tion of these committees is strongly urged by the Medical Inspection Act of 1907. In London, where the committees in charge of the meals were at first merely *' feeding committees," they were reorganized on the larger basis of " Care " committees, after two years' experience with the more limited activity. The handbook pub- lished by the London County Council for the use of the thousand committees shows a wide range of ^ MEALS IN SCHOOLS 73 duties extending beyond the school into the chil- dren's homes, into their early childhood; into the terms and conditions of their industrial life, after school years. Members of the Care Committees look up the records of the children applying for free meals, investigate home conditions, talk to parents, and give help and advice about their children. Beside this they supervise the dietaries in use at the can- teens, appoint the people who cook and serve, and superintend the entire service of the meals. One important part of their work is the attention to individual children at the table, to insure that each child gets enough and is benefited according to his particular need. It seems that, as a rule, about ten per cent, of the children require this special atten- tion, to be induced to eat the food, or even to attend the meals at all, while these are often the very ones most in need. Other good results of the individual work done by these committees was reported from Bristol, where it was found since the meals have been served at school " the parents have fallen in more readily with medical inspection, and the teachers have less trouble now in securing cleanliness." 74 SCHOOL FEEDING MANNERS AND CONDUCT IMPROVED BY MEALS In general the teachers report a marked improve- ment in the manners and conduct of the children, especially in places where the meals are served in special dining-rooms with personal supervision from the teachers or members of the Care Committees. One Head Teacher in Bath describes the meals as " Practical lessons in unselfishness, cleanliness and self help." A characteristic report comes from Gorton, where " in many cases the children never sit at table when having meal at home. The whole- some influence of preparing for the meals — ^by wash- ing hands and faces, singing or saying grace to- gether, sitting at table with others and talking to them quietly, learning to handle knife and fork or spoon, and to eat in seemly fashion — all this has had its due effect which has extended beyond the meals* centre itself to the school, the home, and even to the street." FEEDING OF YOUNGER CHILDREN, BEFORE SCHOOL AGE Beside this provision for children of the compul- sory school age, England is attacking the problem of food at an earlier stage and day nurseries on the MEALS IN SCHOOLS 75 pattern of the French Creches are being established widely. Special attention is paid to the proper feed- ing of the children sent there. In 1908, Parliament passed the " Children's Charter," which includes in a codified and revised form all previous legislation in regard to children, with many new features. Section 12 provides for the prosecution of all people who fail through their own fault to provide sufficient food for the children under their charge. In this section *' wilful neg- lect " includes the failure on the part of the parent or guardian to obtain needed help from govern- mental sources. In 1 9 10 a law was passed which, while not deal- ing directly with children or with the educational system, is destined to remove one prolific source of malnutrition. This was the Board of Trades Law, which provides for the fixing of a minimum wage in certain low grade industries. The agitation for this law began some twenty years ago while a school fee was still charged, and many women chain-makers, the most unprotected class of wage- workers, were being fined for not sending their children to school. These women apparently had two alternatives: to pay the school fee, and send 76 SCHOOL FEEDING their children to school, or to keep them home and pay the fine imposed under the Truancy Law. The condition of these women was relieved but slightly by the removal of the school fee, as their wages re- mained entirely out of proportion with the increas- ing cost of living, and the children were often sent hungry to school. The new law, though rudimen- tary in its implications, is the first step toward an adjustment of wages that may end in abolishing the need for free meals. By these legislative measures — providing for school meals, as a part of the regular school system, for the examination and registration of the nu- tritional condition of all school children, for special committees to do follow-up work and home visiting in connection with the meals, for a means of dealing legally with persons who neglect the feeding of children in their care, and finally for the legal ad- justment of a minimum rate of wages above the starvation line, England is in a fair way to eliminate malnutrition from her list of school problems, and thereby from the list of obstacles in the way of a healthy national life. IV THE CANTINES SCOLAIRES OF FRANCE After bread, education is the first need of a people. — Danton. In 1849, the battalion of the National Guard in the second district in Paris found that they had a surplus in their treasury for which they had no special use. All agreed that it must be used to some good purpose — to benefit the community if possible. The good fellows, many of them fathers, most of them poor men, remembered that their neighbors' children were often unable to go to school because they had no decent clothes or shoes. Their parents could not give them the extra food necessary for the extra work, far less buy for them the expensive books. Here then was a use for the guardsmen's money. They turned it over to the district author- ities to form the nucleus of a *' caisse des ecoles," a school fund that was to help poor children get a schooling. The people of the district became interested; other sums were added, and the Caisse became an important affair in that section. In 1862 another 77 78 SCHOOL FEEDING district adopted the plan, and in 1867 its value had become so apparent as to attract the attention of the Minister of Public Education. The school law passed that year contained a section authorizing the establishment of School Funds in every commune in France. The section ran as follows: The municipal council, with the approval of the prefect, may establish, in any commune, a school fund destined to encourage, and facilitate school attendance, by rewards and help given to the industrious and poor pupils. The revenues for this fund shall come from voluntary gifts, and subventions from the commune, department, or state. Several communes may combine in forming and support- ing such a fund. The collection of this fund shall be made gratuitously by the teacher. In 1882, when primary education was made com- pulsory, Article XVIII of the law enacted that : The school fund instituted by Article XV of the Law of April 10, 1867, shall be established in all the communes. The Caisses des ficoles were thus made com- pulsory and were put under statutory obligation to share in the medical inspection, school lunches, pro- vision for holidays, excursions, vacation schools, CANTINES SCOLAIRES OF FRANCE 79 savings banks, and whatever extra services the school authorities might institute for physical or other welfare of the children. THE CANTINES SCOLAIRES One definitely recognized part of the functions of the Caisses des ficoles soon came to be the Can- tine Scolaire, or school lunch room. The support for this branch of the work was definitely assumed by the government in Paris in 1880 and has since become generally recognized throughout France as regularly comprising part of the expenses of public education. As early as 1867 Victor Duray, the minister of public instruction, had recommended to the prefects that they look after the hygienic conditions of the schools, and direct special attention to the nutrition of the children. As a result, during the next decade school meals for the very poor children were started in about 464 places. These meals, not yet cantines in the strict sense of the word, were generally in the hands of the Caisses des ficoles committees. By the term cantine is meant a school restaurant where any child can get a meal at noon, on presentation of a ticket that represents the payment of the cost 80 SCHOOL FEEDING of the food. Further, the term only appHes to res- taurants supported in part or entirely by public funds. There are at present, according to the latest re- port, about 1400 communes in France supporting school cantines of one kind or another, with pro- vision for about 187,000 children. This report covers only 55 out of the 88 departments making up the French nation, and there is good reason to suppose that the other 33 departments are well sup- plied. The cantines in Paris may be taken as the type of the true cantine scolaire in its most developed form. ADMINISTRATION OF THE PARISIAN CANTINES SCOLAIRES Paris was the first of the great world cities to make complete and adequate provision for the proper nourishment of all her school children, and this, not as a matter of charity but as the expression of a fundamental conviction in education; that is, that the state, in assuming responsibility for the mental culture of the children, must be also respon- sible for their physical preparedness for this culture. London followed her example some twenty years later. CANTINES SCOLAIRES OF FRANCE 81 The municipal provision of cantines was first considered in Paris in 1877 when one of the city councillors proposed that every child whose parents' names were on the lists of the Poor Board should receive warm food and clothing from the city in order that it might attend the public schools. Can- tines were at once started in a few schools, but it was not until 1880, after two years of study and ex- periment, that the council voted financial support and the cantines were established in every school district. From the beginning the cantines were entrusted to the administration of the Caisses in each district, which received a special subsidy of 480,000 francs or $96,000 toward their support, being required to furnish the balance of the cost from local sources. With the development of the cantines, the sub- sidy from the city was gradually increased, till finally it covered the entire cost and the committee in charge of the Caisses, now entirely official bodies, were responsible only for the administration of the cantines. By 1900 the cost of the cantines had risen to 1,000,000 francs or $200,000 in 1905 to 1,050,000 or $210,000 where it has remained. In 1900, the expenditures for the cantines amounted 6 82 SCHOOL FEEDING to a little over four per cent, of the city's entire educational budget. This figure $210,000 does not include the amount given to the teachers who supervise the meals each day. They are paid i fr. 50, about 25 cents a day for an hour's attendance at noon. This fee was gained in 1904 after a long struggle on the part of the teachers, who, while they gave their services gladly enough, felt it was unjust to be required to serve without pay. Each year the different districts apply to the city council for an amount that they think will cover their expenses. At the same time they report the work of the past year and give in detail their plans for the next. The council then distributes the en- tire amount set aside for the cantines in proportion to what they think each district needs. Three gen- eral principles of procedure that have been followed ever since were decided upon when the cantines were first established in Paris. MEALS FOR ALL, FREE FOR THOSE WHO CANNOT PAY The first is that the meals, although open to all children, whatever their economic class, shall not be free to all but free only to those children unable to CANTINES SCOLAIRES OF FRANCE 83 pay the cost of the food. Although the cost of the food does not cover the cost of equipment and ser- vices, it was felt that if the parents were required to pay for the food, it would be an ample safeguard against the possibility of weakening their sense of responsibility. '' The requests for free food are re- ferred to the principals of the schools; they are then investigated carefully by a special delegate of the Caisse des ficoles, who includes in his report not only the parents' statements but also all the circum- stances which oblige the family for the time being to ask for charity. Moreover, the privilege is granted for only one school year at a time." UNIFORM MEAL TICKETS The second principle, developing from the first, is that in distributing the food, no distinction is made between those paying and those receiving the food free. "In order to avoid making any dis- tinctions of such a kind as to wound the feelings of the less fortunate families, it was decided to adopt for all portions distributed, whether paid for or not, a system of uniform checks, to be sold to those families able to pay for them and to be given gratuitously to the needy children. These checks 84 SCHOOL FEEDING are received by those in charge of the cantines, who are absolutely forbidden to receive any payment in money. The distribution and sale of the tickets is taken care of at the town hall under the direction of the mayor, and of a committee appointed by the Caisses des :ficoles and of a second committee appointed from the Cantonal Delegation/' ^ LOCAL INDEPENDENCE OF THE DISTRICT CANTINES The final principle is that the Caisse des !&coles in each district shall have complete control of all other points in the organization of the cantines. This provision allows for local variation in ad- ministration to meet the differing local conditions in the various parts of the city. There are two general methods of organization. By the first, or indirect method, the Caisse entrusts the service of the cantine to a caterer, paying him so much per meal, usually about 15 centimes or 3 cents. By the other, known as the direct method, the Cantines are under the direct supervision of a * Extract from a statement made by the Director of Primary Education in Paris, on "The Organization of the School Cantines in Paris," published in manuscript manifold for distribution. CANTINES SCOLAIRES OF FRANCE 85 committee elected by the Caisse. The latter is in use in the majority of districts and is considered the better from every point of view. It is more eco- nomical, as the cost of a single meal rarely exceeds two cents, as against three or four cents, by the indirect method. MANAGEMENT OF THE CANTINES BY THE DIRECT METHOD In those districts where the direct method is used, the Caisse des &oles gives the entire management of the cantines into the hands of a committee con- sisting of twenty of its members. This committee meets at least once a month. It chooses the trades- men that are to be patronized, the staff of workers in charge of each cantine, and issues orders for the purchase of food, etc. There is always one woman inspector appointed by the committee, who' has fif- teen or twenty woman helpers, all of them respon- sible to the committee. At the outset the committee, having chosen the trades-people, gives specific direction for the buying of the foods, the price to be paid, the quality used, etc. The food bought must always be of excellent quality. Beef, legs of mutton, and fresh pork for 86 SCHOOL FEEDING roasting are the meats most commonly used. The vegetables must be fresh in summer. The menu must include meat or vegetable soup, and meat with a vegetable or macaroni. As a rule, each cantine supplies two schools, though where the schools are very large they may each have their own cantine. At the head of each cantine is a " cantiniere," who is responsible for the receiving, preparation and safe-keeping of the food, as well as for attending to the care of the equip- ment and fuel. She has one or more assistants, according to the size of the cantine. The salaries of these women vary according tO' the amount of work they have to do, but all are allowed their lunches. The head woman inspector must visit as many cantines as possible in a day, and see the food both in the raw and cooked, as well as watch the proc- esses of preparation and service. Her assistant in- spectors visit the other schools, and members of the cantine committee are expected to make frequent visits as well. The inspector, her assistants and the committee are required to report the results of their investigations on blanks provided for the purpose. These blanks are submitted to the Can- tine Committee at each monthly meeting. CANTINES SCOLAIRES OF FRANCE 87 REAL MEALS, NOT " FEEDING " The spirit of the Parisian cantines is thoroughly democratic. The principle is to encourage all the children, rich and poor, to eat together, and there is no distinction made between those who pay and those who do not. A child may bring his own meal with him, but it is never so cheap, is always cold and is rarely as good as the meal provided by the cantine, which, as all observers agree, is remarkably good. " From the very first," writes an English visitor, " the greatest care has been taken not to allow any loss of dignity to arise from the free feeding. The fundamental principle of the whole management is the absolute innocence of the children. They cannot be expected to pay. Their parents may be at fault ; if so there is only the greater reason to shelter the children and try to preserve in them that sense of self-respect which might so easily be wrecked by their parents' bad conduct." ^ To avoid any pos- sibility of the children themselves knowing who pay and who do not, the simple device is used of a small box-office through which each child goes to purchase his ticket. If he claims that he cannot ' Lancet, Reports on the Free Feeding of School Children. 88 SCHOOL FEEDING pay, the ticket is still given, but his name and ad- dress are noted, and inquiries are at once made about his parents. Where the parents are found able to pay they are compelled to do so, but where they cannot, tickets are given to the child without further question for as long as may be necessary. Lists of those who are to receive free tickets are made out at the beginning of every school year. A THREE COURSE DINNER FOR THREE CENTS The food that may be bought for three cents at any Paris school cantine is surprisingly good in quality and there is enough of it to satisfy the hungriest little stomach. Three cents will buy soup, meat and vegetables and sometimes even a little sweet by way of dessert, not to mention all the bread wanted. The older children receive 30 grams of meat, and the younger ones twenty. The menu is changed every day in the week. To quote the Lancet Commissioner again, it is gener- ally something as follows : " Three days in the week there is * bouillon gras,' a delicacy unknown in England, as no ordinary Eng- lish cook will take the trouble to add the proper CANTINES SCOLAIRES OF FRANCE 89 proportions of flavoring herbs and vegetables to the beef. Only twice a week is the boiled beef with which the soup has been made given for the second course. As this meat is lighter than roast meat care is taken to supply for the third course the most substantial vegetables — namely, lentils or haricot beans. On three days a week roast beef, pork, veal, or mutton is given, preceded by a tasty vegetable soup, and followed by a dish of mashed potatoes, or macaroni cheese, or of rice and milk, all well flavored, well cooked, and of excellent quality.'* Though only the midday meal is compulsory, in a number of districts soup is distributed at the be- ginning of school to the poorest children, and a " goutte,'' or little bite, of bread and milk in the afternoon at four o'clock. TEACHERS AND PUPILS EAT TOGETHER Perhaps the most striking proof of the attractive character of the dinners is the approval shown by the teachers who attend regularly even when not supervising. Their presence at the meals is of obvious value, not only in assuring the quality of 90 SCHOOL FEEDING the food, but even more for the opportunities it offers for unconscious culture. Mr. John Spargo, who has visited the cantines and eaten at them, states that *' fully 90 per cent, of the teachers use the canteens more or less regu- larly, though there is absolutely no compulsion in the matter. They prefer to do so on account of the cheapness and wholesome character of the meals." He goes on to say, " I have myself sat down to a three cent dinner in the company of a well-known member of the Chamber of Deputies, a professor of languages, and several teachers, each one of us having gone through the little box-office and bought his ticket in exactly the same manner as the most ragged urchin. All of the children are provided with paper napkins. The presence of the teachers is a sort of practical education in table manners. These cantines serve therefore as a great educational and ethical force as well as a remedy for one of the worst evils arising out of the national poverty problem." ^ The principal of each school is responsible for the distribution and sale of the meal checks, and for ° Spargo, John, in his " The Bitter Cry of the Children," p. 286, 1906, New York, the Macmillan Company. CANTINES SCOLAIRES OF FRANCE 91 keeping an account O'f the numbers of children who buy them or receive them free. He is also respon- sible for " the material and moral well-being " of the cantines. MEDICAL INSPECTION IN THE CANTINES Medical Inspection is obligatory in the schools of most French cities. In Paris one of the duties of the school doctor is to visit the cantines in each district. He must examine the food and see that the children get the proper kind and amount accord- ing to their ages. If he finds any child in need of a special sort of diet, he reports this, and leaves orders with the cantiniere and principal which must be carried out. Sometimes tonics or cod liver oil are prescribed and furnished at meal time to the children needing them. THE COST AND EXTENT OF CANTINES IN PARIS All the districts of Paris have cantines except the eighth, where food is provided for the very poor children only, with no provision for children who can pay. In the school year 1 908-1 909 there were 353 school restaurants. These supplied meals to the pupils of 588 schools and 38,531 children 9^ SCHOOL FEEDING were accommodated. This means an average of 109 children to each cantine and 66 children from each school. The entire number of meals served amounted to nearly eight millions, or a little over 200 meals for each child. This does not mean that each child was fed for two hundred days, for in some districts light meals are given in the morn- ing and evening as well as at noon. The number of cantines and the numbers accom- modated vary greatly in the different sections. In the 1 8th district, where the service is considered the most satisfactory by the city government, 7,128 children are accommodated daily, in 22 cantines. In about one-half the city the cantines accom- modate about 150 children apiece. In the other districts the cantines accommodate on an average of 50 apiece. The meals vary somewhat in cost in the different districts. In the ninth district the average net cost of the meals was just two cents per meal, while in the third it was slightly over six cents. The aver- age cost was just under four cents, to be exact, 3.8 cents. The prices paid by the children who pur- chased their meal averaged three cents per meal. This has come to be the standard price for a meal CANTINES SCOLAIRES OF FRANCE 93 ticket in Paris. In thirteen districts three is the regu- lar amount, in two the tickets are only two cents, while in one district only does it rise as high as four cents. The following summary gives the salient facts about the service of school meals in Paris: Cantines Scolaires in the City of Paris, 1908-1909 Number of schools 588 Number of Cantines Scolaires 353 Total number of different children fed 38,531 Total meals distributed 7,790,627 Meals paid for 2,480,827 Per cent, of meals paid for 32 Meals given free 5,309)8oo Per cent, of meals given free 68 Average cost per meal in cents 3-5 Average charge per meal in cents 2.9 Subsidy from city in dollars 210,000 CANTINES IN THE REST OF FRANCE The pioneer town in France to have school meals was Angers, where as early as 187 1 a society known as " The Society for People's Kitchens in the Pub- lic Schools" (Societe de Fourneau des ficoles Laiques) was established with the approval and support of the city authorities. With the co-opera- tion of the teachers this society still serves a warm 94 SCHOOL FEEDING midday meal free to all who cannot pay and at a cost of two cents to others, from the beginning of November to the end of May. About 1800 children were served daily in 1908. The cantines arose independently in the differ- ent sections of the country, Angers leading in 1871, and Paris making them compulsory in 1882. They now constitute a part of the school equipment in cities, small villages and country districts. An inquiry regarding the number of places having can- tines, the number of children accommodated, etc., was directed by the author of the present work in 1909 to the prefect at the head of each of the 88 departments. The prefects of 55 departments re- plied, and in only two places were there no can- tines; a third prefect replied that he could not give any information about them. All three of these departments were country districts. In at least 52 departments of France there are cantines, providing meals for anywhere from 100 country children on the Swiss border, to 55,000 in the thickly populated department of the Seine. In the majority of cases, the commune holds it- self directly responsible for the maintenance of the meals. Out of 43 cases, the support and administra- CANTINES SCOLAIRES OF FRANCE 95 tion were entirely public in 27, while in the other 16 cases the administration was in the hands of a semi-public society, receiving public subsidy. In other words, the available information seems to indicate that something like three-fifths of the can- tines are supported directly and entirely by public funds, while the other two-fifths are supported in- directly and partially by public funds. The following analyses of official reports make a convenient summary of the present system of Cantines Scolaires in France: I. Analysis of the Reports from Fifty-Five Departments OF France Concerning the Cantines Scolaires Among fifty-five departments thirty-four reported the number of cities. They were 816 in number. Among fifty-five departments forty-five reported the number of communes. They were 1,391 in number. Among fifty-five departments thirty-nine reported the number of Cantines Scolaires. They were 2,720 in number. Among fifty-five departments forty-seven reported the number of school children receiving meals. They were 186,505 in number. Among fifty-five departments forty-three reported facts re- specting the source of support of the Cantines Scolaires. In twenty-seven departments they were supported from public funds; in the remaining sixteen, from public and private funds. 96 SCHOOL FEEDING Among fifty-five departments two reported no Cantines Sco- laires. Among fifty-five departments one gave no information. II. Analysis of the Reports from Paris and the Other Fifty-Four Departments Reporting No. of No. of No. of Children Schools Cantines Receiving Meal. Paris 588 353 38,531 France, exclusive of Paris 2367 147,974 Total 2720 186,505 SUBSTITUTES FOR THE REGULAR CANTINES SCOLAIRES We have already noted that the term cantine has a definite meaning, and that it does not apply to privately run meal centres, nor yet to those run as relief measures even where the government sup- ports them. In a large number of places, where for some reason or another regular cantines have not been installed, the teachers or janitors serve warm soup to the children at a nominal sum, usually during the winter months only. These are called by the general names of " Soupes Chaudes," or " Soupes Scolaires," and may exist in the same town with regular cantines. Still another form of the school meal that is yet CANTINES SCOLAIRES OF FRANCE 97 not a cantine, is found in country districts or in the smaller towns, where the children bring the raw material for the soup, vegetables, meat, flavoring, etc., from which a sort of communal soup is pre- pared by the teacher, of which all partake. Beside the soup stuff, the children bring their own bread and sometimes a little wine and water, or a small cake for dessert. There is one more form of pro- vision for the school child's lunch. Most schools, whether or not they have a cantine, or a system of " Soupes Chaudes," do have a stove for warming the children's food. Thus, a child may bring a little pail of soup, a piece of meat, or an egg, and the teacher or janitor will warm it for him if he is too little to attend to it himself. There are four important points about the public provision of meals in France : 1. Although there is no specific national legisla- tion in regard to school restaurants in France, their provision is nation-wide. The communes are obliged to have school funds, the Caisses des £coles, which may be used for the provision of meals whenever there is need. 2. The cantines are supported directly by the municipalities in the majority of cases. To a less 7 98 SCHOOL FEEDING degree they are entrusted to semi-private bodies, re- ceiving public subsidy. 3. Where well developed, the service of the can- tines is closely allied to that of Medical Inspection, being under the direct supervision of the school doctor, who may at any time suggest a special diet for a particular child, or prescribe a tonic or other medicine. The doctor's orders must be carried out at public expense in these cases. 4. Finally, in no case is the provision of meals regarded as charity, but always as an expression of the ideal " mens sana in corpore sano." It is a cardinal point in the French theory of education that a child must have a warm meal in the middle of the day. How far the government has been interested to put this theory into practice may be judged by the foregoing account of school restaurants, " Soupes Giaudes," the " communal soup," and the handy school stoves. V School Meals in German Municipalities It is easy enough to discover and feed the hungry children, but if we are content with observing the merely external, we run the danger of overlooking the real underlying conditions, and of veiling the social shame that they represent. — Dr. CUNO, 1896. If one were to attempt to characterize in a single phrase the movement for school feeding in France, that phrase might well be " unconscious evolution." For England, the term " national necessity " would seem justified. In Germany the movement in its national aspects assumes the character of scientific experiment. Shortly after the passage of the British Provision of Meals Act, in 1906, it was discovered in Ger- many that from forty- four to forty-six per cent, of conscripts for the Imperial Army were rejected for the same reason of physical unfitness that caused the failure of three out of five men in England. One result of this discovery was to stimulate national interest in the subject of school feeding because here, too, malnutrition during the period of growth 99 100 SCHOOL FEEDING was held to be accountable for a good share of the trouble. The way in which the problem was attacked was characteristically thorough. An exhaustive study was undertaken beginning with the history, extent, character and methods of the organization already providing school meals in two hundred and thirty- nine cities with populations of ten thousand and over. For the most part, these organizations were de- signed to meet the need of only a limited number of children who were in acute distress and the statistics of attendance of these societies were no indication of the real condition of nutrition among the children at large. Therefore the home meals were studied of over 500,000 children represent- ing all social grades in over a hundred cities. Among other things it was discovered that there was widespread ignorance among parents as to the proper food for children, and that as a conse- quence, many thousands of children were growing up with wretchedly bad habits of eating. The social and economic causes of such acute malnutrition as had forced attention from the school MEALS IN GERMAN CITIES 101 authorities were studied in over 23,000 cases, and were found to be almost without exception laid in poverty. The dietaries in use in a score of towns having typical organization for school feeding were sub- jected to chemical analysis in order to determine their food value. This led to an extensive study of the proper diet for the school age, and the con- struction of suitable menus for school use. Finally, school feeding was studied in its relation to the general progress of social reform, and a plan of action was laid out that included the formula- tion of legislative measures involving the schools and the cost of living, and the expense of food. The results of this investigation conducted by Dr. Kaup, director of medical inspection in Berlin, were discussed in May, 1909, during a three days' conference of the League for Social Welfare.^ They are of sufficient value to be enumerated here some- what in detail for the use and guidance of the movement elsewhere. * Kaup, Dr. J., Die Ernahrungsverhaltnisse der Volkschul- kinder. Vorbericht und Verhandlungen der 3 Konferenz der Zentralstelle fiir Volkswohlfahrt. 102 SCHOOL FEEDING GENERAL HISTORY OF THE MOVEMENT IN GERMANY, I 790- I 909 The most striking things about the history of the school feeding movement in Germany are first that it is very old, antedating compulsory education laws, and second that many different forms of social and educational endeavor have contributed to its long development. The beginning was made over a century ago in Munich when it was discovered that the soup kitchens, established in 1790 for the relief of the city's unemployed, and as a guard against vagrancy, might serve also as a relief to the child victims of the bad industrial conditions incident to the introduction of the factory system. From the beginning the schools were encouraged to send groups of children to the kitchens at noon each day, where a warm meal was sold or given free to all who might need it. This work was un- organized and sporadic, as was that in the Children's Homes, which, during the next fifty years, undertook to supply breakfasts or lunches to children in extreme need in the schools in different places. MEALS IN GERMAN CITIES 103 MAKING SCHOOL ATTENDANCE EFFECTIVE In 1875 "The Philanthropic School Society" was started in Hamburg. This society, like many others, started at this time in Germany and in other countries, had as its purpose the promotion of attendance and efficiency in the public schools, by means of the provisions of free text-books, prizes for good scholarship and clothes and food to such children as needed help. School feeding soon came to be one of the main activities of these societies, which were early subsidized by the cities. PRIVATE RELIEF WORK Curiously enough the work of school feeding by purely private effort was begun relatively late with the organization in 1880 of the Dresden " Society for Feeding Needy School Children," and while many similar societies developed elsewhere, this form of administering school feeding has never been so prominent in Germany as other forms which are more closely related to school administration. VACATION COLONIES AND SCHOOL FEEDING Vacation Colonies were started in different parts of Germany in the early seventies, and developed 104 SCHOOL FEEDING during the next twenty years until nearly every city had its little group of men and women — mostly teachers and doctors — who saw to it that sickly and weak children from the crowded sec- tions were sent into the country for a few weeks in the summer. When these vacation colony workers met together in a national convention at Leipsic in 1890, they reported the same thing; the colonies were a good thing, there could be no doubt that the children were benefited by them — but — when the children returned to the old bad con- ditions at home, crowded quarters, bad air, and particularly, bad food — the good effects of the weeks in the country were soon lost. Because of this, many colonies had attempted to extend some of their benefits through the winter by feeding a few of the children, and this work, which involved much home visiting, impressed the teachers with the need existing even among the stronger children. In many cities it was discov- ered for the first time that " thousands of children come to school every morning without having had the least thing to eat.'* In this way the work of feeding the children when they came home from MEALS IN GERMAN CITIES 105 the country came to be considered quite as im- portant as sending them away. As a result of the Leipsic convention an in- vestigation of the subject of school feeding was started with the authority and backing of the Prus- sian Government. The results were published by Dr. Cuno in 1896. At that time there were 79 cities where some sort of provision for school feeding was made. The organization conducting it included private societies, publicly endowed so- cieties, and Children's Homes, beside the work of the vacation colonies. Reports from 42 cities, showed that a total of 2y,6^^ children were being fed. Popular interest in Dr. Cuno's report was so great that a year later, in 1897, the Social Demo- crats introduced a bill into the Reichstag, calling for the provision of school meals in all cities. This bill was opposed and defeated on the ground that the provision of meals at school would cause a migration of population to the cities. However, the agitation resulted in an increased subsidizing of local societies by city councils and the movement grew apace. 106 SCHOOL FEEDING SCHOOL FEEDING BECOMES A NATIONAL ISSUE During the next decade, when all England was being stirred by the rumor of national deteriora- tion, when France was working out its national legislation in regard to children, and at the height of the campaign in Germany for a national Child Labor Bill, the problem of school feeding became more sharply defined and took on the characteristics of a national issue. In Germany, as in England, there was an alarm- ing percentage of physical unfitness among army recruits. Of all these coming up for service, dur- ing a period of ten years, from 1 890-1907, between 44 and 46 per cent, were rejected, in spite of a lowering in the standard physical requirements.^ On the face of it, this did not look quite so serious as England's 60 per cent., but it must be remem- bered that because of compulsory military service the Germany figures are based on a far larger proportion of the male population. As in England, underfeeding during the period of growth was pointed to as one great cause. The matter was taken up in Labor Bulletins, at * Simon, Helene, Schule und Brot, p. 65. MEALS IN GERMAN CITIES 107 teachers' conventions, national and international, in congresses of child hygiene and by the non- technical press, and work for national action was begun in earnest with the investigation now under consideration. PRESENT ORGANIZATIONS FOR SCHOOL FEEDING IN GERMANY According to Dr. Kaup's report, there are 239 cities with some sort of provision for school feed- ing. The majority of the organizations are sup- ported entirely or in part by city subsidies. SCHOOL BREAKFASTS IN STUTTGART In most places the meal served is breakfast either before school or in the forenoon recess at 10 o'clock. The best form of organization is probably that of Stuttgart, where since 1906, a breakfast of bread and milk has been served each week-day morning during the entire year. The work is under the direction of the Medical Inspector of Schools, and is supported entirely by the municipality. In order to keep the expense of provisions down, no children are given free meals save those who are known to be in real need of help. All others must pay. 108 SCHOOL FEEDING There are careful municipal regulations govern- ing the service, the location of centres, the kind of milk sold, and the general sanitation of kitchens and dining-rooms. These regulations together with the provisions for supervision and the rules govern- ing the free admission of children to the breakfasts are given in Appendix D of this book. The most important of the regulations are as follows : 1. Each school district must have at least one school where bread and milk are served in the morning. 2. Meal tickets costing 8 cents for six, are sold each week in the schools to those children who are listed as wanting breakfasts. 3. No child can receive free meal tickets, unless the committee of inquiry for the school has dis- covered a real need. 4. No visible distinction shall be made between children paying for the breakfasts and those re- ceiving them free. 5. Each child shall receive at each meal % liter, a little over a half pint, of warm milk and a bread roll. 6. A special director is in charge of each centre and is responsible for promptness and cleanliness MEALS IN GERMAN CITIES 109 of service. The dishes and all utensils must be washed after each meal in hot water, and rinsed in cold and must l)e kept in a place especially provided. In the year 1907 1908 the meals were served in 25 centres, to an avera^^e of 2,350 or over 17 i)er cent, of the school ])oi)ulation, at a total expense to the city of $6,800. The breakfasts are i)ro- nounced a success by the teachers, who find the children much better able to follow the lessons, which in Stuttgart are heaviest in the morning. SPECIAL PROVISIONS IN POOREST SECTIONS In the very poorest sections, where the mothers and fathers of the children are away from home all day, the cily serves a warm dinner of soup and meat and vegetables at noon in fcjur kitchens, specially erected for the purpose, each of which accommodates something over 200 children daily. In addition there are 475 children fed daily in the subsidized Children's Home. Including these three forms of feeding, the municipal breakfasts in 25 centres, the municipal dinners in four schools, and the work of the children's homes is a total of over 3,600 children, or 26 per cent, of the school popula- tion who are fed in the Stuttgart schools. 110 SCHOOL FEEDING SCHOOL DINNERS IN CHARLOTTENBURG Charlottenburg, now well known to schoolmen as the place where the first open air school was started, has the best form of midday meal, in addition to a system of breakfasts modelled on the Stuttgart plan. In 1906, when the breakfasts were started, a careful canvass of the home feeding of all the chil- dren was made, and it was discovered that about 3,000 children were fed irregularly, going without one or more meals a day, or having no warm meal at noon. This meant that 14 per cent, of the school population were in need of some sort of provisions. A system of meals was inaugurated, under the direction of the Board of Health. Under this sys- tem breakfasts are provided in the schools, and dinners are served in special centres under the immediate direction of the Children's Home So- ciety. All expenses are paid by the city. In the case of the dinners, the city pays the society in charge 4 cents a portion, 3 cents of which is for the raw material and one for the general expenses of service. By the fall of 1908 the breakfasts and lunches were being served to about 1,400 children in all. The service is continued throughout the year. MEALS IN GERMAN CITIES 111 The food is prepared according to special direc- tions furnished by Dr. Max Rubner, the celebrated authority on nutrition. The breakfasts and dinners together are so planned as to meet half of what is thought necessary for a day's ration for the growing child. Meat is served twice a week, but vegetables and rice, cooked with bacon, are served daily. In warm weather fruit is served. The chil- dren are allowed as much as they want. The meals are served with care, the children being seated at tables which are laid with cloths and decorated with flowers. There is considerable " follow-up " work done in connection with the Charlottenburg meals, and in each case the children's home conditions are studied. The attempt is made to find and provide for every case of need. Personal interviews are held with parents, who are instructed in the care of their children. Children whose parents' names are already on the lists of public or private charity associations are admitted to free meals without question. Wherever possible, however, parents are held strictly responsible for payment for the meals. To summarize: The best practice in Germany school feeding as illustrated by Stuttgart and Char- in SCHOOL FEEDING lottenburg includes: Provision all the year round for any child en who care to come. Meals free to those who cannot pay. Supervision during meals and follow-up work in connection with the meals. Correlation with Medical Inspection. Careful preparation of menus, to embody a dietary suited to the needs of growing children. The service, clean, sanitary, and pleasing in appearance. The investigation showed that for one reason or another the meals in Stuttgart and Charlotten- burg could not be considered typical of the service throughout the country. Rather they represented the ideal, or model. The most serious difference between the meals in these two cities and elsewhere was found to be in the character of the food itself. First as regards the breakfasts. GENERAL CHARACTER OF FOOD SERVED There are 153 places beside Stuttgart where a breakfast of some sort is served. In no of these warm milk and bread are given. Nine cities give coffee and bread — merely a stop gap, and not real food. In the other soup and bread, cocoa and bread, or a sandwich is served. MEALS IN GERMAN CITIES 113 In order to determine the best form of breakfast for children, the menus given in six typical organiza- tions were analyzed. One of these breakfasts con- sisted of bread and milk ; the others of soup, made with milk and cereals, peas, beans, or meat stock. The superiority of bread and milk was demon- strated when it was shown that in only one other menu was the food value anywhere near equal to that found in the Stuttgart breakfast. The meals of bean and pea and meat soups, were found to give one-third to one-half of the proper amount of energy, while the protein or tissue-building element was very low indeed. As regards the menus in the dinners, the con- dition was found to be even more serious. Dinners of some sort are served in 86 cities out of 189 reporting. Upon analysis of the food served in 12 different cities, chosen as types from yy cities whose menus were ascertained, it was found that not one contained what was considered a normal amount of nutritive value. The standard used for comparison was that of Dr. Erisman, a Swiss authority on the feeding of school children, who considers that the main meal should contain about one-half of the total amount needed during the 8 114 SCHOOL FEEDING day. As in most cases the school meal was planned to be the chief meal of the day, it seemed fair to apply the standard. In the twelve cities, not one furnished such a standard, that is a meal yielding 8i6 Calories of fuel value. The one that came nearest to meeting this standard served 76 per cent. of this, and the percentage dropped, through the 12 cities, to 25 per cent, in one. On the average the meals yielded 475 Calories each, not bad at all for a light lunch, but not enough for one-half the day's food supply. The amount oi protein was far lower than the standard in nearly all cases, sometimes falling as low as 2^ per cent, of normal. On an average, the meals contained about three- fifths the normal requirements of meat or other protein material. GENERAL CHARACTER AND SUPPORT OF SCHOOL FEEDING ORGANIZATIONS The kind of organization and support varies considerably in the different cities. There are in general three forms. First there are private so- cieties giving meals as relief measures to the chil- dren, and receiving no money support from the city, though nearly always the school authorities MEALS IN GERMAN CITIES 116 co-operate in the work of supervising and service, and in many cases the rooms, and even gas for cooking are supphed free. Such societies v^ere found in 78 cities out of 189 reporting. In 1907- 1908 these societies fed over 17,000 children, a number amounting to 4 per cent, of the school population in these cities. The next form found in 68 cities is in the hands of private organizations, which, however, receive financial support from the city governments and are usually under its supervision. These societies served meals to about 56,000 children in the cities where they operated. Finally there are 43 cities, where the work of school feeding is a municipal affair entirely, and as a rule is in the hands of the school authorities, though occasionally it is conducted by the Board of Health. In these cities nearly 18,000, or six per cent, of the children, attend the meals. In addition to regular forms of school feeding just enumerated the Children's Homes in 43 cities assume part of the work. If we include 16,000 school children fed in this way this makes a total of 111,000 or 6.5 per cent, of the school population that are provided with meals outside their homes. 116 SCHOOL FEEDING SchcK)l feeding is, as we should expect, more extensive in the great cities than in the smaller ones. Of the 41 cities in the empire with popula- tions over 100,000, there are 32 having organiza- tions for school feeding. It is by no means con- fined to the great cities, however; indeed it is in cities of the fourth class with populations from 20,000 to 30,000 that the largest percentages of children attend the meals; and it is the small cities of 10,000 to 20,000 that have the largest per cent, of municipally supported organizations. The movement is best developed where children are best cared for in other directions as well. For example, the State of Hesse has the best child labor laws, and four out of five Hessian cities have school feeding. Over one-half of all the cities in the Empire with school feeding are in Prussia, where compulsory education dates from 1802. CO-OPERATION OF ORGANIZATIONS WITH SCHOOL Whatever the source of funds supporting the meals there is in all cases the closest co-operation between the school authorities and those in charge of the school meals. In the majority of cases it is the teachers who determine which children shall MEALS IN GERMAN CITIES 117 receive the meals. In a few cases, where the meals are supported by pubHc though not school funds, the preliminary investigation is made by the public poor officials. The meals are nearly always served in the school buildings, and the supervision of the children at their meals is nearly always done by the teachers. In Munich, a municipal ordinance passed in 1874 and still operative provides for the supervision of the children during meals and after, before the afternoon work begins. There is the greatest variety in the number of months during the year that the meals are served in the different cities. Of 151 places reporting over a third have meals from 3 to 5 months in the winter; in a quarter they are open from 2 to 3 months; in about one per cent, they are open throughout the school year; and in 32 or one- fifth of all, for the entire year, winter and summer. Another point of difference is the kind of meal served, the majority of places giving breakfasts, some dinners, and some giving both meals. Finally there is the fact that some organizations serve meals only to the poorest children while others conduct regular school restaurants, where all may come who care to pay the cost of the food. 118 SCHOOL FEEDING Because of this great diversity in the form of organization and the length of service a summary as to the number of children involved or the cost of the w^ork is well nigh meaningless. However, from 189 cities enough data were given to make possible the general statement that school feeding of some kind reaches some time during the year 111,000 children, who form 6.5 per cent, of the total school population in those cities. The general statement that 6.5 per cent, of the children are served does not hold uniformly for all states in the Empire. For example, in Saxony the numbers fed form slightly less than 2 per cent, of the whole, while in Alsace-Lorraine, the! numbers fed formed 1 1 per cent. ; in Wurtemburg, 12 per cent.; in Hesse, where 3 cities out of 4 provide school meals, 14 per cent.; and in Baden, 16 per cent. These figures vary even more widely in the separate cities, as in some cities only one- half of one per cent, of the children attend the meals, while in others, for example, Konstance, the numbers form as much as 34 per cent, of the total school population. MEALS IN GERMAN CITIES 119 EXPENSE The total expenditure in i6o cities reached in 1907-1908, $146,136, exclusive of the amounts paid for the meals, by the children themselves. About one-quarter of the children pay 2 cents for breakfasts and 3 cents for dinner. An estimate was made by Dr. Kaup of the prob- able expense of extending the present system of school feeding to all cities, and having the same percentage of children fed on every school day during the year. This would amount to 8,330,333 marks, or $1,666,066. In the open air schools in Charlottenberg, the question of food preparation has been so carefully studied, that the expense of feeding each child fiYQ meals, one of which is a substantial dinner — is a trifle over nine cents a day. If the same care were exercised in the preparation of the lunches in the ordinary schools, $1,666,066 would be sufficient to supply all needy children in city and country with a milk breakfast and a warm dinner every day in the year. The following statements are a summary of the 120 SCHOOL FEEDING present provisions made in German cities for school feeding : From an inquiry sent to 525 cities with 10,000 inhabitants and over, replies were received from 487. Of the 487, 239 reported some form of school feeding and 189 gave details of organization. In 189 cities the financial support of the school feeding was entirely municipal in 43; partially private and partially public in 68; and entirely private in 78. A total number of 111,000 children are fed in 189 cities, these forming over 6 per cent, of the total school population in these cities. THE FOOD HABITS OF GERMAN CHILDREN The next important thing to determine was how well the organizations for school feeding were meet- ing the need, and this meant that the real conditions of school children in general must be known; first the actual food consumed daily, and then, how the children were thriving, or failing to thrive on their diet. Careful inquiries were made by teachers and doctors and social workers in winter and summer, and the results obtained made it possible to account for the food habits of over 500,000 children, with a fair amount of detail. The inquiry embraced MEALS IN GERMAN CITIES 121 altogether 74 cities, details for the summer months being had for only 53 of these. With eight ex- ceptions, the cities involved were small, that is with less than 50,000 inhabitants and most of them with 10,000 to 20,000. The conditions therefore may all the more be taken as typical of the country at large and not merely as exaggerated results of congestion. In general the findings of this inquiry were as follows : For breakfast, 80 per cent, of the children, in all classes of society throughout these cities, have coffee, mostly with but some without rolls or bread. Ten per cent, have milk in some form, usually bread and milk. Five per cent, have tea or cocoa and bread. Nine per cent, have other things — soup, eggs, etc. Finally, over one per cent, have no breakfast of any kind, despite the widespread pro- vision of school breakfasts. In some cities the number of children without breakfast of any kind reached 8 per cent, of the school population. As- suming that the average percentage holds through- out all cities, there are over 30,000 children going daily to school without breakfast. The large majority of children have a warm mid- 122 SCHOOL FEEDING day meal, either at home or in school. About 5 per cent, of all have a cold lunch in winter. This percentage runs much higher in industrial centres, so that, in some factory towns, as many as one- quarter of the children have a cold lunch, sometimes of very meagre quality. Assuming again that the general per cent, of 5 holds in all cities, there are 170,000 children who ordinarily have a cold lunch, often of an entirely inadequate nature for their only midday meal. For supper, about half have a warm meal, and about half a cold lunch. Less than i per cent, of all go supperless to bed, though here the figures vary considerably in different places. The custom of having the children wait till night for a warm dinner is growing rapidly, especially in large towns where the mothers are working away from home all day. In Berlin, whose figures have not been included in the data given so far, 7 per cent, of the children reported that their main meal was between six and seven at night. One rather disquieting discovery was the extent to which alcohol is used — 23 cities reported 2 per cent, of children receiving alcohol in some form at breakfast; 40 cities reported 4 per cent, having it MEALS IN GERMAN CITIES 123 at dinner, while 36 cities reported 5.2 per cent, hav- ing it in the evening. This makes a total of 18,299 children having alcohol as a rule once a day. This survey of the food habits, while suggestive, could not give an adequate view of the nutrition of the children, because in so extensive an inquiry the questions of quantity and quality of the food eaten might not be considered. A superficial survey made by teachers of nearly 170,000 children, showed 12 per cent, well nour- ished, 23 fairly and only 5 per cent, badly. But this was admittedly the result of a superficial in- spection, and was not regarded as at all exact. Later, a special examination of 27,440 of these children, of all social grades, in 22 cities, was made by medical inspectors. They found 11,422 chil- dren, or 42 per cent., whom they were able toi term well nourished. About fifty per cent., 13,823, were fairly well nourished. The remainder, 2,195, o^ 8 per cent., were distinctly undernourished. MAIN CAUSE FOR SERIOUS UNDERFEEDING Throughout this inquiry special attention was paid to the economic and social causes for the large amount of serious underfeeding everywhere 124 SCHOOL FEEDING evident. Specific data were gathered in the cases of over 23,000 children, by doctors, teachers and social virorkers who visited the homes and left no stone unturned to get accurate and adequate infor- mation, filling out elaborate blanks for each child.^ The causes discovered in this way were grouped in the original report under eleven different heads, as follows : Chronic poverty, sickness of bread win- ner, death of bread winner, unemployment, family too large for the income, child labor, mother's em- ployment outside the home, culpable neglect by lazy and drunken parents, children's haste and loss of appetite, from nervousness or illness, long dis- tance to school, and miscellaneous. The first six causes may be grouped as " Poverty." The mother's employment outside the home is an increasingly important factor socially; although it as a rule belongs logically under the caption " Pov- erty," it is listed separately. Haste and loss of appetite from illness or from nervousness, may be grouped as loss of appetite. The long distance from school, a cause of no breakfast and a scanty lunch, was found chiefly in the smaller towns. Culpable neglect was found in relatively few cases. Finally "Kaup, pp. 71-72 and 93-94- MEALS IN GERMAN CITIES 125 under the head miscellaneous came sporadic ac- cidents, temporary illness of children, deserted mothers, and many other ill-defined factors which probably all belonged in other groups. The relative importance of these various causes in producing malnutrition is shown in the following table : Table 4 Causes Number Percentage of Cases of Total 1. Poverty 14,725 62 2. Miscellaneous 2,986 12 3. Loss of appetite 2,709 11 4. Mother works out 1,653 7 5. Culpable neglect i,093 5 6. Long distance 446 2 Totals 23,612 99 SUMMARY AND CONCLUSION The conclusion arrived at by the delegates to the national conference of the League of Social Wel- fare where this report was presented, and discussed during three days, was as follows : A survey of children representing all social classes and all school grades had shown that there was undoubted need existing for some sort of provision of meals at school, not only to relieve distress, but to educate, and raise food standards. 126 SCHOOL FEEDING The amount of extreme need as shown by acute malnutrition, represented, according to the doctors, about 8 per cent, of the whole school population. In addition to the acute cases, 50 per cent, of the children were only fairly well nourished, leaving only 42 per cent, who were really well nourished. This condition of insufficient feeding and under- feeding was fully accounted for in the study made of the home feeding of the children, when it was discovered that 80 per cent, of the children had breakfasts of coffee and bread, and thousands had none at all, while many thousands went till evening before having a warm meal. Underfeeding was found to have a hindering effect on school progress, because the children were dull and listless in work and play. Evidence was submitted to show that malnutrition lay at the bot- tom of many diseases and physical defects in school children. For example, Dr. Delitsch of Plauen said that food was quite as necessary as medicine in helping certain eye and ear troubles that result from scrofula, and also in preventing the development of tuberculosis. Underfeeding during childhood was further held responsible for the failing war strength of the country. MEALS IN GERMAN CITIES 127 Not quite half the cities were making any sort of provision for school meals. Even where meals were served they were reach- ing but a trifle over 6 per cent, of the children. The need was the same in towns without provision, and in country districts. The meals as usually given were inadequate in quality and amount, and even at that were not served throughout the year. PROPOSED NATIONAL PROGRAM Various plans for future work in school feed- ing were discussed at the conference.* Among those that found most favor were the suggestions made by Dr. Max Rubner of Berlin University, who said that school feeding must be considered as one phase of the larger problem of the nutrition of the people as a whole. A definite plan for a cam- paign for national legislation was then presented by Miss Helene Simon, a well known German writer on social economy, who is a leader in the school feeding movement and the author of several books on the subject. * Kaup, Die Ernahrungsverhaltnisse der Volkschulkinder, p. 132, ff. 128 SCHOOL FEEDING The most significant of Dr. Rubner's suggestions were the following: " Since the problem of nutrition for school chil- dren is part of the larger food problem, all measures taken to influence this last will of course have a great influence on the first. Among the necessary reforms affecting the nutrition of the people as a whole are: "(a) Widespread education in all that has to do with nutrition, and the determining of the correct nutritional minima upon physiological grounds. "(&) Selling of foodstuffs, etc., at cost in municipal markets and stores to poor families, es- pecially those with a large number of children. "(c) Establishment of People's Diet Kitchens by municipal and by private societies." PROVISION FOR NATIONAL LEGISLATION The following summary for the provisions that should be made in any national legislation on School Feeding that might be undertaken, was made by Helene Simon, who considers that this legislation to be effective must be compulsory.^ "This was printed in the form given, in Simon, Helene, Schulspeisung, pp. 77-78. MEALS IN GERMAN CITIES 129 (a) School feeding must be provided where it is an assured need. The children of those parents who are on the lists of charity associations as well as those who pay no taxes, i.e., whose income falls below 900 marks, shall be con- sidered as needy without further question. (&) Lists of cases requiring help shall be made out and investigated periodically. (c) The dietaries shall be determined on physiological grounds. Provision should be made possible for breakfast and dinner, for the' whole year. Needy children shall be fed every day. (d) The rooms where the meals are held should be in the schools or in adjoining buildings. All details and direc- tions as to the kind, time, place and organization of feeding, must be left to the discretion of the local municipalities and school boards. Only where these neglect their duty or do not carry out in the right way shall the State Supervision Board interfere. It will be noted that these proposed measures do not differ very much from those in the Pro- vision of Meals Act in England, except for the fact that they are designed to be compulsory. Since the conference in May, 1909, the question of school feeding has been given increasing atten- tion in Germany, and there is every indication that a national act will be passed at no far distant date. 9 VI School Feeding in Other European Countries COMPULSORY education AND SCHOOL MEALS IN HOLLAND Holland was the first country to have national legislation providing for school meals. The law of 1900 enforcing compulsory education contained a section authorizing the municipalities to provide food and clothing for all school children whether in public or private schools " who were unable, be- cause of the lack of food and clothes, to go regularly to school or to those who probably would not con- tinue to attend school regularly unless food and clothes were provided." The law provided that this work might be done directly or by supporting voluntary societies. Up to this time considerable school feeding had been done by voluntary societies and as early as 1892 no fewer than 53 communities had such provisions. By 1907 there were 37 towns that had adopted the provisions of the act, in accordance with the Royal 130 IN EUROPEAN COUNTRIES 131 Decree, and were contributing wholly or in part to the school feeding. The organization is about the same as in other countries, except that the work is almost entirely confined to giving free meals to those in absolute need. The work, however, is entirely a school affair. Teachers and principals select the children and have charge of the meal tickets. The cost per meal is restricted by law, not to exceed one cent and a half. According to reports from ii cities a total of 17,000 children are fed every school day. Some of the towns, for example Amsterdam, provide meals winter and summer. HOW THE SWISS GOVERNMENT PROVIDES FOR SCHOOL MEALS The finest buildings in the Swiss towns are the school houses. But the principle on which they are built seems to be that it is better to have a relatively small number, far apart but of excellent quality, than to sacrifice this excellence by having more of them nearer together. This means that a good many children have a long way to go to school, and so, as it is impossible to go home at noon, a warm lunch, usually of soup and bread, but sometimes of soup, 132 SCHOOL FEEDING meat and vegetables, is provided in most schools. The public funds are used for this purpose, and the lunches are free in the larger number of cases. Eighteen years ago, in 1894, the Federal Bureau of Statistics^ found that no less than 35,000 children, or eight per cent, of the primary school enrolment, were receiving lunches at noon, and that 23,000 of these had over a half hour's walk from home. In other words one child in each twelve received a school lunch, the usual reason being that it was too far for him to go home at noon. Most of the lunches provided in this way had originally been started by private societies, some- times with the object of promoting school attend- ance and more rarely as charitable relief measures. At the time of the government investigation cited above, the support of the work had been largely taken over by the municipalities and cantons. Dr. Huber, the official who made the investiga- tion, stated that the results of school feeding had been universally praised by teachers, who testified that because of the lunches there was better school attendance, better attention and better results in *Jahrbuch des Unterrichtswesens in der Schweiz, 1894. Federal Bureau of Statistics, Bern, Switzerland. IN EUROPEAN COUNTRIES 133 studies as a consequence of better health. Dr. Huber was convinced that the work should be ex- tended to accommodate at least 50,000 children, or ten per cent, of the school population. Nine years after this, in 1903, the Federal Gov- ernment issued an order in regard to the support of the public elementary schools, which put the cantons under obligation to supply food and cloth- ing to whatever children were in need.^ During the next three years the work of school feeding spread rapidly, and in 1906 the Federal authorities authorized the use of state funds for their support, as well as for vacation colonies and milk stations, but with the understanding that in no case should the cantonal or city support be les- sened because of the Federal support. Switzerland, following Holland's lead of 1900, was thus the second country to make national provision for school meals. The point which dis- tinguishes her legislation from either Holland's or the English Provision of Meals Act of 1906, is that the Federal ruling of 1903 was obligatory. Before Federal funds were available, it was the custom to use the money raised by the tax on * Educational Act, January, 1903. Art. 2, Section 8. 134 SCHOOL FEEDING alcohol to pay for the lunches, and this form of poetic justice is still effective in several cantons. Another source of income, before the state assumed more direct responsibility, was from the " school funds ^* (Schulkassen) that had their origin in a quaint old custom of the young people giving a sort of thank-offering to the village for their school- ing when the time came for them to be married. These funds, which were the precursors of the Caisses d'ficoles of France, were used tO' encourage school attendance, by supplying medals and books and to support vacation colonies, school baths and other outside activities of the school. The latest report on school feeding in Switzer- land, made in 1908 by Dr. Erismann, the head medical inspector in Zurich, showed that eighteen of the nineteen large cities have provisions for school meals. The movement is not confined to the cities, but has developed quite as much in the country districts. Thus the central authorities reported that eighteen of the twenty-five cantons give subsidies for school meals. Sufficient data are not available to make a definite statement of the exact number of towns having ^ IN EUROPEAN COUNTRIES 135 school meals, the number of children fed, etc., but it is safe to say that lack' of provision is the exception. The subsidies from state and canton frequently cover 50 per cent, of the entire cost, and a good share of the remainder is paid by city or village funds, leaving only a very small part to be raised by private endeavor. The subsidies are distributed to the schools in different ways. In some places the state or canton or both are responsible for a certain percentage of the entire cost, whatever this may be. In others a special rate per child is decided upon, as for example, in Uri, the state provides an annual amount, 25 cents per child, and the canton supplies the balance of the cost. The larger cities provide their own funds, with only a slight subsidy from the cantons or state. An idea of the exact care with which the meals are administered may be gained from conditions in the city of Zurich, which may be regarded as typical of those in Switzerland as a whole. In this city, parents fill out application blanks for the meals in the same way that they do in Bradford and Charlottenburg. (Appendices C, D.) There are 136 SCHOOL FEEDING careful regulations for the conduct of the meals themselves, both in their preparation and service. The bread must be cut so that each slice weighs lOO grams. Bread and cheese or bread and sausage are served only after the child has eaten at least one plate of soup. The boys and girls eat at separate tables, each group being made up of older and younger chil- dren, in a " family." The older children are ex- pected to look after the younger ones, and see that they get all they want. In some of the schools hav- ing kitchens and dining-rooms in the building, the older girls and boys help in the clearing away and washing of the dishes. The teachers are held re- sponsible for overseeing the work, appointing the monitors and keeping the reports. Care is taken to make the school meals come up to the right standard of food value, and the city requires that on certain days at least, cheese or sausage shall be given with the bread and soup. This is owing to the work of the chief medical inspector, Dr. Erismann, who found in 1901 that the meals were unplanned, and lacking particularly in protein and fat. Dr. Erismann gives the following points among his conclusions in regard to school feeding, after IN EUROPEAN COUNTRIES 137 studying the question throughout Switzerland, and after many years of practical experience in Zurich.^ What makes these recommendations of particular value is that each one has been tried out in prac- tice in some part of Switzerland. 1. Provisions for a free meal at noon should be made every- where, and meals provided for : (a) school children coming a long distance each day from home; (b) school children who are undernourished on account of the poverty of their parents; (c) school children whose parents are away at noon. 2. Children whose parents so desire should be able to buy a meal at cost, where there is no question of poverty. The price asked should never exceed the actual cost of the food. 3. All children who on account of poverty do not receive a sufficiently nourishing breakfast should be given warm milk and bread at school before lessons. 4. The school lunch should be a full nourishing meal. The portions should have enough food value to furnish 816 Calories or one-half the day's required total of Calories per child. It should be especially rich in protein and fat and the food values should be distributed in about the following amounts : 40 grams protein, 26 grams fat, 100 grams carbohydrate for a ten-year-old child. Proper variety should be insisted on. 5. The supply of food to poor children must never be re- garded as charity or pauperizing in any way. ' Erismann, Dr. F., Stadtrat, Zurich, Ernahrung und Kleid- ung durftiger Schulkinder, 1908. 138 SCHOOL FEEDING Dr. Erismann's outline shows the ideal held by workers in school meals in Switzerland. This ideal is already carried out in many parts of the country. Stated in brief it calls for school lunches for all, free to those who cannot pay, as a help to efficient education, and of such a character as to raise the physical standard of the children's development. REFEZIONE SCOLASTICA IN ITALIAN CITIES School feeding as a municipal venture began in 1896, when the Council at San Remo reorganized as a regular city institution the system of school meals, till then supported privately. Other cities followed San Remo's example until at present there are fifty cities with school feeding organizations, over half of which are supported and administered entirely by the community, and the rest of which are administered by specially subsidized voluntary committees under the supervision of the city officials. Milan^. — The work in Milan is typical of the Italian organizations generally. It was begun in 1894 by a semi-official body known as the Com- mittee of Patronage. In 1900, the city, then under a conservative administration, assumed control and introduced a system of lunches into all schools. At first these lunches consisted simply of sand- IN EUROPEAN COUNTRIES 139 wiches made with sausage, cheese or sliced meat, costing I or 1.2 cents. In 1904 warm meals were introduced in certain schools and are gradually being installed in all, consisting of soup and bread, or rice pilaff, meat or cheese and macaroni. Olive oil is used in the preparation of these dishes so that there is a maximum of food value. The portions are slightly larger for the older children; for ex- ample, the bread is cut so that the three younger classes receive 120 grams and the three older classes 150 grams; the rice is served in portions of 300 grams for the little children and 355 grams for the older ones. Delicate children are given eggs in place of the regular menus. The entire cost including preparation and ad- ministration of the warm lunch is 1.4. The meal tickets are one and one-half cents. There are at present an average of 17,600 chil- dren in daily attendance and these form 38 per cent, of the entire enrolment. Of these 30 per cent, re- ceive their meals free. The total expense to the city was $81,322 in 1908-1909. This amount in- cludes the special fee paid to the teachers who super- vise the children and eat with them. One of the results of the school lunches in Milan has been to decrease the number of absences. Be- 140 SCHOOL FEEDING fore 1894 the average daily absence was 28 per cent, of the school enrolment; this number steadily fell until II years later the average number of absences formed but 6 per cent, of the school enrolment. Other Cities. — In general the Refezione Scolas- tica are, like the Paris Cantines, designed to be school restaurants, open to all who may care to come. As a result a larger proportion of school children attend than is the case in any other country. In the large cities, Rome, Genoa, Padua, Venice, etc., the meals are attended by about one-half of the children and are paid for in a large majority of cases. The average attendance in forty-three cities was about 100,000 in 1908- 1909, and this formed 37 per cent, of the entire school population, while in several the attendance rose to over 70 per cent. The total expense to the cities in 44 cases was nearly $215,000 in this year.'* Experiments with Free and Compulsory Feed- ing.^ — In several towns the experiment was tried, of having the meals free for all and attendance upon them compulsory in the same way that school at- * Information sent to writer by Alessandro Schiavi, direc- tor of Bureau of Labor, of the Societa Umanitaria, Milan. "Lancet Reports, and Spargo's Bitter Cry of the Children, App. A and B. IN EUROPEAN COUNTRIES 141 tendance is compulsory. In Vercelli, the best known of these places, it was not altogether a success, because it was found too expensive to provide a really adequate meal for all, free. If a cold meal with a rather low food value was served it was possible to provide for all, but this did not meet the real need. After six years of trial Vercelli returned to a method similar to that of Milan, where warm meals are served to a large proportion of the children, but are free only to those children who are known to be unable to pay.^ Padua. — The work in Padua is distinguished for being the first in the world where an attempt was made to have the school meals planned scientifically to meet the special needs oi the children. Dr. Tonsig, the director of medical inspection, plans the meals so that they furnish one-half of the day's total need and are so proportioned that three- quarters of the necessary fat and protein are pro- vided. The fact that 69 per cent, of the children attend the meals makes this careful planning of considerable importance. Padua's example has been followed in many other cities. 'Letter from the Director of Public Instruction in Ver- celli to His Excellency Mayor des Planches, the Italian Ambassador at Washington, June 11, 1910. 142 SCHOOL FEEDING In the smaller Italian towns and villages the cus- tom is followed of having the meals served out of doors in fine weather. In several places it is re- ported that street begging of the children ceased after the introduction of the meals. To summarize : School feeding is now thoroughly established in Italian cities, most of which provide school restaurants serving daily on an average over a third and in many cases over two-thirds of the children. The large numbers involved make the Italian school meals more important from an edu- cational point of view than they are in any other country. The meals are supervised by teachers who are paid an additional fee for these services. Special care is given to the scientific planning of the meals to serve the physiological needs of growing children. One specially interesting thing about the Italian school feeding is that it was begun in San Remo 15 years ago when the majority of the council happened to be Socialists. For this reason, the movement was looked upon with distrust and was opposed by conservatives in San Remo and other cities. But the good effect of the meals on school progress was so apparent as to overcome political prejudice, and now the different parties vie with IN EUROPEAN COUNTRIES US each other in formulating in their platforms at- tractive plans for school feeding. Moreover the majority of the meals are paid for and this Social- istic activity contrary to prophecies has not resulted in the " pauperization " of the children. Austria, — There is no national school feeding movement in Austria, but most of the larger cities have organized provisions. In Vienna a central school feeding society has been in existence for over twenty years, having charge of the work through- out the city. In 1907- 1908 the meals were served to 10,583 children at a total expense of $35,737, of which $20,000 was furnished as a city subsidy. In spite of this activity, all who need it are not fed and the meals are continued for four winter months only. The meals are inadequate in every way, especially in the outlying districts. For these reasons the city is gradually assuming direct con- trol. Kitchens and dining-rooms were built in 1909 in four new public schools and this work is being extended in all city schools. Sweden. — Most large Swedish towns have well organized systems of school meals, some of them twenty years old. The majority of these are ad- 144 SCHOOL FEEDING ministered by subsidized societies with co-operation by the school authorities. In larger and newer city schools, kitchens and dining-rooms are provided and the work is being gradually taken intO' direct control by the city authorities. From 8 to 32 per cent, of the children in the different cities attend the meals. The principle is everywhere recognized of pro- viding food for the poorest children first. In some places a regular dinner of soup, meat and bread is given every day in the week to the very poorest children, and on three days only to others. In some places breakfasts of milk and soup are served. Where there are cooking classes, these prepare each day the meals for a small number, not usually more than twenty. The teachers pick out the poorest children and meals are given free or at a slight cost, according to the ability of the children's par- ents to pay, as determined by special investigation. In Sweden the problem of school feeding in country districts has received considerable atten- tion, because the schools are so far apart that in some cases, the children have to walk as much as twelve miles each day to and from school. As a result, in about twenty places the system of warm IN EUROPEAN COUNTRIES 145 midday meals has been Introduced. In some cases these meals are simply warm milk and cocoa, or soup, designed to supplement the lunches from home, and in others a regular meal is given. Norway. — Christiania has had a municipal ser- vice of meals since 1897. ^ midday meal is pro- vided every day during the fall and winter terms. There is a large school kitchen on the Bradford plan from which the meals are sent to the different schools, each one of which is equipped with a special dining-room. Two days in the week meat is given and the other days cereal with milk, and every child is allowed as much as it wants. During the year 1 907-1 908, 6000 children out of a total of 30,0(X) were fed, and a great majority of the meals were free, only 11 per cent, being paid for, at a rate of 2.5 cents apiece. School meals are found in many other Norwegian cities. Beigiiim. — Belgium has no compulsory school law, but it has a school feeding problem. The gen- eral custom in cities is to provide food at least in the kindergartens and in the guardian schools which are for very poor children, or for children whose parents work away from home at day. In many 10 146 SCHOOL FEEDING places there are subsidized organizations providing meals in the regular elementary schools. In 1888 a private society, with the consent of the educa- tional authorities, began to provide a warm meal at noon for the poorest children. Six years later an investigation of underfeeding was made by the school authorities and from daily reports by teachers and directors covering 14,500 cases, it was found that 2^ per cent, were underfed. As a result the city granted a subsidy of $1000 to the society, to provide meals, and by 1906 this subsidy had been more than doubled. Denmark. — In 1902 a provisory law was passed allowing municipal subsidies to private societies for school feeding, whose work in some cities was over 30 years old. Although a number of cities have adopted the act, in 1907 a campaign was begun for compulsory national legislation, because it has been found that while meals were more and more a necessity in city schools, local initiative and private effort even with the help of city sub- sidies, could not be relied upon to furnish them in an adequate manner. VII Lunches in American Elementary Schools LUNCHES AND EXPERIMENTS IN NEW YORK CITY " Again I appeal to you, in the name of suffer- ing childhood, to establish in each school facilities whereby the pupils may obtain simple wholesome food at cost price/* Superintendent Maxwell of New York City made this appeal in his annual re- port for 1908. The following fall, with the ap- proval of the Board of Education, a school lunch committee was formed of physicians and social workers who undertook to find out if a three cent lunch might be made self-supporting. They chose two schools for the experiment, one Public School 21, in the Italian district on the lower East Side, and the other Public School 51, in a dis- trict on the middle West Side where the population is largely Irish-American. After two years the Board of Education formally endorsed the lunches and gave permission to instal them in other schools, with the understanding that the Board would sup- 147 148 SCHOOL FEEDING ply rooms, equipment, and gas, and that the cost of the food and of service must be met by the sale of meal tickets. The lunches are now being served in seven schools in Manhattan under the auspices of the School Lunch Committee. Certain schools in Brooklyn and Flushing have also been equipped to serve lunches through the efforts of individual workers. ORGANIZATION OF LUNCHES In each school there is a superintendent who does the buying and oversees the cooking and serving. A cook is employed at $i a day. In the Mott Street School, No. 21, the meals are served in the base- ment yard and the quarters are crowded so that the children have to stand at long tables. Certain of the older children are chosen for helpers, and sell tickets, help serve, and clean and wash up afterwards. For this they are given their lunches each day. They wear white caps and aprons and those who handle the bread wear white gloves. The working out of the dietaries is in the hands of a physician who has planned them not only in accordance with the special needs of growing chil- dren but with reference also to the national customs PREPARATION OF NEW YORK SCHOOL LUNCH LUNCHES IN AMERICAN SCHOOLS 149 of the local population. This means that there is considerable difference in the menus of the differ- ent schools. The lunches are designed to provide at least one-quarter of the necessary daily ration of the children ; as a rule one-third, sometimes one-half, is actually provided. The main dish is usually a substantial soup or stew or a thick rice pudding-, served with big pieces of bread. In addition there are " extras " or desserts, such as cocoa, fruit, cakes, lettuce sandwiches and bowls of vegetable salad, which cost a cent apiece. There is a rule that no child may buy an " extra " until he has eaten the regular food. EXPENSES IN TWO SCHOOLS During 1 909-1910 the lunches served in the Italian district cost $.047 apiece. Those in the Irish-American district cost $.048 apiece. During the year there was a total expenditure in the two schools of $2,453. Because of the fact that a number of children were served free and because of the expense entailed by an inadequate equipment, the receipts for the meal tickets did not quite cover the expenses. There was a daily deficit of about one cent per meal. The School Lunch Committee 150 SCHOOL FEEDING estimates that the lunches may be made self-sup- porting if there are three hundred children buying them daily at each school and that this would suffice to cover the relatively few free lunches. In the first half of the year 1910-1911 the number of children fed daily in Public School 21 averaged 230, of which 30 were fed free, which means that the lunches came nearer to being self-supporting. RESULT OF FEEDING ON WEIGHT In order to find out what effect one meal a day might have on the development of these children, a careful record was kept during three months of the weights of 143 children who attended the meals regularly. At the same time weight records were kept of 81 children who did not eat the lunches at school. At the end of three months, the children taking lunches showed a total net gain of 91 lbs. 4 oz., while the net gain of the 81 children not tak- ing the lunches was 17 pounds. This makes the average gain of the children taking the school lunches 10.2 ounces, while that of the children not taking the lunches was 3.4 ounces. It was found that in both groups a certain number showed a loss in weight, but that the proportion of those losing LUNCHES IN AMERICAN SCHOOLS 151 was considerably less in the group taking the lunch. Careful study of the original figures shows that the result of the feeding was not that the children who increased in weight gained so much more rapidly than is usual, but that more of them gained. This emphasizes the real effect for good in one planned meal a day at school. SCHOOL LUNCHES IN PHILADELPHIA School lunches are more than 15 years old in Philadelphia and have existed ever since the Starr Center Association began them by serving lunches at the forenoon recess in several schools. At pres- ent the management of the lunches has been taken over by the Home and School League and the work extended to include some ten schools. The meals provided are of two sorts. In some schools there is a forenoon lunch given at 10.30, during recess time. In others a fuller meal is offered during the noon intermission, in addition to the forenoon lunch. In all of them the meals are paid for by the children and range in price from one cent, which is the cost of the forenoon lunch, to three or five cents, which purchases the fuller meal provided at noon. 15^ SCHOOL FEEDING ^^^ Each morning after the opening exercises, the teachers in the schools providing the noon meals ask the question, " Which children wish to buy- lunch tickets to-day?" Then those who want lunches go forward to the teacher's desk and buy- little yellow lunch tickets which cost three cents each. The teacher marks their names in a special roll and makes out and sends to the school kitchen an order slip stating the number of lunches desired. At noon, the children, after washing their hands and faces, go to the room that is set apart as a dining-room, where are long tables covered with white oilcloth and set with black japanned trays, on which are paper napkins, and part of the lunch — usually bread and apple butter, or stewed or fresh fruit or a few dates. Then as the children seat themselves, at high, low, or middle size tables, according to their needs, the servers in white aprons bring white enamel bowls filled with soup, corn chowder, rice pudding or whatever is the warm dish of the day. Each child gives up the little ticket, which is destroyed after being counted. Besides the long tables there is a small one on which are displayed plates of Graham crackers, dates, and most attractive of all, little cakes of sweet LUNCHES IN AMERICAN SCHOOLS 153 chocolate in tin-foil wrappers, three for a cent. Children who have not eaten the lunch cannot buy the chocolate, but the other things may be bought by children who either want to supplement a lunch brought from home, or who have not three cents to spend. There is always one warm dish to be had for a penny in this way, sometimes bean soup, some- times warm milk and a half of a shredded wheat biscuit. In the schools where the forenoon lunches are served, the standard price is one cent and for this amount the child can buy a simple dish such as bean soup, rice pudding, milk toast, creamed potato, milk, cocoa, or stewed fruit and shredded wheat. In all of the schools the principals and teachers enthusiastically co-operate in the work and fre- quently buy the lunches themselves. Sometimes they sit down with the children to eat and some- times the lunches are sent to their rest rooms. EQUIPMENT The special equipment necessitated by the lunches is simple. Each kitchen is fitted with a gas stove, large double boilers, agate kettles, and a porcelain sink with drainer. The tables are made of long 154 SCHOOL FEEDING boards resting on horses and so are easily taken down and set up if the lunch room has to be used for other purposes. The tableware consists of white enamelled pint bowls, white enamelled half pint cups, little trays and spoons. Paper napkins are supplied free by a department store for the adver- tisement that comes from the legend " Buy it at E *s " which is printed on each. CLEANLINESS The clearing up and washing of the dishes is done by " aids," chosen from among the older chil- dren, who receive their lunch free for this service. The children are not left to themselves in this work, but are carefully watched by the worker in charge, who sees that the dishes are washed perfectly clean and then sterilizes them by pouring boiling water over them. Once a week all the dishes are boiled. The dish cloths are washed and boiled daily after using. DIETARIES The extreme care in the planning of the dietaries, the arrangement of food values in the menus and the careful accounting system are the most striking things about the lunches. The superintendent plans THREE-CENT DINNER IN PHILADELPHIA SCHOOLS. IN UPPER PICTURE NOTE "PENNY TABLE' LUNCHES IN AMERICAN SCHOOLS 155 the lunches a week ahead in each of the schools, having a personal interview with each school worker. She does all the buying, and so is sure of the quality of the food used. In order to simplify the planning of the menus, she keeps a card catalog of the different dishes served, giving the amount and exact food value of each constituent, and the total number of Calories per portion, as shown in the accompanying card. A minimum requirement that is observed in plan- ning each lunch is that one cent shall buy at least lOO Calories of food value, and as a rule, one cent buys more than this. The menus show considerable variety, but dishes that are very popular like rice pudding, cocoa and bean soup are given often. RECORDS A monthly account of the menus, receipts and expenditures in each school is kept by the superin- tendent on loose-leaf pages like the one shown in Table 6. 156 SCHOOL FEEDING Table 5. Sample Recipe Card Showing Constituents and Fuel Values of Ingredients l&l i»> 1 i • — Ch >« ^ ^ 1 u «1 II 2 ft- *1 >5 • s i •id ' 2 fV *- si •i* • e c > ^ ^ - • ^ V, ««. K r~^ - u ^ f ^ «1 5 •« c -< 5 < <; > Q § < 1 ^ ^ ^ A J 1 ^ >5 V e 1 >* 1 <: s. ^ ^ > Sk N %. }i ^ a. ? c o\ c V > •• V f u c ^ -a \, «; w i i. R ^ 4. f •*• n V «0 1 c <; r>k^ ^ cc c 4 a. a u s > C or h- ^ < 1 ' LUNCHES IN AMERICAN SCHOOLS 157 Table 6. Monthly Account Sheet in Use for Philadelphia Lunches Washington School : Saleswoman, Mary Shephard school luncheon account December 1-2 Luncheon receipts — ist week $4.12 December 5-19 Luncheon receipts — ^2nd week 10.79 December 12-16 Luncheon receipts — 3rd week 11.63 December 19-23 Luncheon receipts — 4th week 13.18 Total $3972 Crackers $27.96 Milk (9.12 — 1. 14 discount) 7.98 Sugar, 9 lbs 45 Cereals : Oatmeal, 4 lbs 20 Soup bones, 3 15 Rice, 3 lbs .25 Hominy Fresh Fruits Chestnuts, 4 qts 28 Dried Fruits, Prunes 09 Vegetables, Potatoes, Onions 07 Salt, Pepper, Cinnamon, Nutmeg Soap 05 Total $37.48 Total receipts $39.72 Total expenditures 37-48 Balance on hand December 23 $2.24 The saleswomen at the schools keep daily accounts of the menus, the number served, and the money collected, delivering the cards weekly to the super- intendent. The card shown happens to be one used in connection with the penny lunch at 10.30. 158 SCHOOL FEEDING Table 7. Daily Record Card Kept by Saleswoman at School Lunch CO CO o » o 8 o CO o o JC CI CO Ci c > ■ • •N. S ^ «» fc 2 8 0^ NO 1 ^ «« ci 1 > c« «>. z «* i> e* > < 2 3E < S c3 c § 5" •• No 1 41 1 v<2 ^ ^ t V^ ^ 2 «0 \2 IS < LUNCHES IN AMERICAN SCHOOLS 159 FOLLOW-UP WORK During the first year the committee in charge of the lunches definitely experimented to find out which form is best suited to the need of each of the various localities. One school in a very poor district where large numbers of the children come from families frequently dependent on public or private charity, is provided with both a forenoon lunch and a three cent dinner at noon. A second school, in a slightly better district, was equipped with a forenoon lunch. A third, in an even better, though still poor district, was equipped with a noon- day dinner. A Home Visitor who was a graduate dietitian visited the homes of all the children in the three schools, but gave special attention to the children who were registered as attending the lunches and to those obviously underfed. She got as complete an account as possible of the con- ditions there, and talked to the mother especially about the food of her children. She tried to per- suade the mothers to send the children regularly to the lunches, whose use and value she explained. In 160 SCHOOL FEEDING the case of children obviously underfed, she advised the mother as to the necessary food and treatment. If there was special need she referred the case to the Society for Organized Charity or some other philanthropic body. This part of the work was shown to be most valuable, and the Home Visitor was retained in- definitely as a salaried member of the committee. SCHOOL LUNCHES AND CHILDREN'S DEVELOPMENT During 1910-1911 two studies were made of the physical development and school progress of the children attending the lunches.^ In the first experi- ment, measurements were taken and recorded of 362 .children from two schools of whom 114 were in more or less regular attendance at the noon three cent dinner and 248 were not. Among the children taking the meals the average number of dinners per child was 50.6. Measurements were made of weight, height, hand-strength and lung capacity of the two groups of children at the beginning and * Annual Report of the School Lunch Committee, Home and School Leajfue, Philadelphia, 191 1, page 12. LUNCHES IN AMERICAN SCHOOLS 161 end of a six months' period. The gains Oif the two groups are shown in the accompanying table : Table 8. Average Gains of Children Attending Lunches Voluntarily for Six Months Compared with Average Gains of Children Not Attending the School Lunches. Hand- Lung Weight Height Strength Capacity 114 "diners" 344 lbs. 1.36 in. 343 lbs. 12.55 cu. in. 248 "non-diners" ... 3.21 lbs. 1.07 in. 4-i81bs. 10.47 cu. in. In favor of "diners" .231b. .29 in. -75 lb. 2.09 cu. in. This experiment was designed to show the result of what might be called haphazard feeding. No special attempt was made to have the children at- tend the meals. They came or not according to their own choice and the attendance was irregular. The second experiment was one in which the factoirs were more definitely controlled. The prin- cipal of an elementary school was called on to choose 80 children who were conspicuously poor and ill- nourished. Of these 40 were given a daily dinner for three months. The 40 children who were fed averaged 55.3 dinners each. At the beginning and the end of the period records were kept of the weight, height, hand-strength and lung capacity of II 162 SCHOOL FEEDING the two groups of children. The average gains of the two groups are shown in the following table: Table 9. Average Gains During Three Months of Chil- dren Fed Regularly Compared with Average Gains of a Similar Group of Children Not Fed Regularly. Hand- Lung Weight Height Strength Capacity Children fed 178 lbs. .90 in. 3,19 lbs. 11.96 cu. in. Children not fed . . .80 lb. .68 in. 4.13 lbs. 5.40 cu. in. In favor of children fed 98 lb. .22 in. .94 lb. 6.56 cu. in. LESSON AVERAGES AND CONDUCT The physical results were not surprising in view of the many similar experiments that have been tried elsewhere. More interesting was the study made of the marks in school work and conduct of the second group of children. Results are shown in the following table: Table 10. Showing Comparative Marks in Lessons and Conduct at Three Months' Interval of Fed with Unfed Group of Children. Average Average Lesson Marks Conduct Marks Before After Gain Before After Gain The forty fed 64.0 70.1 9.5 69.4 72.0 3.7 The forty not fed 64.5 69.2 7.2 74.2 76.7 3-3 JUST TO SHOW HOW IT LOOKS. THREE-CENT DINNER, PHILADELPHIA i.iNDERGARTEN CHILDREN. THREE-CENT DINNER, PHILADELPHIA LUNCHES IN AMERICAN SCHOOLS 163 It will be noted that although the effect of the feeding on mental ability and conduct was not great, still even in this short time the children fed gained perceptibly over their comrades. ORGANIZATION The School Lunch Committee of Philadelphia comprises first, a small Executive Committee meet- ing at least twice a month, and an Advisory Board of twenty members meeting two or three times a year. The Executive Committee is organized as follows : A superintendent of lunches, an expert dietitian, devotes all of her time to the work, planning the menus, buying the material and keeping all the accounts. Under her are the workers in the various schools who do the cooking, serving and immediate supervising of the lunches, keeping daily account of the number served. A specially trained social worker — also a dietitian — devotes her time to visiting the homes of the children who attend the meals. Two members of the Psychological Clinic of the University of Pennsylvania serve on this committee and in 1910-1911 had charge of the mental and 164 SCHOOL FEEDING physical examinations made to test the value of the lunches. Finally there are two men who are financially responsible and who act as adviser and supervisor of the committee. The Advisory Board includes in addition to the Executive Committee, members of the Board of Education, superintendents, teachers, school phy- sicians, and persons engaged in social and philan- thropic work. To this board are submitted ques- tions of general policy and organization and from it are elected sub-committees to work on particular problems of administration. THE BOSTON MORNING LUNCH Although the matter had been under discussion for some years, lunches in the Boston Elementary Schools were not begun till 1909. Shortly after a meeting of the Home Economics Association in December, 1909, at which the New York and Phila- delphia work was described, a Hygiene Committee of the Home and School Associations was formed, with the late Prof. Ellen H. Richards as chair- man.2 Work was begun immediately in one of the ^ Second Annual Report of the Boston Home and School Association, Oct., 1910, Boston, Mass., pp. 32-37. LUNCHES IN AMERICAN SCHOOLS 165 schools that was fully equipped with kitchens for cooking classes. Before the end of the school year, there were lunches in five other schools. The cost of equipping these with sinks, stoves, kitchen utensils and table ware, etc., was $300. By the fall of 191 1 the work had been extended with addi- tional appropriations to twenty-two schools. Once the equipment was supplied, the lunches have been entirely self-supporting. In schools where there is a kitchen, the cooking classes prepare and serve the meals each day, and here the one cent paid by the children has been found ample to cover the cost of the food. In other schools, outside help is hired and an extra cent per meal ticket meets this expense. The following dishes are served : Pea soup with crackers; potato chowder; corn meal with milk, sugar and crackers ; rice and prunes with milk and sugar and crackers, sandwiches made with peanut butter or jam and one-half pint of milk; apple-sago pudding; rice pudding; Indian pudding; apple sauce and crackers; ginger cookies wth a glass of milk. All of the food is chosen with regard to its cheapness and to its high nutritive value. Of course the fact that the materials are bought at wholesale 166 SCHOOL FEEDING gives a distinct advantage. In general each lunch yields a fuel value of 300 Calories. The way in which it is possible to serve so satis- fying a lunch for one or two cents is explained by the statement made by Mrs. Richards, the food ex- pert and veteran in the fight for the common health : " The milk used is skimmed milk, costing at whole- sale about three cents a quart, appreciably lower- ing the cost, and the only loss in food value is the fat; the casein of the milk which is a valuable and expensive element is as high as in whole milk and the milk sugar is retained. That fat is made up by butterine, a cheaper product than butter which has, however, as great a food value and is as easily assimilated in most cases. "The chairman of the committee took the re- sponsibility for the use of these foods. There is probably less danger in this combination than in the whole milk as commonly found to-day. The increase of lactic acid organisms in the skimmed milk tends, as Metchnikoff has shown, to crowd out others present and the conditions of manufac- turing butterine oleomargarine render it exceed- ingly improbable that disease germs shall have access to the product. THE PRINCIPAL EATS DINNER EACH DAY WITH THE CHILDREN IN THIS PHILADELPHIA SCHOOL THE FIRST SCHOOL LUNCH IN PITTSBURG LUNCHES IN AMERICAN SCHOOLS 167 " Sugar is one of the least expensive as well as the cleanest of foods and is used freely. The best authorities apparently agree that under four ounces a day the child may be allowed it freely. Flour in the form of crackers is also inexpensive and nutritious. Ferguson's bread proved to be well baked and well liked. There is little danger in loaf bread which is crusty and baked through." The very fact that such care and attention are given to the selection of a penny's worth of food is a lesson to the mothers, who are encouraged to visit the lunches. Mrs'. Richards says, " To those who give little children a penny to spend without any suggestion as to what to buy with it or where to buy it, this extreme care given to a luncheon must be a revelation, and in time this influence must tell for good. One of the worst habits of children of this age is the patronizing of the candy and pastry shops." So far, if reports from teachers and principals are to be trusted, the lunches have been an un- qualified success, from a school point of view. The children are more attentive and interested than be- fore the lunches were started in the lessons during the last hour of the morning and this is shown by improved recitations. 168 SCHOOL FEEDING In addition, noon lunches are being* introduced to serve the needs of a large number of chil- dren, known as the " shut outs," whose mothers are away at noon and who, locked out from their homes, roam the streets. It is hoped to form a class of these children in each school to prepare their own lunch and this, judging from the in- terest the cooking classes have taken in working to serve real needs, should be a successful venture. CINCINNATI PENNY LUNCHES In Cincinnati penny lunches have been introduced in five schools by the combined efforts of teachers, the Civic League and the Council of Jewish Women. The School Board pays for the equipment as is the custom in most places. The following account is taken from a report of the Lunch Committee of one of the schools to the School Board. Superintendent Dyer in his report of 191 1 remarked that the Board should also pay the cook. " In beginning our work at the Sherman School we realized the fact that this school is not in a neighborhood where the direst poverty prevails, but where many mothers are the principal wage-earners of the family. They have to leave their homes early LUNCHES IN AMERICAN SCHOOLS 169 in the morning, and this is one of the reasons why many of the children are obliged to go to school without a nourishing breakfast, or with a very meagre one. Before a penny lunch was provided, it was a frequent occurrence for children to buy, during the forenoon recess, at the school gates, for the penny oi; two they brought with them, food that was anything but wholesome. As we were reliably informed by teachers in the school, it was a common occurrence to see children come into the school during recess with a pickle in one hand and a cone of ice cream in the other. This, with a scanty breakfast at home, in many cases was all the food obtained by the children until their evening meal. Our aim is to give the children something that will nourish them at a cost of one cent. " EQUIPMENT " Our first equipment was donated by generous friends. It comprises two fireless cookers, two gas cooking stoves without broiler ovens, one gas radiator, six wire baskets for sandwiches, four cone racks to hold 200, three wooden chopping bowls, six large tables covered with white oil cloth, six asbestos lids, one dozen tea towels, one-half dozen 170 SCHOOL FEEDING pot cloths, six paring knives, one meat grinder, one sandwich cutter, three granite kettles and two col- landers, etc. We find it economical not to use a refrigerator. All our supplies are delivered daily. " THE FOOD THAT IS PROVIDED ** The following is a complete list of all the articles we have provided in the lunch room, each item of which is sold for one cent : One hot wiener, with one slice rye bread. Hot meat sandwich, consisting of chopped boiled beef, with two pieces bread. One baked sweet potato in jacket. Mashed sweet potato in cone. Rice pudding in cone (5 cent size). Baked beans in cone. Baked beans with sausage in cone. Boiled baked dried peas with sausage in cone. One orange. One apple. One banana. Three figs. Three Graham crackers. One Graham jelly sandwich. Ice cream sandwich, one Graham cracker with slice of cream. Half orange peeled and one Graham cracker. One candy ball (puffed wheat rolled in molasses and sugar) . Five molasses candy kisses. Two small cakes. LUNCHES IN AMERICAN SCHOOLS 171 " We serve five articles each day — two of them hot. " We change the bills of fare daily. The follow- ing are a few samples : 1. Hot meat sandwich; baked sweet potato; oranges; candy balls; Graham crackers. 2. Hot wieners; rice pudding in cones; candy; bananas; cakes. 3. Baked beans with sausage; hot sweet potatoes; candy balls ; ice cream sandwich ; oranges. 4. Hot wieners; baked beans in cone; Graham crackers; candy ; fruit. " PURCHASE " Our purchases are all made at wholesale prices. We have always impressed the dealers that ours is philanthropic, not charitable work. And it gives us pleasure to state that we have always found them responsive in the way of accommodation and liberal discounts. " In a school of 900 children, we served on an average 600 daily. We used twenty loaves of bread — fourteen of rye, weighing 18 ounces each, and six of white, weighing 12 ounces each. We used daily either twenty-five pounds of wieners or fifteen pounds of choice solid beef, boiled and chopped and mixed with bread crumbs for sand- 172 SCHOOL FEEDING wiches. We used daily either one and one-quarter quarts of rice or twoi quarts of navy beans. These are boiled for twenty minutes and put in fireless cooker the day before they are used. " We give these details in order that they may serve as guides for others who may wish to engage in similar work. " MANAGEMENT " We have a corps of directors, one of whom serves regularly the same day of each week during the entire year. We have also a volunteer corps of assistants so arranged that six ladies serve the same day each week for one month, thus making the task not arduous, but one of pleasure. All ex- penses of the lunch room but the salary of our paid assistant, who does the cooking, have been met by the receipts of the lunch room. The salary of our cook is paid out of the Philanthropic Fund of the Council. " All our receipts being deposited in bank, our bills are paid by check, either weekly or monthly, out of this account. " Since co-operation is the watchword of the day, we are now planning to establish a Penny Lunch Room Club. We hope thus to meet all the workers LUNCHES IN AMERICAN SCHOOLS 173 of the several school lunch rooms in Cincinnati, and by exchange of ideas bring about a perfect system and closer affiliation of interest." MUNICIPAL SCHOOL LUNCHES IN ST. LOUIS In October, 191 1, an experiment was begun to extend the luncheon services long provided in high schools to the elementary schools of St. Louis. A noon lunch is served in five schools in congested sec- tions of the city. The lunches are primarily in- tended to benefit poorly nourished children, but are also designed to provide wholesome food at cost to all children who do not eat lunch at home. The patronage is entirely volunta^y^ Approximately 900 children are served daily in all lunch rooms. The manager of one of the high school lunch rooms is also the manager of the grade school lunches. For about a month the food was prepared at the Central High School kitchen and distributed in fire- less cookers by rapid delivery to the schools. On account of the expense of carriage, this method was abandoned for the plan of preparation in the separate schools. Luncheons are served under the direction of a paid assistant, but the larger girls of the schools can receive their lunches as compensation. The 174 SCHOOL FEEDING work of accounting and reporting is handled by the principal in each school. The School Board pays for equipment and the children's money covers the cost and service. MENUS The following dishes are served, each costing 2y2 cents: 1. Soup, baked beans or stew with one slice of bread. 2. One meat sandwich. 3. One jelly, cheese or salmon sandwich. 4. One cup of milk and two slices of bread. 5. One dessert, such as pudding or gingerbread. EQUIPMENT The equipment provided by the Board comprises the following: Two-burner gas stoves, folding chairs and kindergarten tables, mugs, plates, tea- spoons, tubs for washing dishes and towels, milk cans, metal checks and slot boxes for same. LUNCHES IN CLASSES FOR MENTALLY DEFECTIVE CHILDREN There is one form of school lunch that meets with immediate approval and is growing rapidly, and that LUNCHES IN AMERICAN SCHOOLS 175 is the lunches served in classes and schools for mental defectives. In Philadelphia, the School Board has given per- mission to the School Lunch Committee to serve lunches in all special classes. This work has come largely as the results of the demands of special class teachers, who eagerly assume the additional re- sponsibility which they know will in the end lighten their burden. One special difficulty is to get the children to remember their pennies; it takes several weeks to establish this habit gained by normal chil- dren in a few days, but this is valuable training. Because the percentage of underfeeding in these classes is far greater than among normal children — sixty instead of ten — the need for carefully planned meals is larger, but there is no difference in the kind of food required. There is a real differ- ence in service, however, in that these retarded children need even more than their brighter fellows the training that comes from preparing, serving and cleaning up. Indeed, for these children, to whom so many of the normal channels of learning are closed, the relatively simple movements associated with such a fundamental interest as the food in- terest afford an unrivalled educational opportunity. 176 SCHOOL FEEDING Fortunately, the fact that the classes are small makes it possible to take advantage of this opportunity in most places. The experience of Milwaukee, where the lunches have been organized for several years, is typical. Here many of the children in the class are under- fed and so the menus are chosen with special care. The following things are given: thick vegetable soups, or porridges of oatmeal and cornmeal, baked beans and potatoes, bread and butter, and plenty of milk, with popcorn, peanuts and fruit for dessert. The children are taught to set the table, wash and wipe the dishes and put the kitchen and dining- room in perfect order after the meal. Each child has his own particular piece of work to do every day. Considerable attention is given to table man- ners and to the general appearance of the room and table. The dishes are not the heavy white ware so often found in institutions, but are delicate and pretty and the children are taught to value them and care for them. The table is decorated with flowers and plants and with colored paper strips. The city considers that this work is so impor- tant that it bears the entire expense. READY TO SERVE RURAL SCHOOL LUNCH. MINNESOTA ■!?i530 8. Cream of wheat 5-5 lbs. .44 .70 9,267 9. Eggs 64 1.30 .65 3,955 10. Zweiback 5 lbs. .50 .50 9,850 11. Macaroni 7-5 lbs. .60 i.oo 12,187 12. Meat and fish 23 lbs. 5.00 3.46 21,270 13. Milk 124 qts. 8.88 8.20 80,600 14. Oranges 6 lbs. .60 1,440 15. Potatoes 47 lbs. 1.35 -80 23,420 16. Rice 4-5 lbs. .27 .40 2,295 17. Shredded wheat 16 lbs. 1.60 1.60 27,200 18. Spinach 6 lbs. -.60 .70 1,560 19. Sugar 14.5 lbs. 1.16 .... 29,970 20. Vegetable soup 5 lbs. .25 .04 1,300 Grand total $37-93 26.26 403,544 Total average per child. 1.52 1.05 16,142 Food value and cost of average meal per child. .076 24 grams. 807 MEALS IN OPEN AIR SCHOOLS 193 COST The cost of supplying the school meals varies from about 12 cents per capita per day to about 25 cents. In Germany and England the expense is distinctly less than the same meals would cost in this country. The five meals per day supplied to the children at Charlottenburg cost only 12 cents per child per day. At Elberfeld 5 daily meals which include one quart of milk per child are supplied for 16 cents per day. The same sum supplied 4 meals per day in the first English school at Bostall Wood. In New York City, where eight public open air food was about 20 cents per child per day and the cost of preparing and serving it increased the ex- pense to about 25 cents. In New York City, where eight public open air schools are in operation, the committee in charge estimates that where the full lunch including milk both morning and afternoon is provided, the cost is 17 cents per child per day. The midday lunch alone costs about 10 cents per day per child and milk alone twice a day without any midday lunch costs about 5 cents per child per day. In Syracuse the total cost of food, service and 13 194 SCHOOL FEEDING gas for one school month, or twenty days, for twenty-five pupils was fifty-two dollars and ninety- three cents. This amount was distributed as follows : Raw food for twenty days $37-93 Service (two hours daily) 12.00 Gas 3.00 Cost per pupil per month 2.12 Cost per pupil per day 11 Cost per day per pupil of food alone 076 ADMINISTRATION In nearly all cases American open air schools are administered by a partnership of responsibility. In a majority of the cities the cost for teachers' salaries, equipment and so forth is met by the Board of Education, while the expense for food as well as for clothing is defrayed by hospitals, charitable organizations and systems for the prevention and cure of tuberculosis. At the close of the school year 191 1, data as to the administration of schools in 47 American cities were as follows : Board of Education and tuberculosis association 20 Board of Education and private association 11 Board of Education only 7 Board of Education and other city departments 6 Tuberculosis association only 2 Board of Education and private fund i MEALS IN OPEN AIR SCHOOLS 195 As a general summary of feeding in open air schools, it may be said that the meals are an essential feature of the treatment, that plentiful, wholesome food may be provided at relatively light cost and that in the majority of American cities the special cost of the food is shared by bodies outside the school boards. IX Investigations of Underfeeding Among American School Children THE NUMBER OF UNDERFED CHILDREN General public interest in school feeding began with the publication, in 1904, of Robert Hunter's book, " Poverty." In trying to give some estimate of the amount of suffering that must exist as a result of poverty Mr. Hunter made the statement that there must be "very likely sixty or seventy thousand children in New York City alone who often arrive at school hungry and unfitted to do well the work assigned to them." ^ This statement has received more publicity than any other one sentence in the whole book and it was all too often translated by the newspapers into " 70,000 starving children in New York City come breakfastless to school." As a result many so-called investigations were made and most conflicting reports published which alternately refuted, corroborated and outdid Hunter's original statement. * Hunter, Robert, Poverty, The M-acmillan Co., p. 216. 196 UNDERFEEDING 197 Shortly after the publication of this book, John Spargo undertook to find out by personal investiga- tion the real facts about underfed children in New York City.2 He first confined his attention to the subject of the usual breakfasts eaten by school chil- dren. He was able with the cordial co-operation of principals and teachers to gather fairly reliable in- formation in regard to the breakfasts of 12,800 children, in sixteen different schools. The method used was as follows: Each child was questioned privately by the class teacher as to what he had for breakfast that day. If he reported no breakfast, the fact was noted, and also' if he reported an inadequate breakfast. For this inves- tigation, an inadequate breakfast was defined as one not containing any of the following articles: Milk, eggs, meat, fish, cereal, butter, jam or fruit; it further meant one consisting of coffee or tea, either alone or with bread or cake or crackers. Each teacher reported to the principal the number of children with no breakfast, and those with in- adequate breakfasts, omitting so far as possible chil- dren of fairly good circumstances whose lack of breakfast was accidental or unusual. •Spargo, John: The Bitter Cry of the Children, New- York, 1906, Macmillan Company, pp. 61-124. 198 SCHOOL FEEDING The inquiry revealed the following facts: Of 12,800 children, 987 or nearly 8 per cent, had no breakfast; 1,963 others, or over 15 per cent., had inadequate breakfasts. This made a total of 23 per cent, of all the children in those schools who were badly fed, so far as this might be indicated by break- fasts alone. Mr. Spargo then tried to find out what sort of lunches the children had. He was assured by teachers and principals and by his own observation that many children did not go home at noon, but remained playing about the school yard, with no lunch at all. No exact figures were gathered on this point. From questioning, by the teachers, it was found that anywhere from 10 to 20 per cent, of the children were given pennies to buy their own lunches. He watched what they bought and re- ports this special illustration as a fair example of their choice in winter. Fourteen children, eight boys and six girls, in one delicatessen store, bought, seven of them pickles and bread, four of them pickles alone, two of them bologna and rye bread, and one pickled fish and bread. On a summer day he saw a group of nineteen buy, six of them pickles, two of them pickles and bread, six ice cream, two UNDERFEEDING 199 bananas, and three candy. Mr. Spargo found that another way the lunch pennies go is in gambling, especially among boys. This investigation was followed by many others, both in New York, and in other cities, which may be grouped in two classes ; the first being confined, as was Mr. Spargo's, to a study of the kind of breakfasts and lunches eaten by the children; and the second a survey of the children's nutrition, made by physicians. I. Following is an account of various inquiries into the subject of the breakfast of school children: In 1906 Dr. Lechstecker, acting for the New York State Board of Charities, examined 10,707 children in the 12 Industrial Schools of the Chil- dren's Aid Society. He found that of these, 439 had had no breakfast on the day of inquiry and 998 others had had breakfasts of coffee alone or with bread. These children, who formed 13 per cent, of all examined, showed marked anaemia. Dr. Lech- stecker declared that he found that only 18 per cent, of all children had started the day with what he considered suitable and adequate meals. In a similar examination made in 1905 in Chicago of 5*150 children in 5 schools, 1,586, or 31 per cent.. 200 SCHOOL FEEDING reported an entirely inadequate breakfast or none at all. In Buffalo, of 7,500 children in 8 schools, 5,105 reported a breakfast of tea or coffee and bread. The principals in these schools asserted that there were 1,150, or 15 per cent, of all examined, who were obviously handicapped by poor nutrition. In Philadelphia 4,589 children were examined and 189 reported no breakfast, and 2,504, tea or coffee and bread, making a total of 59 per cent, coming to school inadequately fed.^ 2. Beginning with the year 1906, Medical In- spectors in New York Public Elementary Schools have recorded cases of malnutrition. During these five years from 1906-19 10 inclusive, in a total number of 860,728 examinations the average per- centage of cases found was five. This means that in the proportion of one in twenty cases examined the condition of malnutrition was so marked that it was entered on the official records as one of the physical defects of the child."* The condition revealed by these investigations "The Hunger Problem in the Public Schools — What the Canvass of Six Big Cities Reveals, Special Correspondence in the Philadelphia North American, May 31, 1905. * Reports of the New York Superintendent of Schools, years 1906 through 1910. TH1-; WAITING LINE. BIFFALO, X. V. UNDERFEEDING ^01 have been repeatedly mentioned by Dr. Maxwell, who has year by year recommended earnestly the establishment of school lunches. His latest recom- mendation reads: Provision should be made in all schools for supplying food at cost prices for the pupils in the middle of the day. In 1907 the New York Committee on the Physical Welfare of School Children found on ex- amination of 1400 typical New York school chil- dren that 145 or 10 per cent, showed marked symp- toms of malnutrition, and visits to the homes showed that the daily food of many others was unsatis- factory. A few months after the first examination 990 of these children were re-examined more care- fully and of these 128 or 13 per cent, were declared to be suffering from malnutrition.^ In 1909 Dr. E. Mather Sill, at his clinic on the lower east side of the city, made a very careful medical examination of 1000 children whose ages ranged from six to twelve years and found 400 children who were badly undernourished.^ •The Physical Welfare of School Children, Quarterly Publication of American Statistical Association, Boston, 1907. •Sill, E. Mather, M.D. : A Study of Malnutrition in the School Child, Journal of the American Medical Association, vol. Hi, No. 25, p. 1981. 202 SCHOOL FEEDING Finally in the early part of 19 lo, the School Lunch Committee made a special examination of 2,150 children in the lower grades of two New York schools, and found 283 of these or 13 per cent, were marked cases of malnutrition. These children weighed on the average nine pounds less than the normal for their ages. In Chicago, in 1908, of 10,090 children in 12 schools, 825 children were found by medical in- spectors to be suffering seriously from malnutrition, due to deficient food. In addition, 353 others were found who were undernourished, but for whose conditions other causes than inadequate food might be responsible. This means that a total of 1,178 or 12 per cent, of those examined were badly nourished. One striking fact shown by the Chicago investiga- tion was that the number of acutely undernourished children decreased in the higher grades. An analysis of the distribution of the 1,178 children in the different grades follows : ^ 'Reports on Underfed Children, Reprinted from Minutes of the Board of Education of the City of Chicago, Oct. 21, 1908. UNDERFEEDING WS Table 12. Investigation of Underfeeding in Chicago. Number Grade underfed Per cent. Kindergarten 70 15.5 First grade 502 14 Second grade 235 11 Third grade 19S 10 Fourth grade 91 9 Fifth and above 85 6 Total 1,178 12 In Philadelphia, a special investigation of 500 children in one school, in a poor district, including a medical examination and a visit to the home of each child, revealed serious underfeeding in 119 cases, forming 24 per cent, of the whole. In Boston, the routine medical inspection of all children in 1909 revealed between 5,000 and 6,000 cases of underfeeding and anaemia among a total of 80,000 children. In St. Paul, in 19 10, Dr. Meyerding, the head of the Medical Inspection, made a special examina- tion of 3,200 children in schools frankly chosen from the poorer district. He found that 644 or 20 per cent, of the whole showed marked under- feeding. 204. SCHOOL FEEDING As a general conclusion from these investigations it seems fair to place the probable number of seriously underfed school children in New York and other American cities at lo per cent, of the school population. This number doubtless includes many who might be able to pay for an adequate lunch at noon, if the opportunity were provided. POVERTY, IGNORANCE AND MALNUTRITION No one doubts that there is a close relation be- tween poverty and underfeeding — the terms are practically synonymous. Many persons, however, insist that the immediate cause of most of the under- feeding among the school children in American cities is not poverty but ignorance — that if the majority of incomes, slender as these are, were ex- pended wisely, the children might be properly fed. Light on the general problem of the relation of income to nutrition was thrown by Dr. Chapin's study of the Standard of Living Among Working- men's Families in New York City.^ His investiga- tion involved keeping a detailed account during one week of the actual expenditures for and consump- • Chapin, Robert Coit : The Standard of Living Among Workingmen'-s Families in New York City, New York, 1907, pp. 123-161. UNDERFEEDING 205 tion of food in loo typical families of a dozen nationalities. So far as possible " normal " families consisting of a father, mother and three children were chosen. The material gathered in this in- vestigation was submitted to dietetic experts, who estimated the actual food value consumed each day per family, and by each member of the family. These results were compared with the American standard ration of persons of different ages as com- puted by Atwater. In this computation the unit taken is the daily food need of the father of the family, a man at moderately active muscular work. The needs of the women and children are then cal- culated in progressive fractions of this unit, varying from three-tenths for the child under twO' to eight and nine-tenths for the women and adolescents in the family.^ When the expenditure for food was compared with the actual amount of food purchased, it was discovered that, in general, the families that spent on food less than 22 cents per man per day were underfed, that is were unable to buy enough to support life on a plane of physical efficiency. •United States Department S. Agricultural Farmers' Bul- letin No. 142, p. 2)Z- See also p. 240, this text. 206 SCHOOL FEEDING The yearly expenditure for food in each of the 391 families was then determined, and it was found that applying the minimum standard of 22 cents per man per day, the families might be grouped as follows, according to the income and the percentage of necessary underfeeding, as estimated by the amount spent on food: Table 13. Relation Between Income and Underfeeding in American Workingmen's Families. Total No. of Underfed families Annual income families Number Per cent. $400-$599 25 19 76 600- 799 151 48 32 800- 899 7Z 16 22 900-1099 94 8 9 1 100 and over 48 o o Totals 391 91 23-2 The figures in this table indicate that with less than $600 a year to spend, an adequate food supply is not provided in three families out of four. On incomes from $600 to $800, one family in three is underfed, while less than one-tenth of the families having $900 to $1000 to spend fall short of the minimum allowance for food. The income of $1100 for a family of five is apparently a safeguard against underfeeding. NOON LUNCH IN TWO BUFFALO SCHOOLS. TABLECLOTHS AND WHITE WARE TEACH CLEANLINESS AND BEAUTY UNDERFEEDING 207 INCOMES OF FAMILIES OF UNDERFED SCHOOL CHILDREN The study made by Dr. Chapin was not directly concerned with the problem of underfed school children. So far as specific investigations have been made of the family incomes of underfed school children Chapin's findings have been corroborated. The most careful study of the kind yet made was that conducted by the New York School Lunch Committee in 1909. This study covered 262 cases of undernourished children. Records were made of all the details in their home life which might bear on their condition. Some of the results were as follows : Of the families of 106 children, it was found that in 69 per cent, of the cases the yearly income fell below $825. The families were grouped accord- ing to incomes as shown in the accompanying table : Table 14. Incomes of Families of Underfed Children Annual income Number Per cent. $825 and over ^^ 31 5oo-$8oo 38 36 400- 500 II 10 Less than $400 24 23 Totals 106 100 208 SCHOOL FEEDING HOME FEEDING A Study of the food given to 262 undernourished children at home showed that 93 per cent, had tea or coffee every day and of these nearly 40 per cent, had it twice a day. Given a breakfast of tea or coffee and bread, a great many of these children had to wait till night time for a real meal. In nearly ten per cent, of the cases the mother worked away from home all day and could not prepare any lunch at noon. In 23 per cent, there was no prepared lunch at home and the children had to get it for themselves. In a still larger number of cases forming 38 per cent, of the whole there was no available lunch at home of any kind and if the children did not have pennies they had nothing at noon. This makes a total of 68 per cent, for whom there was no regular provision for a noon-day meal at home. From accounts given by the mothers, the evening meal was not of such character as to make up for the other poor and irregular meals. Detailed accounts of the actual food eaten at home by 141 children showed that yj per cent, were receiving too little food of any kind, leaving suitability out of the question. I UNDERFEEDING 209 HOUSING But poverty may affect nutrition in other ways besides mechanically limiting the food supply. Pov- erty means narrow living quarters and even a limit to the supply of air. This was well illustrated dur- ing the same investigation, when details were gath- ered of the housing of 217 families with under- nourished children. The following table shows the number of persons to a room: Table 15. Housing of Underfed School Children No. Per cent. I person or less per room 17 8 1-1.5 person per room 47 22 1.5-2 persons per room 63 28 2-2.5 persons per room 39 18 2.5~3 persons per room 3S 18 Over 3 persons per room 13 6 Total 217 100 In 42 per cent, of the families there were more than two persons to every room in the house. This means that the sleeping rooms were even more crowded because the kitchen is included in the number of rooms. In 17 families there was a 14 210 SCHOOL FEEDING room for each member of the family. The number of rooms taken by itself is only a rough indication of the actual condition of crowding and bad air, because of the fact that many rooms are window- less. Further, in the old style " railroad " flat, which still outnumbers any other style in New York, the " rooms " are simply vaguely defined sec- tions in a long corridor. Similar investigations into the social and economic factors making for underfeeding in New York and other cities have given results like those just outlined. Among the conditions making for underfeeding in school children, especially in large cities, are overcrowding, irregular and bad food habits and actual lack of enough to eat. These are not the only ones, but they are the important ones, and in a majority of cases are directly traceable to poverty. X Malnutrition in Childhood ITS SYMPTOMS, CAUSES, RESULTS AND CLASSIFICATION Malnutrition is the name given to the bodily condition arising when, for any reason, the tissues of the body do not receive enough of the food neces- sary to build them up and to furnish energy and vitality for functioning. In England and Germany, where the classification of school children according to their nutritive con- dition has been a matter of discussion for more than ten years past, it has been found that five grades of nutrition may be distinguished, varying through ex- cellent, good, fair, poor and bad. Some idea of what these various grades mean may be had from the following plan which has been elaborated by Dr. Hogarth ^ for the use of medical inspectors in English schools. This indicates what are the main points by which nutrition is judged; growth as shown by height * Hogarth : Medical Inspection of Schools, p. 158. 211 212 SCHOOL FEEDING and weight; bulk as shown by musculature and the character of the external tissues ; and circulation as shown by complexion. Grade 1. Excellent 2. Good 3. Fair or av- erage 4. Poor 5. Bad Stature and growth A healthy giant Well-grown Average Stunted Miserable, de- formed Nutrition Excellent muscular development Well-n o u r i s h e d , healthy Medium Thin, or fat and flabby tissue Very thin Circulation and complexion Ruddy and bronzed Healthy pink Average Anaemic, sallow PalUd If a child fails consistently to measure up to his racial standard of height and weight for his age, the chances are that the cause is chronic malnu- trition. If a child's superficial circulation is bad, as shown by his general lack of color, by the loose feeling and flabby look of his skin, and especially by the pale color of the mucous membranes about and in the mouth and about the eyes — the cause is probably malnutrition. Rough hair, not necessarily untidy, a furred tongue and a bad breath are other signs. Right here may be mentioned a symptom which, while as yet little known, is coming to be accepted as a most certain indication of acute malnutrition. MALNUTRITION IN CHILDREN 213 This IS the appearance of small reddish spots under the skin, known as purpuric petechise. They are really capillary hemorrhages and though sometimes confused with flea bites are the result of insufficient or unsuitable feeding and disappear in a short time with proper feeding. Even more prominent are the mental symptoms of malnutrition. The animal spirits and vitality of normal children are lacking in those who are underfed, who are easily fatigued and listless in play and work and show this even to a casual ob- server by the expression of their eyes and entire face. This characteristic lack of vitality means, too, that the children succumb easily to infectious dis- eases of all sorts. Similarly, the undernourished body cannot repair quickly the minor injuries, cuts and bruises of childhood. CAUSES In general, the body fails to grow properly or to function harmoniously — that is it is malnourished — if as a whole it is not supplied with enough of the right kind of food. The food provided may be lacking in quantity or 214 SCHOOL FEEDING it may be of bad quality, adulterated, badly pre- pared, etc. In any case the body is not getting what it needs. Because of the conversion of food into tissues and life energy requires the co-operation of many different organs involving many chemical and physi- cal forces, there may be a truly formidable number of hindrances and perversions in the process. The causes of malnutrition may in general be grouped according as it results in one of two ways : one, the insufficient building up of tissue; two, the excessive breaking down of tissue. A more obscure problem of malnutrition lies in hereditary and con- genital conditions which may cause arrested or de- layed development. I. I. The main cause of an insufficient building up of tissues is deficiency of food in quantity or quality. 2. The second cause is faulty assimilation, that is digestion and absorption. This may result mechanically from insufficient mastication because of hurried meals, or bad teeth, or because of an excess of liquids. Bad teeth is the most frequent of these. Strong tea and coffee, alcoholic drinks and smok- ing may interfere chemically with assimilation. 3. After the food leaves the alimentary canal, MALNUTRITION IN CHILDREN 215 ready for carriage to the other parts of the body, defects in the lymphatic system, particularly those caused by subacute or chronic tubercular conditions, may hinder it from arriving at its destination. This constitutes a third possible cause. 4. The fourth cause of an insufficient building up of tissues is a deficiency of oxidization resulting from (a) the quality of air breathed; (b) a defi- ciency of air entering the lungs because of nasal obstructions such as catarrh, adenoids, etc., or de- fects of the chest from rickets, bad posture, tight clothing; (c) circulatory defects in tubes or capil- laries, mechanical defects of the heart, anaemia, lymph stagnation from want of exercise. II. Excessive breaking down of tissues may accompany : 1. A nervous condition arising from insufficient sleep, late hours, irritation from vermin. 2. Overwork and chronic fatigue. 3. Recovery from fevers. These causes are not of equal value, many may exist at once and all are interrelated. Bad and insufficient food results in badly formed and weak- ened teeth and other defective structures, whose impaired powers of functioning make it difficult for ^16 SCHOOL FEEDING them to receive the full benefit of good food. It is a vicious circle. However, it is an important fact to remember that malnutrition, whatever the cause, cannot be cured without good food and enough of it. The most frequent results and accompaniments of malnutrition are anaemia, stunted growth, diminished energy and lowered vitality as shown by weakened resistance to diseases. All these things have been studied with considerable care in differ- ent countries by experts interested in the develop- ment of children. The following are the results of some of this study. ANEMIA Anaemia, which is the term used for deficiency of blood, particularly of the red corpuscles in the blood, is the frequent accompaniment of malnu- trition. It is seldom or never found in the well- nourished body, but it may occur in a body that is fairly nourished. Its most common indication is pallor, which may be general or, in the case of dark complexioned children, it may be seen only in the mucous membranes about the eyes, the gums, the inside of the cheeks, etc. Frequently a blood test is necessary to detect its presence. MALNUTRITION IN CHILDREN 217 Ansemia is extremely common among school chil- dren, especially in towns. How it varies with the state of nutrition of the children is illustrated by the results of the investigation of 716 cases among school children in the poorer districts of London.^ These children were classified in five groups on the basis of nutrition. Those rated as " excellent " and " very good *' were found to include practically no cases of anaemia. Among those rated " good " the percentage suffering from anaemia was 59; among the "fair," 89; and among the *' bad," 93. Dr. Gastpar ^ of Stuttgart reports a more exten- sive investigation of anaemia covering over 8000 cases. These children were classified as to nutrition into " good," " fair " and " bad " groups. In round numbers there were 2000 in the first group; 4000 in the second; and 2000 in the third. Among the children classified as " good " there were no cases of anaemia ; among those classified as " fair " the percentage was 34; among the " bad " it was 49. To summarize, anaemia, as the word is commonly understood, means an impoverished blood supply. ' Report Educational Commission, London County Council, 1909, p. 19. ' Gastpar, Dr. : Die Beurteilung des Eruahrungszustandes der Schulkinder. 218 SCHOOL FEEDING It is a symptom, but not an invariable one, of chronic under-nourishment. Among its causes which are like those of malnutrition are insufficient or im- proper feeding, hereditary disease, frequent hemor- rhages, general debility following acute diseases, rickets, insufficient sleep, and want of fresh air. When found among the children of the well-to-do it simply gives the effect of pallor and the skin is often of fine texture. When it is found among children who are underfed and come from crowded homes, the prominent symptom is the earthy tinge of the skin together with other characteristic signs mentioned as " symptoms of malnutrition." HEIGHT AND WEIGHT MEASUREMENTS In general cases of malnutrition may be divided into two types. The first is the result of chronic underfeeding or incorrect feeding, and its results are shown in the child by constant failure to come up to the average of weight and height, lung ca- pacity, grip, etc. The second type of malnutrition is temporary in character and its results are shown, not by a deficit in both weight and height, but by a deficit in weight alone as compared with height. In the first place the child will be diminutive, in the second, starved — both problems of nutrition. MALNUTRITION IN CHILDREN 219 The standard of absolute height and weight at different ages differs according to race and chmate in countries. In spite of these differences, height and weight still remain the surest single indication of nutrition. They may also be recorded more easily than any other. The direct and definite way with which they do vary with nutrition is shown in the investigation into the physical condition of school children conducted in 1907 by Dr. Leslie Mackenzie and Captain Foster of Glasgow. This is the biggest, most extensive and careful investiga- tion of the kind ever conducted. It includes 72,800 cases varying from five to fifteen years, and cover- ing all of the children in the public schools of the city. The fact which is significant in this connection is that the children are divided into four groups, in accordance with the number of rooms in their houses — whether one room, two rooms, three or four rooms and more. In a crowded city like Glasgow, the size of the house is a fair index of the degree of comfort or poverty of the family. There are exceptions, in cases of especially small families, but when tens of thousands of cases figure in the data, the number of rooms is a trustworthy index of the economic status. The one-room child is the poverty stricken 220 SCHOOL FEEDING child, and hence the underfed child. The four- room child on the other hand belongs to a family much better situated economically. The truth of these principles is forcibly illustrated by the results obtained in the investigation under consideration. When the average height and weight of the chil- dren of the different groups are taken, it appears that the child from the one-room house is always lighter and shorter than the child from the two- room. He in turn is shorter and does not weigh so much as the child in the three-room house — who in turn is the physical inferior of the child living in a house of four rooms or more. These results are shown in the following table: Table i6. Average Height and Weight of all Children FROM 5-18 Years, According to Housing Average weight Average height Housing in pounds in inches 1 room 52.0 46.5 2 rooms 55-5 48.9 3 rooms 60.0 50.4 4 rooms 64.9 51.5 In the following chart the average weights for the one-, two-, three- and four-room children, from 5 to 14 years old, are represented by the upright columns in black. It will be seen that for each age the first column represents the average weight of MALNUTRITION IN CHILDREN 221 the one-room child and that these are consistently less than the weight of the two-room child in the next column. This is true of every age — up to i8, $0 eo 70 • 60 • 50 ko 20 10 J n 13 r 12 r i 11 J 10 n rj" 9 jj] it ^ rTl rf II. Average weights of one-room, two-room, three-room and four-room children at each age from five to fourteen. but the number examined of children older than 15 was too small to be of statistical value. A similar diagram constructed to show the heights at 222 SCHOOL FEEDING each age would be almost identical and show with equal clearness the relation of housing to nutrition and nutrition to development. It would be difficult to get more striking proof than these figures show of the immediate and in- timate relation between the state of nutrition and the amount of development that is accordingly possible. STANDARD AMERICAN MEASUREMENTS As the problems of development and nutrition receive increasing attention in this country it is necessary to have available for reference some standard measurements. The British Anthropomet- ric Association has been at work compiling figures for the use of British investigators and scientists, but their figures, though probably not seriously un- suited for use in this country, cannot be used for exact work. The accompanying tables (Nos. Ill and IV) compiled by Dr. Wood, of Columbia Uni- versity, are in part the result of measurements made periodically during ten years on thousands of boys and girls attending the Horace Mann School. The figures gotten in this way were compared and checked up with those of Drs. Bowditch and Hast- ings, and with the standard adopted by the British 1 MALNUTRITION IN CHILDREN 223 Anthropometric Association. The tables show the standard mean variations in weight as related to III. Relative Weight and Height Table— Boys. The figures under the age column represent weight in pounds. a "^ m IT fll Years. ^.-S 60O 5 6 7 8 9 10 II 12 13 14 15 16 17 18 19 20 39 35 40 38 36 41 39 39 42 41 41 43 42 42 42 44 46 44 43 45 46 46 45 46 48 48 48 47 49 50 SO 48 54 S3 S3 S3 49 54 55 55 50 57 58 58 SI 59 60 60 6r 52 62 62 61 63 S3 62 65 65 67 67 67 S4 65 68 68 70 71 71 SS S6 69 71 75 75 76 71 77 76 78 79 79 57 77 79 80 82 82 S8 78 84 85 86 87 59 60 6l 62 63 ^4 6s 66 67 68 69 70 71 72 73 84 86 90 91 85 91 94 95 90 98 97 99 96 99 103 106 104 104 100 107 112 112 IIO 118 114 118 120 117 120 120 122 119 122 122 120 126 I2S 121 125 125 126 129 130 128 129 128 131 134 132 133 133 130 136 136 136 134 136 139 139 139 136 140 143 144 145 140 146 146 146 149 154 I6S height, at different ages, from five to twenty years. A perfectly well child of ten years may be anywhere from 48 to 56 inches in height and weigh anywhere 224 SCHOOL FEEDING from 53 to 71 pounds, but if his weight does not correspond with his height, or if he is less than 48 inches tall, there is something wrong with his de- velopment and probably with his nutrition. IV. Relative Weight and Height Table — Girls. The figures under the age column represent weight in pounds. a Years. 4J v -a-s •rt fl 5 6 7 8 9 10 II 12 13 14 IS 16 17 18 19 20 39 34 40 37 35 41 38 37 42 41 39 39 43 41 41 42 44 45 43 44 42 4S 45 45 45 46 48 47 47 47 50 49 49 48 51 51 49 53 53 54 SO 56 56 57 51 59 58 60 52 63 62 62 63 S3 64 63 66 65 54 69 68 69 68 55 70 71 73 56 75 75 76 78 57 78 80 83 58 83 86 88 89 59 88 89 93 97 100 60 94 94 96 100 104 109 103 99 99 61 99 100 102 109 109 106 los III 62 104 104 106 III IIO 107 III 114 63 107 109 116 no 112 113 114 64 112 1X8 116 117 114 119 115 65 114 118 121 125 120 123 125 This method of calculation is much more exact, especially in a heterogeneous group, such as may be found in any American city, than the easy and crude method of measuring development at each age by a single figure for weight or height. MALNUTRITION IN CHILDREN 225 RESULTS MALNUTRITION AND MENTAL DEFECTS The relation of malnutrition to mental defective- ness has long been given substantial recognition both here and abroad in the provision of lunches in special schools for subnormal children. Dr. Collie, Medical Inspector of the London School Committee, declared in this connection before the Committee on Physical Deterioration, that " mental disability is not only preventable but, in many cases, curable. In a large number of instances, after the careful individual attention and midday dinner of the special schools, children are returned to the regular elementary schools after from sixteen to eighteen months with a new lease of mental vigour." Dr. Brown Ritchie, reporting for Manchester, stated that of the 641 mentally defective children in that city, 325 could be classed as having poor nu- trition, while III were marked cases, making a total of 68 per cent, showing malnutrition. Similarly, of 10 12 children in classes for mental defectives in New York in 1908, 60 per cent, were found to be suffering from malnutrition. Similar data come from Plauen in Germany, where it is 15 226 SCHOOL FEEDING stated that underfeeding is the main cause for chil- dren being in the special schools for mental defectives. The only case on record where the relation be- tween malnutrition and simple retardation has been quantitatively estimated, occurs in one district of Manchester, Conn. All the children in eight grades were specially examined, in order to determine what features of their physical condition or of their home environment might be responsible for non-promo- tion. Of 1396 children examined, 174, or 12 per cent., were malnutrition cases. But the percentage of malnutrition in the promoted group was 9, as opposed to 25 in the left back group. Malnutrition was found to be second only to poor mentality in its retarding influence.'* In many of these cases the explanation seems to be that these children are functionally mentally de- fective; in other words, their brains are starved and naturally fail to react to the ordinary methods of elementary teaching. * Ayres, Leonard P. : A Simple System of Discovering Some Factors Influencing Non-promotion, Psychological Clinic, vol. iv, Na 7, Dec. 15, 1910. MALNUTRITION IN CHILDREN 227 MALNUTRITION AND PHYSICAL DEFECTS Emmet Holt, an American authority on chil- dren's diseases, says that '^ one of the most striking things about children suffering from malnutrition is their vulnerability. They * take ' everything. There is but little resistance to any infectious dis- ease which the child may contract." A most careful investigation, bearing on the cor- relation between malnutrition and physical defects, was conducted by Dr. Gastpar, of Stuttgart.^ He examined some 8000 children in all classes of the public schools who were suffering from one or more of thirteen diseases. These children he divided into five classes, according to the state of their nutri- tion, by the method already described. He found that with one exception the largest percentage of disease was present among the badly nourished, anaemic children. Some of the differences were striking. Diseased glands occurred in 12 per cent, of the worst nour- ished and in only 5 per cent, of the best nourished. Adenoids, perhaps the most familiar disease of the school child, occurred in 26 per cent, of the worst " Gastpar : Op. cit. 228 SCHOOL FEEDING nourished cases, as compared with 17 per cent, of the well nourished. Unhealthy heart murmurs occurred in 26 per cent, of the badly nourished, and only in 3 per cent, of the well nourished. There was no tuberculosis in the class marked good. Tuberculosis of the lungs varied from .07 per cent, in the fairly nourished to 3 per cent, in the worst nourished. Other diseases, such as rickets, vermin and ear troubles, showed similar variations in their occur- rence. Albuminuria alone of the thirteen diseases involved seems tO' have no special correlation with malnutrition, the largest percentage (3) occurring in the class marked ''fair, with anaemia," while the two last groups showed only 2 per cent, apiece of this trouble. Table 17. Relation of Nutrition and Vulnerability to Disease Class of Nutrition a w c 03 m "o .2 Non-tubercular Respirational Diseases 4) P Defects Among Each 100 Children I. Good 8 49 IS 25 31 20 82 70 96 103 260 529 253 209 210 77 379 289 314 441 365 1039 627 644 785 1984 2625 1385 1045 998 18 2. Fair 39 3. Fair and anaemia 4. Poor 45 62 S. Poor and anaemia 79 128 371 I46I 1500 3460 8037 43 MALNUTRITION IN CHILDREN 229 The following table shows the results of the study in the cases of the four most important diseases : The important feature of the table is the column of percentages at the right hand. It will be noted from this that of the children classed as " good " with respect to their nutrition, only i8 per cent, are found to have these physical defects. This percent- age steadily and rapidly advances as we pass to the " fair " children and those who are " fair with anaemia," and so on to the last group classed as " poor with anaemia," where the percentage has reached 79. In other words, among children classed as " good '' only one in five was defective ; among those classed as " poor with anaemia " four out of five were defective. CLASSIFICATION AND RECORDING OF NUTRITION OF SCHOOL CHILDREN: PROFESSIONAL AND LAY DIAGNOSIS After reading the necessarily vague and general instructions for passing judgment on the fact and degree of malnutrition, it is not surprising to learn that there is great variability in the recorded results of such examinations. This is true when the exam- ining is being done by medical men, and the differ- 230 SCHOOL FEEDING ences are even greater when children are first ex- amined and reported on by their teachers and these results are checked up by the school doctors. A pertinent example is found in the examinations recently conducted in German cities.^ A large num- ber of such examinations, some of them covering nearly 170,000 cases in 68 cities, showed that where the teachers reported the nutrition of 73 per cent, of the children as good; that of 22 per cent, as fair; and that of the remaining 5 per cent, as bad; the school physicians, examining the same children, reported the good cases as being 42 per cent, of all; the fair ones 50 per cent.; and the bad 8 per cent. It will be noted that the doctors found a much smaller percentage of children whom they could put in the first class, and a larger percentage of those fairly and badly nourished. Because of results like these and because the sub- ject of the nutrition of school children is so im- portant, and at the same time so complex, its proper classification and recording has recently been studied with great care by scientists in Germany and England. The most practical scheme yet devised for work- •Kaup: Die Ernahr. der Volks., pp. 95-100. MALNUTRITION IN CHILDREN ^31 ing with great numbers of children is that of Dr. Gastpar, Director of Medical Inspection in Stutt- gart J This plan, which represents the accumu- lated experience of many years and has been en- dorsed by English workers, is as follows : 1. There is first an individual examination of each child, in which measurements of height and weight are taken, and the state of nutrition deter- mined by these and other factors such as the state of the superficial circulation, the musculature, skin tonicity, the condition of the mucous membrane, the expression of the eyes and the entire face, the rough- ness or smoothness of the hair, etc. At the same time, other physical defects are noted that may bear upon nutrition, as the condition of the teeth, pres- ence or absence of adenoids, and particularly the presence or absence of anaemia. 2. After these records have been made for each individual child, the children are then divided according to their ages. Then the children of each group are divided into those having anaemia and those without it. These two groups are further subdivided until, in order of nutritional excellence, children in each age group stand thus: (i) good; ■^Gastpar, Op. cit. 232 SCHOOL FEEDING (2) fair; (3) fair with anaemia; (4) poor; (5) poor with anaemia. Experience in the appHcation of this plan of classi- fication has developed three general rules that are valid for application in any country. Briefly these rules are as follows : (a) Every child is examined separately in a room specially provided, where the light and temperature may be regulated. (b) One physician should make all the examina- tions for any given group of children. (c) The examining physician should be familiar with the racial peculiarities of growth, complexion, and coloring. This system involves time and care, but it insures a fair degree of accuracy in a subject not easy to define rigidly. Some such scheme is absolutely necessary if experience is to be shared. This has been found specially valuable in record keeping and in finding the correlation between the state of nutri- tion and other physical conditions. XI Food Needs of Growing Children. Old men bear the want of food best; then those that are full-grown ; youths bear it least, most especially children, and of them the most lively are the least capable of enduring it. — Hippocrates. Growth and play are the great needs of the child. Growth means the development of new body cells, and play requires energy, which is simply another name for heat. The only source of material for the new body cells and of fuel for the heat and energy is food, and the question to decide is how much and what kinds of food best meet the two great needs. If the child were simply a little man, and like the man in everything except size, it would be an easy matter to give him a fraction of the man's food in proportion to his size. But this is not the case, first, because the child is growing and therefore, unlike the man whose growth is past, has a constant need of new material in large quantities. Then, because the child is more active, physically and nervously, he needs more heat and energy in proportion to his size than the man. 233 234j school feeding To plan rightly for the child's particular needs, we must first know what foods will best form tissue, and which ones will best supply heat and energy. As foods perform these two functions they are classified in two great groups, corresponding to the kind of contribution that they predominantly make. These two groups are the Proteins, or structural foods, and the fuel or energy suppliers, which in- clude Carbohydrates and Fats. protein: the tissue builder The word '' Protein " comes from the Greek " protos," meaning " first," and it is used to desig- nate the tissue-building elements in food, because these are the first and basal elements in all life, whether animal or vegetable. The reason they are so important is because they contain, ajnong other things, the chemical element Nitrogen, which is absolutely necessary for cell growth. Though pro- teins are found in varying proportions in nearly all animal or plant tissues, they are found chiefly in the parts which are centres of growth and vital activity such as the muscles, milk and eggs of ani- mals and the seeds of plants. Thus they are found in large quantities in such foods as the lean of meats FOOD NEEDS OF CHILDREN ^5 and fish, eggs, milk, peas, beans, lentils, nuts and the grains like rice, oats, and wheat. When proteins are digested and assimilated, they form the vital or living part of the cells, and com- pose from one-sixth to one-tenth of the body weight. During adult life, the breaking down and building up of cells is a slow process, and comparatively little new material is needed each day. The daily need of the cells for protein has been estimated at anywhere from 0.85 gram per kilo of body weight ^ (the lowest possible amount) to 1.6 grams (the highest American standard ).2 This means for an average man weighing about 70 kilos, or 1 50 pounds, a daily ration including enough meats, milk, eggs, cheese, bread, peas or beans, etc., to give from 60 to 115 grams of protein elements. A gram is approxi- mately 1/454 of a pound, or 1/30 of an ounce. During childhood, the period of greater cell activ- ity, the daily standard of protein need has been estab- lished by custom ^ and experiment * at an amount ranging from 2.5 to 1.4 grams per kilo of body weight. That is, according to different authorities, a child weighing anywhere from 20 to 35 kilos will * Chittenden. * Camerer. ' Atwater. * Siegert and Lungwitz. ^36 SCHOOL FEEDING require an average daily amount of from 39 to 70 grams of protein. To summarize: the amount of tissue-building food required by the child during the growing period is five-fourths of what is required by a man, com- paring weight with weight. CARBOHYDRATES AND FATS ! THE ENERGY SUPPLIERS Carbohydrates is the name given to the two foods, sugar and starch, which have about the same chemical composition, both containing approxi- mately 44 per cent, carbon, 6 per cent, hydrogen, and 49 per cent, oxygen. Sugars and starches are found in substantial vegetables like potatoes, corn and grains, sugar cane, beets and bananas — that is, in the parts of plants that are used for storing the plant's own food materials. The function of carbohydrates is to supply heat and energy which enable the body to do its muscular and nervous work. Once digested, they are either burned immediately and reduced to gas and water, setting free heat and energy in the process, or they are stored for future use. Before being stored carbohydrates are almost entirely converted into fat, and in their original form constitute only about one per cent, of the weight of the body. FOOD NEEDS OF CHILDREN 237 Fats, which perform the same function as the carbohydrates, are found most abundantly in butter, cream, cheese, meat, fish, nuts and vegetable oils. Their chief value is that they supply bulk for bulk over twice as much fuel as the sugars or starches, because they contain a far larger amount of carbon. But oxygen is present in far less quantities, and this means that the fuel is not so easily available as in the carbohydrates. In the human body the fats constitute the great storehouse of reserve material from which energy and heat may be taken when the supply from food temporarily becomes short. Fat occurs in minute particles scattered throughout the various tissues and in masses under the skin, where it helps to con- serve the bodily heat from tooi rapid irradiation. Because the proportion of skin surface to bulk is greater in children's bodies than in adults, their bodily heat is lost more quickly, and this makes the fats of special value in this period. Although the special function of protein is to build tissue, it does contain elements similar to those found in carbohydrates, and these may serve as fuel. However, the presence of nitrogen hinders their being completely burned, so that protein is not as economical a form of fuel as carbohydrates and fats. 238 SCHOOL' FEEDING As a summary of experience with children's fuel needs it may be said that in proportion to their weights they require on an average from one- quarter to one-half more foods yielding heat and energy than do adults. INORGANIC SUBSTANCES IN FOOD In addition to the need of material and energy that are supplied by the organic food compounds, the child must have lime in large quantities for tooth and bone building. This is found in its most avail- able form in milk, but also occurs in meats and in association with protein generally. Other mineral needs are common salt, potassium, phosphorus, sulphur and iron. These are found mostly in com- pound with organic foods, the chief value of watery vegetables, like celery, cabbage and spinach, being in the salts that they hold in solution. These inor- ganic substances, where they do not help to form cells, are used as aids in secretion and digestion, and their value in the child's bodily economy is being more and more recognized. The materials so far described, protein, sugars, starches, fats and mineral substances, together make up about one-third of the weight of the body. The rest is water, which, though it furnishes neither liv- FOOD NEEDS OF CHILDREN 239 ing tissue nor fuel, is absolutely necessary for the carrying on of vital processes, such as circulation, secretion and maintaining a constant body tempera- ture. The minimum allowance of water, in addition to what is furnished in food, has been placed at about a quart a day for all ages beyond infancy. MEASUREMENT OF FOOD VALUES BY CALORIES The fact that all organic foodstuffs yield heat or energy when burnt in the body makes it possible to measure and compare them by a single unit of measurement. This unit is the Calorie, which is the amount of heat necessary to raise one kilogram of water one degree Centigrade, or one pint of water four degrees Fahrenheit. In applying this unit it is assumed that, for ex- ample, if a certain quantity of white of tgg or cane sugar, on being burned outside the body, yields enough heat to raise a kilogram of water one degree Centigrade, it will produce the same amount of heat when burned inside the body. As a matter of fact, certain foodstuffs are never completely oxidized within the body, and the esti- mate of the real fuel value of any food takes account only of the material finally available to the body. Once the component parts of any food are known, 240 SCHOOL FEEDING its caloric value may be determined by the use of the following scheme of fuel values: Protein : Fuel value, 4 Calories per gram ; 1,816 Calories per lb. Carbohydrates: Fuel value, 4 Calories per gram; 1,816 Calories per lb. Fats : Fuel value, 9 Calories per gram ; 4,086 Calories per lb. A list of common foods, showing the amount of protein, starch, carbohydrates, mineral matter and water each contains, is published by the United States Department of Agriculture, and forms the standard reference list for this country.^ DIETARIES FOR DIFFERENT AGES In general we have seen that the food needs of children are relatively greater than those of adults, but this broad statement fails to distinguish between the needs of children at different ages. Dr. Lang- worthy has indicated these differences by a formula like the following: Taking the standard requirement to be that of a man at moderately active work The child under 2 years requires 3/10 of this. The child from 2 to 5 years requires 4/10 of this. The child from 6 to 9 years requires s/io of this. The child after 10 years requires from 6/10 to 9/10 of this. "^U. S. Dept. of Agriculture, Washington, Office of Ex- periment Stations. Bulletin 28 (Revised Edition). FOOD NEEDS OF CHILDREN 241 This formula has the disadvantage of not indicat- ing the relative proportions of the different kinds of foodstuffs needed, and it further takes no account of weights. The following chart represents the food Ik years iK) .Kilos 6-^ years 1^-20 KUos 10 years 26-2^ Kilos 1^0 kQ 56 235 h2 65 30^ ■ 61 -| in, II II 1*0 61 V. Daily food needs in grams of school children of varying ages and weights. Carbohydrates in outline; fats in horizontal lining; protein in solid black. needs of children at three different school periods, at six, at ten and at fourteen. The figures upon which it is based are taken from a French dietitian. Dr. A. Gautier.^ They do not exactly correspond " Gamier, Armand : Diet and Dietetics. Edited and trans- lated from the French by A. J. Rice Oreley. 242 SCHOOL FEEDING to figures in American standards, but they are^ sufficiently near the average to show how food needs progress with advancing years. SCHOOL DIETARIES In computing dietaries for use at school, the large numbers and different ages of the children make it necessary to use average ages and weights. Experi- ence in different countries has shown that an ample dietary formed with the needs of the ten-year-old child weighing about sixty pounds, or 27-28 kilos, about meets the requirements for the " average child," and, by making the portions larger or smaller, may be modified up or down quite easily to suit the needs of older and younger children. Those in charge of school meals have first to decide how much the total daily ration of ithe average child should be and then what proportion of this shall be provided in the school meal or meals. The following table shows in summary form the child's daily requirements for food as these have been worked out, first by three men in the school feeding movement of three different countries, Italy, Switzerland and England, and then the average FOOD NEEDS OF CHILDREN 243 requirements computed by fifteen different experts in children's food needs: Table i8. Daily Food Needs of the Average Child, Age id. Weight 27-28 Kilos Average of Tonsig Erisman Crowley is experts Fat 23 41 57 40 Protein 48 60 68 60 Carbohydrates 282 225 288 250 Calories 1531 1540 1937 1600 Calories per kilo... 56 55 72 58 Protein per kilo ... 1.7 2.1 2,4 2 The first three estimates represent very fairly a low, a middle, and a high standard of food needs, and these grades are indicated particularly in the figures for protein and fat. These differences are dependent upon local variations in national, racial and local customs, as well as the demands of climate, the muscular and nervous activity and so forth. For practical general reference it may be stated that those who have studied the diets of school chil- dren are in fair agreement that the daily ration of a child of ten, weighing 60 pounds, should be com- posed as follows: Protein 60 grams Fats 40 grams Carbohydrates .... 250 grams Total 350 grams yielding 1600 Calories. 16 244 SCHOOL FEEDING PROPORTION OF DAILY RATION TO BE MET BY SCHOOL MEAL The fraction of the daily ration that is to be supplied by the school meal will of course depend in large measure upon whether it is breakfast, din- ner, or a light lunch. In any case school workers are agreed that if the school meal is to be of signifi- cant value it must supply deficits in the usual home diets of the children, and in its general make-up help to raise the home standards. Practically this means first that the meal shall be a substantial one, and, more important, that the elements of fat and protein have to be emphasized. This is because fats and protein, being largely animal foods, are the most expensive kinds, and are therefore bought sparingly by the vast majority of families. It is possible to so arrange a dietary that enough protein and fat will be supplied for comparatively little outlay, but this requires a more accurate knowledge of food values than is common among housewives. The following table shows how the problem of the distribution of foodstuffs in the different meals has been worked out by experts in connection with FOOD NEEDS OF CHILDREN 245 the school feeding movement in three different countries, Switzerland, Germany, and England : Table 19. Showing Amounts of Various Foodstuffs Con- sidered Necessary at Different Meals for the Average School Child Weighing 27-28 Kilos Protein Pat Carbohydrates Authority Meal Grams Grams Grams Calories Erisman : Breakfast ... 13 10 zi 285 Dinner 40 26 100 794 Supper 7 s 98 465 Total 60 41 235 1544 Rubner : Breakfast ... 13 12 Z7 308 Dinner 2>^ 26 104 794 Supper 15 12 45 348 Total 64 50 186 1450 Crowley: Breakfast ... 19 20 86 600 Dinner 29 18 154 894 Supper 20 19 48 443 Total 68 57 288 1937 In this table the breakfasts are suitable for a light lunch, and on the average are designed to furnish about one-quarter of the day's fuel needs, about one- quarter of the protein and a little less than one- third of the fat. The dinners furnish on an average over half the day's fuel requirements, or 827 out of a total of 1643 Calories. Over half of the total protein is 246 SCHOOL FEEDING supplied in the dinners, on an average, and a little less than one-half of the fat. Ideally, the food of each child should be so arranged as to give the right proportion at the proper intervals according to age, degree of activity, etc. But for the practical purpose of meeting actual needs, modified from the normal by poverty and ignorance, the one meal at school must be planned to supply the deficit in the day's total. The difference in distribution of foodstuffs in these two arrangements is illustrated in the follow- ing table : Table 20. Comparison of Distribution of Food Constitu- ents AND Values in the Three Daily Meals Under Conditions of Good Home Feeding with Distribution When School Meals Supplement Poor Home Feeding. All Figures are Percentages. Protein Fat Carbohydrates Calories HS HS HS HS Breakfast ..10 23 10 29 20 23 20 25 Lunch 40 55 5o 48 40 50 46 50 Supper 50 22 40 23 40 2^ 34 25 Total 100 ICO 100 100 100 100 100 100 The actual amount of food is the same, but the proportions are dififerent. In this table H indicates well balanced home meals "^ and S the school break- 'Kaup, Dr. J. : Die Ernahrungsverhaltnisse der Volk- schulkinder, p. 53. FOOD NEEDS OF CHILDREN ^47 fast and school lunch supplementing the actual inadequate home meal at nighty. The figures refer to percentages of the day's total requirements. The salient points with respect to the food needs of growing children and their relation to the prob- lem of school feeding may be summarized as follows : 1. Food elements are of two kinds, tissue builders and energy suppliers. 2. Tissue building food elements are known as proteins and energy supplying elements as carbohydrates and fats. 3. Food values are measured by the heat unit called the Calorie. 4. The consensus of opinion of authorities on children's dietaries is that the ten-year-old child weighing 60 pounds should receive each day food containing 60 grams of protein, 250 grams of carbohydrates and 40 grams of fat, and having a fuel value of 1600 Calories. 5. Students of the problems of school feeding are agreed that where school meals are provided they should be so arranged as to supply deficiencies found in the home meals. 6. This generally means that the school meal, if a mid- day dinner, shall supply at least one-half of the daily require- ments in heat units, and more than half of the daily re- quirements in fats and proteins. The way in which these principles are applied in the actual construction of menus for the school meal will be discussed in the chapter following. XII School Menus One day in December, 1910, the writer went at noon to the school yard of a large public school in New York City and made notes on the lunches the children were eating. With the help of a teacher four lunches were selected as typical of the kind of lunches bought by the children in stores and pushcarts near the school, and the children were given pennies and asked to buy duplicates of what they had eaten. The lunches bought in this way were as follows : a tiny frankfurter and roll, costing one cent; a Swiss cheese sandwich, costing two cents; two small bananas and two long licorice " shoestrings," costing two cents ; two frosted cup cakes, costing three cents. In order to find out the real amount of food the children were getting for their pennies, the material in these lunches was weighed and analyzed in the Nutrition Laboratory at Teachers College. Some interesting things were disclosed by this experiment. The frankfurter, which was a sort of 248 SCHOOL MENUS 249 cerise in color, was found to be heavily dyed, and the frosted cakes were dyed with a bright yellow substance. Dyeing, in itself a form of adulteration, is usually a cloak to some other adulteration — in sausages, to conceal '' filling," or the use of bad meat. In the lunch of bananas and licorice, that bulked quite large and was probably fairly satisfy- ing at the time, the only nourishment was in the bananas, for the licorice had neither sugar nor glucose, nor any trace of a real food substance. The exact composition of the food in the lunches as revealed by analysis is shown in the following table, in which is given the number of grams of protein, fat and carbohydrates in each case: Table 21. Comparative Food Value of Lunches Purchased BY Children A BCD Frankfurters Banana & Swiss cheese Frosted and roll licorice bread cakes Protein 5 .6 12 8 Fat 6 7 19 Carbohydrates 9 24.4 46 76 Total grams 20 25 65 103 Total Calories 1 10 108 295 507 Cost I c. I c. 2 c. 3 c. The real question is how much food value these lunches yielded for each cent expended upon them, 250 SCHOOL FEEDING and this is shown in the following table in which are given the number of Calories and the total num- ber of grams of food material, of protein, and of fat purchased for one cent in each case: Table 22. Food Values Purchased by One Cent A B C D Average Calories no 54 147 169 120 Grams of food 20 12.5 32.5 34.3 25 Grams of protein 5 .3 6. 2.6 3.5 Grams of fat 6 .... 3-5 6.3 3-95 This table shows in different units just how much the children received for each cent that they spent. The next question is how much they might have received had they spent the same amounts in pur- chasing carefully planned school lunches instead of buying from the small shops in the neighborhood. The tables presented show the food values of four lunches bought by the children in the small shops. These consisted of one i-cent lunch, two costing 2 cents, and one costing 3 cents. A similar analysis has been made of the food constituents of four planned lunches such as are daily being served in the schools of New York and Philadelphia. These likewise consisted of one i-cent lunch, two costing 2 cents each, and one costing 3 cents. SCHOOL MENUS 251 The contrast between the values of the two sets of lunches is shown in the following diagram in which the first upright column shows the average School Lunch Unplanned Lunch 11. K. 51^3 3.9 1:1 IK6 i VI. Average purchasing power of one cent spent for unplanned lunch, contrasted with purchasing power if spent for school lunch. Carbohydrates in outline; fats in horizontal lining; protein in solid black. purchasing power of one cent when the food is bought at the small shops, and the second column what one cent purchases on the average when the food is furnished with planned lunches. ^52 SCHOOL FEEDING The diagram shows that the child who patronizes the school lunch buys on the average 44 grams of food material for each cent, whereas the one who visits the small shop gets only 25 grams. The con- trast is no less striking when the units of food values in Calories are computed. The average number of Calories purchased for one cent at the small shops is only 118, whereas that bought by the same amount spent in the school lunch room is 200 Calories. The child who is able to purchase a planned lunch at cost price gets more protein for his money, more fats and more carbohydrates. He gets nearly twice as much food and gets it unadul- terated. Studies of the home diets of children, particularly those who are underfed, have shown that they are deficient in protein and fat, and this is likely to happen in any case where the food is provided by people ignorant and careless of the right food for children. The reason is that meat, fish, milk, eggs, oils, etc., are everywhere more expensive than bread, coffee, and canned foods, and that naturally these are either supplied in small quantities or not at all, and no attempt is made to make up the deficit by the use of less expensive sources of protein and fat. SCHOOL MENUS 253 THE need: well constructed and economical MENUS *The two main problems of constructing menus for a school meal are, first, how to assure the chil- dren a lunch that shall be satisfying to the appetite, yield a fair proportion of the day's whole ration, and make up for the probable deficiencies in the children's home diets ; and second, how all this is to be done, while keeping the whole cost of food, prep- aration and service within the ability of the school children to pay. These two problems have been solved so success- fully in Bradford, England, that the experience there may well stand as model for other places. When the school authorities in Bradford began to provide meals in accordance with the provisions in the National Education Act of 1906 ^ the Direc- tor of Medical Inspection, Dr. Ralph Crowley, and the Superintendent of Domestic Science, Miss Cuff, with infinite care and study made out a set of menus to meet the special needs of the children in their schools. The following specimen menus, with the excep- tion of the supper, are examples of the sort of food ^See p. 43ff, this text. 254i SCHOOL FEEDING Dr. Crowley considered necessary for the children of Bradford if they were to grow and play and work in the best way : BREAKFAST Oatmeal Porridge, Treacle, Milk and Bread and Butter Material Quantity Protein Fat ^^^^^'^^ (grains) (grains) Oatmeal ..... i oz. 72 31 Treacle i oz. Milk >4 oz. 140 176 Bread 2 oz. 80 12 Margarine — ^oz. ... 92 Total Calories, 600. 292 (18.9 grams) 31 1(20.1 grams) Wholesale cost, 2.204 cents. Retail cost, 2.5 cents. DINNER NO. XI Cottage Pie (Meat with Crust), Green Peas and Gravy; Stewed Fruit Material Quantity Protein Fat (grains) (grains) Beef 2 oz. 162 17 Potato 3 oz. 24 I Onion I oz. 6 i Flour iM oz. 87 7 Margarine . . ^ oz. 3 279 Peas 15^ oz. 162 6 Bread iH oz. 60 9 Fruit 3 oz. 4 Sugar 5^ oz. Total Calories, 894. 508 (33 grams) 320 (21 grams) Wholesale cost, 3.0 cents. Retail cost, 4.27 cents. SCHOOL MENUS 255 TEA Bread and Margarine, Tea with Milk Material Quantity Protein Fat (grains) (grains) Bread 6 oz. 240 36 Margarine . . ^ oz. 2 184 Milk 4 oz. 56 70 Tea i/io oz. 298 ( 19.3 grams) 290 ( 18.8 grams) Total Calories, 443. Wholesale cost, 2.07 cents. Retail cost, 2.17 cents. (In Appendix E will be found the menus of all the seven- teen dinners.) Breakfast. — The breakfast menu was never varied in practice after it proved on trial to be more satis- factory than any other combination. The oatmeal, milk and bread furnish 19 grams of protein, and the oatmeal, milk, bread and margarine furnish 20 grams of fat, while the starch and sugar in the treacle and bread form the carbohydrates. The breakfast yielding a total of 600 Calories is designed to furnish between one-quarter and one-third of the day's ration. Supper. — The supper is made out, not like the others on the basis of the child's real needs to be 256 SCHOOL FEEDING met in a school meal, but on the basis of what inves- tigation showed was the children's most usual home supper. Dr. Crowley says that the protein and fat estimates are probably a trifle higher than is actually the case, while the carbohydrates may be too low. Dinners. — There are in all 17 dinner menus, which are served in rotation, providing considerable variety. There are among them four different kinds of soup and boiled puddings. Six are " vegetarian " dinners consisting mostly of savory vegetable stews with milk pudding or wholemeal cake. The most elaborate dinner is fish and potato pie, green peas and lemon sauce, blancmange and jam. This is an example of the meals served on Fridays. The protein in the dinners is provided in meat, milk or beans and peas. The greater part of the fat is from meat or margarine, though in a few cases a vegetable fat, called " nutter," is used. In the menu given above, there are ^^ grams of protein and 21 grams of fat, and both these are slightly higher than the average in all the dinners, which are: 29 grams protein and 18 grams fat. The large amount of protein is due to the use of peas and meat together. SCHOOL MENUS 257 The dinner menus are arranged so that the pro- tein never falls below 24 grams and is more often 29 grams or a little over. The other component parts vary greatly in amount in the different menus, but this is less important than a variation in the amount of protein daily, for the reason that both fat arid carbohydrates may be stored in the body for future use, whereas any excess of protein over what is needed at the time for tissue building is eliminated as soon as possible. This means that the supply has to be kept up, though it need not be large. The Bradford kitchens are equipped to serve ten thousand meals a day and it is probable that no such careful plan has ever been made for the feed- ing of large numbers of children that has worked out so practically. There are several important principles illustrated by the Bradford regimen that must be taken into account in any similar under- taking. They are as follows: 1. The proper amount and proportion of foodstuffs are provided each day. The protein and fat elements are em- phasized. 2. There is great variety in the kind of foods in the dinners, where variety is more essential than at other meals. 17 258 SCHOOL FEEDING 3. The foods are simple, easily digested, are prepared palatably, and served daintily * and are valuable in cultivating the taste for the right sorts of food. 4. Finally there is the question of economy, — ^the meals are very cheap. The wholesale rate per child never exceeds three cents, for a dinner, while the breakfast costs in all two cents. Menus in Paris Cantines.^ — In the Paris cantines, though there is no plan like Bradford's, the meals are hearty, well prepared and well served, and afTord considerable variety. In schools where there are very small children they are given different food from the rest and have, as a rule, milk in some form, and their meat is cut into small pieces. The menus in each district^ are made out once a month and a printed copy hung up on the kitchen wall at each cantine. Following is a specimen of a two weeks' plan for one school : I. Monday: Beef broth and bread. Vermicelli, cooked in milk, with hashed beef. Tuesday: Macaroni and veal. Wednesday: Beef stew, potatoes. Thursday: Macaroni, sardines. Friday: Veal, white beans. Saturday: Cabbage soup, sausages. * See p. 48ff., this text. ' See p. yyfi., this text. SCHOOL MENUS ^59 2. Monday: Vegetable soup, red beans, roast beef. Milk porridge, bread, red beans, roast beef. Tuesday: Beef stew, potatoes. Wednesday: Veal stew, lentils. Vermicelli in milk, veal stew, lentils. Thursday: Rice cooked in oil and cheese. Friday: Beef stew, white beans. Saturday : Potato puree, sausages. Some of the Paris schools serve more elaborate meals, giving soup, meat and vegetables and a little dessert. It is quite customary, however, for children to bring their own desserts, as well as their own bread. Local Menus in New York. — In Bradford or Paris there is no special difficulty in getting dishes that all the children will eat, as they are almost all of the same nationality and are used to the same general foods. In a city like New York, with its heterogeneous population, it would be impossible to give the same food to the children of different sections. There are religious as well as national customs that must not be violated. In a school where there are large numbers of Catholics, meat must not be served on Fridays and other fast days. In Jewish districts the laws of Kosher must be observed. At the same time, a taste for new kinds 260 SCHOOL FEEDING of food must be cultivated, and elements wanting in the home meals must be supplied. Following are specimen menus made out for an Italian and an Irish- American district: Rice and beans with tomato. Clam chowder. Polenta — cornmeal with cheese, Samp. tomato, oil. Macaroni soup. Menestra — vegetables stewed Baked beans. in oil. Boiled rice. Lima beans and postum. Noodle soup. Macaroni, cheese, tomato. Vegetable soup. Rice, tomato and cheese. Rice pudding and cocoa. Potato soup and fish. Cocoa and prunes. Cheese sandwich and cocoa. Apple sauce and crackers. Pea soup. Barley soup. These menus which are always served with bread contain on an average 30 grams of protein, 13 grams of fat, and 130 grams of carbohydrates, and yield about 750 Calories. This equals one-third to one-half of what Dr. Wile, who superintends the dietary end of the lunches, considers necessary for the day's food supply of the children in the schools. ANNOTATED BIBLIOGRAPHY ON SCHOOL FEEDING ARRANGED ACCORDING TO TOPICS I. Belgium. II. Food Values, Dietaries, Etc. III. France. IV. Germany. V. Great Britain. VI. Italy. VII. Malnutrition. VIII. Periodicals. IX. Switzerland. X. United States. BIBLIOGRAPHY I. Belgium Bruxelles, Julien Baertsoen : College au conseil communal. Enquete sur rhabillement, la nourriture et le logement des eleves des ecoles communales. Rapport, 1896, 68 pages. Montgomery, Jessie Douglas: School Hygiene in Brussels. In London. Board of Education. Special reports on educational subjects. London, Wyman & Sons, 1898, pp. 689-787. Synge, M. B., and May, M. G. : Provision Made for Children under Compulsory School Age in Belgium, France, Ger- many, and Switzerland. Special Reports on Educational Subjects, vol. 22, 1909. Board of Education, Great Britain (Cd. 4477), price is. 3d. (Children's Homes, etc., for children of working mothers; food carefully attended to; paid for by parents when possible.) II. Food Values, Dietaries, etc. Atwater, Wilbur Olin, and Bryant, A. P.: The Chemical Composition of American Food M!aterials. Washington, Government Printing Office, 1906. Rev. ed., 87 pp. (U. S. Office of Experiment Stations. Bulletin No. 28.) Atwater, W. O., Ph.D. (Special Agent in Charge of Nu- trition Investigations, Office of Experiment Station, U. S. Bureau of Agriculture.) : Principles of Nutrition and 263 264 BIBLIOGRAPHY Nutritive Value of Food. Farmers' Bulletin No. 142 (Corrected to April 5, 1906). Washington, Government Printing Office. (Popular introduction to the study of food values, standards used being based on observation of what people do eat, not on experimental work.) AuDEN, George A., M.D. (Med. Sup. Birmingham Ed. Com.) : The Feeding of Necessitous School Children. In the Medical Officer, vol. i. No. 30, 1909, p. 767 ff. London, Whitefriars Street, Fleet Street, E. C. (Food values of breakfasts in Birmingham and other places.) Berry, Elmer: The Effects of a High and Low Protein Diet on Physical Efficiency. Amer. Phys. Ed. Rev. XIV, 1909, p. 288 ff. (Account of experiment in low protein diet for athletes in Springfield, Mass., Y. M. C. A.) Bryant, Louise Stevens: (a) Some Recent Experimental Work on Children's Food Needs. The Dietetic and Hygienic Gazette, June, 191 1. (An account of work on children's diets analogous to Chittenden's work on that of adults. Comparative study of fifteen standard dietaries. Four tables.) (&) Nutrition and Growth in the Special Class for Back- ward Children, by Lightner Witmer. The Psychological Clinic Press, Philadelphia, Pa., 1912. (An account of six weeks' feeding of a class of eighteen backward children, giving dietaries, menus, food values, accounts of home feeding, results on weight, height, haemoglobin, etc.) BIBLIOGRAPHY 265 Camerer, Wilhelm: Der Stoffwechsel des Kindes (von der Geburt bis um Beendigung des Wachstums). Tubingen, 1896. Laupp. (Record of observational work on his own children's diets.) Chittenden, Russell H. : The Nutrition of Man. New York. Frederick A. Stokes Co., 1907. 301 pp. (Most extensive account that has appeared of results and conclusions following experimental work on the true food needs of the body. Technical, but with some matter on practical applications. No reference to chil- dren's diets.) Corbett, Florence R. : Dietaries for Charitable Institutions. State Board of Charities, New York, 1906. Dukes, C. : The Essentials of School Diet. London, 1899, 211 pp. Food Values, Practical Methods in Diet Calculations. Bulletin of the American School of Home Economics, March, 1909, Series I, No. 13. Chicago, 111., 606 W. 69th Street. (An account of Prof. Irving Fisher's graphic method of calculating food values by the hundred Calories portion, and the use of his graphic chart and mechanical diet indicator. Valuable for the practical worker in diets. Bibliography.) Gautier, Armand: Diet and Dietetics. Edited and trans- lated from the French by A. J. Rice Oreley. Philadel- phia. J. B. Lippincott. 1906. (Takes up children's diets, especially relation between growth and changing needs.) 266 BIBLIOGRAPHY GiBBS, Winifred Stuart: Popular Education in Dietetics. In The Journal of Home Economics, April, 1910. (An account of the work of a "visiting dietitian.") Hall, Winfield S. : Nutrition and Dietetics. New York and London. D. Appleton & Co. 1910. (General treatment. Short section on " rations varied by sex and age.") Hendrick, Burton J.: Some Modern Ideas on Food. In McClure's Magazine, Vol. xxxiv, April, 1910, p. 653 ff. New York. (A review in non-technical terms of the most recent scientific observations and experiments with especial reference to the " low-protein diet " and " Fletcherism." Accurate and interesting.) Heubner: Eine Betrachtung iiber die Emahrung des Kindes jenseits des Sauglingsalters. Jacobi's Festchrift, p. 290. Hunt, Caroline L. : The Daily Meals of School Children. Washington, Government Printing Office, 1909. (Main emphasis on food values and dietaries for children. Bibliography and index.) Hutchinson, Robert: (a) Food and the Principles of Die- tetics. London, Arnold. 1906. (General text-book on Nutrition. Not written es- pecially for the trained reader. Considerable matter on children's diets.) (b) Improper Feeding of Cardiff Children. (Brit. Med. Jour., 1907, No. 2404, pp. 226, 227.) BIBLIOGRAPHY 267 Kellogg, J., M.D.: The Battle Creek Sanitarium Diet List. Modern Medicine Publishing Company, Ltd., Battle Creek, Michigan, 1909. (Standard dietaries for different ages made out in accordance with the low-protein diet principles. Tables of normal weights and heights.) Langworthy, C. R: Food and Diet in the United States. Reprint from Year Book of Department of Agriculture for 1907. Washington, Government Printing Office. (Account of various dietary standards, with general information about food and food values that may be of practical use. The standards followed are the older ones of Voit and Atwater, no account being taken of the more recent results of definite experimental work.) Leach, Albert E. : Food Inspection and Food Analysis. John Wiley & Sons, New York, 1909. Legendre. p.: The Nourishment of Youths of Both Sexes in the Family and in Educational Institutions. (Rev. Soc. Sci. Hyg. Aliment., 3 (Paris, 1906), No. 3, pp. 450-468.) Locke, Edwin A., M.D. : A Report of Dietary Studies made at the Franklin Park Hospital School for Tubercular Children (Boston, Mass.). Proceedings of the Sixth Cong. Amer. School Hygiene Assoc, Springfield, Mass., 1912. (Account of food values of daily home and school meals of 191 children, giving cost of school meals, amount of protein ingested, etc. A careful and useful piece of work.) 268 BIBLIOGRAPHY LuNGWiTZ, Hans: Stoffwechselversuche iiber den Eiweissbe- darf des Kindes. Halle a S., Carl Marhold. 1908. (82 pp.) (This is a summary of all the work, observational and experimental, on the protein needs of children. It deals particularly with Siegert's work and corroborative experiments made by the author. It is the only work on children's true protein needs at all comparable to Dr. Chittenden's work on adults. Tables. Bibliography. The bibliography is of especial interest to the scientific student of metabolism and the pathology and therapy of nutrition.) Maurel, E. : Rapport sur la ration d'entretien aux divers ages. In Revue d'Hygiene Alimentaire. Ill, 1906. pp. 763-854. Paris. Masson et Cie. 120 Boulevard Saint- Germain. Price 2 francs. (A complete outline of all the food needs from infancy to old age, including considerations of weight, height, cutaneous surface, lung activity, climate, etc. Tables showing relation of growth to nutrition, typical regimens for every period of life. Gear style, concrete treatment, with a practical point of view throughout. The estimates given have been submitted to years of test in general practice.) MiLNER, Robert Denniston: The Cost of Food as Related to its Nutritive Value. In U. S. Dept. of Agriculture. Year Book, 1902. Washington, 1903. pp. 387-406. MuLLER, Erich : Stoffwechselversuche an 32 Kindern im 3 bis 6 Lebensjahre mit Beriicksichtigung des Kraft- wechsels auf Grund direkter calorimetrischer Bestim- mungen. In Biochemische Zeitschrift. V. 1907. (2, 3, 4, Heft.) pp. 143-303. Berlin. Julius Springer. BIBLIOGRAPHY 269 (Observational merely; no experimental data, as with Siegert and Lungwitz. The children under observation were from 2 to 6 years old, in weight from 9 to 17 kilos. Bibliography. A summary table of the material in this article is given in Lungwitz, pp. 22.) Richards, Ellen Henrietta : (a) First Lessons in Food and Diet. Boston, Whitcomb & Barrows, 1894. 52 pp. (b) Plain Words about Food. The Rumford Kitchen Leaf- lets, 1899. Boston, Rockwell and Churchill Press, 1899. 176 pp., 10 plates, diagram. Richards, Ellen Henrietta, and Woodman, Alpheus C. : Air, Water and Food (from a Sanitary Standpoint). John Wiley & Sons, New York, 1909. Rubner, Max, M.D. : (a) Gesetze des Energieverbrauchs bei der Ernahrung, 1902. (b) Das Problem der Lebensdauer and seine Beziehungen zu Wachstum and Ernahrung, Munich und Berlin. R. Oldenbourg, 1908, 208 pp. (c) Kraft und Stoff im Haushalt der Natur. Akad. Verlags- gesellschaft. m. b. H. Leipsig, 1909. (A popular, yet philosophical treatise on the processes of nutrition. A summary of Rubner's work on Nu- trition.) (f/) Volksernahrungsfragen. Leipsig. Verlagsgesellschaft m. b. H. 1908. (i. The minimum requirement of protein. The prac- tical issues involved in the " low protein " standard of nutrition. A critical study of the complex nature of protein metabolism. 2. The diet of the poor. Influence of poverty on nutrition.) 270 BIBLIOGRAPHY (e) Die Ernahrungsverhaltnisse der Volkschulkinder. (Re- port of address at Congress on School Feeding in Darmstadt, May, 1909,) Pub. in Schriften der Zentral- stelle fur Volkswohlfahrt. Heft 4 der neuen Folge der Schriften der Zentralstelle fiir Arbeiter-Wohlfahrtein- richtungen. Berlin. Carl Heymanns. 1909. p. 132 ff. Schroeder: t)ber die Ernahrung 8-15 Jahriger Kinder. Archiv fiir Hygiene, IV 39, 1886. Sherman, Henry C. : Chemistry of Food and Nutrition. New York, Macmillan Co., 191 1. (An authoritative treatment in non-technical language, with sections on children's diets.) (Further experimental work on children's diets.) Siegert, F., M.D. : (a) Der Nahrungsbedarf des Kindes jen- seits des Ersten Lebensjahres. (Koln.) (Verhandlungen der Gesellschaft fiir Kinderheilkunde. 1906. Stuttgart.) J. F. Bergmann. Wiesbaden. 1907. (Account of first experimental work on children's food needs.) (b) Der Eiweissbedarf des Kindes. Arch. f. Exper. Path- ologic und Pharm. 1908. Supplt. Bd., pp. 489-495. Simple Dishes for Children of School Age. Boston Cooking School Magazine, 13 : 145, Oct., 1908. S medley, E., Milner, R. D., Knight, Pratt, and Lang- worthy: Dietary Studies in Public Institutions. Wash- ington, Government Printing Office, 1910, 98 pp. Stewart, Gwendolyn: Diet in Relation to Growth. Jour. Home Economics, Feb., 191 1, pp. 81-86. BIBLIOGRAPHY ^71 Sutherland, G. A. : A System of Diet and Dietaries, London, 1908. (Summary and discussion of recent clinical and other work on dietaries; all ages, from infancy to end of school life.) VoELCKER, A. F. : Some Common Errors in the Diet and General Hygiene of Children. (Brit. Med. Jour., 1907, No. 2404, pp. 181-185. Watson, C. : A Plea for the Use of Oatmeal in the Dietary of Children. Brit. Med. Jour., 1907, No. 2417, pp. 985, 986, Figs. 2. Wither, Lightner, Ph.D. : The Special Qass for Backward Children. The Psychological Clinic Press, Phila., Pa. 1911. (Contains chapter on Nutrition and Growth. See reference under Bryant.) III. France Butte, L. : (a) Les cantines scolaires. L' hygiene scolaire, 189, 1910. (b) L'education physique. La medecine scolaire, 4, 51 (1911). Courgey, Dr.: Cantines Scolaires. La Medicine Scolaire. June 10, 1908, pp. 85-92, Paris. Librairie Ch. Delagrave. 15 Rue Soufflot. (Short history of the Paris cantines, and an estimate of their value by a medical inspector.) Elliott, Charles Alfred: Cantines Scolaires of Paris. Nineteenth century, 59:834-41, May, 1906. (Case against them. Their expense used as argument against their adoption by England.) 272 BIBLIOGRAPHY Kleine, Marcel: The Cantines Scolaires of Paris. (Inter- national Congress for the Welfare and Protection of Children. Special conference, 1906.) Report of the proceedings. Westminster. Published for the Com- mittee by P. S. King & Son, pp. 65-70. Discussion, pp. 70-82. (History and description.) Lancet Reports : The Free Feeding of School Children. A reprint of the reports by the Special Sanitary Commis- sioner of the Lancet on the action taken by the municipalities with regard to the provision of meals for the children attending the elementary schools of Paris, Brussels, Milan, Vercelli, San Remo, Mentone, Nice, Cannes, Toulon, and Marseilles. Second edition, 1907. The Offices of The Lancet, 423, 424 Strand, London, W. C Price 3d. (Those interested in the important questions of the popular and political reactions to the introduction of meals into the schools will find these reports most valu- able. The political and financial dangers and complica- tions as well as their final solution are given in detail for each place.) Laurentie, FRANgois: La Protection de I'Enfance. Rheims. (L Action Populaire.) (Summary of French movements toward child wel- fare.) Lavergne^ F. : (a) (Chef du Secretariat de la Direction de TEnseignement.) Les ficoles et les CEuvres Municipales D'Enseignement. 1871-1900. (Ville de Paris.) 447 pp. Paris Societe Anonyme de Publications Periodiques. P. Mouillot, Imprimeur. 13 Quai Voltaire. BIBLIOGRAPHY 273 (Complete, non-official discussion of the entire public educational system of Paris, from the maternal schools to the higher, professional colleges, including night schools, art and industrial work, and central administra- tion, and finally the extra-academic activities, such as the cantines, medical inspection, excursions, vacation colonies, military classes, student insurance. The book is of particular value because of the general difficulty of obtaining first-hand information about French institu- tions. The administration of the cantines is treated at some length.) (t) Organisation des Cantines Scolaires a Paris. A report in manuscript manifold issued by the " Direction de I'En- seignement primaire 3me Bureau. Prefecture du departe- ment de la Seine." (An account of the origin and history of the cantines in Paris from 1879 to 1903, with a detailed description of their conduct in the i8th district, regarded as the model in this respect.) IV. Germany Albu, A. : Der Anteil der Schule an den Storungen der Entwicklung und Ernahrung der Kinder. Reprinted from Zeitschr. f. pad. Psych., Path. u. Hygiene. Fischer: Einrichtungen fiir die Speisung armer Volkschul- kinder in den Stadten Dresden, Prag, Wien, Nurnberg, usw. Berlin, 1908. Kaup, Dr., Med. I. : (a) (Zentralstelle fur Volkswohlfahrt, Berlin.) Schulspeisung armer Kinder. (Referat auf der Konferenz der Deutschen Zentrale fiir Jugendfiirsorge in Berlin. Am. 31 Mai 1907.) 25 pp. Sonderabdruck 18 274 BIBLIOGRAPHY aus der Zeitschrift der Zentralstelle " Concordia," No. 24, vom 15 Dec, 1907. Carl Heymanns, Berlin W. 8, Mauerstrasse 43/44. (This was the first time the school feeding problem in Germany had been considered from the point of view of the trained dietitian. The first part of the book con- siders the food needs of the school child and includes comparative tables of growth. The second part deals with organizations for school feeding in Germany, but this material is superseded and included in Kaup's later book. See below.) (b) Die Ernahrungsverhaltnisse der Volkschulkinder. (Vor- bericht und Verhandlungen der 3 Konferenz der Zentral- stelle fiir Volkswohlfahrt. 1909. Darmstadt.) Berlin. Carl Heymanns Verlag. 1909. 170 pp. 22 tables. (This is an account of the most extensive investigation of School Feeding that has ever been made in any country. It covers the reports of school feeding or- ganizations in all towns of 10,000 and over in the German Empire; these are analyzed and the results tabulated; an account of the daily food of about 500,000 school children; the report of a special examination of the nutritional conditions of 170,000 children. The causes and effects of malnutrition are discussed at length. Plans and outlines for future work, the correlated social reforms, etc., are given. Critical analysis of the food values in the meals of some 25 towns.) (c) Ernahrung und Lebenskraft der landlichen Bevolke- rung. Schr. d. Z. f. V. Heft 6 N. F. Lemberg, Hedwig: Schulspeisung in Wien. Reprinted from Nos. 5 and 6, H Jahr. der Zeitschr. fur Kinderschutz und Jugendfiirsorge. Vienna, 1910. 1 BIBLIOGRAPHY 275 Munsterberg: Schulspeisung. Handbuch d. St. Art. Kinder- fiirsorge. Berlin. RiEGEL, Maria: Schulspeisung in Mannheim, 1909. RuBNER, Dr. Max: Leitsatze betreffend die Emahrungs- verhaltnisse der Volkschulkinder. In Internationales Archiv fiir Schulhygiene. Vol. VI, No. 3, Mai 1910, pp. 357-364. (Proposals in regard to permanently bettering the nutrition of school children, by meals in school, but more especially by the installation of Day Homes, for children below as well as of school age, with working mothers; by widespread provision for* sick and unem- ployed, such as insurance, pensions, etc. These pro- posals are summarized in French and English as well as German.) Seydel: (Stadtrat, Charlottenburg) : Die Mittagsspeisung von Schulkindern in Charlottenburg in Archiv fiir Volks- wohlfahrt, II, 4, Jan., 1909, pp. 227-231. (Charlottenburg has one of the best systems in Ger- many. It corresponds in some respects to Bradford, England. The educational and aesthetic possibilities of the school meal are recognized.) Simon, Helene: (a) Schulspeisung: Armenpflege oder Schulpflege? Gesetzliche Regelung. In Soziale Praxis. XVIII, No. I, Oct., 1908, p. i. Duncker & Humbolt, Leipsig. (Is school feeding the affair of charity or school? Legislative measures necessary if it is to be effective.) (b) Schule und Brot. 1908, Leipsig, Leopold Voss. 112 pp. 1st edition, 1907. 276 BIBLIOGRAPHY (General treatment of the whole problem from the social, economic and legal points of view. Propagandist rather than statistical. Historical and descriptive account of English, French and German systems to date.) (c) Die Schulspeisung. 1909, Leipsig. (Oct.) Duncker und Humbolt. 93 pp. Appendices. (General treatment of whole subject, taking into account the latest German reports (see Kaup, No. 2), social, ejconotnic and legal aspects and implications. Other countries.) (d) Schulspeisung. 191 1. Enzyklop. Handbuch des Kinder- schutzes, usw., pp. 206-213. (Material in Die Schulspeisung, 1909, brought up to date and condensed for encyclopedia. Bibliography.) ZiEGLER, G. : Eine Erhebung iiber die Ernahrungsverhaltnisse der Volkschiiler. Die Deutsche Schule. June, 1910. XIV Jahrgang, 6 Heft, pp. 374-378. V. Great Britain Alden, Percy: English Child Life. Outlook, Sg:7Sgr763, Aug. I, 1908. Anson, Sir William R. : Provision of Food for School Children in Public Elementary Schools. Economic Journal, 16:181-188, June, 1906. Barnett^ Samuel A.: Free Meals for Underfed Children. Independent Review, 6: 154-172, June, 1905. Bradford Education Committee: (a) Return as to the Pecuniary Circumstances of 966 Families whose Children have been Provided with Meals under the Education Act (Provision of Meals Act, 1906). 1908. Education Offices, Manor Row, Bradford, Eng. Tables. BIBLIOGRAPHY 277 (&) Report for 1909. Education Office, Manor Row, Brad- ford, Eng. (Statistics of school feeding in B., 1908-1909. De- scriptive account of plant.) (c) Recipes, compiled by Marian E. Cuff (Superintendent of Domestic Subjects) and used in the preparation of the Seventeen Dinners served in the School Dining Rooms. Pub. at Education Offices, Manor Row, Brad- ford, Eng., Feb., 1908. Bristol Education Committee: Report for year ended March 31, 1909. Bristol, Times and Mirror, St. Stephen Street, Bristol, Eng. Clay, Arthur Temple Felix: (a) Free Meals for Underfed Children. Monthly Review, 20 : 94-104, July, 1905. (b) School Feeding Question in England. Charities and Commons, New York. 17 : 699-707, Jan. 19, 1907. Crowley, R. H. : The Provision of Meals for School Chil- dren. Pub. Health (London), 20 (1908), No. 5, pp. 325-335, chart. Davies, Mary A.: The Feeding of School Children and the Cookery Classes. Contemporary Review, 87 : 564-569. April, 1905. Denyer, C. H. : Feeding of School Children at Public Expense. Summary of official reports. Economic Journal, 16:617-622, Dec, 1906. Edwards, A. D. : Evolution, Economy, and the Child. West- minster Review, 171 : 78-85, Jan., 1909. (A defence of school meals from the points of view of national and racial evolution upwards, and national economy.) 278 BIBLIOGRAPHY Elliott, Sir Charles : Children's Relief Committees in Elementary Schools. In Report of the Proceedings of International Congress for Welfare and Protection of Children, Special Conference, 1906. Westminster, pub- lished for the committee by P. S. King & Son, pp. 50-58. Fabian Society: After Bread, Education. A plan for the state feeding of school children. London, 1905. 15 pp. (Fabian Tract No. 120.) The Feeding of School Children. (Pub. Health, London, 2.2 (1908), No. 3, pp. 97, 98.) Free Meals for School Children. In the Reformer's Year Book for 1908, 4 Clement's Inn, London, W. C, p. 94 ff. (Short Summary of English Provision of Meals Act, 1906, with report of English Investigation of Continental Systems of School Feeding.) Frere, Margaret (Member of the Education Committee, London County Council) : A Scheme for Dealing with Underfed Children. In International Congress for the I Welfare and Protection of Children. Special confer- ence, 1906.) Report of the proceedings, Westminster, Published for the Committee by P. S. King & Son, pp. 58-65. Children's Care Committees. P. S. King & Son, Great Smith Street, Westminster, 1909. is. net. 86 pp. (Official Handbook for members of "care com- mittees " having charge of social and charitable work in schools. Ch. II on " How to Feed Necessitous School Children." Appendix giving typical menus.) BIBLIOGRAPHY 279 GoRST, Sir John Eldon : The Children of the Nation : How their Health and Vigour should be Promoted by the State. London, Methuen & Co., 1907, 207 pp. Hughes, Robert Edward: Feeding the School Children, in his. The M'aking of Citizens, 2d ed., London (etc.), The Walter Scott Publishing Co., 1906, pp. 19-24. (Table of sums distributed in various European cities, p. 22.) Hunter, Robert: Social Significance of Underfed Children. International Quarterly, 12 : 330-349, Jan., 1906. Loch, C. S. : The Feeding of School Children. Yale Review, 12 : 230-250, Nov., 1906. (A study of the English voluntary system of school feeding, and an argument against any form of school meals.) London School Board: Underfed Children Attending School, 1898-1899. Report. London, Alexander & Shepheard, printers, 1899, xv, 272 pp. Parliamentary Reports of Great Britain. (These all to be obtained from Wyman & Sons, Fetter Lane, E. C, or Eyre and Spottiswoode, East Harding Street, Fleet Street, E. C.) 1903 (Cd. 1507) Price is. id.: Report of the Royal Com- mission of Physical Training (Scotland). Vol. i, report and appendix. (Containing findings of committee in regard to nu- tritional condition of school children, and proposals in regard to school feeding.) 280 BIBLIOGRAPHY 1904 (Cd. 2175) Price is. id.: Report of the Inter-Depart- mental Committee on Physical Deterioration. Vol. I, report and appendix. (Proposals of this committee in regard to feeding of school children, pp. 65-71.) 1905 (Cd. 2779 and Cd. 2784) : Report of the Inter-Depart- mental Committee on Medical Inspection and Feeding of Children Attending Public Elementary Schools. Vol. I. (Cd. 2779) Price is. 3d. Vol. II. (Cd. 2784) Price 3s. (Includes statistical account of the voluntary systems of feeding children in Great Britain in 1905.) 1906 (Cd. 2926) : Statement of Information collected by the Board of Education and the Foreign Office regarding methods adopted in Great Continental and American Cities for dealing with Underfed Children. (Statistical and classified report of systems in 38 foreign cities.) 1906 (288) : Special Report and Report from the Select Committee on the Education (Provision of Meals) Bill, 1906; and the Education (Provision of Meals) (Scot- land) Bill, 1906; together with the Proceedings of the Committee, Minutes of Evidence, and Appendix. Price 2S. 4d. with Index and Digest of Evidence. (Methods and administration in England, particularly in voluntary systems of feeding, reported on by 28 wit- nesses, all with practical experience. Valuable and sug- gestive for practical workers.) 1907 (Cd. 3637), Mackenzie, W. Leslie, M.D., and Captain Foster : Report on a collection of statistics as to the Physical Condition of Children Attending the Public Schools of the School Board for Glasgow. BIBLIOGRAPHY 281 (Most extensive investigation of the kind ever made, including 72,800 cases. The heights and weights of the children classified according to housing and nutrition.) 1910 (Cd. 5131) Price 3d.: Report on the Working of the Education (Provision of Meals) Act, 1906, up to the 31st of March, 1909. (Includes a classified report of information received from over one hundred towns having adopted the act. Administrative, financial and educational issues.) 1910 (Cd. 5724; Price 3d.: Report on Working of Provision of Meals Act. (Continues Cd. 5131 through Dec, 1909.) 1911 (Cd. 5925), Newman, George: Annual Report for 1910 of the Chief Medical Officer of the Board of Education. (Complete account of the workings of the Education Act, 1906 up to March, 1910. Administration of Act now in hands of Medical Division of Board of Educa- tion. Section of Malnutrition, Statistics, and Classifica- tion, pp. 26-32,) London County Council (Publications relative to School Feeding. To be obtained from P. S. King & Son, 2-4 Great Smith Street, Victoria Street, Westminster, S. W.) No. 922. 1904-1905: Report of the Education Committee of the London County Council Submitting the Report of the Medical Officer (Education) for the Year ended March, 1905. (Short statement of the London problem, given by medical officer. Stigmata of malnutrition, hereditary and social factors. What can be done: in general, imme- diately.) ^82 BIBLIOGRAPHY Nos. 962 and 1074. 1907 : Reports of the Joint Committee on Underfed Children. For the years 1905-1906, 1906-1907. Price 6d., post free 7d. (These reports give the list of schools having meals, the numbers fed, and a general account of the work of school feeding in London for the year.) No. 1203. 1908 : Home Circumstances of " Necessitous " Chil- dren in Twelve Selected Schools. Reports by the chair- man of the Sub-Committee on Underfed Children and the Education officer, submitting report by the organizers. (This is a careful inquiry embracing about 1200 chil- dren, reported to be underfed, giving tabulated results.) No. 1251. 1909: Report of the Education Committee of the London County Council Submitting the Report of the Medical Officer (Education) for the Twenty-one months ended 31st Dec, 1908. Presented to the Council, nth May, 1909, pp. 16-20. Price 2s., post free 2s. 3d. (School Feeding. Stigmata of malnutrition from the point of view of the medical inspector; report of ex- amination of over 10,000 children in regard to their nutrition, and classified according to nature of the dis- trict; heights and weights of children in badly fed and well fed sections. Review of Dr. Gastpar's work. See Bibliography.) No. 1318. 1908-1909: Report of the Education Committee Submitting the Report of the Education Officer for the Educational Year 1908-1909. Part IL The Provision of Meals for Necessitous Children and the Work of Children's Care Committees. Presented to the Council 1st March, 1910. BIBLIOGRAPHY 283 (This gives complete statistical account of the work in London for 1907-1908 and 1908-1909.) Education Committee (Children's Care, Central, Sub-com- mittee) : Handbook containing general information with reference to the work in connection with the Children's Care (Central) Sub-committee. Price is.; post free is. 3d. (Official handbook for members, giving technical and legal information about all points covered in care com- mittee work in London. Appendix J gives 14 typical menus for 100 children.) McMillan, Margaret, and Cobden- Sanderson, A. : London's Children, How to Feed Them and How Not to Feed Them. Published by the Independent Labour Party, 2Z Bride Lane, Fleet Street, London, E. C, 1909. Price id. (A criticism of present methods of work in London, with constructive suggestions for bettering them.) Macnamara, Dr. Thomas James : (a) Physical Condition of Working-class Children, Nineteenth Century, 56:307-311, Aug., 1904. (&) In Corpore Sano. Contemporary Review, 87:238-248, Jan., 1905. O'Brien, M. D. : Child and the Home. Westminster Review, 165:668-675, June, 1906. Oxford House Magazine: January, 1909. Bethnal Green, London. Price 6d. Symposium on the Feeding of Necessitous Children, pp. 33-54. (Written before London adopted 1906 act. Gives short history of movement in England, and then argu- ments from the "Socialist" and "Individualist" stand- point.) 284 BIBLIOGRAPHY Palin, Councillor J. H. : Bradford and its Children: How They are Fed. Published by the Independent Labour Party, 23 Bride Lane, Fleet Street, London, E. C, 1908. (History of movement in Bradford, written by an active worker. Interesting.) Philpott, Hugh B. : School as a Social Force. In his " London at School." London, T. Fisher Unwin, 1904, pp. 290-314. (The East Lambeth Teachers' Association; the penny meal; the scholars' free meal fund can feed 5000 children a day.) Royal Commission on the Poor Laws and the Relief of Distress (Minority Report) : Report 1238 pp. (Cd. 4499) 5s. 6d. See p. 195. Relief School Children's Order, 1905; pp. 197-198. Education (Provision of Meals) Act, 1906; pp. 834-840. School Feeding. Smyth, A. Watt: Physical Deterioration: Its Causes and the Remedy. New York. E. P. Dutton & Co., 1904. (The findings of the Parliamentary Commissions on National Deterioration in England, brought together in readable form, together with suggested remedies. See Bibliog. Great Britain Parliamentary Reports. Cd. 1507 and Cd. 2175.) Stewart, Gwendolyn : School Dinners in London Schools. In The Journal O'f Home Economics, Vol. II, No. 2. (Account of personal observation of the service and organization of meals in the one meal centre in London.) Webb, Sidney and Beatrice: The Prevention of Destitution. Longmans, Green & Co., 39 Paternoster Row, London, 1911. (Sections showing result of various acts of legislation on social progress.) BIBLIOGRAPHY 285 VI. Italy BosELLi, A.: La refeziona scolastica a Bologna. Boll, delle sz. med. Ser VIII 5 (1905). Lancet Reports : See Bibliog. Sec. III. (Description at first hand of systems in Milan, Vercelli, and San Remo.) ScHiAvi, Alessandro (Director of the Labor Bureau of the " Societa Umanitaria," Milan, and Municipal Councillor of Milan) : Les Cantines Scolaires Municipals de Milan. In "Les Annales de la Regie Directe," 1909, June-July, Geneva, p. 152 flf. (An account of the development of school meals in Milan, giving menus, statistical tables of numbers fed, finances, etc.) Spargo, John: How Foreign Municipalities Feed Their School Children. In his "The Bitter Cry of the Chil- dren," New York, Macmillan Co., 1906. (An account of the free and compulsory system of feeding at Vercelli in existence from 1900^1906, now succeeded by a privately directed, publicly subsidized organization.) ToNSiG, Dr. C. (Director of Medical Inspection in Padua) : "Qber das Schiilerfriihstuck, mit besonderer Beriicksich- tigung der in der stadt Padua bestehenden Einrichtungen. In Zeit. f. Schulges., vol. 17, 1902, p. 605 ff. See Bibliog. Sec. VIII. (Account of the first critical analysis ever made of the food values of the meals served at school. Marks the beginning of an important kind of inr'?iry.) 286 BIBLIOGRAPHY VII. Malnutrition ITS CAUSES, SYMPTOMS, RESULTS AND CLASSI- FICATION Badger, George, S.C, M.D. : Malnutrition in School Children. Proceedings of the Sixth Congress of the American School Hygiene Association, Springfield, Mass., 1912. (Recommended for the conducting of special classes for acute cases of malnutrition, the enumeration of causes, with stress on lack of sleep and bad food habits.) Bray, Reginald: Malnutrition and the School Meal. In his "The Town Child," London, T. Fisher Unwin, 1907, pp. 106-117. Bean, Homer C. : Starvation and Mental Development In The Psychological Clinic, May, 1910, p. 78. (The study of the results, psychological and physical, of starvation, during the first six years of life. The boy, sixteen years old at the time, had not acquired some of the most fundamental neuro-muscular co-ordinations.) Beeley, Dr.: Report of the School Medical Officer of East Sussex (England), 1910. (Relation of enlarged glands to enlarged tonsils, dental caries and defective nutrition.) Dr. Burgerstein, Leo, and Netolitzky, Dr. August: Handbuch der Schulhygiene, pp. 207-210. Section on Abspeisung. (Account of School Lunch Movement in different countries, with stress on administrative requirements.) Camerer, Wilhelm : Ernahrung des Kindes. In Das Buch vom Kinde., pp. 48-50, Leipsig, 1907. BIBLIOGRAPHY 287 Chate, Dr. : Report of School Medical Officer of Middlesex (England), 1910. (Special investigation of the causes of defective nu- trition.) Cornell, Walter S., M.D.: Health and Medical Inspection of School Children. F. S. Davis Co., Philadelphia, 1912. (Chapter on Nutrition, pp. 479-498, and section on School Feeding, pp. 100-114.) Crowley, Ralph E. (Medical Dept. o^f Board of Education, Great Britain): (a) The Hygiene of School Life! London. Methuen & Co., 36 Essex Street, W. C 1910. (General treatment of nutrition of child, p. 12 ff. Chapter on the Provision of School Mbals. This chap- ter represents the author's conclusions in regard to the subject, reached after several years of practical ex- perience in organizing meals in Bradford.) (b) Report by the Medical Superintendent. (In conjunction with Superintendent of Domestic Subjects, Marian E. Cuff.) On a course of meals given to Necessitous Chil- dren from April to July, 1907. Published by city of Bradford Education Committee, Bradford, England, Sept., 1907. (Out of print.) (This is an account of an experiment to determine the effect of food alone on the health and growth of school children. It is notable in being the first experiment where proper precautions were taken to isolate the factor of food, and to have control records kept. The original report is out of print, but a summary of its con- clusions and the chart in the original are given in " Progress," April, 1908. See Bibliog. sec. VIII. ^88 BIBLIOGRAPHY Gastpar, Dr. (of Stuttgart) : Die Beurteilung des Ernahr- ungszustandes der Schulkinder. Zeit. of Schulges., xxi. Jahr. 1908. 689-702. (The correlation of thirteen diseases found in 8000 school children, with their nutritional condition. Four times as many cases of disease are found among the badly nourished as among the well nourished. 6 tables. Practical method of classifying nutrition. A remarkable and highly significant piece of work, and the first of its kind.) Hastings, Dn. W. W. : Manual of Physical Measurements. Springfield, Mass., 1902. (Gives standard tables of weights and measurements for different ages, with methods of registering same.) HoAG, E. B. : The Health Index of Children. San Francisco, Whitaker & Ray-Wiggin Co., 1910. Hogarth, A. H., M.D. : M'edical Inspection of Schools. London. Henry Fronde. Oxford University Press. 1909. (Short statement of Koppe's scheme of classifying nutrition, pp. 157-158.) Holt, Emmet L., M.D. : i. The Diseases of Infancy and Childhood. 2. The Care and Feeding of Children, A catechism for the use of mothers and children's nurses. Fourth edition revised and enlarged. New York and London, D. Appleton & Co., 1907. 192 pages. Kelynack, T. N., M.D. : Medical Examination of Schools and Scholars. London. Published by P. S. King & Son, Orchard House, Westminster, S. W., 1910. BIBLIOGRAPHY 289 Knopf, S. A., M.D. : The Duties of the School Teacher in the Combat of Tuberculosis as a Disease of the Masses. Pp. 21-22. A special study of the dietaries of thirty-four families, all having undernourished children. Mackenzie, W. Leslie, M.D.: The Medical Inspection of School Children. Edinburgh and Glasgow. William Hodge & Co., 1904. (Excellent summary of the effects of food in racial selection and the relation of nutrition to growth. Pp. 196-231 include tables of height and weight. Subject treated practically as aid to medical inspection.) .Mendel, Lafayette Benedict: (a) Some Features of Nutri- tion During Growth. Jour, of Home Economics, Vol. HI, June, 1911. (A helpful discussion of the peculiar needs of the growing body.) (&) Childhood and Growth: a paper read Oct. 6, 1905, before the New Haven Mothers' Club, with an introduction by Horace Fletcher. New York, the F. A. Stokes Company, 1906, 54 pages. Oppenheim, Nathan: The Care O'f the Child in Health. New York and London, The Macmillan Company, 1900, vii, 308 pages. Sill, Dr. E. Mather: (a) A Study of Malnutrition in the School Child. In the Jour. Amer. Med. Assoc, vol. Hi, No. 25. (A study of causes. The home conditions, meals, etc., of 310 New York children suffering from malnutrition.) (b) Dietary Studies of Undernourished School Children in New York City. Jour. Amer. Med. Assoc, Nov. 26, 1910, p. 1886. 19 290 BIBLIOGRAPHY Taylor, Charles Keen: The Psychological Clinic, April, 1912. (Describes the result of comparing the school progress and conduct marks of children drinking coffee and those not drinking coffee. Two tables.) Wood, Thomas Denison : Health and Education. The Ninth Yearbook of the National Society for the Study of Education, Part i. Published by the University of Chicago Press, Chicago, 111., 1910. Net $0.75, postpaid $0.80. (Gives tables of standard v^^eights and heights of American children at different ages and based on meas- urements during ten years, of boys and girls in Horace Mann School, New York. These compared with and checked up by work of Hastings and Bowditch.) VIII. Periodicals Archiv fur Volkswohlfahrt: Deutscher Verlag fur Volks- wohlfahrt. G. m. b. h., Berlin, W. Nollensdorfstrasse, 30. The British Medical Journal, London: (The management of this journal has taken an active interest in School Feeding since it started in Great Britain, and has pub- lished frequent articles on the subject.) The Child: Published monthly by John Bale Sons & Danielsson, Ltd. $0.50 per copy, $5.25 a year. 83-91 Great Tichfield Street, Oxford Street, London, W. Concordia: Zeitschrift der Zentralstelle fiir Volkswohlfahrt. Berlin, S. W., 11 Dessauerstrasse. BIBLIOGRAPHY 291 Internationales Archiv fur Schulhygiene: Quarterly publica- tion by Otto Gmelin, Miinich, Liebherrstrasse 8. Organ of the permanent committee of the International Con- gresses on School Hygiene and of the International Society for School Hygiene. Collaborating editors and publishers, Dr. Albert Matthieu, Paris; Sir Lauder- Brunton, M.D., London ; Dr. Med. Axel Johannesen, Christiania; Dr. Med. et phil. Herman Griesbach, Muhl- hausen, Basel. The Journal of Home Economics: Published bi-monthly by the American Home Economics Association. $0.40 per copy, $2.00 a year, Roland Park Branch, Baltimore, Md. The Lancet: London, 423-424, Strand. (Frequent discussions on subject from medical standpoint.) La Medicine Scolaire: Bulletin de la Societe des Medicins Inspecteurs des ficoles. Paris, Charles Delagrave, 15 Rue Soufflot. Progress: Organ of the British Institute of Social Service, II Southampton Row, London, W. C. Quarterly. Per annum 2s. 6d. (An English " Survey.") Second International Congress on School Hygiene (see be- low) : London, 1907, Royal Sanitary Institute, London, 1908, 3 vols. (Considerable discussion of School Feeding.) School Hygiene: Published monthly by the School Hygiene Publication Co., Ltd. Price 6d. net per copy, 7s. 6d. a year. 2 Charlotte Street, London, W. Der Schularst (supplementary publication) : Organ of the School Medical Inspectors of Germany. Published and edited by the same people as Zeit. f. Schulges. ( See below.) 292 BIBLIOGRAPHY (Treats subjects of school hygiene from a definitely technical standpoint.) The Survey: A journal of constructive philanthropy, pub- lished by the Charity Organization Society of the City of New York, 105 E. 226. Street, New York, and 35 Dearborn Street, Chicago. Price $2.00 a year. Zeitschrift fiir SchulgesundheitspUege' Edited by Dr. Stephani, Mannheim, pub. Leopold Voss, Hamburg. Monthly, annually, sub. 12 marks. IX. Switzerland Erismann, Dr. F. (Stadtrat, Zurich, Director of Medical Inspection) : Ernahrung und Kleidung diirf tiger Schul- kinder. 36 pages. In Jahrb. der Schweiz. Gesellschaft fiir Schulgesundheitspflege. IX Jahr., 1908, Ziirich. (Account of school feeding in Switzerland, with critical analysis of food values of meals in Zurich and Basle. The only general account of the present Swiss system printed.) 1889, Switzerland : Zeit. f. Schulges., Vol. II, 1889, pp. 54 and 90-91. (Enumeration and description of societies for school feeding then existing.) X. United States Anderson, Alma: Hot Lunches for the Country School. School Education, 31 : 18, March, 1912. Anderson, Elizabeth N. : " After Bread — Education." Teacher, 11:9-11, Jan., 1907. BIBLIOGRAPHY 293 Ayres, Leonard P.: Open Air Schools, 1910, New York, Doubleday & Page, Chapter VI. (Describes feeding in Open Air Schools.) BoNNELL, Henry H. : First Annual Report of the School Lunch Committee of the Home and School League. Philadelphia, December, 191 1. (Account of lunches in Philadelphia schools, with particular reference to experimental work and study of home conditions. 7 tables.) BouGHTON, Alice C. : (a) Administration of School Lunches, Psychological Clinic, April, 1912. (Problems of administration and how they are being met in Philadelphia.) (b) Penny Luncheons. Psychological Clinic, Jan. 15, 191 1. (Plan of work under auspices of Home and School League.) (c) Report of the Penny Lunches Served in the Starr Centre Association, Philadelphia. In The Journal of Home Economics, April, 1910. ((f) School Luncheons, Jour, of Home Economics, vol. iii, No. I, Feb., 191 1. Bryant, Louise Stevens: (a) The Feeding of School Chil- dren, Dietetic and Hygienic Gazette, Sept., 1910, vol. xxvi. No. 9, pp. 527-536. (Summary of history, detailed description of Brad- ford system, correlatioTi of malnutrition with other physical defects, and mental defects. Two charts.) (fc) School Feeding in Europe. Journal of Home Economics, April, 1910, pp. 149-159- 294 BIBLIOGRAPHY (A summary of the present condition of school feeding in France, England, Germany, Italy and other European countries.) (c) The School Feeding Movement. Psychological Qinic, April, 1912. (General historical summary of work abroad, together with special investigations into underfeeding among American school children. Four tables.) Bull, Mary L. : Domestic Science in Rural Schools. Minnesota Farmers' Library, Vol. II, No. 7, Univ. of Minn., Extension Div. (Suggestions for warm lunches in rural schools, with simple recipes.) BuRNHAM, Wm. H. : Food and Feeding. Cyclopedia of Education, Vol. II, p. 627-630. New York, Macmillan, 1911. (Sections on Nutrition, School Lunches in America and England, careful argument for School Lunch as part of school life and equipment. Bibliography.) Chapin, Robert Cort. : The Standard of Living Among Workingmen's Families in New York City. Published by the Russell Sage Foundation. New York, Charities Publication Committee, 1909. (The factor of food is treated prominently. Estimates are given of the percentages O'f " underfed families " in New York City, grouped according to the income. Under- feeding exists in 76 per cent, of the cases where the family income lies between $400 and $699 and is found to lessen as the incomes rise, until only 9 per cent, of the families receiving $900 to $1099 a year are underfed, and disappears with the income of $1100 and over.) BIBLIOGRAPHY 295 Chicago Board of Education: Chicago Public Schools: Reports on Underfed Children. Chicago, 1908, 23 pages. CuRRAN, Margaret Craig: Warm Lunches in Country- Schools. Northwest Journal of Education, 23 : 161-168, December, 191 1. Devine, Edward Thomas: (a) Feeding the School Children in New York. Charities and the Commons, 20 : 381-382, June 20, 1908. (b) Underfed Child in the Schools. Charities and the Com- mons, 20 : 413-416, June 27, 1908. Dunbar, O. H. : Three-cent Luncheons for School Children. Outlook, Jan. 7, 191 1, vol. xlvii, pp. 34"37- (Account of New York work to date.) Farrell, Elizabeth : School Lunches in the Special Classes of the Public Schools — A Suggestive Experiment. Charities, 13:569^571, March 11, 1905. Garber, John E. : Annals of Educational Progress, Phila., 1911. (Section on School Lunches.) Hamilton, James H. : (a) The School Children's Lunch Room. In Charities and Commons, 20, 1908, No. 12, pp. 400-402. (b) The Heritage of the Hungry. Compulsory School Attendance and the Underfed Child. (Reader Magazine, New York, 6:365-373, Sept., 1905-) HoLLOPETER, Dr. W. C. : The School Child's Breakfast. In the Journal of the American Medical Association, vol. liii, No. 21, Nov., 1909, p. 1727. ^96 BIBLIOGRAPHY (Frequency of underfeeding reported in Great Britain. Breakfastless children in this country. Poverty the real cause only in small proportion. Real cause, the un- hygienic condition of the home that must be remedied.) Hunter, Robert : The Child. In his " Poverty," New York. The Macmillan Company, 1904, pp. 190^260. KiTTREDGE, M'ABEL H. I Experiments with School Lunches in New York City. In the Journal of Home Economics, April, 1910. Mayer, M. J.: Vital Question of School Lunches. Review of Reviews, vol. xliii, 455-459, April, 191 1. MowRY, Mrs. D. : Penny Lunches in Milwaukee Public Schools. American City, vol. iv, 283-288, June, 191 1. Nearing, Scott : Underfed School Children, in his " Social Adjustment," Philadelphia, 191 1. Northend, M. H. : Children's Luncheons. Illustrated. Harper's Bazar, New York, Jan., 191 1. Perkins, Frances: Some Facts Concerning Undernourished Children. The Survey, vol. xxv, pp. 68-72. (Home conditions of several hundred underfed school children in New York City.) Phillips, Walter L. : School Lunches at Lansdowne, Pa. School Progress, April, 1911. (An account of lunches in a consolidated school where 75 per cent, of the pupils cannot go home at noon.) Richards, Ellen H., and Talbot M. : Food as a Factor in Student Life, Chicago, 1894. BIBLIOGRAPHY 297 Rose, Mary Schwartz: The School Dietitian. The Psycho- logical Clinic, April, 1912. (Requisites for the new profession of School Dietetics.) Spargo, John: The Problem of the Underfed Children in Our Public Schools. Independent, 58, io6or-io63, May 11, 1905. Superintendents' Reports: New York, Buffalo, Cleveland, Rochester, St. Louis, Philadelphia, Houston, Chicago, Cincinnati, etc. Taylor, Charles Keen: The Moral Training of Children. Philadelphia, 1912. (Section on The School Lunch.) Torrey, Emmeline E. : Penny Lunch Movement. Good Housekeeping, 52, 242-244, 191 1. (Illustrated. Describes lunches in Boston Schools.) White, M. . L. : A Study of the Undernourished School Children of Baltimore. In The Journal of Home Economics, April, 1910. Wile, Ira S. : School Lunches. Journal of Home Economics. Vol. ii. No. 2, pp. 162-169, Roland Park, Baltimore, Md. (The need of the lunch for elementary pupils. Ex- tent and causes of malnutrition in the United States. Educative value of lunches. Food values. Variation in diet imposed by race and religion.) Worcester, Wood F. and Daisy W. : Woman and Child Wage-Earners in the United States. In 19 volumes. (Vol. XVI. Family Budgets of Typical Cotton Mill Workers. Extensive accounts and analyses of food con- ditions, expenditures, food values, etc.) APPENDICES APPENDIX A Education (Provision of Meals) Act, 1906 CHAPTER 57 An Act to make provision for Meals for Children attending Public Elementary Schools in England and Wales. [21st December, 1906.] Be it enacted by the King's Most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows : — Power of Local Education Authority to Aid School Canteen Committees in the Provision of Meals for Children 1. A Local Education Authority under Part III of the Education Act, 1902, may take such steps as they think fit for the provision of meals for children in attendance at any public elementary school in their area, and for that purpose — (a) may associate with themselves any committee on which the authority are represented, who will undertake to provide food for those children (in this Act called a " school canteen committee") ; and {h) may aid that committee by furnishing such land, buildings, furniture, and apparatus, and such officers and servants as may be necessary for the organisation, preparation, and service of such meals ; 299 300 APPENDIX but, save as hereinafter provided, the authority shall not incur any expense in respect of the purchase of food to be supplied at such meals. Recovery of the Cost of Meals 2. — (i) There shall be charged to the parent of every child in respect of every meal furnished to that child under this Act such an amount as may be determined by the local education authority, and, in the event of payment not being made by the parent, it shall be the duty of the Authority, unless they are satisfied that the parent is unable by reason of circumstances other than his own default to pay the amount, to require the payment of that amount from that parent, and any such amount may be recovered summarily as a civil debt. (2) The Local Education Authority shall pay over to the school canteen committee so much of any money paid to them by, or recovered from, any parent as may be determined by the authority to represent the cost of the food furnished by the committee to the child of that parent, less a reasonable deduction in respect of the expenses of recovering the same. Power of Local Education Authority to Defray the Cost of Food in Certain Cases 3. Where the Local Education Authority resolve that any of the children attending an elementary school within their area are unable by reason of lack of food to take full ad- vantage of the education provided for them, and have ascer- tained that funds other than public funds are not available or are insufficient in amount to defray the cost of food fur- nished in meals under this Act, they may apply to the Board APPENDIX 301 of Education, and that Board may authorise them to spend out of the rates such sum as will meet the cost of the provision of such food, provided that the total amount expended by a Local Education Authority for the purposes of this section in any local financial year shall not exceed the amount which would be produced by a rate of one halfpenny in the pound over the area of the authority, or, where the Authority is a County Council (other than the London County Council), over the area of the parish or parishes which in the opinion of the council are served by the school. Provisions as to Disfranchisement 4. The provision of any meal under this Act to a child and the failure on the part of the parent to pay any amount demanded under this Act in respect of a meal shall not deprive the parent of any franchise, right, or privilege, or subject him to any disability. Application of Education Acts 5. — (i) The powers of a Local Education Authority under this Act shall be deemed tO' be powers of that Authority under the Education Acts, 1870 to 1903, and the provisions of those Acts as to the manner in which the expenses of a Local Education Authority are to be charged and defrayed, and as to borrowing, and as to the manner in which the amount which would be produced by any rate in the pound is to be estimated, shall apply to expenses incurred and money borrowed under this Act, and to the estimate of the produce of any rate in the pound for the purposes of this Act. (2) Any expression to which a special meaning is attached in the Education Acts, 1870 to 1903, shall have the same 302 APPENDIX meaning in this Act, except that for the purposes of this Act the expression " child " shall, notwithstanding anything in section forty-eight of the Elementary Education Act, 1876, include any child in attendance at a public elementary school. Provision as to Teachers 6. No teacher seeking employment or employed in a public elementary school shall be required as part of his duties to supervise or assist, or to abstain from supervising or assist- ing, in the provision of meals, or in the collection of the cost thereof. Extent of Act 7. This Act shall not apply to Scotland. Short Title 8. This Act may be cited as the Education (Provision of Mteals) Act, 1906. APPENDIX B Circulars Issued by the Board of Education I. Circular 552. Board of Education, Whitehall, London, S. W., Sir, January ist, 1907. The Education (Provision of Meals) Act, 1906, which came into operation on the 21st day of December, 1906, gives to Local Education Authorities, for the first time, statutory powers in regard to the important matter of the provision of meals for children attending our public elementary schools. APPENDIX 303 It brings those Authorities into recognised relation with the voluntary agencies which already exist in many localities for providing meals for school children, and gives them power to aid such agencies by provision of kitchens, dining-rooms and plant, as well as of cooks, servers and other necessary officers. It further empowers the Authorities, where sufficient funds for the purchase of food from voluntary contributions and parents' payments are not forthcoming, to spend money from the rates for the provision of food for such meals within the limit of a halfpenny rate. The Act, which is purely permissive and imposes no duty where a Local Education Authority think it unnecessary to bring it into operation, is primarily of an educational char- acter. Its object is to ensure that children attending public elementary schools shall, so far as possible, be no longer prevented by insufficiency of suitable food from profiting by the education offered in our schools, and it aims at securing that for this purpose suitable meals shall be available just as much for those whose parents are in a position to pay as for those to whom food must be given free of cost. It is obvious that the passing of this Act opens up possibilities of a most beneficial nature, if its operation is handled with full circumspection and on carefully thought-out lines by the local authorities and voluntary agencies to whom these great responsibilities are entrusted by Parliament; since it furnishes unrivalled opportunities to the earnest, yet wise, social reformer for mitigating some of the deepest physical injuries that beset the children of the rising generation, par- ticularly in " slum areas," without necessarily involving (if care and thought be exercised in its administration) undue intervention by the State in the sphere of parental respon- 304 APPENDIX sibilities or in the duties and influences of any properly- ordered home. For those who desire information as to the various ways in which this most important and difficult problem has in recent years been handled, the Reports of the Departmental Committee and the Select Committee lately issued as Blue Books, Cd. 2779, price i.y. 3d. (by post is. 6d.) [Evidence, Cd. 2784, price 3^. (by post 3s. 5d) ] and H.C. 288, price 4y2d. (by post 6d.) [or, including Evidence, price 2s. 4d. (by post 2s. 8c?.)] will be found extremely useful; and the Board of Education hope that some preliminary help may, perhaps, be afforded by their issue of the following summary of the contents of the Act, together with the further observa- tions upon a few matters appearing to require special notice, which are given belo'W. I. The Act is applicable to every County and Borough and Urban District Council in England and Wales which is an Education Authority under Part III. of the Education Act, 1902. 2. — (a) It is probable that in most places where a Local Education Authority decide to make use of some of the new powers given them by the statute they will find it expedient to act through the agency o^ one of the voluntary Associations or Committees which, in so many localities are already in existence, have amassed much valuable experience, and are doing admirable work in the provision of meals for school children. In order that the Authority may in these cases supplement the work of such a Committee, or grant to it any of the forms of aid referred to in the first paragraph of this letter, arrange- APPENDIX 305 ments must be made for securing adequate repre- sentation of the Authority upon it in accordance with the Act (unless that is already provided for by the constitution of the Committee or Association). This may be done either directly by appointing one or more members of the Authority to serve on the Committee, or in- directly by nominating as representatives of the Authority outside persons, some of whom might, if desired, be selected from among existing members of the Committee. (6) In those cases, on the other hand, where there is no sufficient agency already in existence, the Local Education Authority may themselves establish a Committee ot obtain the establish- ment of one in any manner which may com- mend itself, subject to the requirement as to representation of the Authority. 3. These Committees for the supply of food are henceforth to be known as "School Canteen Committees" (Section i (a)); and with a School Canteen Committee thus in exist- ence, whether directly established by the Local Education Authority or having representatives o-f the Local Education Authority upon it, three valuable consequences will follow from the adoption of the Act: — (i) The Authority will have power to make such pro- vision or such supplementary provision as may be found necessary, of kitchens, dining-rooms, fur- niture, and other plant, and also to pay persons to organise, cook and serve the meals. No doubt, as heretofore, much of this work will be done ao 306 APPENDIX by unpaid helpers — an arrangement which, in the case of those who assist in organisation, or man- agement, or visiting parents, has many advantages if such helpers are of the right type and can bring to the work the benefits of regular oppor- tunities for keeping in useful touch with the children out of school hours, and at their homes, (ii). Hitherto the Board of Education have not been able to permit inclusion of kitchens and dining- rooms in public elementary schools to be built with loans charged upon the rates. Henceforth, when desired by the Authority, the reasonable provision of such adjuncts will be passed by the Board in school plans. (Section i (&)). (iii) One grave difficulty in the way of the proper organisation of school meals has been noticed by the Select and Inter-Departmental Committees which have dealt with the question of such meals. There has been no method by which it could be ensured that a parent whose child has had food should pay the cost of the meal, when he is well able to bear the expense. This difficulty is now removed. By Section 2 (i) the Authority are directed to make a charge to the parent for every meal supplied to his child, and in the event of non-payment it becomes their statutory duty, un- less they are satisfied that the parent is unable to pay by reason of circumstances other than his own default, to recover the sum so charged from him by summary procedure before the magistrates. 4. The amount of the charge for a meal is not prescribed by the statute, nor is anything laid down as to the mode of APPENDIX 307 payment; these matters are left to the discretion of those responsible for the working of the Act. It is desirable that, when parents are in a position to pay it, the Authority should fix such a charge as will normally cover, not only the cost of the actual food, but also' the cost of cooking and serving. They will also, probably, do well, wherever pos- sible, to insist upon prepayment. Where parents cannot pay the full cost, they will often be able to pay part cost. For reasons which need not be here stated, it is better that they should pay whatever their means permit, rather than that meals sho>uld be given free of cost. 5. So far these observations have been confined to the ordinary case of a locality where — with or without assistance from the Local Education Authority in providing rooms, plant and service — the expenses of the School Canteen Com- mittee as regards the actual provision of food are defrayed, without any recourse to the rates, from such sources as parents' payments, voluntary contributions and endowments. Under this system there will generally be no difficulty in providing, where it is so desired, a school dinner at a fixed price in the middle of the day, attended by children for whom, by reason of distance from the school or because the mother's absence makes a home meal difficult, the parent prefers to take advantage of an arrangement similar to that now in operation in most secondary day schools. It will also, as a rule, be possible to provide a meal free, or at a nominal cost, for poorer children during periods of severe weather or industrial distress, or to meet individual cases of temporary want of employment. 6. There will remain, however, a few exceptional cases where the money available from the sources alluded to above 308 APPENDIX is insufficient to meet the cost of the necessary food. For these, provision is made in Section 3 of the Act which em- powers a Local Education Authority to apply to the Board of Education for sanction to spend money to a limited amount out of the rates in the purchase of food. When an Authority desire to make use of this power they must first pass a resolution that some of the children attending an elementary school within their area are unable by reason of lack of food to take full advantage of the education provided for them, and they must further ascertain that funds other than public funds are not available, or are insufficient in amount, to defray the cost of food furnished in meals provided under the Act. Armed with this resolu- tion and information, they must apply to the Board of Education for the requisite sanction. Before exercising their power under this section, the Board will consider the cir- cumstances of the case and the extent of the emergency which has to be met, and will also require to know what sum the Authority consider to be necessary to meet so much of the cost of the provision of food for a stated period, as cannot be paid for in any other manner, together with the grounds for that view. The Board do not propose to give any permanent sanction or even one extending over a period of years. They will deal in each case with the particular emergency, and their sanction will, as a rule, be limited to the raising of a definite sum from the rates. Should such sum prove to be insufficient, it will be open to the Authority to apply for, and to the Board to sanction, the raising of an addi- tional sum, and so on from time to time as occasion may re- quire, subject always to the condition that the amounts raised from the rates for this purpose in the area of the Authority in APPENDIX 309 any single year shall never exceed the produce of a half- penny rate. 7. In London and in the areas under Local Education Authorities for County Boroughs, Boroughs and Urban Districts the limit will be found by ascertaining the produce of a halfpenny rate for the whole area, but for areas under County Councils the mode of calculation will be different ; here the halfpenny rate will be calculated over the area of the parish or parishes which, in the opinion of the Council, are served by the school (Section 3). It should be noted, however, that, though this calculation will give the limit of the money which may be raised, the money will not be actually raised over the area mentioned. Thus, where a halfpenny rate over the parish or parishes served by the school in connection with which a meal is to be provided produces, say, 20I., that amount will be actually raised on the whole elementary education area of the County Council and not solely from the particular parish or parishes (Section 5 (i)). 8. For the general working of the provisions of the Act by the Local Authorities and the School Canteen Com- mittees, the Board of Education do not propose to issue any Regulations, but to leave them full discretion, within the statutory conditions, for dealing with the necessarily varied circumstances of the different areas, or of different schools within any one area, in the manner best suited thereto. There remain, however, a few points, in addition to those named above, to which the Board think it right to call attention in this Circular. 9. First, it has been found that there has been a tendency in some of the places where the work of providing school meals has already been in operation, to require teachers to 310 APPENDIX take part in the management and supervision of school meals as part of their ordinary duties. The Board, like the Com- mittees which have reported on this matter, recognise fully the admirable work which has been done in this direction by teachers all through the country. They consider, however, that there is a danger that too much of the teacher's time and energy may be taken up in this serving of tables, and they hold that, while teachers should not be forbidden to take part in work which is to them of absorbing interest, their help should be used as sparingly as possible and that in no case should they be required to take any part at all. The Act accordingly contains the following special provision on this matter : — " No teacher seeking employment or employed in a public elementary school shall be required as part of his duties to supervise or assist, or to abstain from supervising or assist- ing, in the provision of meals, or in the collection of the cost thereof (Section 6)." 10. Next, the Board concur also with the various Com- mittees in holding that it is undesirable that meals should be served in rooms habitually used for teaching purposes. The first use for school-rooms and class-rooms is for teach- ing. Nothing, therefore, should be done in them to inter- fere with their proper ventilation before and after school meetings, or to cause disorder and uncleanliness. At the same time, the Board recognise that in some cases meals can be served in rooms used for teaching without detriment to such use, and that circumstances may arise where these are the only rooms available. 11. It will be observed that the Act does not in any way prescribe the time at which the meal should be served. Evidence is in the possession of the Board showing that APPENDIX 311 while, perhaps, a midday dinner is the meal which usually meets with most favour from the existing voluntary agencies, there are many which for good reasons consider that break- fast is preferable. Again, there is an opinion prevalent in many quarters that a school meal may in certain schools advantageously take the form of milk, which may be served either at the opening of morning school or in the course of the morning at the recreation interval. 12. The Act contains no specific reference to the Boards of Guardians, but in a well-organised system which attempts to provide free or cheap meals for destitute children, it is obvious that touch must be kept with the Guardians, and in- formation in their possession or at their disposal must be used. As a rule it would be desirable that there should be one or more Guardians on the School Canteen Committee. Where there is in the locality a branch of the Society for the Prevention of Cruelty to Children, the help of that Society may also Tdc enlisted with great advantage, and the same remark applies to other persons and agencies whose work brings them into intimate relation with the life and needs of the children at our elementary schools and their parents, such as district visitors, health visitors, and the like. 13. Lastly, when a system of medical inspection of school children such as already exists under several Local Educa- tion Authorities has been established, the School Canteen Committee, so far as its operations are concerned with under- fed, ill-nourished or destitute children, should work in intimate connection with the school medical officer. I have the honour to be, Sir, Your obedient Servant, Robert L. MbRANT. To the Local Education Authority. 312 APPENDIX APPENDIX C Form Used by the City of Bradford Education Committee IN Order to Ascertain the Circumstances of the Families of the Children for Whom Application is Made for the Provision of Meals. city of bradford education committee Provision of Meals Act, 1906 Name of Child or Children School Address Name of Father Age. . . .Occupation. Employer Name of Mother Age .... Occupation . Employer Name of each other member of family, age and occupation Weekly wages when full time i....s d. Average income for last four weeks i....s d. Total income Deduct rent Net income APPENDIX 313 If Father out of work, how long so ? If Father sick, how long so, and by whom attended?, If in receipt of Relief, state amount. Character of Parent Remarks, especially as to any other sources of income or expenditure, e.g., Doctor's Bills, Insurance, etc Date Visitor At the expiration of each month an entry as to change of circumstances should be made below: Date Date Date Date Date, Date Date Date Date Date. Submitted to Committee on RESULT APPENDIX D Regulations for the School Breakfasts in Stuttgart I. In accordance with an order of the City Council a warm breakfast is provided for school children at one centre in every public school district, which shall be served either free or at cost, as follows: 314 APPENDIX 2. Only those children may participate in the breakfasts who are designated after application to the special commis- sion. Only those can receive a meal free whose necessity is assured. 3. The application must be made by the parents or guardians of the child through a teacher and must include answers to certain questions, such as whether the meal is desired at cost or free; what the daily income of the family is and how great the number of children under 16. If the information given is satisfactory a further investigation is not necessary. For this purpose the class teacher will give to each child a questionnaire in a closed envelope which will include a return slip. The teacher must add to this in- formation a statement as to the physical condition of the children and any points omitted by the parents. This card is then forwarded to the commission after passing through the hands of the school superintendent. In so far as the information given is unsatisfactory or insufficient the com- mission may supplement it by an investigation by charity officers, who in these instances are not to be regarded as acting under the Poor Law, but as special school officers. These inquiry officers are held responsible for the most careful investigations possible and must report these tO' the commission. A record of each case, including its final dis- position, must be kept. 4. The permits for free or paid meals are valid for any length of time which the City Council may decide. During this time new permits are issued only to those paying and to children who may have newly entered the school. Only in very special cases may free permits be given to other chil- APPENDIX 515 dren during this time. Permits given in these latter cases begin with the first school day of the next week. 5. Little booklets containing coupons are issued to the children. Each coupon entitles a child to a breakfast. The coupons are to be given every Saturday morning for the coming week. The class teacher is to have charge of both the free permits and the coupons that are paid for. 45 pf. (11 cents) is charged for the book of 6 coupons. This coupon is good only in the feeding centre in the district where the child belongs and is not to be transferred to another child. It is not permitted to offer more than one co'upon in one day. 6. The coupons must be gotten by the class teacher or principal every month according to the apparent number who will need them. An account is to be kept by the teacher or principal of every child receiving these coupons with the date. The amounts received for the bought coupons are to be reckoned up the first of every month. The free coupons are to have as a distinguishing mark a heavy line under the first few words, but this mark is to remain absolutely un- known to the children. 7. In case a child is removed from one school district to another the head teacher will transfer his name to the new school lists, indicating whether or not he is to have coupons and of what sort. If he moves out of Greater Stuttgart the coupons that have not been used shall be returned to the class teacher. The money shall be refunded on the coupons that have been paid for. These returned coupons are to be delivered to the central school authority every month. 8. Every Saturday the daily amount of milk and bread for S16 APPENDIX the various feeding centres shall be made out for the coming week according to the number of children who are enrolled to receive them. In the event of the school being closed for extraordinary reasons such as vacations given on account of conferences, etc., or epidemics of sickness, the principal of each school shall notify the central school authorities so that the day's supply of rations may be changed in accordance. 9. The director in each feeding centre must be responsible for having the milk and bread ready to be served, at the earliest one hour, at the latest three-quarters of an hour before the beginning of school. The director of the feeding centre must twice each month, on the isth, and on the last day, forward to the school authorities an account of the amount of food that he receives each day. He must also give a daily receipt to the contractor who delivers the goods. 10. The cans and baskets in which the milk and bread are delivered must remain at the feeding centre during breakfast. The milk must be kept so that it does not get cold before serving. Any bread and milk that may remain is to be given back to the contractors. An account is to be kept of this and the cost deducted and placed on credit. 11. Any delay in the delivery of the food must be reported at once to the school authorities. Likewise any other failure to carry out orders, such as food being delivered too early or too late, not enough being delivered, milk not being sufficiently warm, and so forth, is to be reported to the contractor at once, by telephone if possible, so that no delay shall be caused. Any broken contracts are to be reported at once to the school authorities. 12. The person in charge of each feeding centre is held APPENDIX 317 responsible for having the proper utensils and furniture ready each morning and for removing and cleaning them after breakfast. 13. The breakfast is to be served during the half hour before the beginning of the morning session, the hour of which varies as follows: The spring and the summer vaca- tion at 7 o'clock; after the vacation till the 15th of November at 8 o'clock; from November i6th to February 14th at 8.30; from February 15 to the end of the school year at 8 o'clock. Each child shall receive on presenting its coupon one- quarter of a liter of milk and a roll. The milk must be kept in the warm cans until immediately before serving and put into serving pitchers only at the last minute. The coupons received must be placed each day in special numbered and dated envelopes ready to forward twice a month to the school authorities. 14. Immediately after breakfast all the dishes and other utensils used at breakfast are to be washed in hot water and rinsed with cold, and the furniture in the room cleaned. The manager will be held responsible for the utmost clean- liness in all details of service. 15. A special place must be provided for the storage of utensils. 16. The children must not remain in the centre any longer than is necessary to eat their breakfast. They must maintain order, be quiet and follow the directions of the person in charge. Children who do not obey may have their privilege withheld by the commission for a longer or a shorter time. 318 APPENDIX 17. If teachers are present at the breakfast they shall have the supervision, otherwise the house master of the school, or in case he is not present the manager shall be held responsible for keeping order during breakfast. It is preferable to have the supervision done by a teacher. Where there are several centres for one district the house master, if he himself is not in charge of one centre shall go about and inspect each centre in turn. APPENDIX E Menus of seventeen dinners served on alternate days in the schools of the city of Bradford, England. The materials, the amount, the number of Protein and Fat grams and the cost, wholesale and retail, is given in each case. Dinner No. I. Green Pea and Vegetable Soup (clear) ; Boiled Jam Roly-Poly. Material Quantity g^^;^ J^^^^ Peas 3 oz- 324 12 Carrot i3^ oz. 3 2 Turnip PA oz. 6 i Onion iji oz, 6 i Bread iK oz. 60 9 Flour i^/^ oz. 75 6 Nutter Suet % oz. 49 196 Jam Yi oz. I Wholesale Price — 2 cts. 524 227 Retail " —2.5 cts. (34 grams) (15 grams) APPENDIX 319 Dinner No. II. Brown Haricot Soup, Dumplings; Baked Jam Roll ,- . . /-^ i-i Protein Material Quantity (grains) Beans i}^ oz. 133 Carrot K oz. i Onion i oz. 9 Flour % oz. 36 Nutter Suet }^ oz- 22 Milk Powder K oz. 81 Bread iK oz. 60 Flour i}^ oz. 75 Margarine ^ oz. 4 Jam Yi oz. I Wholesale Price — 2 cts. 422 Retail " —2.3 cts. (27 grams) Dinner No. III. Lentil Soup; Ginger Pudding and Sweet Sauce. Material Quantity Protein Lentils 3 oz. 305 Carrot i oz. 2 Turnip i oz. 4 Onion i oz. 6 Bread iK oz. 60 Flour i}^ oz. 59 Bread Crumbs K oz. 20 Nutter Suet % oz. 49 Golden Syrup i oz. Ginger Ke oz. Baking Powder Ke oz. Milk M20Z. H Margarine % oz. Sugar 1K2OZ. Wholesale Price— 2.45 cts. 529 Retail " —3.27 cts. (34 grams) Fat (grains) 13 I 2 3 88 2 9 6 279 403 (26 grams) Pat 26 I I I 9 5 3 196 30 62 334 (22 grams) 320 APPENDIX Dinner No. IV. Savory Batter, Gravy and Beans; Rice and Currants. Material Quantity Protein Fat Meat I oz. 8i 89 Milk ^ oz. 35 44 Flour I oz. 50 4 Egg K oz. 23 18 Beans iK oz. 150 15 Butter J^ oz. ... 46 Bread i}^ oz. 60 9 Milk % pint . 35 44 Rice }^ oz. 17 Sugar Yi oz. Currants and Sultanas K oz. 2 2 Wholesale Price — 2.5 cts. 453 191 Retail " — 3.1 cts. (29 grams) (12 grams) Dinner No. V. Baked Lentil Savory, Green Peas and Bean Gravy; Milk Pudding and Stewed Fruit. Material Quantity Protein Fat Lentils % oz. 74 6 Rice ^ oz. 8 Potato K oz. 4 Bread Crumbs )^ oz. 20 3 Onion % oz. 4 Egg K20Z. 8 4 Margarine 3^ oz. ... 62 Peas iVi oz. 162 6 Beans J^ oz. 50 5 Bread iK oz. 60 9 Milk Yi pint. 70 88 Rice J4 oz. 17 Fruit 3 oz. 4 Sugar % oz. Wholesale Price — 2.5 cts. 481 185 Retail " —3.4 cts. (31 grams) (12 grams) APPENDIX 321 Dinner No. VI. Yorkshire Cheese Pudding, Peas and Bean Gravy; Buttered Rice and Sugar. Material Quantity Protein Fat ^^ 3^ pint. 35 44 Floiir I oz. 50 4 Egg M oz. 23 18 Cheese i oz. 122 162 Peas ii^ oz. 162 6 Beans 1^ oz. 50 5 Bread i^ oz. 60 9 Rice 3^ oz. 25 Sugar y^ oz. Margarine 14 oz. i 93 Wholesale Price — 2.54 cts. 528 341 Retail ' — ^3 cts. (34 grams) (22 grams) Dinner No. VII. Cornish Pie (vegetarian), Green Peas and Bean Gravy; Blanc- mange and Jam. Material Quantity Protein Fat Potato 2K oz. 20 I Apple I oz. I I Onion 2 oz. 12 2 Lentils 2^ oz. 74 6 Flour 13/ oz. 87 7 Margarine 3^ oz. 3 279 Peas i3^ oz. 162 6 Beans }^ oz. 50 5 Bread i'4 oz. 60 9 Milk % pint. 46 58 Cornflour ^ oz. 8 i Sugar % oz. Jam 1^ oz. I Wholesale Price — 2.62 cts. 524 375 Retail " —3.29 cts. (34 grams) (24 grams) 21 S22 APPENDIX Dinner No. VIII. Cheese and Lentil Savory, Bean Gravy; Milk Pudding and Fruit. Material Quantity Protein Fat Cheese i oz. 122 162 Lentils % oz. 68 6 Onion K oz. 3 i Bread Crumbs }^ oz. 13 2 Margarine % oz. 62 Beans K oz. 50 4 Bread i^ oz. 60 9 Milk , M pint. 70 88 Rice )^ oz. 17 Sugar % oz. Fruit 3 oz. 4 Wholesale Price — 2.71 cts. 407 334 Retail " — ^3.58 cts. (26 grams) (22 grams) Dinner No. IX. Baked Cheese and Potato Pie, Peas and Bean Gravy; Bread and Fruit Pudding. Material Quantity Protein Fat Cheese i oz. 122 162 Potato 3 oz. 24 I Bread Crumbs K oz. 20 3 Egg J^ oz. 15 12 Rice Yi oz. 9 Margarine Yz oz. 124 Peas 1% oz. 162 6 Beans H oz. 50 4 Bread i J^ oz. 60 9 Bread i oz. 40 6 Fruit 3 oz. 4 Sugar J^ oz. Wholesale Price — 2.77 cts. 506 327 Retail " — 3.59 cts. (33 grams) (21 grams) APPENDIX S2S Dinner No. X. Meat Hash, Savory Balls and Rice; Stewed Fruit. Material Quantity Protein Pat Beef 3 oz- 243 26 Onion iK oz. 9 2 Carrot i oz. 2 i Turnip i oz. 4 i Flour and Bread Crumbs % oz. 41 5 Nutter Suet K oz. 16 66 Rice % oz. 26 I Bread iK oz. 60 9 Fruit 3 oz. 4 Sugar K oz. Wholesale Price — 2.9 cts. 405 in Retail " —4.5 cts. (26 grams) (7 grams) Dinner No. XI. Cottage Pie (Meat with Crust), Green Peas and Gravy; Stewed Fruit. Material Quantity Protein Fat Beef 2 oz. 162 17 Potato 3 oz. 24 I Onion i oz. 6 i Flour 1% oz. 87 7 Margarine ^4 oz. 3 279 Peas 1% oz. 162 6 Bread i J^ oz. 60 9 Fruit 3 oz. 4 Sugar % oz. Wholesale Price— 3 cts. 508 320 Retail " —4.27 cts. (33 grams) (21 grams) 324 APPENDIX Dinner No. XII. Scotch Barley Broth; Rhubarb Tart. Material Quantity Protein Fat Beef 2^ oz. 202 22 Carrot i oz. 2 i Turnip i oz. 4 i Onion 1)2 oz. 6 i Barley % oz. 14 3 Bread i)^ oz. 60 9 Flour ij^ oz. 75 6 Margarine ^^ oz. 4 279 Fruit 3 oz- 4 Sugar /^ oz. Wholesale Price — 2.9 cts. 371 322 Retail " — 4.2 cts. (24 grams) (21 grams) Dinner No. XIII. Fish and Potato Pie, Green Peas, Lemon Sauce; Blancmange and Jam. Material Quantity Protein Fat Fish 4 oz. 66 5 Potato 5 oz- 48 2 Margarine K oz. 74 Flour K oz. 10 I Milk Yqo pint. 14 18 Lemon M4 oz. Peas 1% oz. 162 6 Bread i}^ oz. 60 9 Cornflour K oz. 8 i Milk Ye pint. 46 58 Sugar Yg oz. Jam }^ oz. Wholesale Price — 3 cts. 414 174 Retail " — 4.46 cts. (27 grams) (11 grams) APPENDIX 325 Dinner No. XIV. Meat and Potato Hash, Beans and Gravy; Milk Pudding and Fruit. Material Quantity Protein Fat Beef i}i oz. 122 13 Potato 4 oz. 32 I Carrot % oz. Onions iK oz. 9 i Beans 1% oz. 147 12 Margarine }^ oz. 46 Bread i}^ oz. 60 9 Milk Yi pint. 70 88 Rice K oz. 17 Sugar ^^ oz. Fruit 3 oz. 4 Wholesale Price — 3 cts. 461 170 Retail *' — 4.35 cts. (30 grams) (11 grams) Dinner No. XV. Meat Pudding, Cabbage and Gravy; Boiled Rice and Currants. Material Quantity Protein Fat Meat 2 oz. 162 17 Carrot i oz. 2 i Turnip i oz. 4 i Onion iK oz. 9 2 Flour iK oz. 75 6 Nutter Suet K oz. 49 196 Cabbage ji oz. Bread iK oz. 60 9 Rice K oz. 17 I Currants and Sultanas 3^ oz. 2 2 Sugar Yi oz. Milk X pint. 35 44 Wholesale Price — 3. 13 cts. 415 285 Retail *' — ^4.30 cts. (27 grams) (19 grams) Sm APPENDIX Dinner No. XVI. Rice and Cheese Savory, Cabbage and Bean Gravy; Whole- meal Cake. Material Quantity Protein Fat Milk % pint. 70 88 Rice i)^ oz. 52 I Cheese i oz. 122 162 Margarine }^ oz. 2 186 Beans % oz. 50 5 Cabbage % oz. Bread i)^ oz. 60 9 Wholemeal 1% oz. 60 9 Currants and Sultanas % oz. 8 7 Sugar % oz. Margarine Ke oz- 69 Wholesale Price — 342 cts. 424 536 Retail " — 4. 10 cts. (28 grams) (35 grams) Dinner No. XVII. Shepherd's Pie (Meat and Potato), Gravy; Milk Pudding, Stewed Fruit. Material Quantity Protein Pat Beef 3 oz. 243 26 Potato 6 oz. 48 3 Onion i oz. 6 I Bread i)^ oz. 60 9 Rice M oz. 17 Sugar % oz. Milk Yi pint. 70 88 Fruit 3 oz. 4 Wholesale Price — 3.49 cts. 448 127 Retail " — 5. 12 cts. (29 grams) (8 grams) APPENDIX 327 APPENDIX F Specimen Recipes of Hot Dishes Served in Philadelphia Schools. These Recipes are Kept on File at Each Kitchen. Cream of Pea Soup Four and one-half pounds dried peas; ten tablespoonfuls, or one-quarter pound butter; seven quarts milk; one quart water (rinse bottles) ; twenty tablespoonfuls or one and one- quarter cups flour; salt. (Serves 60. Portion, two-thirds of a cup.) Soak peas day before. Drain and wash. Put on to cook in large quantity of water. Cook until tender, adding salt when nearly done. Make white sauce in agate sauce-pan (care or will burn). Do not allow to cook directly over fire long enough to boil after each addition; but prepare long enough ahead to cook in double boiler about three-quarters of an hour before adding peas. Drain peas and add to white sauce about one-half hour before serving. Rice Pudding One quart rice ; one quart sugar ; four quarts water ; eight quarts milk; four teaspoonfuls salt. (To serve 48. Por- tion, two-thirds of a cup.) Wash and drain the rice, add with sugar and salt to the boiling salted water. Cook directly over the heat ten minutes. Heat milk in the double boiler and cook with the rice, etc., at least one hour — better two. To vary monotony, sprinkle cinnamon or nutmeg over the pudding or use one-half pound seedless raisins or one dozen dates cut in small pieces. 328 APPENDIX Corn Chowder Eight cans corn; eight quarts diced potatoes; one-half pound salt pork ; salt ; eight onions ; eight quarts milk ; six- teen crackers; pepper. (To serve 95. Portion, two-thirds of a cup.) Put milk and corn on in large double boiler to heat. Put water on in which to boil potatoes. They must be cooked in relays in order to get ready in time. Try out pork, add onions, and brown. Parboil potatoes five minutes. Then add to fat and onions with enough boiling water to prevent burning. Cook until tender and add the whole to the milk and corn. Season. About five minutes before serving, add the broken crackers. Cocoa Three cups cocoa; three cups sugar; four quarts boiling water; twelve quarts milk. (To serve 96. Portion, two- thirds of a cup.) Mix the cocoa and water together and cook directly over the heat ten minutes, stirring constantly to prevent scorching. Add it to the heated milk in which the sugar has been dis- solved and cook one-half hour in the double boiler. Beat well before serving. Bean Soup Four quarts or five and five-eighths pounds beans ; one pound salt pork (cut in pieces) or three pounds shin bone; two small onions ; two bunches potherbs ; twelve to sixteen quarters boiling water; three tablespoonfuls salt; pepper; two stalks celery, if cheap. (To serve 72. Portion, three- quarters of a cup.) APPENDIX 329 Pick over and thoroughly wash the beans. Soak them in cold water over night. Drain and rinse them, then add the boiling water, part of which is stock from the meat. Add the seasoning and cook until the beans are thoroughly soft. First day, soak beans ; second day, start cooking ; third day, finish cooking and serve. In schools where the Jewish- children are very orthodox, substitute butter for meat. 330 APPENDIX APPENDIX G Dietaries for Children of School Age Show- ing School Meals as Supplements to Other Meals, and Daily Cost and Food Value* 1. Dietary for Child 6 Years pf Age Assumed weight, 44 lb. Protein, 50-60 grams ; 1650 Calories BREAKFAST Oatmeal, Top Milk and Two Teaspoonfuls of Sugar Poached Egg-on Toast Toast and Butter Glass of Milk PENNY LUNCH Cup of Milk and Cracker DINNER Cream of Pea Soup Baked Potato Bread^and Butter Creamed Carrots SUPPER Glass of Milk Steamed Rice and Prunes i Zweibach Food Amount Protefn, trranis Calories Cost Oatmeal % cup 4.20 100 $0,030 Bread 4 slices 9.40 300 0.017 Butter 1 tablespoon 0.1.3 100 0.010 Egg 1 8.15 90 0.030 MUk % qt, 24.36 510 0.060 Sugar 2 tablespoons 0.00 100 0.000 Pea Sdup % cup 3.86 100 0.020 Potato 1 medium 1.32 75 0.005 Carrots, Creamed Vz cup 2.57 100 0.010 Rice 2 tablespoons 2.28 100 0.005 Prunes 5 0.70 100 1675 0.010 Totals 56.97 $0.1.73 Nutritive ratio 1 :& * Prepared by Normal Domestic Science Department. Drexel Institute, Philadelphia. APPENDIX 331 2. Dietary for Child 8 to 10 Years of Age Assumed weight, 60 lb. Protein, 60 grams ; 1760 Calories BREAKFAST Cream of Wheat with Dates Top Milk Glass of Milk Bread and Butter PENNY LUNCH Cocoa and Cracker DINNER Hamburg Steak Mashed Potato Bread and Butter Cup Custard SUPPER Milk Toast Creamed Onions Gingerbread Baked Apple Food Amount Protein. sr'nniK Calories Cost Cream of Wheat ^cup 3.04 100.0 $0,008 Dates 5 0.60 100.0 0.008 Bread 5 slices 13.20 377.0 0.020 MUk 1 pint 16.09 337.5 0.040 Cocoa Mqt. 4.55 124.0 0.010 Butter 2 tablesps. 0.26 200.0 0.020 Steak 2 oz. 12.50 65.0 0.025 Creamed Onions 4 3.20 100.0 0.005 Potato Vi cup 0.65 25.0 0.005 Cup Custard ^cup 4.40 100.0 0.040 Apple 1 0.25 75.0 0.010 Gingerbread H oz. 3.00 50.0 0.010 totals 61.74 1653.5 10.201 Nutritive ratio. 1:5:7 332 APPENDIX 3. Dietary lor Ctilcl 10 to 12 Years of Age Supplementary to Peimy and Three-cent Lunches Assumed weight, 80 lb. Protein, 70 grams ; 1800 Calories BREAKFAST Corn Meal Mush Milk and Sugar Glass of Milk Bread and Syrup PENNY LUNCH Cocoa and Cracker THREE-CENT LUNCH Bean Soup Peaches Bread DINNER Mutton Stew with Vegetables Bread Rice Pudding Glass of Milk Pood Auiount Protein Calofle!! Cost Com Meal 3 tablesps. 7.26 200.0 $0,005 Bread 5 slices 13.20 377.0 0.025 Milk 1 pint 16.09 337.5 0.040 Cocoa H quart 4.55 124.0 0.010 Bean Soup H quart 9.91 194.0 0.010 Peaches 2 halves 2.45 145.0 0.010 Mutton Stew 1 cup 15.00 200.0 0.060 Rice Pudding % cup 3.16 164.0 0.010 Sugar 3 tablesps. 0.00 200.0 0.010 Totals 68.62 1941.5 $0,170 Nutritive ratio 1 ;6 INDEX Absences, decreased, 139 discouraged, 103 Accounting, see Administra- tion Records, Cost, I54ff. Adenoids, 227, 231 Administration (see Organiza- tion, Support), 45, 54ff-. 6ofe.,66,67,7iflF.,77ffM8off., 93ff., 100, I07£E., ii4ff., I30ff., I38ff., I43» I45» 146, 147, isifif., i64ff., 168, 173, 174, 177, i84ff. Adulteration of foods bought in streets, 248ff. Advisory Board, 164 Agriculture, Division of .Univer- sity of Minnesota, 178 United States Department of, 240 Airy, Dr., on voluntary feeding societies, 32ff. Albuminuria, 228 Alcohol, cause of malnutrition, 214 taxes on, 134 use of by German chil- dren, 122 Allied movements, 74, 78, 102, 127 Alsace-Lorraine, 118 America, open air schools, 188-195 America, school lunches in, 18, 147-183 underfeeding, 196-210 Amount of food, see Dietaries, Food Values, Menus Anaemia (see Malnutrition), extent, symptoms, etc., 2i6ff. Anemic classes for children, i84ff., 191 Analysis, see Dietaries, Food Values, Menus Angers, pioneer town in France, 93 Anthropometric (see Measure- ments), British Association, 69, 222 Appetites, loss of, I24ff. training of, 50, 73 Applications for meals, 55, 135, 312, 314 Attendance, school, 16, 7iff., 103, 132, 140 Attention, 132, 167 Attic space, 180 Atwater standard of diet, 205, 235 Austria, 143 Ayres, Leonard P., 68, 226 Baden, 118 Belgium, 145, 263 Berlin, loi, 122 333 334 INDEX Bibliography, 263-297 Birkenhead, 70 Birmingham, 32, 39ff., 70 Blood, see Anaemia Boston, meals in, 1645. open air schools, i88ff. underfeeding, 203 Bowditch, measurements, 222 Box-office, 87 Boys, relative height and weight table, 223 Bradford, England, meals in, 37, 46ff. menus in, 2535., 3i8fiE. record blank, 312 Breakfasts, children without, i2off., I96ff. home, 12 iff., I96ff. school, see Different Countries' Menus, etc. Breath, bad, 212 Bristol, England, 70 Brooklyn, 148 Buffalo, 181, 200 Caisses des Ecoles, 15, 77ff., 81, 84, 134 Calories (see Food Values, Dietaries, etc.), defini- tion, 239 for one cent, 155, 166, 150 numbers needed, 241, 243 use of, 239ff. Canteen (see England, Legisla- tion), committees, 45, 54ff., 63, 299, 305 Cantines Scolaires, adminis- tration in, 8 iff., 93, 94ff. Cantines Scolaires, cost, giQ. definition, 79 educational features, 89 extent of, 9 iff. home visiting, 88 menus, 88, 258 substitutes for, 96 Carbohydrates (see Food Needs, Menus, Die- taries, etc.), amount needed, 241, 243 composition, 236 measurement, 2392. use of, 236ff. Caterer, 84 Causes (see Malnutrition, Un- derfeeding) , external , 1 4 , 68, 100, I23ff., 125, 131, I96ff. physiological, 204ff., 2i3ff. Cent, purchasing power, 249ff. value of, 155, 167 Chapin, Dr. Robert Coit, investigation of working- men's families, 204ff. Charity (see Voluntary), meals not, 5, 44, 80, 87, 98, 108, 137, 198 support of meals by, 16, 30ff., 41, 96, 103, 114 Charlottenburg, 11 off. Chemical, see Dietaries, Food Values, etc. Chicago, 19, 181, 199, 202ff. Children (see Underfeeding, Malnutrition, Food Needs, etc.), cruelty to, 68 INDEX 335 Children, help in serving, etc., 49. 50, 57. 73. 136, 165, 175,191 paying, 82, 93, 119, uyff. selection of, see Adminis- tration special food for delicate, 139 Children's Care Committees, 72ff. Children's Charter, 75 Children's Homes, 102, 105, 115 Child Labor, 124 Child Welfare, the State and, 5,6 Christmas, relief at, 38 Cincinnati, I73ff. Classification of nutrition, 230S. Classrooms, 179, 310 Cleanliness, 58, 152, 317 Clinic, 59 Clothes provided, 77, 130, 133 Coffee, drinking (see Food Habits), 121, I97ff., 208, 214 Collie, Dr., testimony on un- derfeeding, 225 Communal meal, 97 Composition, see Dietaries, Food Values, Menus Compulsory education, 78, 102, 116, 130 legislation, 67, 128, 133, 146 meals, i4off. military service, 106 Conduct, see Results Congestion, 18, 26, 104, 121 Conservation, national, 66 Control children, 48, 69, 150, i6off. Cooking classes, 144, 165 Co-operation in administra- tion, 116, 172 Correlation, see Diseases, Mal- nutrition, Measurements Cost (see Support, Administra- tion, etc.), in Open Air Schools, I49ff. keeping down, 253ff. meals at, 137, 147, 173 of meals in general, 45, 56ff., 63ff., 8 if!., 92ff., 119, 130, 135, 140, 145, 149, 248ff. Country, children sent to, 104 districts, meals in, 134, 144, 177 districts, need in, 127 Crowley, Dr. Ralph, on die- taries, 47, 243, 253-256 Cuff, Miss, Director Domestic Science, 253 Cuno, Dr., German investiga- tions, 116, 172 Danton, quoted, 77 Deficit, in home food, 121, 149, 208, 246ff. Degeneracy, factors making for, 28ff. Delitsch, Dr., of Plauen, on malnutrition, 126 Democratic, character of can- tines, 87 336 INDEX Denmark, 17, 146 Dental defects, 214 Dessert, 149, 259 Deterioration, fear of, 22ff. inquiry concerning alleged, 25 Diagnosis, 2296?. Dietaries (see Food Needs, Values, Menus, etc.), analysis, loi Bibliography, 263-271 for different ages, 24off. in different countries, 48, 111,141,148,1543., 165, 189, 242 planning, 46ff., 112, 129, 137, 141, 148, 154, 166 proportion of foodstuff in, 235ff- school, 242-247 Dietitian, 163 Diet Kitchen, 128 Dinners (see Menus, Food Values, etc.), late, 122, 208 Dining-rooms, 57, 129, 229, 306 Diseases, correlation of, with malnutrition, 126, 2273. percentage of, according to nutrition, 229 Disenfranchisement, non-pay- ment not to cause, 45, 301 Distance to school, 13, 124, 131. 137. 144 Distribution, foodstuffs (see Dietaries) meals, 56 Don, Surgeon-General, testi- mony of, 24 Dresden, 103 Duration of meals, 40, 112, ii7 Duray, Victor, Minister of Public Instruction, 79 Dyed food, 249 Dyer, Supt. of Schools in Cincinnati. 168 Ear trouble, 228 Economy, 253, 258 Edinburgh, 23 Educational features of lunches, 50, 57ff., 165 lunches primarily, 44, 301, 303 value to mental defectives, 175 Effects, see Resiilts Efficiency, physical, 205 Eichholz, Dr., testimony of, 27ff. England, Bibliography for, 276-284 deterioration in, 22-43 history of school feeding, I5ff., 22-43 legislation in, 41, 43-45, 63ff., 66ff., 299-311 malnutrition in, 23-43 open air schools, 184 provision of meals in, 43 Equipment, 45, 56ff., 147, 148, 152, i64ff., i69ff., 174, 178 Erismann, Dr., authority on diet, 134, I36ff., 243 Expenditure (see Administra- tion, Cost, etc.), of families on food, 204ff. INDEX 337 Expense, see Admmlstration, Cost, etc. Experiments (see Results) 35, 47-54. 69, 99. 147, i6off. Extent (see Underfeeding) of school feeding, 13, 14, 15, i6ff., I9flf., 31, 6off., 79ff., 91, 93ff., 100, 109, no, 114, 120, 127, 130, I3iff., 138, 143- 146, 151, 165, i8off. Extra-academic activities of school, 72 Families (see Home), underfed, 204ff. circumstances of, 312 Fat, deficiency of , 48, 249 emphasis, on 48, 166, 244ff., 257 food value of, source of, etc., 237, 240, 243, 249, 255 for one cent, 25off. Fatigue, 215 Feeding (see Nutrition) of infants, 26 selective agency, 28, 29 Fevers, 215 Filling as adulteration, 249 Financial, see Cost, Support, etc. Finland, 17 Fireless cookers, 169, 173, 178 Flushing, New York, 148 Food (see Food Values, Menus, Dietaries, etc.), choice oi, 85, 155 (see Admin- istration) Food, energy supplying, 236ff. measurement of, 239 mineral constituents, 238 tissue-building, 234ff. Food needs, adults, 235-238 Bibliography, 263-271 children, 235-238, 240, 247 difiEerent ages, 2402. graphic chart of, 241 Food values (see Menus and Dietaries), Bibliog- raphy, 263-271 consumed by families, 205 failure to meet standard, Ii3ff. lunches, planned and un- planned, 248ff. taught, 58, 179 Forced feeding, 184, 188 Foster, Captain, of Glasgow, investigation by, 219 France (see Cantines Scolaires, Caisses des l^coles). Bib- liography, 271-273 school meals in, 15, 77-98 Free meals, compulsory, i4off. in different countries, 18, 29. 55. 66, 73, 82, 87, 107, 108, 132, 137, 140 investigation before giv- ing, 55. 73. 108 (see Home Visiting, Parents) logical culmination of free education, 29 no distinction in case of children with, 55, 87 Fuel, value of food, 236ff. Furred tongue, 212 338 INDEX Gain, see Experiments, Results, Measurements Gambling, lunch pennies, 199 Gastpar, Dr., of Stuttgart, in- vestigations by, 217, 2272., 23 Gautier, Dr. Armand, food standards of, 241 Germany, Bibliography, 273- 276 food habits of children, 120-123 open air schools, 185 malnutrition in, 99ff., I22fif. school meals in, 14, 99-129 Girls, relative height and weight tables for, 224 Glands, diseased, 227 Glasgow, housing in, 219 Great Britain, see England Growth (see Results), provi- sion for, 233ff. Hair, rough, 212 Halifax, 69 Hall, Dr., of Leeds, on mal- nutrition, 35 Hamburg, 103 Hand-strength, tested, 160 Hands washed, 58, 152 Hastings, measurements, 222 Heart disease, 228 Health Board, see Medical Inspection, 66, no, 116 Heat forming foods, 236fiE. lost, 237 source of, 2335. Heat, units, 239 Height (see Result, Tables), 223, 224 significance of, 2i8fiF. Hereditary causes of malnu- trition, 214, 218 taint, 26 Hesse, State of, child labor laws, 116 High school lunches, 14, 173 History of school feeding move- ment, England, 22ff. France, 77ff. general, 13-21 Germany, I02ff. Holland, I30ff. Italy, I38ff. Switzerland, I3iflf. Holland, 130, 131 Holt, Dr. Emmet, on malnu- trition, 227 Home (see Follow-up Work, Parents), condition studied, 123, 159, 207 feeding, 100, i2off., 208, 252 standards raised, 57, 244 visiting, 104, in Home and School Association in Boston, 164 League, Philadelphia, isiff. Home Economics Association, 164 Horace Mann School, meas- urement of children in, 222 Housing, relation to nutrition, 209, 219-222 INDEX 339 Huber, Dr., Swiss investigator, 132 Hugo, Victor, starts school feeding in England, 15 Hungry, underfed children not, 35 Hunter, Robert, author of "Poverty," 196 Hutchinson, Dr., opinions on nutrition, 27 Hygiene, committee, 164 regulations for, io8ff., 3i5ff. school, 16 taught, 58, 72, 154 Ignorance combated, 43ff. relation to malnutrition, 204ff. Incomes (see Poverty Scales), and underfeeding, 2o6ff. Industrial schools, meals in, 18, 24 superior children, 24 Inspection, see Administration, Medical Inspection Irish- American menus, 260 children commonly under- fed, 28 Italy, Bibliography, 485 refezione scolastica, 138- 143 Juvenile degeneracy, influence of bad food on, 28 Kaup, Dr., dietaries, 246 German investigator, 1 1 fif . Kelly, Dr., Roman Catholic Bishop of Ross, testimony of, 28 Kindergarten, 145 Kitchen (see Equipment), cen- tral, 56, 108 legislation providing for, 299, 306 Konstance, 118 Labor-saving devices, 56 Lambert, Dr., of Brighton, on tuberculous children, 68 Lancet Commission, on French cantines, 88 Langworthy, Dr. C. F., nutri- tion expert, 240 Lechstecker, Dr., investigates underfeeding, 199 Legislation, allied, 66ff. compulsory, 67, 133 different countries, 17, 20, 41-46, 66, 67, 78, 81, 107, 117, 128, 130, 133, 146, 183,299-311,313- 318 taxes, 63-65, 299ff. Lessons, see Results Leipsic, 104 Licorice, no food in, 249 Local needs met, 84, 259 London meals in, 36, 6iff. Lunches (see Menus, Die- taries, Different Coun- tries), children's choice of, 44, 199, 248 composition and cost of street lunch, 248S. 340 INDEX Lung capacity, i6o Lymphatic system, 215 Mackenzie, Dr. Leslie, 28, 218 McMillan, Margaret, quoted, 59 Malnutrition (see Underfeed- ing and Diseases), acute, 26, 106, 99, 100 Bibliography, 286-290 causes, 2136?. chronic, 26, 218 classification, 211 definition, 211 extent of, see Underfeeding results, 126, 225fiF. social causes, 1232. symptoms, 21 iff. temporary, 218 Management, see Administra- tion and Organization Manners, improvement in, 50, 74 Manchester, 36 Manhattan, 148 Massachusetts, legislation pro- posed, 20, l82ff. Maurice, Major General Fred- erick, on military unfitness, 22 Maxwell, Dr. William, Super- intendent of New -York Schools, 18, 147, 201 Meals, see Extent, Administra- tion, Menus Measurements (see Experi- ments, Results), Ameri- can standard, 222ff. British standard, 222 Measurements, index of nutri- tion, 2l8ff. Medical inspection, co-opera- tion, 311 committees, 30, 91, 98 English act, 66 France, 91 Germany, 107, 112 reports on nutrition, 66, 91, 123, 200ff. Mental ability, increased by meals, 7off. not increased by, 71 Mental defectives, malnutri- tion, 225ff. school meals for, 24, 174 Mental symptoms of malnutri- tion, 213, 225ff. Menus (see Dietaries, Food Values, etc.) analyzed, ii3ff. Bibliography, 263-271 in different places, 49, 85- 89, iioff., 152, 165, 170, 174, 250ff. planned, in, 141, 2482. records, I55ff. specimen, 240; Appendices E, F, G unplanned, 136. Metchnikoff, lactic acid in skimmed milk, 166 Milan, 138 Military unfitness, England, 22 Germany, 99, 126 Milk (see Menus, Food Value, etc.), 49. 107. 166, 184, 238^ 3ii,3i6ff. INDEX 341 Milwaukee, 176, 182 Minerals in food, 238 Minimum wage, 75 Minnesota, I78ff. Mothers (see Parents), wage earners, 14, i24flE., 168 Munich, 102 Municipal (see Administra- tion), regulation, 107, no, 3i3ff. support, 114,115,132,145 Musculature, 212 National (see Legislation), cus- toms, 148, 259 Need, see Extent Neglect, relatively infrequent, 124 wilful, 68, 75, 76 North American, Philadelphia, 200 Northampton, England, 69 Norway, 145 Numbers fed, 36, 37, 47, 57, 6iff., 79, 9iff., 105, logff., 118, 131, 144, 150, 171, 173 Nurses, school, 54 Nurseries, 74, 145 Nutrition (see Food Needs, Malnutrition, Medical Inspections, Dietaries), classification, 21 iff. education in, I29ff. importance nationally, 24- 29 in school age, 27, 28, 24off. Nutrition laboratory , Teachers' College, 248 Oatmeal, 51, 187 Obligatory, see Compulsory Object of school feeding, 5, 6, 13, i69ff., 173, 244ff. Open Air Schools, meals in, i84ff. administration, 194 amount of food needed, 192 cost of food, I92ff. England, i85ff. Germany, 184 requisites, 184 support, 194 United States, 188 Organization (see Administra- tion, Support, Equipment) of meals, 31, 54, 61, 8off., 95, ii4ff., 117, 131,1352., I43ff., I45ff., I48ff., i63ff., 172 Overcrowding (see Housing) Overlapping of effort, 40 Overwork, 215 Oxidization, 215 Padua, 140, 141 Parents, absent from home, 13, 14, 137, 208 apply for meals, 55, 135, 314 delinquent, 40, 45, 124, 300, 306 encouraged to visit meals, 58 ignorance of, 44 instruction of, 44, 58, 72, III, 159 payment by, 45, 64, 83, 111,300,306 342 INDEX Parents, responsibility of, 59 visited, 55 » 83, 11 1, 159 welfare of, secondary, 6 Paris, see Cantines Scolaires Parliamentary, investigations and reports, 17, 22, 2795. Pauperization, 45, 137, 143 Penny lunch, American cities, I47flf. Penny Lunch Club, 172 Percentage, see Underfeeding Periodicals, 290-292 Permissive, character of Edu- cation Act, 1906, 44; Ap- pendices A, B Philadelphia, 19, I5iff., 175, 203 Philanthropic School Society, 103 Physical defects (see Diseases, Malnutrition), 126, 227ff. Physical training, inquiry into, 23ff. Royal Commission on, 23ff. recommendation regard- ing, 25 Place, of meals, 117, 129, 142, I79»229, 306 Play, 213, 233 Politics, Italian municipal, I42ff. Poor, Guardians of, 5, 41, 311 Poorest, children, 98, 91, 117, 144 sections, 109 Poverty (see Causes), book, 196 Poverty, relation to underfeed- ing, 204ff. Poverty Scale, England, 55, 64 Germany, 129 Preparation and service (see Administration, Organiza- tion), 45, 49, 50, 56, 64, 86, 96, 97, 136 Prevention of cruelty to chil- dren, 68 Preventive measure, 68 Price (see Cost), should not exceed, 137 Private (see Charity, Volun- tary) schools, 130 Promotion, influenced by un- derfeeding, 226ff. Protein (see Dietaries, Menus, etc.), amount for one cent, 25off. amount needed, 235^., 243 emphasized in school menus, 48, 244, 245, 257 fuel value, 237, 240 lacking in home meals, 48, 244ff. low amount found, ii3fiE., 249 sources, 2343., 255fiE. starvation, 48ff. tissue-building, 2345. Provision of Meals Act, Com- mittee on, 3ifif. passage and adoption, 43ff. text, 43ff., Appendices A and B Prussia, 105 Psychological Clinic, 163 INDEX 343 Public Charity (see Voluntary, Charity, Private, etc.), 41,46 Purpuric petechias, 36, 213 Purchase of food (see Adminis- tration), 85, 148, 171 Pushcarts, 169, 248 Racial standard of food, growth, 212, 219, 232, 259ff. Ration (see Dietaries, Food Val- ues, Menus) , daily, 242ff . proportion, 244J0f. Recipes (see Menus), 156, 248fif., 3i8ff., 327ff., 330ff. Records (see Administration, Organization), 68, 86, I55ff., 230ff., 312, 314 Refezione Scolastica, Italy, I38ff. Relief (see Charity, Voluntary, etc.), Germany, 103 of school children's order, 41 societies in England, soff. Religious customs, 259 Resistance to disease, 227ff. Responsibility of parents, see Parents of State for physical con- dition, 5, 6, 80 Restaurant (see Canteens, Can- tines, etc.), school, 16, 44, 79, 117, 140 Results (see Malnutrition, Un- derfeeding, Disease, Ex- periments, Physical De- fects) , conduct, manners, lessons, 50, 58, 63, 70, 74, 162 medical inspection, 73 Results, school meals, 34, soff., 66ff., 70, 74, 150, 162 Retardation and malnutrition, 226ff. Richards, Prof. Ellen H., i64flf. Rickets, 228 Ritchie, Dr. Brown, on under- feeding, 36, 225 Rome, 140 Royal Decree in Holland, 130 Rubner, Dr. Max, nutrition expert, m, 127, 245 Rumford, Count, social re- former, 14 Russia, 17 St. Paul, Minn., 181, 203 Salaries, see Cost, Support, Administration Sanitation (see Hygiene), 108 San Remo, 138, 142 Scotland, 67 School authorities, see Admin- istration School Lunch Committee, 147, 163, 202, 207 Schoolroom, use of, for meals, 57, 129, 229, 306 Self-supporting, 147, 150 Service, see Preparation, Ad- ministration, etc. Shops, food, 44, 250 Shut-outs, lunches for, 168 Sill, Dr. E. Martin, investiga- tion in New York, 241 Simon, Helene, German writer on social economy, I27ff. Skimmed milk, 167 344 INDEX Social, all grades represented, 14, 55, 87, 121, 125 legislation, 66ff., 12'jS. reforms, allied, loi, I27ff. workers, 19, 120, 124, 187, 159, 163 Socialist, activity in Italian cities, I42ff. Germany, 105 Soup kitchens, 14, 102 Spain, 17 Spargo, John, 90, I97ff. Standard (see Nutrition, Menus, Dietaries, Un- derfeeding) of living, 204ff. ration, 136, 205 Starch, 236, 246 Starr Centre Association, Phil- adelphia, 19, 157 Sterilization of dishes, 154 Stove in rural schools, 97, 178 Strain of school work, 27, 53 Street begging, 142 food bought on, 44, 169, 198, 248 Stuttgart, 107, 217, 3132. Supervision, see Administra- tion Subsidies, see Cost, Support, Administration Sugar, 167, 236 Supplementary lunch, 190 Support (see Cost, Administra- tion), statistics of, 15, 45, 63ffv 77, 9iffM ii4ffM 1195., i30fif., I38ff., I44ff., I47ff-, 170, i93fiE. Sweden, 143 Switzerland, 131-138 Bibliography, 292 Symptoms, see Malnutrition Syracuse, open air schools, 191 Tables, dining, 50, 57, 74, III Tables of measurements, 222ff. Taxes, see Legislation Teachers (see Administration) attend meals, 57, 82, 139, 153 not required to serve, 45, 83, 301 payment of, 57, 139 reports on meals and un- derfeeding, 34, 51, 58, 120, 123, 132, 167 selection of children, 54, 117, 131 Teeth, bad, 214 Tickets (see Administration), 87, 108, 152, 315 Time, Economy, 179 Tissue (see Food, Malnutri- tion, Protein, Dietaries, etc.) I excessive breaking down of, 2i5fif. insufficient building up, 2142. Tonics, 91 Tonsig, Dr., of Padua, on dietaries, 141, 243 Truancy law, 76 Tuberculosis (see Open Air Schools), children with, 68, 126, I39ff., 228 INDEX 345 Underfed, see Underfeeding Underfeeding (see Malnutri- tion), American cities, 196-2 I I among mental defectives, 225 causes, 120-123, I96ff. effect, see Malnutrition extent of, 25, 29, 30, 34, 46, 47, 105, 120, 125ff., 130-145, 175 other countries, 5, 22-43, 123-126, I30ff. relation to income, 206 to housing, 209, 2i9ff. Unemployment, 33, 38, 65, 102, 124 Uniform meal tickets, 87, 108, 375 Unit, food need, 205 heat measurement, 239 United States (see American), Bibliography, 292-297 Uri, 135 Vacation, colonies, 17, I03ff. loss of weight during, 53 meals during, 62 Vagrancy, 14, 102 Variety, in menus, 49, 172, 155, 256ff. Venice, 140 Vercelli, 141 Vermin, 215, 228 Vienna, 143 Vitality, 69, 213 Volkswohlfahrt, Zentralstelle fiir, loi Voluntary (see Charity and Relief), societies, support, etc., 3off., 38ff., 64ff. Wales, 43, 62 ff. Wallesey, 71 Warming, facilities for, 96, 177 Washing up, 136, 148, 154 Water, need, 238ff. Weight, see Tables, Measure- ments, Malnutrition Webb, Beatrice, quoted, 5, 6 Wile, Dr. Ira S., on diet, 260 Wood, Dr. Thomas D., meas- urements, 222 Women's clubs, 19, 168 Wurtemburg, 118 Zurich, I34ff. r FOR ELEMENTART READING * ELEMENTARY SCIENCE READERS With Object Lessons and Illustrations IN THREE PARTS Part One, $2^ Part Two, ;^30 Part Three,'$35 Each profusely illustrated. Cloth, i2mo. The Elementary Science Readers may be used as regular reading books. They are intensely interesting to children because all the lessons are on subjects from which the greatest pleasure comes to boys and girls. As new words are introduced they are placed at the head of the lessons for spelling exercises, and at the end of each book are object lessons which every teacher can use to advantage. Home Life in All Lands Series Vol. I, How the World Lives Vol. 11. Manners and Customs of Uncivilized Peoples Vol. III. Animal Friends and Helpers School Edition. Illustrated, i2mo. Per Vol. $ .60. Regular Edition. i2mo. Cloth, Gilt top. Per Vol. $1.00. In these very interesting books Mr. Charles Morris, the author, pre- sents charmingly the home-life, occupations, manners and customs of the various peoples of the world, and the animal friends and helpers of man. These books are of rare merit. They are a valuable adjimct in the teaching of geography. Suitable for grades five to eight inclusive. J. B. LIPPINCOTT COMPANY PUBLISHERS PHILADELPHIA JUL "8 IS!4 ^^ THE WORCESTER SERIES OF SCHOOL DICTIONARIES CONSISTS OF Worcester's New Primary Dictionary 354 pages. Profusely illustrated. i6mo. Half leather. Price, $ .50. Worcester's New School Dictionary New Edition. 392 pages. Profusely illustrated. i2mo. Half leather. Price, $ . 80. Worcester's New Comprehensive Dictionary New Edition. 689 pages. 577 illustrations. Large i2mo. Half leather. Price, ^^1.40. Worcester's New Academic Dictionary New Edition. 689 pages. 264 illustrations. Large 12010. Half leather. Price, $1.50 Worcester's Dictionaries are comprehensive, up to date, and in all respects, are better adapted to school use than are any other small dictionaries. They fully meet the requirements of all grades of schools. Mechanically they are superior to all others, and the price at which they are sold bring them within reach of every child. J. B. 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