Malnutrition, (Innutrition, Undernutrition) is simply poor or inadequate or defective nutrition--slow starvation. The child is undernourished or is not well nourished. Such a person may be overfed. The cases of malnutrition in those who actually do not eat a sufficient bulk of food are comparatively very rare.

Almost the whole of the American population is suffering from undernutrition. The discovery during the war that so many of the young men in this country are such miserable specimens of physical manhood occasioned a temporary interest in the subject of malnutrition, just as a similar interest in the nutrition of her young followed a similar discovery in the young men of England during the Boer war. Although, this temporary interest in the physical welfare of our future cannon-fodder waned as the patriotic fervor which gave rise to it lessened, with the passing of the war, malnutrition of our children and adults is as acute as ever if not more so. Routine examinations of school children have revealed that malnutrition is as prevalent in these as it was in the young men examined in 1917-1919 and 1933-1946.

Sir Stephan Tallents, Secretary of the Marketing Board (England) in an appeal, in the first half of 1932, for a closer understanding of matters vital to the British Empire, declared: "Research workers have satisfied themselves that whole populations--indeed a scientist told me the other day that I might safely say whole continents--are suffering from malnutrition." He lamented the fact that it takes twenty years for the results of scientific research to percolate into practice.

The United States Children's Bureau found that one-fourth to one-third of the children in this country are definitely malnourished according to medical standards. In some communities malnourishment is so common that it is hardly recognized as en abnormal condition. They found that the number of children of really superior nutrition is really very small.

While a majority of these children manage to grow up, they carry the marks of faulty nutrition with them throughout their lives. Small bones, weak, receding, deformed chins, deformities, defective teeth, undeveloped bodies, flat chests, deformed spines, poor sight, anaemia, marked susceptibility to disease, and low mentality are only some of the more obvious results of malnutrition. Here in San Antonio, among our Mexican population, one scarcely sees a single Mexican who does not present unmistakable evidences of malnutrition.

Malnutrition shows itself in a variety of ways. In young children growth is arrested, the teeth and eyes are defective, sore eyes and rickets, emaciation and deformity develop. In adults, anaemia, loss of appetite, underweight, constipation, pellagra, beri-beri, and nervous troubles result.

Malnutrition manifests itself not only in a failure to gain in height and weight but in many other ways. Indeed many malnourished children are fat, while, others are as tall as the average child of their age. A child may be normal, meaning the median or average, as far as height and weight are concerned, and still present many evidences of malnutrition.

The more common symptoms of malnutrition are a dry, delicate skin which is either pale or wax-like or else sallow, or pasty, or earthy in appearance; dry, rough hair, brittle nails; blue circles or dark hallows under the eyes, with a pale, colorless mucous lining of the eye-lids; loose skin, flabby, undeveloped muscles, round shoulders, projecting shoulder blades, fatigue posture, prominent abdomen, irritability, listlessness, inattention, "laziness," undue mental and physical fatigue, mental backwardness, a temperamental disposition, lack of natural inquisitiveness and a lessened power of concentration; the child is also likely to be finicky about his food. The undernourished child is usually underweight, although some of them are fat and flabby. Borderline conditions of malnutrition commonly pass for healthy conditions.

Dr. Hess, of Columbia University, says that clear-cut disorders are not the most common or important results of food deficiency. Lack of vitamins, he says, "generally does not bring about typical pathological states but obscure alterations of nutrition, ill-defined functional disabilities which cannot be characterized or even recognized as disease."

These ill-defined functional disabilities and obscure alterations of nutrition represent the initial beginnings and the subsequent so-called disease is only a further development of the same alterations and disabilities. It is of the highest importance that we realize that by reason of faulty diet, or other factors that impair nutrition, serious damage to the young may occur without the development of symptoms which definitely mark the condition as deficiency.

The causes of malnutrition are commonly divided into three classes: physical, social and dietetic.

The "physical causes" are diseases and various malformations. Among these are listed tuberculosis, chronic disease of the tonsils and sinuses connected with the nose, pyelitis, decaying teeth, adenoids and deformities of the jaw and nose. Chronic disease of the tonsils and sinuses connected with the nose are said to be "the most common of the diseases causing malnutrition in childhood." "Decaying teeth often cause malnutrition." "Adenoids and deformities of the jaw and nose are the most common of the deformities which produce malnutrition." Tuberculosis is not considered a common cause of malnutrition in childhood.

Morse, Wyman-Hill say of malnutrition due to these causes: "The remedies are obvious: removal of diseased tonsils and teeth and of the adenoids, treatment of the sinuses and pyelitis, and correction of the deformities." This is a surgical program and is aimed at effects, not causes.

K. B. Rich in a report of the work of the educational authorities in the Chicago Elementary Schools, showed that the treatment of enlarged tonsils, adenoids, carious teeth, and flat-foot are ineffectual in over-coming malnutrition, although the program had been undertaken with great expectations of success. Fresh air. sunshine, exercise, and improved diet and cleanliness were then tried and these proved effective.

Decay of the teeth is due to malnutrition. So is tuberculosis. So are most deformities of the nose and jaw. The medical profession is so in the habit of getting the cart before the horse--of converting an effect into the cause--that they do it unconsciously. Take the one factor of decay of the teeth. This is so unmistakably an effect of faulty nutrition that we can hardly excuse those who say that the tooth decay causes faulty nutrition.

In the discussion of the "social causes" we usually find more evidence of intelligence, although the treatment of these seldom goes far enough, due to the fact that our universities and research institutions are controlled by big business interests and to the further fact that these same universities and research institutions are large stock holders in oil companies, mining companies, cotton mills, etc., and are deeply interested in dividends from these. It is, therefore, more profitable to these institutions to vivisect animals, study germs, and endorse serums and surgery than it would be to tell the truth about the social causes of disease, where this might tend to decrease the incomes of these big business concerns.