In order grasp the actual condition of the so-called delicate children and pupils, I investigated the physique, physical strength, career of growth, and home circumstances of all the 89 children and pupils in the institutions of Chunichi Aoba, Shirahato, and Akabane from 1961 to 1962, with the following results. 1. The height, weight, girth of the chest, the index numbers of weight to height, girth of the chest to height, Vervaeck, and Tsurumi-Nakatate of the children and pupils are below the national average of children and pupils in both sexes and at almost all ages. Especially it is remarkable in the height, weight, girth of the chest of both males and females and weight to height of males. 2. In 50-metre running, standing broad-jump, soft-ball throwing, chinning exercises, Serjent jump, Berpeetest, strength of back, and vital capacity, they, male and fomale, are inferior to the national average of children and pupils, but it is not very remarkable in standing broadjump, Serjent jump, Berpeetest, and strength of grip. 3. 27.0% of those children and pupils are to delicate constitution, 11.2% are of tubercular weak constitution, 9.0% are of tuberculous parentage, and anotner 9.0% are in bad home circumstances. 4. As to occupation, 29.3% of their guardians have no definite occupations, and 24.0% are day labourers, outside workers and odd-jobbers, 17.3% are sala-Tied men and very few have regular occupations. As to health condition, 46.8% of their parents are in good health both father and mother, and the others are in poor health, both father and mother, or father or mother. As to blood relationship, 59.7% of their parents are real ones, 20.8% are real mothers and the others are real fathers and stepparents. 5. The male average of their weight at birth is 2.818kg and the female average is 2.85kg. As to lactation, 50% of them were fed on mother's milk, 25.9% on artificial milk and 24.1% on mixed milk. 6. 48.1% of their places of birth and growth are farm villages, 44.2% are fishing villages, 22.1% are commercial districts, and 23.4% are industrial districts.

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Continued from the previous part. I order to grasp the actual condition of the so-called physically weak children, I made an enquete investigation of the 459 boys and 266 girls in 9 institutions for weak children and pupils in the whole country, , with the following results. 1. The backgroun Of the reasons for entrance into the institutions, 25.5% are under-growth, under-nourishment and anemia, 15.1% are tuberculous disposition, and 15.1% are cold, alimentary disorder, eczema, nettle rash and suppuration. They form the majority of the reasons and nervelessness. As to home circumstances, 29.2% of the children have sickly or somewhat unhealthy mothers. Probably in conseauence of this. 47.7% of them were nourished with artificial milk. Their standard of living is generally low and 57.4% of them are lowest. Their interest in the health of children is little and 37.8% are quite indifferent. 27.4% of the children had been bred in other institutions before they entered the present ones. Thus, many of them have grown in unfortunate circumstances from birth. 2. The features of form. At the time of entrance into the institutions, their height, weight, and girth of the chest are, both male and female, about one year inferior to the national average of the same ages. Especially, they are inferior in the ratio of weight to height. However, one year after entrance, though the value of actual measurement is low, the rate of increase is higher than the national average of all the items in the boys, and also in the girls except height. In view of these results, I find that the management and education of the institutions is perfect and realize how important circumstances are and how great their influence is.

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I made an investigation into their weight at birth, the age of their parents, the reasons for entrance, their birthplaces and the number of their brothers, of the 282 boys and 175 girls in 9 institutions for weak babies, children and pupils in the whole country, with the following results. 1. Relation between weight at birth and age of parents. Many of those who are inferior in weight at birth have young parents. Generally at the birth of their first-born children the age of parents is young-the average age of fathers is 28.48 years and that of mothers is 25.13 years. 2. Relation between weight at birth and reasons for entrance into institutions. Most of the reasons for entrance of those who are inferior in weight at birth are cold, alimentary disorder, eczema, nettle rash and suppuration to which they are subjeot from sensitiveness of skin and mucous membrane. Many of them are of so-called nervous constitution and enter the institutions at the age of mere infancy. 3. Relation between weight at birth and place of birth. Many of those who are inferior in weight at birth were born in cities, especially in commercial and industrial districts or ammusement centers. 4. Relation between weight at birth and number of brothers. Many of those who are inferior in weight at birth are only and first-born children. 5. Relation between weight at birth and premature infant. The average weight at birth of the boys is 2.969kg and that of the girls is 2.931kg. About 21.9% of them are premature children. As mentioned above, they are heavily handicapped already at their birth. What with the law of health for mother and child, and the respect and protection of motherhood, and mother's own effort, and later education and management, this problem will be satisfactorily solved. I wish the authorities of public and local bodies will take proper and effective measures.

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From November in 1956 to March in 1967, in order to grasp the actual condition of the so-called physically weak children and pupils and to inquire into the causes, I questioned all the institutions for weak children in the whole country on their birth and growth, home circumstances and physique. 9 of them answered my questionnaire, in which there are 1, 174 children (733 boys and 441 girls), whose average age is 6.82%±2.85 years (boys, 6.96±2.57; girls, 6.56±2.68). I mentioned the results of this investigation in Volume I (from Part 1 to Part 3). In this part I have generalized them, with the following results. 1. Home circumstances.It is not too much to say that healthy children are born of healthy mothers. From this point of view, healthy mothers are very few (65.6%). In delivery, 11.2% of the children are. difficult or abnormal and 15.8% are premature. Their parents are in narrow circumstances (57.4% are in the lowest class) and their interest in the health of children is . not great (37.8 are quite indifferent). As to lactation, 35.5% of them were fed on mother's milk, 16.8% on artificial milk and 47.7% on mixed milk. 2. Places of birth.90.6% of them were born in their own homes, and 2.4% in institutions (hospitals, clinics and maternity homes). 48.7% of their places of birth are cities, 23.3% are towns, 20.1% are villages and 8.0% are unknown. 3. Various, conditions centering around their weight at birth. They have many brothers (the average number of brothers is 2.46 the highest is 7 and the lowest is 1). 11.5% of them are eldest children, 51.7% are youngest children, and 36.8% are intermediate ones. In dividing the number of brothers into three classes, I exclude one and two brothers. The age of their parents at their birth is 31.94±6.85 years for fathers and 27.89±5.92 years for mothers. This is insignificant in statistics, but the older mothers are, the heavier children weight at birth (r= 0.016 for boys, r=0.029 for girls).The birth rate of premature infants is as high as 17.5% (13.5%, or boys, 24.0% for girls). Many of those who are inferior in weight at birth were born in cities, .especially in commercial and industrial disrticts or amusement centers. Children with four brothers are heaviest in weight (3.11kg±0.41 for boys, 2.93kg for girls), while children with two brothers for boys (2.78kg±0.45), and one brather for girls (2.82kg±0.60) are lightest. The latter's weight at birth is lighter then that of the former by about 0.1kg (2.991kg±0.438 for boys, 2.920kg±0.444 for girls). 4. Conditions of growth. 27.4% of the children had been housed in other institutions before they entered these institutions. They began to syeak fifteen months after birth and to walk seventeen months after. Their intelligence quotient (Tanaka's B form) is 90.5, and generally they are slow in developing intellectual faculties. The tuberculin test proved positive for 54.3%. (negative for 5.9%). 5. Physical features at entrance and the growth of . them after entrance.Their height, weight girth of the chest are about one year below the national average. Especially, they are inferior in height and weight, but one year after entrance, the rate of increase is more than two-thirds higher than the national average of all the items. 6. The classification of the reasons for entrance.The 610 reasons for entrance may be classified into three groups : undergrowth and undernourishment (41.6%), diseases (25.6%), and suspected tuberculosis (15.1%). They form the majority of the reasons (82.3%). From the above-mentioned results the physical weakness. of children arises from the mother's body. I can safely say that the respect and protection of motherhood and the prope education and management of children after entrance will enable them, to regain their physical and mental health.

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In order to find a clue for determining the quality and quantity of the practice of physical and health education, I investigated the fatigue after practice of all the 59 children and pupils (40 boys, 19 girls) in the institutions of Chunichi Aoba and Shirahato, by means of Donaggio's test Sasagawa's filtration test, conscious and un-conscious symtoms. 1. According to the result of Donaggio's test, the degree of fatigue is low in both institutions of Chunichi Aoba and Shirahato. The former shows the highest index number of 1.30 after two hours, and the latter shows the highest index number of 1.47 after two hours. 2. According to the result of un-conscious symtoms observed by the teacher, the degree of fatigue is low in both institutions of Cnunichi Aoda and Shirahato. The former shows 2.08%, and the latter shows 4.68%. 3. According to the result of conscious symtoms, the degree of fatigue is low in both institutions of Chunichi Aoba and Shirahato. The former shows 22.51% and the latter shows 30.69%. 4. The relation between form and Donaggio's test, Sasagawa's filtration test conscious and un-conscious symptoms. The relation between form and the total of Donaggio's test (4 examinations of urine from after-practice to the next morning) proves plus correlation (the better the form the less the fatigue), but it is insignificant in statistics. The relation to after-practice shows significantly negative correlation with the rate of danger under 5.0% in the girth of the chest and in the ratio of weight to height. The relation to un-conscious symptoms shows significantly plus correlation with the rate of danger under 1.0%. However, it is statistically insignificant in height, weight, weight to height, Vervaeck Index, and Tsurumi-Nakatate Index and it shows negative correlation. The relation to conscious symptoms shows significantly plus correlation in weight and the girth of the chest with the rate of danger under 1.0%. Besides, it is statistically insignificant in the girth of the chest, weight th height, Vervaeck Index, Tsurumi-Nakatate Index and Rohrer Index, but it shows negative correlation. The relation between the point of synthetic judgement of physical status and strenght and Donaggio's test, conscious and un-conscious symptoms shows plus correlation of insignificance with r=0.188, r=0.025, r=0.125 respectively. As the result of this investigation, I am led to the conclusion that, though how to measure the degree of fatigue may require further study, we need not worry about fatigue, so far as the contents of the recent practice of physical and health education are concerned, and that it would be well to adopt more advanced contents. Be that as it may, there is still need of further investigation

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From April in 1963 to March in 1964, I gave guidance in physical and health education for the restoration and cultivation of basic physical strength under proper nutrition for 36 minutes a day from Monday th Friday every week to the 17 boys (the average age is 10.6 years in a certain institution for so-called physically weak children and pupils in Gifu Prefecture, and tried to see its effect upon the rate of increase in form and function. As the result of this investigation, the following conclusions were obtained. 1. As to the increase of form, I found there was little effect. 2. As th the increase of function it was remarkable, especially, in 50-metre running, soft-ball throwing, strength of grip, and strength of back. In view of the above-mentioned conclusions, I believe that the ideal of bodily health is to make both form and function grow and develop as far as possible. In this sense, I think that an increas in the growth of form should be promoted by checking the fall of nutrition in summer and especially by giving thought to subsidiary foods. In any case, I am confirmed in my belief that proper nourishment and active practice of physical and health education with careful protection will bring about an early rehabilitation of their health.

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From April in 1964 to March in 1965, I gave guidance in regular living and physical and health education under proper nutrition to the 26 children (21 boys, 5 girls) in acertain institution for so-called physically weak children and pupils in Gifu Prefecture, and tried to see its effect upon the restoration and increase of their health through the growth of form and fu nction. As the result of this investigation, the following conclusions were obtained. 1. The condition of nutrition. From the caloric point of view on the monthly condition of nutrition which is 2, 524.2 Cal (the rate of nutrition is 94.6%), with 81.6g in albumen and 5.06g in fat, they have the most calories in March (2, 446.3 Cal.) and the fewest in June (2, 270.2 Cal.). The rate of nutrition (supplied foods-remains of foods/supplied foods × 100) is the highest in March (96.3%) and the lowest in June (93.3%). Such being the case, measures must be taken to check the fall of nutrition in summer, and generally to increase the rate of nutrition. 2. The form. Seventeen boys were measured three times in a year (April, October, and March), in height, weight, girth of the chest, the index number of weight to height, girth of the chest to height, Vervaeck, Rohrer and Tsurumi-Nakatate, and it was found that height was below the national average. The rate of increase during a year is very remarkable in the index numbers of weight to height, Rohrer, and Tsurumi-Nakatate. Height and weight show an increasing tendency from April to October, while the others do from October to March. There is high correlation between form and nutrition (nutrition to height r=0.503, nutrition to weight r=0.552, nutrition to girth of chest r=0.609, nutrition to the index numbers of weight to height r=0.598, nutrition to the index numbers of girth of the chest to height r=0.392, nutrition to the index numbers of Vervaeck r=0.732), and significance is observed in height, weight, girth of the chest, the index numbers of weight to height, girth of the chest to height, and Vervaeck. 3. The function. Fifteen boys were measured three times in a year (April, October, and March) in 50-metre running, standing broad-jump, soft-ball throwing, Serjent jump, Berpeetest, strength of back and vital capacity, and it was found that they were generally below the national average. Esp ecially in 50-metre running, strength of grip, strength of back, and vital capacity, it was verb remarkable. The rate of increase during a year is remarkable in all the items, especially, in 50 metre running, Serjent jump, strength of grip and vital capacity. Individually, those who were inferior in April showed a considerable increase. As in from, the rate of increase from April to October being compared with that from October, to March, soft-ball throwing, strength of grip and strength of back show an increasing tendency from April to October, while the others do from October to March. There is high correlation between function and nutrition (nutrition to 50-metre running r=0.408, nutrition to standing broad-jump r=0.465, nutrition to soft-ball throwing r=0.549, nutrition to strength of grip r=0.529, nutrition to strength of back r=0.534), and significance is observed in 50-metre running, standing broad-jump, soft-ball throwing, strength of grip and strength of back. In view of the abovementioned results, I am convinced that those physically weak children who are apt to be regarded as dangerous and neglected will be able to recover their health under proper management and education.

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For two years from April in 1965 to March in 1967, I gave guidance in regular living, proper nourishment and physical exercise for six days a week (three days, curricular and three days, extra-curricular) to the 15 children (10 boys, 5 girls) of the average age of 9.9 years (boys, 9.6: girls, 10.2) in the S institution in Gifu Prefecture and the 30 children (22 boys, 8 girls) of the average age of 11.10 years (boys, 11.6: girls, 12.6) in the C institution in Aichi Prefecture, and tried to see its effect upon the restoration and increace of their health from the formal (12 lines such as height, weight, ?c 14 items) and functional (8 lines such as 50-metre running, standing broad-jump, ?c9 items) point of view. In determining the quality and quantity of physical education, I was very careful about the measurement of the degree of fatigue. with the following results. 1. The form. All the 14 items of form by actual measurement are below the national average except the index number of Rohrer. Especially it is remarkable in height. However the annual rate of growth is remarkable in all the items, showing 52.7% (boys, 55.7%: girls, 45.3%). By items, thickness of the chest, 67.8%, (boys, 62.5% with he index numbers of Vervaeck and Rohrer : girls, 84.6%) is the highest, and generally, an increase in the width of the chest is large. 2. The function. Almost all the 9 items (8 lines) of function by actual measurement are below the average of children aind pupils in Gifu Prefecture. Especially it is remarkable in running and jumping such as 50-metre running and standing broad-jump, but the annual rate of increase is superior in all the items, showing 46.6% (boys, 44.8%; girls, 50.9%). By items, 50-metre running, 70.5%, (boys, 69.4%; girls, 73.1%) and standing broad-jump (73.1%) are the highest. Generally the growth of running and jumping is remarkable. 3. Synthetically speaking, I think that, in view of the growth of form and function, this physical guidance for curricular three days and extra-curricular three days was very effective and that, though the time of guidance was short, the very continuance of it was important with the backing of proper nutrition.

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Since the 38th fiscal year of Shôwa, I have given guidance in nourishment and physical exercise to the 81 children and pupils in the institutions for so called physically weak children and pupils in Gifu Prefecture and Aichi Prefeture and investigated its effect upon the restoration and promotion of the health of the children and pupils from the synthetic viewpoint of hygienic studies and physical and health education. In nourishment, I was very careful about the supply of albumen, fat, and Vitamin. In physical exercise, I attached importance to such teaching materials as plays, free gymnastics, heavy gymnastics, rhythmic exercise and rope-skipping, and taught them for five days a week in the 38th fiscal year of Shôwa (36 minutes a day), for 3 days a week in the 39th fiscal year of Shôwa (40 minutes a day) and for six days a week in the 40th and 41st fiscal year of Shôwa. The results of this investigation are as follows: 1. There is little difference between year and year. In the 38th and 39th year, the growth of form is not large, but the growth of function is remarkable. 2. In the 40th and 41st year, there is a large increase of form. 3. For four years from the 38th to the 41st year, both form and function by actual measurement are inferior, but many children and pupils show alarge quantity of increase. In order to increase form in parallel with function, it is desirable for them to take exercise even for a few hours every day. 4. In physical training, free gymnastics, heavy gymnastics and rope-skipping are effective from the viewpoint of the development of physical strength, and cirquet training is desirable as form of training.

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