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Shaw ffirs.tex V3 - 08/21/2014 2:33 P.M. Page ii
 Shaw ffirs.tex V3 - 08/21/2014 2:33 P.M. Page i

Clinical Paediatric Dietetics

Shaw ffirs.tex V3 - 08/21/2014 2:33 P.M. Page ii
 Shaw ffirs.tex V3 - 08/21/2014 2:33 P.M. Page iii

Clinical Paediatric Dietetics

EDITED BY

Vanessa Shaw

Fourth Edition
 Shaw ffirs.tex V3 - 08/21/2014 2:33 P.M. Page iv

This edition first published 2015 © 2015 by John Wiley & Sons, Ltd

Registered office: John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offices: 9600 Garsington Road, Oxford, OX4 2DQ, UK

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Library of Congress Cataloging-in-Publication Data

Clinical paediatric dietetics / edited by Vanessa Shaw. – Fourth edition.

p. ; cm.
Preceded by Clinical paediatric dietetics / edited by Vanessa Shaw and Margaret Lawson. 3rd ed. 2007.
Includes bibliographical references and index.
ISBN 978-0-470-65998-4 (cloth)
I. Shaw, Vanessa, editor.
[DNLM: 1. Diet Therapy. 2. Child. WS 366]
RJ53.D53
615.8′ 54083–dc23
2014007124

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in
electronic books.

Set in 9.5/11.5pt Palatino by Laserwords Private Limited, Chennai, India

1 2015
 Shaw ftoc.tex V3 - 08/04/2014 2:01 P.M. Page v

Contents

List of Contributors vii Part 3 Clinical Dietetics

Preface xi
Acknowledgements xiii 6 Preterm Infants 83
About the Companion Website xv Caroline King and Kate Tavener

7 Gastroenterology 104
Part 1 Principles of Paediatric Sarah Macdonald
Dietetics
8 Surgery in the Gastrointestinal Tract 143
1 Nutritional Assessment, Dietary Danielle Petersen, Vanessa Shaw and
Requirements, Feed Supplementation 3 Tracey Johnson
Vanessa Shaw and Helen McCarthy
9 The Liver and Pancreas 161
2 Provision of Nutrition in a Hospital Jason Beyers
Setting 23
Ruth Watling 10 Endocrinology 195
Alison Johnston and Jacqueline Lowdon

Part 2 Nutrition Support and Intensive 11 Cystic Fibrosis 222

Care Carolyn Patchell

3 Enteral Nutrition 35 12 Kidney Diseases 242

Tracey Johnson Julie Royle

4 Parenteral Nutrition 48 13 Congenital Heart Disease 282

Joanne Louise Price David Hopkins

5 Nutrition in Critically Ill Children 66 14 Food Hypersensitivity 308

Rosan Meyer and Luise Marino Rosan Meyer and Carina Venter
 Shaw ftoc.tex V3 - 08/04/2014 2:01 P.M. Page vi

vi Contents

15 Immunodeficiency Syndromes, HIV 24 Epidermolysis Bullosa 690

and AIDS 335 Melanie Sklar and Lesley Haynes
Natalie Yerlett, Julie Lanigan and Lisa
Cooke 25 Burns 707
Helen McCarthy
16 Ketogenic Diets 354
Georgiana Fitzsimmons and Marian
Sewell Part 4 Community Nutrition

17 Disorders of Amino Acid Metabolism, 26 Healthy Eating 717

Organic Acidaemias and Urea Cycle Judy More
Disorders 381
Marjorie Dixon, Anita MacDonald, Fiona 27 Children from Ethnic Groups and
White and Jacky Stafford those following Cultural Diets 744
Eulalee Green
18 Disorders of Carbohydrate Metabolism 526
Marjorie Dixon, Anita MacDonald, Jacky 28 Faltering Weight 764
Stafford, Fiona White and Pat Portnoi Zofia Smith

19 Disorders of Mitochondrial Energy 29 Feeding Children with

Metabolism, Lipid Metabolism and Neurodisabilities 774
Other Disorders 588 Jennifer Douglas and Leanie Huxham
Marjorie Dixon, Jacky Stafford, Fiona
White, Nicol Clayton and Janine Gallagher 30 Obesity 798
Laura Stewart
20 Peroxisomal Disorders 637
31 Prevention of Food Allergy 809
Anita MacDonald and Eleanor Baldwin
Kate Grimshaw
21 Childhood Cancers 654
Appendix I L-amino Acid Supplements
Evelyn Ward
for Phenylketonuria 816

22 Eating Disorders 668

Graeme O’Connor and Dasha Nicholls Appendix II Dietetic Products 830

23 Autistic Spectrum Disorders 677 Index 833

Zoe Connor
 Shaw fbetw.tex V3 - 08/04/2014 1:49 P.M. Page vii

List of Contributors

Eleanor Baldwin BSc, RD Jennifer Douglas BSc, BPhEd

Advanced Dietitian – Adult Refsum’s Disease PG Dip Dietetics, RD
Chelsea & Westminster Hospital, Fulham Rd, Formerly Specialist Paediatric Dietitian
London SW10 9NH Mile End Hospital, London E1 4DG
Jason Beyers BSc, PG Dip Dietetics, RD Georgiana Fitzsimmons BSc, PG Dip Dietetics,
Formerly Specialist Paediatric Liver and Critical BPhEd, RD
Care Dietitian Principal Paediatric Dietitian – Ketogenic Diets
King’s College Hospital, Denmark Hill, London Great Ormond Street Hospital for Children NHS
SE5 9RS Foundation Trust, Great Ormond Street, London
WC1N 3JH
Nicol Clayton BSc, RD
Specialist Paediatric Dietitian − Barth Syndrome Janine Gallagher BSc, PG Dip Dietetics, MSc
NHS Specialised Services Specialist Paediatric Metabolic Dietitian
North Bristol Trust, Southmead Hospital, Royal Manchester Children’s Hospital, Central
Westbury-on-Trym, Bristol BS10 5NB Manchester Foundation Trust, Oxford Road,
Manchester M13 9WL
Zoe Connor MSc, RD
Freelance Paediatric Dietitian and Lecturer Eulalee Green BSc, MSc, RD
www.zoeconnor.co.uk Dietitian and Public Health Nutritionist
PO Box 63973, Putney Health, London SW15 9BB
Lisa Cooke BSc, MA RD
Head of Paediatric Dietetics Kate Grimshaw PhD, RD
Bristol Royal Hospital for Children, Upper Research Fellow
Maudlin Street, Bristol BS2 8BJ University Hospital Southampton NHS
Foundation Trust (UHS), Tremona Road,
Marjorie Dixon BSc, RD
Southampton SO16 6YD
Principal Paediatric Dietitian – Metabolic Medicine
Great Ormond Street Hospital for Children NHS
Foundation Trust, Great Ormond Street, London
WC1N 3JH
 Shaw fbetw.tex V3 - 08/04/2014 1:49 P.M. Page viii

viii List of Contributors

Lesley Haynes Dip Dietetics Sarah Macdonald BSc, RD

Formerly Principal Paediatric Dietitian − Principal Paediatric Dietitian – Gastroenterology
Epidermolysis Bullosa and Surgery
Great Ormond Street Hospital for Children NHS Great Ormond Street Hospital for Children NHS
Foundation Trust, Great Ormond Street, London Foundation Trust, Great Ormond Street, London
WC1N 3JH WC1N 3JH
David Hopkins BSc, MSc, RD Luise Marino BSc, PG Dip Dietetics, MMed Sci
Specialist Paediatric and Adult Cystic Fibrosis Nutr, PhD
Dietitian Chief Paediatric Dietitian
University Hospital Southampton NHS University Hospital Southampton NHS
Foundation Trust (UHS), Tremona Road, Foundation Trust (UHS), Tremona Road,
Southampton SO16 6YD Southampton SO16 6YD
Leanie Huxham BSc, MNutr, RD Helen McCarthy BSc, PgCHEP, PhD, RD
Freelance Paediatric Dietitian Lecturer (Dietetics)
[email protected] School of Biomedical Sciences, University of
Ulster, Coleraine, Co Londonderry BT52 1SA
Tracey Johnson BSc, RD
Senior Specialist Paediatric Dietitian Rosan Meyer B Dietetics, MNutr, PhD, RD
Birmingham Children’s Hospital NHS Trust, Principal Research Dietitian
Steelhouse Lane, Birmingham B4 6NH Great Ormond Street Hospital for Children NHS
Foundation Trust, Great Ormond Street, London
Alison Johnston BSc, RD
WC1N 3JH
Lead Clinical Specialist Diabetes Dietitian
(Paediatric) Judy More BSc, RD, RNutr
Royal Hospital for Sick Children, Dalnair Street, Freelance Paediatric Dietitian, London
Yorkhill, Glasgow G3 8SJ www.child-nutrition.co.uk
Caroline King BSc, RD Dasha Nicholls MD, MBBS, MRCPsych, FAED
Specialist Neonatal Dietitian Consultant Child and Adolescent Psychiatrist
Hammersmith Hospital, Du Cane Road, London Great Ormond Street Hospital for Children NHS
W12 OHS Foundation Trust, Great Ormond Street, London
WCIN 3JH
Julie Lanigan BSc, PhD, RD
Paediatric Research Dietitian/Clinical Trials Graeme O’Connor BSc, PG Dip Dietetics, PhD, RD
Coordinator Specialist Paediatric Dietitian
Childhood Nutrition Research Centre, UCL Great Ormond Street Hospital for Children NHS
Institute of Child Health, London WC1N 1EH Foundation Trust, Great Ormond Street, London
WC1N 3JH
Jacqueline Lowdon BSc, MSc, PGCE (FE), RD
Paediatric Dietitian Team Leader Carolyn Patchell BSc, RD
Royal Manchester Children’s Hospital, Central Head of Nutrition and Dietetics
Manchester Foundation Trust, Oxford Road, Birmingham Children’s Hospital NHS Trust,
Manchester M13 9WL Steelhouse Lane, Birmingham
Anita MacDonald BSc, PhD, RD Danielle Petersen BSc, MSc, RD
Consultant Dietitian in Inherited Metabolic Specialist Paediatric Dietitian
Disorders, Birmingham Children’s Hospital and Great Ormond Street Hospital for Children NHS
Honorary Professor of Paediatric Dietetics, Foundation Trust, Great Ormond Street, London
Plymouth University WC1N 3JH
Birmingham Children’s Hospital NHS Trust,
Steelhouse Lane, Birmingham B4 6NH
 Shaw fbetw.tex V3 - 08/04/2014 1:49 P.M. Page ix

List of Contributors ix

Pat Portnoi BSc, RD Jacky Stafford BSc, MSc, RD

Galactosaemia Support Group Dietitian and Great Ormond Street Hospital for Children NHS
Register Coordinator Foundation Trust, Great Ormond Street, London
www.galactosaemia.org WC1N 3JH
Joanne Louise Price BSc, RD Laura Stewart PhD, RD, RNutr
Chief Paediatric Dietitian − Gastroenterology and Paediatric Overweight Service Tayside Team Lead
Surgery NHS Tayside, Perth Royal Infirmary, Perth PH1
Royal Manchester Children’s Hospital, Central 1NX, and Children’s Weight Clinic, Edinburgh
Manchester Foundation Trust, Oxford Road,
Kate Tavener BSc, PG Dip Dietetics, RD
Manchester M13 9WL
Specialist Neonatal Dietitian
Julie Royle BSc, PG Dip Dietetics King’s College Hospital, Denmark Hill, London
Clinical Specialist Dietitian (Renal) and Team SE5 9RS
Leader
Carina Venter BSc, PG Dip Allergy, PhD, RD
Royal Manchester Children’s Hospital, Central
Allergy Specialist Dietitian and Senior Lecturer,
Manchester Foundation Trust, Oxford Road,
University of Portsmouth
Manchester M13 9WL
The David Hide Asthma and Allergy Research
Marian Sewell Dip Dietetics RD Centre, St Mary’s Hospital, Newport, Isle of Wight
Specialist Paediatric Dietitian PO30 5TG
Great Ormond Street Hospital for Children NHS
Evelyn Ward BSc, RD
Foundation Trust, Great Ormond Street, London
Senior Specialist Paediatric
WC1N 3JH
Oncology/Haematology Dietitian
Vanessa Shaw MBE, MA, PG Dip Dietetics, RD, Leeds Children’s Hospital, Leeds General
FBDA Infirmary, Leeds LS1 3EX
Head of Dietetics, Great Ormond Street Hospital
Ruth Watling BSc, RD
for Children and Honorary Associate Professor of
Head of Dietetics
Paediatric Dietetics,
Alder Hey Children’s NHS Foundation Trust,
Plymouth University
Eaton Road, Liverpool L12 2AP
Great Ormond Street Hospital for Children NHS
Foundation Trust, Great Ormond Street, London Fiona White BSc, RD
WC1N 3JH Lead Specialist Metabolic Dietitian
Royal Manchester Children’s Hospital, Central
Melanie Sklar BSc RD
Manchester Foundation Trust, Oxford Road,
Formerly Principal Paediatric Dietitian −
Manchester M13 9WL
Epidermolysis Bullosa
Great Ormond Street Hospital for Children NHS Natalie Yerlett BSc, PG Dip Dietetics, RD
Foundation Trust, Great Ormond Street, London Specialist Paediatric Dietitian
WC1N 3JH Great Ormond Street Hospital for Children NHS
Foundation Trust, Great Ormond Street, London
Zofia Smith BSc, RD
WC1N 3JH
Formerly Community Paediatric Dietitian
St Mary’s Hospital, Greenhill Rd, Leeds LS12 3QE
Shaw fbetw.tex V3 - 08/04/2014 1:49 P.M. Page x
 Shaw fpref.tex V1 - 05/12/2014 6:52 P.M. Page xi

Preface

The aim of this manual is to provide a very practical whilst maintaining the growth potential of the
approach to the dietary management of children individual. The section on community based nutri-
with a wide range of disorders that can benefit tion includes healthy eating throughout infancy,
from dietary therapy. Interventions range from childhood and adolescence, the principles of which
nutritional support to the diet being the major or underpin many clinical interventions. The distinc-
sole treatment for particular disorders. The text will tion between clinical dietetics and nutrition in the
be of relevance to professional dietitians, dietetic community is rather arbitrary and there is of course
students and their tutors, paediatricians, paediatric a continuum between care provided between the
nurses and members of the community health acute and community settings.
team caring for children who require therapeutic There has been an expansion of the range of
diets. The importance of nutritional support and disorders, treatments, guidelines and recommen-
dietary management in many paediatric conditions dations described in many chapters, e.g. endocri-
is increasingly recognised and is reflected in new nology, the ketogenic diet, inherited metabolic
text for this edition. disorders, food hypersensitivity and prevention of
The authors are largely drawn from practising allergy, eating disorders and neurodisability.
paediatric dietitians around the United King- Arranged under headings of disorders rather
dom, with additional contributions from academic than type of diet, and with much information pre-
research dietitians and a psychiatrist. The need for sented in tabular form and with worked examples,
evidence based practice has demanded a thorough the manual is easy to use. There are case stud-
review of the current scientific and medical litera- ies throughout which demonstrate the practical
ture to support clinical practice wherever possible. application of the theory.
Where the evidence base is lacking, expert clinical The most recent information and data has been
opinion is given. used in the preparation of this edition, but no guar-
The major part of the text concentrates on antee can be given for validity or availability at the
nutritional requirements of sick infants, children time of going to press.
and young people in the clinical setting. Normal
dietary constituents are used alongside special Vanessa Shaw
dietetic products to provide a prescription that March 2014
will control progression and symptoms of disease
Shaw fpref.tex V1 - 05/12/2014 6:52 P.M. Page xii
 Shaw flast.tex V2 - 08/04/2014 1:59 P.M. Page xiii

Acknowledgements

I would like to thank a number of dietitians who Chapter 15 Immunodeficiency Syndromes:

wrote for the third edition of this book whose work Marian Sewell & Vivien Wigg
contributed to the following chapters: Chapter 16 Ketogenic Diets: Liz Neal & Gwyneth
Chapter 1 Nutritional Assessment, Dietary Magrath
Requirements, Feed Supplements: my former Chapter 20 Lipid Disorders: Patricia Rutherford
co-editor Margaret Lawson Chapter 25 Burns: Claire Gurry
Chapter 5 Nutrition in Critically Ill Children: Chapter 28 Children from Ethnic Groups and
Katie Elwig those following Cultural Diets: Sue Wolfe
Chapter 9 The Liver and Pancreas: Stephanie Chapter 30 Feeding Children with Neurodisabil-
France ities: Sarah Almond, Liz Allott & Kate Hall
Chapter 14 Food Hypersensitivity: Kate Chapter 32 Prevention of Food Allergy: Carina
Grimshaw Venter
Shaw flast.tex V2 - 08/04/2014 1:59 P.M. Page xiv
 Shaw flast.tex V2 - 08/04/2014 1:59 P.M. Page xv

About the Companion Website

This book is accompanied by a companion website:

www.wiley.com/go/shaw/paediatricdietetics
The website includes:
• Powerpoints of all figures from the book for
downloading
• PDFs of all tables from the book for download-
ing
• PDFs of all chapter references for downloading
Shaw flast.tex V2 - 08/04/2014 1:59 P.M. Page xvi
 Shaw p01.tex V1 - 05/05/2014 1:37 P.M. Page 1

Part 1
Principles of Paediatric Dietetics

Chapter 1 Nutritional Assessment, Dietary Requirements, Feed Supplementation

Chapter 2 Provision of Nutrition in a Hospital Setting
Shaw p01.tex V1 - 05/05/2014 1:37 P.M. Page 2
 Shaw c01.tex V3 - 08/22/2014 9:21 A.M. Page 3

1 Nutritional Assessment, Dietary

Requirements, Feed Supplementation
Vanessa Shaw and Helen McCarthy

Introduction by a range of healthcare professionals, whereas

nutrition assessment is a more detailed and lengthy
This text provides a practical approach to the means for nutrition experts, i.e. dietitians, to quan-
dietary management of a range of paediatric dis- tify nutritional status.
orders. The therapies outlined in Parts 2 and 3
describe the dietetic interventions and nutritional
requirements of the infant, child and young person Nutrition screening
in a clinical setting, illustrating how normal dietary
constituents are used alongside special dietetic While nutrition screening tools can be used to
products to allow for the continued growth of the identify all aspects of malnutrition (excess, defi-
child whilst controlling the progression and symp- ciency or imbalance in macro and micro nutrients),
toms of disease. Nutrition for the healthy child and they are generally used to identify protein energy
nutritional care in the community is addressed in undernutrition [1]. Despite the recommendations
Part 4. from benchmark standards and national and inter-
The following principles are relevant to the national guidelines that screening for nutrition risk
treatment of all infants, children and young people be an integral component of clinical care for all
and provide the basis for many of the therapies [2–5], the development of nutrition screening tools
described later in the text. for use with children has lagged behind work in
the adult world. However, in recent years a num-
ber of child specific nutrition screening tools have
Assessment of nutritional status been developed. Internationally the Nutrition Risk
Score (Paris tool), the Subjective Global Nutrition
Assessment and monitoring of nutritional status Assessment (SGNA) and the Strongkids tool are
should be included in any dietary regimen, audit available [6–8]. Each of these has strengths and
procedure or research project where a modified limitations in terms of validity and reliability of the
diet has a role. Although the terms are used inter- tool, the time taken to complete, and the level of
changeably in the literature, nutrition screening is skill required by individuals applying the tool.
a simple and rapid means of identifying individ- Within the UK two child specific tools have been
uals at nutritional risk which can be undertaken developed: the Screening Tool for the Assessment of

Clinical Paediatric Dietetics, Fourth Edition. Edited by Vanessa Shaw.

© 2015 John Wiley & Sons, Ltd. Published 2015 by John Wiley & Sons, Ltd.
Companion Website: www.wiley.com/go/shaw/paediatricdietetics
 Shaw c01.tex V3 - 08/22/2014 9:21 A.M. Page 4

4 Nutritional Assessment, Dietary Requirements, Feed Supplementation

Table 1.1 Child specific screening tools developed and the scientific basis for future developments in this
evaluated in the UK. area [14].
STAMP PYMS

Criteria utilised Diagnosis Diagnosis

Dietary intake Dietary intake
Nutritional assessment
Anthropometrics: Weight loss
weight and height Anthropometrics: Nutritional assessment comprises anthropometric,
centile BMI clinical and dietary assessment, all of which should
Scored High/medium/ High/medium/
be used to provide as full a picture of the nutri-
low risk low risk tional status of the individual as possible; no one
method will give an overall picture of nutritional
Criterion validity status. Within these areas there are several assess-
Agreement with full 54% 46% ment techniques, some of which should be used
nutritional routinely in all centres, whilst others are better
assessment∗ suited to specialist clinical areas or research. This
Positive predictive 55% 47%
chapter provides a brief overview of the common
value†
Negative predictive 95% 95%
techniques and sources of further information.
value††
Training 30 minutes 60 minutes
Anthropometry
Used by Any trained Registered nurses
healthcare Measurement of weight and height (or length) is
professional critical as the basis for calculating dietary require-
ments as well as monitoring the effects of dietary
STAMP, Screening Tool for the Assessment of Malnutrition in intervention. It is important that all measure-
Paediatrics; PYMS, Paediatric Yorkhill Malnutrition Score;
ments are taken using standardised techniques
BMI, body mass index.
∗ Children identified as being at nutritional risk by tool and full and calibrated equipment. Ideally staff taking mea-
nutritional assessment. surements should receive some training on how
† The proportion of children identified as at risk by the tool to do this accurately. There are a variety of online
who are actually at risk. resources to support training in anthropometric
†† The proportion of children identified as not at risk by the
measurement of children.
tool who are actually not at risk.

Weight
Malnutrition in Paediatrics (STAMP) and the Pae- Measurement of weight is an easy and routine
diatric Yorkhill Malnutrition Score (PYMS) [9, 10]. procedure that should be done using a calibrated
Both of these tools have been evaluated in practice digital scale. Ideally infants should be weighed
and comprise a number of elements that are scored naked and children wearing just a dry nappy
to give a final risk score (Table 1.1). The reliability or pants; however, this is often not possible or
of each of these tools has been published, along appropriate. In these situations it is important to
with a number of other studies evaluating their record if the infant is weighed wearing a clean
use in a variety of clinical settings and conditions dry nappy, and the amount and type of cloth-
[11–13]. The main limitation of these evaluation ing worn by older children. A higher degree of
studies is that they rely on the dietetic assessment accuracy is required for the assessment of sick
of nutritional status as the ‘gold standard’ and the children than for routine measurements in the
findings of studies comparing the tools to date community. Frequent weight monitoring is impor-
have been equivocal. There is an ongoing multicen- tant for the sick infant or child, and local policies
tre Europe-wide study under the auspices of the for weighing and measuring hospitalised infants
European Society of Paediatric Gastroenterology, and children should be in place. Recommenda-
Hepatology and Nutrition (ESPGHAN) to evaluate tions for the routine measurement of healthy
a range of the tools available. Results have not yet infants where there are no concerns about growth
been published, but it is hoped that this will form are given in Table 1.2 [15]. If there are concerns
 Shaw c01.tex V3 - 08/22/2014 9:21 A.M. Page 5

Assessment of Nutritional Status 5

Table 1.2 Recommendations for routine measurements for about growth or weight gain a height measurement
healthy infants and children. should be made more often.
Head
Weight Length/height circumference Proxy measurements for length/height
In some cases it is difficult to obtain length or
Birth Birth Birth or neonatal
period height measurements, e.g. in very sick or preterm
2 months 6−8 weeks if birth 6−8 weeks infants and in older children with scoliosis. A
weight <2.5 kg or number of proxy measurements can be used which
if other cause for are useful to monitor whether longitudinal growth
concern is progressing in an individual, but there are no
3 months recognised centile charts as yet and indices such
4 months
as body mass index (BMI) cannot be calculated. In
8 months
Additional weights at No other routine No other routine younger adults arm span is approximately equiva-
parent’s request; not measurement of measurement lent to height, but body proportions depend upon
more frequently than length/height of head age and while there is some evidence that there
2 weekly <6 months, circumference is a correlation in older children and adolescents,
monthly 6−12 months this measurement may be of limited usefulness in
12−15 months
children. Ulna length has been demonstrated to
School entry School entry
act as a good proxy for stature in adults although
Source: Adapted from Health for all Children [15]. evidence in children is limited [16]. Measurements
of lower leg length or knee−heel length have been
used and are a useful proxy for growth [17]. Total
about weight gain that is too slow or too rapid, leg length is rarely measured outside specialist
measurement of weight should be carried out more growth clinics and is calculated as the difference
frequently. between measured sitting height and standing
height. A number of other measures have been
Height used in children with cerebral palsy as a proxy
Height or length measurement requires a sta- for height (p. 780), but numbers are too small for
diometer or length board. Measurement of length reference standards to be established [18]. Formu-
using a tape measure is too inaccurate to be of use las for calculating stature in children from proxy
for longitudinal monitoring of growth, although measurements are available [19].
an approximate length may be useful as a single
measure. Under the age of 2 years supine length Head circumference
is measured; standing height is usually measured Head circumference is generally considered a use-
over this age or whenever the child can stand ful measurement in children under the age of 2
straight and unsupported. When the method of years. After this age head growth slows and is a
measurement changes from length to height there less useful indicator of somatic growth. A number
is likely to be a drop in stature; this is accounted of genetic and acquired conditions, such as cerebral
for in the UK-WHO growth charts (p. 6). Mea- palsy, will affect head growth and measurement of
surement of length is difficult and requires careful head circumference will not be a useful indicator
positioning of the infant; positioning of the child is of nutritional status in these conditions. Head
also important when measuring standing height. It circumference is measured using a narrow, flexible,
is recommended to have two observers involved non-stretch tape. Accuracy is dependent on the
in measuring an infant or young child. It is good skill of the observer and, as such, training and
practice for sick infants to be measured monthly practice in this technique is a requirement.
and older children at clinic appointments or on
admission to hospital. Healthy infants should have Supplementary measurements
a length measurement at birth but further routine While the measurement of weight and length or
stature checks are not recommended until the height forms the basis of routine anthropometric
preschool check [15]. Whenever there are concerns assessment, there are a number of supplementary
 Shaw c01.tex V3 - 08/22/2014 9:21 A.M. Page 6

6 Nutritional Assessment, Dietary Requirements, Feed Supplementation

measurements which can be used. These include Interpreting anthropometric measurements

the proxy measurements for stature already men- Anthropometric measurements alone confer lim-
tioned and mid upper arm circumference (MUAC). ited information on growth, nutritional status and
This is a useful measurement in children under the health and require the use of growth reference data
age of 5 years, as MUAC increases fairly rapidly up and conversion to indices for interpretation.
until this age. Increases in MUAC are less likely to
be affected by oedema than body weight; they can
also provide a useful method of assessing changes
Growth charts
in children with solid tumours and liver disease. Measurements should be regularly plotted on a rel-
There are age related standards for infants and chil- evant growth chart. In the UK the growth standards
dren [19, 20]. Measurement of waist circumference are the UK-WHO Growth Charts 0−4 years and the
and the index of waist to height can be helpful in UK Growth Charts 2−18 years [27]. The charts for
the identification and monitoring of overweight preschool children incorporate data from the WHO
and obesity [21–23]. Research has shown links multicentre growth study, a longitudinal study of
with dyslipidaemias, insulin resistance and blood optimal growth in breast fed singleton births from
pressure although the evidence for benefit using six countries across the world [28]. Every child in
waist circumference centiles over BMI centiles is the UK is issued with a growth centile chart as part
limited [23]. of the personal child health record that is held by
When monitoring interventions, particularly parents and completed by healthcare professionals
those addressing undernutrition, it is important to whenever the child is weighed or measured.
determine if changes in weight are due to increases Accuracy is crucial when plotting growth charts,
in fat mass or lean muscle mass. In order to fully and therefore training is essential as a number of
differentiate between lean and fat, measurement of different professionals may be plotting on a single
skinfold thickness (SFT) can be used. This can be chart and errors could result in the misdiagnosis
unpleasant for young children and is not used as or non-identification of nutritional and growth
a routine anthropometric measurement in clinical problems. When assessing a child in relation to
practice, but it can provide valuable data in research the growth charts a number of factors need to be
studies. The equipment and technique are identical accounted for including gestational age at birth
to those used in adults and the measurement is and parental height. The growth charts give clear
subject to the same high rates of inter-observer and guidance on correction for prematurity and the
intra-observer error. Reference data for infants and estimation of the child’s adult height.
children are available [20] and arm muscle and arm It can be difficult to assess progress or decide
fat area can be calculated. Full details on skinfold upon targets where a measurement falls outside
measurements and their interpretation has been the nine centile lines (<0.4th centile or >99.6th
published elsewhere [19, 24]. centile). The Neonatal and Infant Close Monitoring
Modern technologies can provide information growth charts [27] show −3, −4 and −5 standard
on body composition. Bioelectric impedance anal- deviation lines to allow assessment of very small
ysis is easily undertaken in a clinical setting using infants up to the age of 2 years. ‘Thrive lines’
foot to foot or hand to foot techniques. However, have also been developed to aid interpretation of
while studies have reported validity of this method infants with either slow or rapid weight gain. The
of determining body composition in healthy popu- 5% thrive lines define the slowest rate of normal
lations of young children, validity in sick children weight velocity in healthy infants. If an infant
and infants has yet to be fully established [25, 26]. is growing at a rate parallel to or slower than a
More invasive technologies for assessing body 5% thrive line, weight gain is abnormally slow.
composition include dual-energy x-ray absorp- The 95% thrive lines define the most rapid rate of
tiometry and air displacement plethysmography. normal weight gain in healthy infants and weight
These tend to be restricted to research assessments gain that parallels or is faster than the 95% thrive
of body composition and further information can line is abnormally rapid [28]. There are a range
be found elsewhere [19]. of resources available to support training on the
 Shaw c01.tex V3 - 08/22/2014 9:21 A.M. Page 7

Assessment of Nutritional Status 7

plotting and interpretation of growth charts on reference or standard measurement, the calculation
the Royal College of Paediatrics and Child Health giving a numerical score indicating how far away
website. from the 50th centile for age the child’s measure-
Some medical conditions have a significant effect ments/index falls. For the UK growth charts each
on growth and where sufficient data exist separate centile space equates to 0.67SD; therefore a child
growth charts have been developed, e.g. Down’s on the 2nd centile will have a z-score of −2SD
syndrome, Turner syndrome, sickle cell disease, and a child on the 98th centile will have a z-score
achondroplasia. of +2SD; a measurement that falls exactly on the
50th centile will have a z-score of 0SD. Calcula-
tion of z-scores by hand is extremely laborious,
Body mass index
but a computer software program is available
A BMI measurement can be calculated from (www.childgrowthfoundation.org) that will enable
weight and height measurements: BMI = weight calculation of z-scores from height, weight, BMI,
(kg)/height (m2 ). This provides an indication of gender and age data. The z-score can also used
relative fatness or thinness. In children the amount when comparing groups of children when a com-
and distribution of body fat is dependent on age parison of the measurements themselves would
and sex. BMI is now routinely used to identify and not be useful.
monitor overweight and obesity in children, on an The WHO defines moderate malnutrition and
individual and population basis, in the clinical and obesity in children in terms of z-score for weight as
research environments [29]. There are limitations, −2SD and +2SD respectively [28].
however, to the use of BMI in children: The calculation of height for age, height age and
weight for height are useful when assessing nutri-
• It is not recommended in children <2 years
tional status initially or when monitoring progress
of age as during this period BMI changes
in children who are short for their chronological
rapidly and weight gain rather than BMI has
age. Table 1.3 shows examples of calculations for
been shown to be more indicative of future
these indices. The Waterlow classification [32]
overweight and obesity [30].
may be of use when assessing children in the UK
• In chronic undernutrition there is stunting as
with severe failure to thrive. An adaptation of the
well as low weight for age and thus undernu-
classification is shown in Table 1.4. Calculation of
trition may be masked by using BMI.
height age is necessary when determining nutrient
• Although BMI is a relative index of weight
requirements for children who are much smaller
to height it does not provide information
(or larger) than their chronological age.
about body composition; it cannot be used to
distinguish between fat mass and lean mass.
Paediatric BMI charts have been developed and Clinical assessment
can be used to indicate how heavy a child is relevant
to its height and age [31]. The UK growth charts Clinical assessment of the child involves a medical
have a quick reference guide to estimate BMI centile history and a physical examination. The medical
on the basis of the child’s weight and height cen- history will identify medical, social or environ-
tiles. mental factors that may be risk factors for the
development of nutritional problems. Such fac-
tors may include parental knowledge and finance
Anthropometric indices and the classification
available for food purchase, underlying disease,
of nutrition status
treatments, investigations and medications. Clini-
The World Health Organization (WHO) and cal signs of poor nutrition, revealed in the physical
research publications frequently report standard examination, only appear at a late stage in the
deviation (SD) score or z-score for length/height, development of a deficiency disease and absence
weight and BMI. This involves converting the of clinical signs should not be taken as indicating
measurement or index into a finite proportion of a that a deficiency is not present.
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After all defences made be the said Mr Andrew, the haill Kirk finds
him to have broken the act, That no ministers shall marry the
parochiners of ane uther parochine without ane sufficient
testimoniall, and so guiltie of the paines contanit therein; not the
less the Commissioners and ministers of the towne of Edinburgh
made supplication to the haill Assembly that the rigour of the act
should not strike upon him, but that some satisfaction should be
made to the kirk of Edinburgh at the discretioune of the haill kirk:
Whilk supplication the haill brethren acceptit, and ordained that the
said Mr Andrew shall compeir before the Sessione of the kirk of
Edinburgh on Thursday next to come, and there confess his awne
offence, desyreing pardone thereof, with promise of never to offend
in sic sort heirafter, under the paines containt in the said act, to be
execute to the rigor thereof.

Sess. 4a. Marche 7, 1568 [9.]

Tenor of the Letter sent be the Duke of Chatlherault his Grace, to the
Generall Assembly.

Grace, mercy, and peace, from God the Father, through Jesus Christ,
we wische to you.

Brethren, We thocht it expedient to certifie yow that being in

France, and hearing the great troubles in this our native countrey, of
conscience and dewtie was compellit to come home, desyreous to
helpe to pacifie the same at our utter power: First to the glory of
God Almightie, and next to the relief of the right sair and lamentable
oppressed trew subjects, quhais innocent blood and innumerable
heirschips, oppressiones, wrongs and slewths that hes been
committit, and daily is upon them, is to us so grievous and
intollerable a burden both in conscience and honor, that we refuse
not only this our native realme, but also the hale warld or it were not
reformit; and albeit in my absence I have sustained wrong, I assure
my owne particular naither in blood, lands, nor gear, is so heavie to
me as the great danger this haill kingdome stands intill, giue be the
grace of Almighty God, and help of the old and natiue Scotts blood,
it be not foreseen and relieved in tyme. Heiring of your Conventione,
brethren, at this tyme, I have send this bearer to you to declare this
to be our full and determinit minde to follow be the grace of God;
First, That the word of God may have free passage through this haill
realme, and that the sacraments may be ministrat according to the
institutione of Christ Jesus his Sone our Saviour: Next, That every
true subject of this realme may live without feare upon that whilk is
justly his owne, according to God’s calling and commandement. In
this cause of this present diversitie of our native Soveraigne and ane
pairt of her subjects, ffor the qwhilk we are very heartilie sorrie, and
as Almightie God knawes innocent of foirknawledge of any thing, so
we would wische all uthers to be the lyke. Our desyre is, that all
hostilitie and troubles might be pacified according to the command
of God, and that the haill Estates in quiet and peaceable manner
may continew, and first calling for his grace and Holy Spirite of
righteous judgement, might consider the ground and beginning of
this altogidder evill deid, I meane the slaughter of the Queen’s late
husband, what hes proceedet thereupon sinsyne, and what God
wald of reasone sould be done therefore; and this to be devysed
either be the haill estates or 25 of the wysist of the nobilitie chosen
be the haill, and to be followit be the whole people of the realme,
whereunto we of the nobilitie and all that continews under our
obedience to the Queen our Soveraigne, sall for God’s and for the
commone weall be found agreeable. I avoyde the wrougous
judgement may be spoken that we wreit this to yow because of
proclamations that the Earle of Murray hes made in diverse shyres of
this realme, to have the people in Glasgow the 10. of March: We
would ye should consider we doe it not for that cause: ffor first as ye
knaw sen before thir troubles begane we have never been in this
countrie before the 25. of this instant Februarii, wherethrough we
might haue shawen our minde herein, and all the people of Scotland
war gathered together, both for nativeness of blood and for good
deserving of my forbears and my selffe, thairs the strenth of the
world quhilk I could wishe myself and find me maist sure; and giue
the said Earle of Morray wold take upon him to invade me or any of
my friends or dependars, or any trew man of this realme, (as I
cannot think he will,) then trust I, that the nobilitie or people will not
assist him thereto, whill first they finde ane cause worthy, and be
declared be the antient lawes of the realme: And though we desyre
thir conventions and forces of men of war to be turnit upon the
thiefes and oppressors of the realme; whereunto we shall be most
ready with our bodies and gear to doe the devoure of noble and
trew men; yet, giue he will persevere to persew us, we doubt not in
God and the justice of our cause, to finde all the noble and trew
men so favourable to us, that it shall not be in his power to doe us
wrong upon particular malice, altogether without deserving.
Therefore, we require you in God’s behalfe to make some of our
affaires and mynde patent unto the people, and giue ye finde not on
our pairt socht here, and offerit that our Christiane professione
dewlie requireth, that ye come and reasone the same with us, where
ye shall finde us reasonable in all causes according to God’s word
and equitie, on qwhaies divyne protectione we committ you. Off
Hamiltoune, the 27th of February.
Your Christiane Brother,
James Hamiltoune.
After reading of the said letter, the brethren being advysit
thereupon answerit to the bearer of the letter, That the Kirk would
send some of the brethren to my Lord Regent’s Grace to knaw his
pleasure, whidder they should wreit or send ane certaine of the Kirk
with Commissione frae the same to my Lord Duke’s Grace, schawing
and declareing the opinione of the Kirk touching his Grace’s letter. As
for that same, the haill Kirk gaue Commissione to the brethren, Mrs.
John Spottiswood, John Wynrhame, and John Row, to passe to my
Lord Regent’s Grace, and knaw his pleasure touching the said letter,
and thereafter to passe according to his Grace command, to my Lord
Duke’s Grace, and conferr with him and uthers of the nobilitie whom
they find present, and be all means possible to reconcile the nobilitie
forsaid to the obedience of the King’s Majestie and his Regent; and
farder to doe as the said Commission proports.

Sess. 5a. March 8, 1568(9).

 It was concludeit be the haill brethren assemblit, that an generall
fasting be proclaimit throughout all Scotland, and to begin in
Lawthiane, Fyfe, and sic uther places as may receiue advertisement,
the 13th day of this instant. Thereafter, the Superintendants and
Commissioners of provinces to advertise and begine at sic tymes as
they think expedient, and to continow from the first day to that day
aucht dayes inclusive; and in the meane tyme to use the exercise
accustomed in the Kirk of the first institutione, and als to use
sobrietie in eating and drinking in tyme of the exercise.
Moreover, concludeit that all Superintendants and Commissioners
of provinces shall hereafter institute and use the same order of
fasting, so oft as just occasione shall serve and sall seem meit be
their godlie wisdome, without any farther appointment by the
Generall Assemblie.
That remedie may be provydit against the oppressione of the Earle
of Huntlie and of uthers, who hes deposit the Collectors of the Kirk,
and tyrannouslie placit their owne.
That it may please his Grace and the Secret Councill that the Kirk
from admonitione may passe to farther censures against the said
Earle and all uthers guiltie of the lyke oppression, unto publick
excommunication, in case of his and their contempt.
That the Kirk, without offence of his Majestie, may appoint their
brother Mr Robert Pont where that his labours may be more fruitfull
than they can be for this present in Morray.
That order may be taken that sic odious crymes as this day
provoks God’s displeasure against the haill land, may be punished as
God hes commanded: giue his Grace send us to the Justice Clerk,
experience hes teached us sufficientlie what he hes done in any sic
matters.
The Kirk requyres that aines the jurisdiction thereof may be
separate from that whilk is civill.
That the questione of adulterie may once take effect; at leist a
decisione in that heid—whether the adulterer shall be admittit to the
benefite of marriage or not.
 [NINETEENTH GENERAL ASSEMBLY.]
The Generall Assembly of the Kirk conveint in Edinburgh, and Nather
Counsell-house of the same, the 5th of July 1569: In the quhilk were
present the Superintendants, Ministers, Barrons, and Commissioners
of Townes and Kirks.

For eschewing of confusione quhilk might chance in reasoning

amongst the brethren presently conveint, with ane voyce was
choysen for Moderator, William Chrystesone, minister of Dundie, for
this Conventioune, who being present acceptit the office on him.

Sess. 2a. July 6, 1569.

Anent the defence gine in the Assemblie halden in December
1567, be Mr John Craige, ane of the ministers of Edinburgh, touching
the proclaiming of the Queene and Earle Bothwell, the said defence
being publickly read, the haill poynts therein conteint be the haill
Assembly maturely considerit; It was funde be the haill brethren that
he had done the dewtie of ane faithfull minister, and had committed
nothing sclanderous to sic as hes righteous judgement, in respect of
the defence forsaid, quhilk was fund both godlie and sufficient for
declaration of his innocencie thereanent, quhilk the haill Assembly
declarit and testified, and ordained the same to be notified to all and
syndrie.

Sess. 3a. July 7, 1569.

Anent the punischment of adulteries, murther and uthers criminall
and capitall crymes quhilk deserves death, &c. Whether the
supreame Magistrate aught first to declare his minde of his
satisfactione and admissione, or if the Kirk shall receave them to
repentance before the declaratioune of the Magistrats will?
 Anent persones guilty of capitall crymes fund the Superintendants,
Ministers, Elders or Deacons of reformit Kirks, to compeir to this
Assembly or any uther hereafter, and the saids persons fund not
compeirand, the Kirk ordaines the saids Superintendants or Ministers
to proceed to excommunication against them, and to notifie to the
Supreame Magistrate so many as for the offences are alreadie
excommunicate, that further punischment may be execute.

Certaine of the Articles presented to my Lord Regent.

That order may be tane for the sustentation of the poor, and that
ane portion of the teynds be appointit for that effect. And in like
manner, that the labourers of the ground may have intromissione to
lead their owne teynds upon reasonable compositioune.
Item, That sic as hes pluralitie of benefices may be compellit to
dimitt all save one.
Item, That remedie may be provided for chaiping and changing of
benefices, and selling of the same, dimminisching of the rentall, of
setting of lang taks in defraud of the Kirk, and that all taks sett sen
the assumption of the thrids may be disannullit, with express
inhibitioune agains the same in tyme to come.
Item, That the jurisdiction of the Kirk may be separate from that
quhilk is ciuill.
Anent this article, my Lord Regent’s Grace ordaines the persones
nominat in the act of Parliament to conveine the tyme of the nixt
chekker, and defyne and limitat the said jurisdictione according to
the word of God and the said act. Extract. ex libro actorum secreti
concilii.
Alex. Hay.

The tenor of the Act made for Assignatioune of Stipends.

Forsuameikle as this lang tyme bygane the ministers hes been
universallie defraudit and postponit of their stipends, and now at last
it hath pleasit God to move the hearts of the superiour power and
Estates of this realme to grant the thrids of the haill benefices within
this realme to the ministers of Christ’s religione be plaine and publick
proclamation, as at mair lenth is conteinit in the said Parliament,
holden at Edinburgh in the moneth of December 1567; In respect
quhereof the Kirk presently convenit finds it maist needfull and
expedient, that all Superintendants, Ministers, Exhorters, and
Readers, shall have their owne particular assignations appointit to
them, to receave the same frae the hand of the laborers, taxmen, or
uthers addebtit in payment of the saids thirds: And therefore the
Kirk in ane voyce, be this act, gives their full power and commissione
to every Superintendant and Commissioner of Kirks within their
owne bounds, as they shall find the same expedient, under the
Superintendant’s subscriptione and ministers foresaids, with all
clauses needfull and expedient thereto, quhilks sallbe alse sufficient
as if the same were specifiet be the Generall Assembly of the Kirk.
And as concerning the Superintendants and Commissioners of Kirks,
their provisione and assignatione to be made be the Generall
Assembly of the Kirk.
And to the effect this act may take full perfectione, the Assembly
present requyres maist humbly, my Lord Regent’s Grace and Secrett
Councill, to interpone their authoritie thereto, that the assignations
forsaids, generall and particular, as they shall be presentit to his
Grace, may be specifit in forme of provisione ad vitam, under the
Privy Seal, with ordinance thereupone, that Letters may be direct at
every man’s instance, under all the four formes, as is grantit to the
possessors of the twa part; and alse to the same end, that his Grace
and his Counsell forsaid wald decerne the thrids of the benefices
forsaids within this realme, to be separate and devydit reallie and
with effect, from the twa part, so that the Kirk may intromitt with
the thrid part, as the possessors does with the twa part, the
superplus always to be comptable to the commone effaires,
conforme to the act of Parliament.

Sess. 5a. July 9, 1569.

My Lord Regent’s Letter to the Assembly.
 After our maist hearty commendations; Seeing we are not able to
be present at the Assembly now approachand, as our intentione
was, We thocht it convenient, brieflie to give you significatioune of
our meaning in wreit, of the quhilk we pray you to take good
consideration, and, accordingly, to give your advertisement. Ye are
not ignorant, as we suppose, what has beene the estate of the Kirk
of God within this realme, baith before we acceptit the burding of
regiment and sinsyne: How, first, the thirds of benefices war grantit
to the ministrie, thereby partlie relievit and sustainit in sic sort, that
nothing inlaikit that our travells could procure. The first order,
indeed, was divers wayes interruptit and brokin in, but chiefly in that
year when we were exyled in England, quhairthough that year the
haill ministers war frustrate of their livings. Shortly, in the estate of
Government altering at God’s pleasure, and the King our soveraigne
being inaugurat with the crowne of this kingdome, the first thing we
war careful of was, that the trew religion might be established, and
the ministers of the Evangell made certain of their livings and
sustentatione in tyme comeing: ye knaw, at the parliament we war
maist willing that the Kirk sauld haue been put in full possessione of
the proper patrimonie, and toward the thrids we expeded in our
travel, and inlaikit only a consent to the dissolutione of the prelacies,
whereunto, although we were earnestly bent, yet the estates delayit
and wold not agree thereunto; and sen that tyme to this houre, We
trust we will affirme, that we have pretermittit nothing that may
advance the religione, and put the professors thereof in surtie,
whereanent the haill and only inlaike hes been in the ciuill troubles
that God hes suffered the countrie to be plagued with. Now, the
matter being, after so great rage, brought to some stay and
quietness, it was convenient that we returne where matters left and
prease to reduce them to the estate they stand in. Ane thing we
must call to remembrance, that at sic tyme as we travellit in the
parliament to cause the estates to agrie, that the thrids should be
decernit to pertaine to the ministrie, they plainly opponit them to us
in respect of the first act, alleadgeand, that, with the sustentation of
the ministrie, there was also regard to be had to the support of the
puire, in sustaining of the public chairges, quhilks, if they had not
some reliefe be that meine, the revenue of the crowne being so
diminisched, and the ordinare charges cume to sic grytnes, on force
they wold be burdenit with exactions; and so this dangerous
argument compellit us to permitt to the estates, that we wold take
upon us, the act being grantit to the Kirk, they should satisfie and
agrie to ony thing sould be thocht reasonable, for supporting of the
public charges of the prince. And, according to this, the
Commissioner Deput for the affaires of the Kirk agriet to certaine
assignations of the thrids for supporting of the King and us bearing
authoritie; quhilk order had been sufficient for the haill, give the ciuil
trouble had not occurrit; yet the disobedience growand so
universallie, we are content to sustaine ane part of the inlaik and
loss for the tyme past. But because there hes bene murmure and
grudge for that thing assignit to the King’s houss and ours, and
some other needfull things in the State, as that thereby the Ministers
were frustrate of their appointit stipends, some communicatione was
had at St Androis, and nothing yet concludit qwhill the Generall
Assembly of the Kirk, quhilk now moves us wreit to yow in this
forme, prayand yow richtlie to consider the necessitie of the cause,
and how the same hes proceeded frae the beginning, haveing
respect, that the Kirk will not be very well obeyit without the King’s
authoritie and power, and that now the propertie of the Crowne is
not able to sustaine the ordinarie chairges. How in the beginning the
thrids had not been grantit giue the necessitie of the prince had not
been ane of the chief causes; and at the parliament, the estates, as
we have before written, stak to consent that the haill thrids sould be
declareit to pertaine to the ministrie, whill first we take in hand, that
they being made without conditione in favours of the Kirk, the same
wold againe condescend to so meikle as wold be sufficient to the
support of the publick affaires, in furthsetting of the King’s
authoritie, and that therefore we will agrie and condescend to ane
certaine and speciall assignatione of it, that sall be imployit to this
use: The quantity qwhairof, diverse of your selves and the beirer
heirof, Mr John Wood, our servant, can informe you, that after ye
may distribute to everie ane haveing chairge in the Kirk of God his
stipend, according to the conditione of the place he serves in,
according to your wisdomes discretione. Hereby, all confusione that
lang hes troublit the estate of the Kirk toward the stipend, shall be
avoidit, and some speciall provision being made for sustaining of
their publick chairges, we may the better hald hand to sie the Kirk
obeyit of that whereon the ministers should live, as ye shall reporte.
That dureing our travells in the north countrey, they have found our
effectious good will, and travellit in their furtherance. Farder, we man
put yow in minde brieflie of ane matter that occurrit at our late
being in Elgine. Ane Nicoll Sudderland in Forres was put to the
knawledge of ane assyse for incest, and with him the woman: the
assyse hes convict him of the fault; but the question is, whether the
same be incest or not, so that we behovit to delay the executione
whill we might have your resolutione at this Assemblie. The case is,
that the woman was harlot of before to the said Nicoll’s mother
brother. Herein Mr Robert Pont can informe yow mair amplie, to
whais sufficiencie we remitt the rest. Mair over, at our coming at
Aberdeen, there came ane named Porterfield, minister, provydit of
before to the Viccarage of Ardrossane, and required also of us, that
he might also have the viccarage of Steinsone, seeing both was ane
matter meine aneuch to sustaine him, and because the kirks war
neir, he might discharge the cure of both. We haveing him
commendit be diverse great men to the same, but thocht guid to
advertise yow that this preparatione induce not evill example and
corruptione; alwayes, in caice sic things occurr hereafter, let us
understand what ye would have us to doe, as in lyke manner,
towards the chaplanries shall happen to vaike; whereanent, because
there is no certaine order, and some confusione stands, some
desyrand them for lyftyme, some for inffants that are not of the
schooles, and some for seven yeares. We are sometyme preasit to
receave or confirme assignationes or admissione of benefices, the
preparature whereof appears to bring with it corruptione, and so we
would be resolvit how to proceed. Before our comeing from Fyfe,
and sinsyne, we have beene very willing to doe justice on all suspect
persones of witchcraft, as also upon adulterers, incestuous persons,
abusers of sacraments, quherin we could not have sic expeditione as
we would have wisched, because we had no uther probabilitie
whereby to try and convict them but ane generall delatione of
names; the persones suspect not being, for the maist part, tryit and
convict be order of the Kirk of before. This hinderit many things that
utherwayes might have been done; and therefore we pray you
appoynt and prescryve, how the judgement of the Kirk may proceed
and be execute against all sic trespassers, before complaint be made
to us, that when we come to the cuntrie, we may cause execute the
law, and be relievit of the tryall of inquisitione heiranent. We thocht
expedient to give yow this for advertisement; and so remitts the haill
to your care and diligence, committs yow in the protectione of
Eternall God. Aberdeene, July ultimo, 1569. Your assurit ffriend,
James, Regent.

Articles and their Answers.

To the Questione, whether the cryme before specifiet, committit
be Nicoll Sudderland, be incest or not? Answerit, The Kirk finds it
incest, and so hes resolvit.
Item, Anent the Chaplanries that shall happen to vake? Annswerit,
The Kirk agriees that they be disponit to Colledges or to the puire,
conforme to the act of Parliament, and no utherwayes.
 [TWENTIETH GENERAL ASSEMBLY.]
The Generall Assembly being appointit in Strevilling, February 25, be
reason of troubles falling out be the slaughter of my Lord Regent’s
Grace, was continueit till the first of Marche, and begunne in
Edinburgh the said day, 1569(70), in the Tolbuith thereof; where was
present the Nobilitie, Superintendents, Commissioners to plant Kirks,
Ministers, and Commissioners of Kirks and Townes. The Sermone and
Prayers made be William Christisone, Minister of Dundee, last
Moderator.

Ordour to proceed in the Assemblies.

First, That he who is moderator in the last Assemblie, shall make
the prayer and exhortation in the Assembly thereafter following;
whilk endit, the Kirk proceedit to the chuseing of a new moderator,
quho shall continue make prayers and exhortations as said is, and so
furth, from Assembly to Assembly.
Secondlie, The tryall of Superintendants and Commissioners for
planting of Kirks, with the accusationes, if any beis, be
Superintendants, Commissioners, or any uthers, against ministers.
Thirdlie, The penitent committit to the Superintendants or
ministers at the last Assembly, to be receavit according to the ordour
appointed be the last Assembly, and alse to give injunctions to
uthers notorious criminall persones, that aither are fund be the
Superintendant, Commissioner of the Kirk, or of their own freewill,
moveit be hatreit of their cryme, presents themselffs in the Generall
Assembly.
Fourthlie, To decerne upon sic things as aither was undecydit at
the preceidand Assemblie and remittit to this, or else referrit
hitherto, be the Lords of Sessione, Auditor of Chekker, or any uther
wayes.
 Sessio 2a. March 2, 1569(70).
The haill brethrene convenit, in ane voyce, for eschewing
confusione in reasoning, chuse Mr John Craige, ane of the ministers
of Edinburgh, to be Moderator in this Assembly, and to make the
prayer and supplicatione in the beginning of the next Assembly,
according to the order appointit.
Anent the complaint gine in be Thomas Smith in Ochiltrie, againes
Mr John Smyth, minister in Ochiltrie, for debarring the said Thomas
from the Lord’s table, because he removeit ane shoe off ane horse
upon ane Sonday afternoone in Ochiltrie, where neither preaching
nor publick prayers was. After long reasoning, the said Thomas was
ordainit to be receavit to the participatione of the Lord’s table, and
uther benefites of the Kirk, hereafter, notwithstanding of the
alleadgit fault abovementionat.
The Kirk ordaynes sic persones as are convict of incest or
adulterie, and hes not stubbornly contemnit the admonitions of the
Kirk, nor sufferit the sentence of excommunication for their offences,
shall make publict repentance in sackcloath, at their owne kirks,
bairheaded and barefooted, three severall dayes of preaching, and
after the said third day, to be receavit in the societie of the Kirk, in
their owne cloathes. The uthers that hes been excommunicat for
their offences shall present themselves bareheaded and barefooted
sax preaching dayes, and the last, after sermone, to be receavit in
their owne cloathes, as said is.

Sessio 3a. March 3, 1569(70).

Anent homicids, incestuous persones, and adulterers not fugitive
from the lawes, but continuallie suteing to be receavit be the Kirk to
publick repentance; after long reasoning, with mature deliberatione,
the haill brethren presently assembleit, concludit, that all sic
persones, humbly suiting, shall be receavit, to give the signes of
their repentance in their awne kirks, according to the order appoyntit
before, at qwhilk tyme the minister shall publickly notifie their
crymes, that thereby the civill magistrates may know the crymes,
and pretend no ignorance thereof.
Give they be excommunicat for their offences, they shall stand
bareheaded at the kirk doore, every preaching day, betwixt the
Assemblies, secluded from prayers before and after sermone, and
then enter in the kirk, and sit in the publick place bareheaded, all
the tyme of the sermons, and depart before the latter prayer.
The uthers that are not excommunicat shall be placeit in the
publick place where they may be knawne from the rest of the
people, bareheaded the tyme of the sermones, the minister
remembering them in his prayer in the tyme after preaching; all the
saids persons to bring their ministers’ testimonialls to the next
Assembly of their behaviour in the meantyme, according to the act
made thereupon be the Kirk in the 2d Sessione, halden July 7, 1569.
Anent the complaynt of the parochiners of the kirk of Kilmenie for
wanting of ane minister to preach God’s word and minister the
sacraments, the haill Kirk concludes, that in respect of the number of
qualified and learnit men of the auld Colledge able to preach, and
also the nearness of the said Colledge to the said kirk, That some of
them shall either preache and minister the sacraments to the people,
or else injoyne uthers to doe the same qwhill farder order be taine.

Sess. 7a. March 3, 1569(70).

Anent Robert Lickprivick his supplicatioune for support of the Kirk
in his office of printing: The Kirk haveing respect to his povertie, the
great expenses he hes made in bying printing irones, and the great
zeal and love he beirs to serve the Kirk at all tymes, hes assigned to
him, ffyftie punds yearly, to be payeit to him out of the thrids of the
Kirk, be the Collectors underwritten, viz. the Collector of Lowthiane
20 łb., the Collector of Fyfe 20 łb., the Collector of Angus 10 łb.;
Quhilk soume the auditors of the compts for the Kirk shall thankfully
allow to every ane of them.

Sessio 8a. March 9, 1569(70).

 It is statute and ordanit that no minister, provydit or heirafter that
shall be provydit to benefices, sett in tack any manner of way, their
gleib or manse, neither yet any part of the fruits or emoluments
thereof, in diminutione of their rentalls, under the paine of depryving
from the benefice for ever; decernyng also the tacks sett in manner
forsaid, to be null and of none effect as done be him that hes no
power.

Sessio 9a. March 11, 1569(70).

Quhat shall be done to them that will not forbear the company of
persones excommunicat, after dew admonitions? To be
excommunicat except they forbear.
The children of the excommunicat persones to be receavit be ane
faithfull member of the Kirk to baptisme.
Ane single woman committing adulterie with ane married man
should be equally punished.
Quhair a man repudiats his wife and bairnes without ane cause,
and no wayes will receave her againe, the minister should labour for
reconciliatione, and the pairtie offendit complaine to the judge
competent.
Ane promise of marriage made before the readers and elders in
ane reformit kirk, the parties contractit compeirs before the Minister
and Sessione, requires their bands to be proclaimit; quhilk beand
done, the Kirk finds carnall copulatione to have followit, be
confessione of baith parties: when the Kirk requires them to proceid
to the solemnizatione, the woman refuses.
Admonische the refuisand to solemnize the marriage, or else to
gett ane decreit from the judge competent, that they should not
marrie, under the paine of excommunicatione.
Persones, after promise of marriage and proclamation of the
bands, desyrand to be frie from the bands, no carnall copulatione
following, should be free, si res est intergra, and their inconstancie
punishit.
 It is not lesum for ministers to leave their vocatione and use other
offices and chairges within the commone weill, without consent of
the Kirk; and in tymes cumeing, it is needfull that all them that
serves in the ministrie be publickly inaugurat.
 [TWENTY-FIRST GENERAL ASSEMBLY.]
The Generall Assembly of the Kirk, halden at Edinburgh in the Nether
Councill House, the 5th day of July 1570, quhair was assembleit the
Nobilitie, Barrones, Superintendants, Commissioners of Kirks,
Provinces, Townes, and Ministers: the prayer made be Mr John
Craige.

The haill brethren presently conveint, chuse Mr Robert Pont

Moderator for this Assembly.
Penitents that, for their offences, resorts to the Generall
Assemblie, either to receive injunctions for to schaw signes of their
repentance, or that sould present themselfes before the same in
linnen cloathes and receave farther injunctions, that they be warnit
to compeir the second day of the Assembly peremptorlie.
Ministers, at their publick inauguration, shall protest solemnlie that
they sall never leive their vocatione any tyme thereafter under the
paine of infamie and perjurie.
Anent the tryall of young children, and how they are brought up
be thair parents in the trew religion of Jesus Christ: It is ordainit,
that ministers and elders of kirks shall, universallie within this
realme, take tryall and examine all young children within their
parochines that are come to nyne years, and that for the first tyme;
thereafter, when they are come to twelve yeares for the second
tyme; the third tyme, to be examined when they are of fourteen
years, wherethrough it may be knawne what they have profited in
the schoole of Christ from tyme to tyme.

Sessio 3a.
It is ordained, be reasone of the great troubles fallen out lately in
this realme be defectione of some from the King’s Majestie’s lawfull
authoritie, that certaine brethren be sent from the Kirk to all sortes,
Earles, Lords, Barrones, and gentlemen whatsumever, that hes made
the foresaid defectione, and travell with them be all meanes
possible, to reconcile them to the lawfull obedience of his Majestie,
and to certifie them that disobeys, that the haill Kirk will use their
sword against them, quhilk God’s word hes committit to them.
Commissioners for that effect—Mr Andrew Hay and Mr David
Lindsay, to my Lord Duke’s Grace, the Earles of Argyll, Eglintoune,
Cassills, the Lord Boyde, and uthers barrones and gentlemen that
they can gudlie meit with within the wast parts; The Laird of Dunn,
Superintendent of Angus and Mernes, to the Earle of Crawford, the
Lord Ogilvie, and their assisters: Qwhilk Commissioners war
commandit to report their answers to the next Generale Assemblie.

Sessio 4a.
The controversie in St Androis betuixt Mr Robert Hamiltoune,
minister there, and his Colleges on the ane parte, and Mr James
Carmichael and his Colleges on the uther parte, is traitit and
discussit be the Assembly of the haill Kirk, because the same
concerns doctrine, sclander that may rise therein, or discipline of the
Kirk.
Cloakers of adulterie sould be callit and convict; and if it be fund
that they have cloakit publick adulterie after their knawledge, then
let the law haue place. Consentientes et agentes pari pœna
puniantur.
Quhen a woman beares a bairne to a certain man, and, in the
tyme of her birth, before the midwife, alleadges the bairne to be this
man’s, and beand callit before ane judge, beand readie to sweir the
same, and this man is ready to swear the contrare, and that he
never had carnall dealings with this woman, and there is no other
witness, Whether shall credence be gine to the man’s oath or to the
woman’s? and shall the bairne be left without ane father knowne?
Answer, Neutri credendum.
 All things being done that the civil ordour requires of them that
withhalds the dewtie of the Kirk, whereby the ministers wants their
stipends, the Kirk may proceed to excommunication for their
contempt.

Sessio 5a.
Compeirit Mr James M‘Gill of Rynkelour Nather, Clark of Register
and Counsellor to our soveraigne Lord L., John Ballantyne of
Auchnouchill, Knight, Justice Clark, and Mr Archbald Douglass, ane
of the Lords of the Colledge of Justice, who, in presence of the haill
Assembly, proponit in my L. Chancellor’s name, how his L. had
understand that in the contraversie amongst them in St Androis
there was continwet some heads tending to treasone and against
the King’s Majestie’s authorities, Therfore requirit the Kirk presently
assemblit to superside all devisione in that matter concerning the
King’s Majestie, untill the tyme the nobilitie conveine, qwhilk will be
within ten days, before whom that heid aucht to be sichted;
nottheless that the Kirk proceed to sic things therein as pertayns to
their owne jurisdictione; unto the qwhilk protestation the Kirk agriet.
The said day the haill Kirk presently assemblit, in ane voyse and
mynde, gives full commissioune and power to the honorable their
brethrene, John Erskine of Dunn, knight, superintendant of Angus
and Mernes, Mrs John Wynrhame and Spottiswood, superintendants
of Fyffe and Lawthiane respective, Mr James M‘Gill, Rankelour
Nather, Clark of Register and Counsellor to our soveraigne Lord, Mr
John Knox and John Craige, David Lyndsay of Edinburgh and Leith,
ministers, the proveist of Dundie, Mr Thomas M‘Allzean, The Lairds
of Balvaird, Spott, Braid, Carnaill, Dreghorne, Lundie, Howstowne,
Drumqwhassell, Coldenknows, Carden, Fawdensyde, Thorntowne,
Inchbrakie, David Forrest, Generall of the Conzie, David Ramsay of
Dundie, Patrick Morray in St Johnstowne, and Robert Campbell of
Kinzeaunclewghe, or any eight or seven of them, To compeir in
Edinburgh the vi of this instant moneth of July, with continuatione of
dayes, so oft as the nobilitie of this realme shall conveine betwixt
this and the next Generall Assembly of the Kirk; and there, in name
and behalf of the haill kirks of Scotland, propone and present to the
said nobilitie, articles, heids, supplicationes, and complaints, such as
the said Kirk hes pennit and delyverit to the said brethren, or
hereafter shall, before the next Generall Assembly, delyver maist
humbly in their names, to require answer and grant to their articles
and supplicationes, and with redress of their complaintes according
to equitie and justice, To assist, concurr, and consent to all and
whatsumever shall be treatit in the said conventione tending to the
setting forward of the glory of God, preaching and maintaining of
trew religion within this countrie, King’s Majestie authoritie,
commonweall and authoritie of this realme: As also to take
cognitione in all and whatsumever complaints, supplications, and
requests of brethren speciallie remittit to them be this Assembly;
and whatsumever beis done be them in the præmises, to report the
same to the nixt Generall Assembly of the Kirk to begine in
Edinburgh the first day of March nixt to come, ffirm and stable
haldand and for to hald, all and whatsumever the saids brethren any
aucht or sevine of them in the premises leads to be done. The Kirk
presently assemblit, for certaine causes moving them, discharges all
and sundrie assignationes and pensiones grantit be the Kirk dureing
their will, to whatsumevir persone or persones before the date
heirof, and ordaines the Collector of the Kirk to intromett therewith
heirafter, and to put inhibitione to all them that heretofore hes had
any sic assignationes or pensiones, except that whilk is assignit to
the King’s Majestie’s hand allanerly.
 [TWENTY-SECOND GENERAL ASSEMBLY.]
The Generall Assembly, halden at Edinburgh the 5th of Marche 1570(71),
In the qwilke war present the Barrons, Superintendants,
Commissioners to plant Kirks, Commissioners of Provinces,
Universities, Towns, Kirks, and Ministers, Mr George Hay was chosen
Moderator be the suffragis, to make prayers in this Assembly and
exhortation in the beginning of the nixt.

Sess. 1a.
The Kirk assemblit ordains all superintendants and commissioners
to plant kirks, to present hereafter, their books of their visitationes,
every ane within their province respective, to every Assembly
heirafter following, to be sichted and considerit be sic brethren as
shall be appointit thereto, fra Assembly to Assembly, To the effect
the Kirk may knaw their diligence in executing their offices within
thair provinces. The Kirk finds fault that Mr John Rutherfurde,
minister at Cultis, hes not done diligence in serving the said cure at
leist certaine tymes in the year, admonisching him therefore to
amend the said fault in tymes comeing, wtherwayes the Kirk will
proceed against him as ane neglector of dewtie.

Sessio 2a.
Articles pertayning to the Jurisdictione of the Kirk, to be proponit to the
Regent’s Grace and Secret Councill, and socht to be appointit be
them.

1. Ffirst, that the Kirk have the judgement of trew and false
religion or doctrine, heresies or sicklyke, annexit to the preaching of
the word, and ministratione of the sacraments.
2. Electione, examinatione and admissione of them that are
admittit to the ministrie, or uther ffunctions in the Kirk, charge of
sawls, and ecclesiasticall benefices, the suspensione and deprivation
of them therfrae for lawfull causes.
3. All things concerning the discipline of the Kirk, whilk stands in
correctione of manners, admonitiones, excommunicationes, and
receaving to repentance.
4. The judgement of ecelesiasticall matters betwixt persones that
are of the Kirk, and speciallie among them that are constitute in the
ministrie, alseweell concerning beneficiall causes as uthers.
5. Jurisdictions to proceid be admonitiounes, to the process of
excommunication, if neid beis, against them that robbs the
patrimonie of the Kirk pertaining to the ministrie, or utherwayes
intromitts therewith unjustlie, whereby the ministrie is in danger to
decay, be occasion of the povertie of the ministers.
6. And because the conjunctione of marriages pertaynes to the
ministrie, the cause of adherents and divorcements aucht also to
pertaine to them, as naturallie annexit thereto.

Adulterers, incestuous, and homicids, war ordainit to repair

towards their own ministers, there to receave their injunctions, whill
the next Convention Synodall of the Superintendants or
Commissioners of their own provinces respective, and there to
present themselve in linnen cloathes, bareheaded and barefooted,
humblie requestand the Kirk there assemblit to receave them to the
societie of the faithfull, with farther injunctions, and to bring their
testimonialls from their ministers of their behaviour in the mean
tyme.

Sessio 3a.
Forsuameikle as it hes been ordainit be the Generall Assemblies,
that all adulterers, murtherers, incestuous persons, and uthers
committers of hainous crymes, first sould present themselves to the
Generall Assembly, there to resave their first injunctione, and at the
next thereafter following, to present themselves in linen cloathes,
&c.; And forsuameikle as diverse of the saids offenders partly are far
distant frae the places of Generall Assemblies, uthers for povertie
and deidlie feids may not nor dare not travell through the countrie to
present themselves before the saids Assemblies: for thir causes and
uthers considerationes moveing the Kirk presently assemblit, they
statute and ordaynit that all sic offenders sall be callit heirafter be
the Superintendants and Commissioners of provinces, to compeir
before them in their Synodall conventions, to be halden be them
twyse in the yeir, to receave and take their injunctions, conforme to
the order usit before the Generall Assemblies in all sorts.
The haill Kirk assemblit ordaynes, that all questions heirafter be
proponit and presentit to the Superintendants and Commissioners
forsaids in the saids Synodall Conventions, there to receave their
solutions; and gif any questione happins to be hard for them that
shall happen to be at the said conventione, then, and in that case,
the Superintendant or Commissioner of Kirks, present the said hard
questions to the Generall Assemblie, there to receave solutione in
their roome, according to the rule; with certification that no
questions hereafter shall be receavit in Generall Assemblies from
particular ministers.

Sessio 4a.
The Kirk assemblit statutes and ordaynes, that all marriages be
made solemnly in the face of the congregation, according to the
ordour published; and also inhibits all ministers and exhorters, that
nane of them solemnize marriages of any persones of uthers
congregationes nor their awne, without sufficient testimonialls from
their ministers, or else licence askit to obtaine it be the contractors,
under the pains establishit before, against the ministers and
contractors, with their parents, to make publick repentance at the
commone pillar of repentance, at the discretione of their awne kirks.

Sessio 5a.
 The Kirk assemblit ordayns all ministers to inhibit all civil
magistrates to hald their courts within Kirks; if need bees, to
admonishe.
The Kirke ordaines all Superintendants and Commissioners to
plant kirks in their first Synodall conventions hereafter following,
with the advyse of their ministers, to reason and appoint publick
fasting if it shall be thought necessar; and also that they appoint
certaine brethren to creat unitie and concord among the nobilitie of
this realme.
Compierit in Assemblie, Mr Robert Wynrahame, collector of Fyfe,
and schaw how he was purgit be ane condigne assyse before the
civill magistrat, for the slauchter of Thomas Kinries, citicen in St
Androis; nevertheless, because the blood was sched against his will,
allwayes he willingly offerit himself to the Kirk for satisfaction of the
Kirk.
The Kirk ordaines Mr Robert Hamiltone, minister of St Androis, to
declare, after the sermone upon ane Sonday, the purgation of the
said Mr Robert of the slaughter, and, therefore, call upon him to
repaire before the pulpit, exhorting him to enter in consideration
with himself, according as is contenit in the book of
excommunication, and thereafter to humble himself, ask God, the
congregation, and the partie, pardon, and to uthers that were
sclanderit with the fault, &c.
Anent excommunicat persons for now adhereing to the established
religion, and not joynit thereto of before, yet nottheless, presently of
their awne frie will, submitts themselves, and requires to be receavit
in the societie of the faithfull. The Kirk ordaines the saids persones
to be receavit be the minister in low and humble habite, with
sackcloth, observing the order prescryvit in the book of
excommunicatioune in all uther poynts.
Quhair ministers are not in practise of excommunicatione, or will
be contemnit in their executiones, it is necessar that the
Superintendant, or some uther sufficientlie qualified and authorised,
use the same.
If it be lisum to the minister to proceed against the magistrats
who will not put to execution the acts of Parliament concerning
discipline, and uther particular acts universallie agreit upon be their
owne particular congregatione, with the sentence of
excommunication?
This is else concludit; admonitions passing dwely before, against
them.
Promise of marriage, per verba de futuro, sall be made, according
to the ordour of the reformit Kirk, be the minister, exorter, or reader,
takand cautione for abstinence till the marriage be solemnizat.
If ane man ravishe a woman against her will, and her parents, and
strike her parents under silence of night, and the magistrat will put
no correction thereto, Qwhither if the Kirk sould proceed with
monitors and excommunicatione to satisfie the sclander? It is lawfull.
Qwhat order shall be taken with her, who, committing fornication
with a man, does suffer the same man heirafter to marrie her own
sister, and, hearing the bands proclaimit, wad not reveall the
impediment, but, be concealing of the cryme, was guiltie of the
incest following? Answer, Baith he and she to be punishit according
to the discipline of the Kirk, but chiefly the man, and the second
cannot be his wife.
Qwhat order shall be taken with them that impugnes proclamation
of bands, and chieflie be infamie, and proves not? Let sic persones
be punischit according to the discipline of the Kirk as infamous.
It is altogether unthankfull be any minister of God’s word, to
receave any benefice be the presentation of a laick persone patrone,
under pactione and condition made with the patrone thereof,
tending to simonie, viz., that the patrone have the great part of the
teinds and the minister the small portione thereof.
 What order shall the Superintendant take with a man that hes
suitit libertie to marrie thir three or four yeares, being, before his
owne particular kirk, inhibited to marrie, because he deflorit a
virgine, being his own servant, lest he wald take her to his wife,
seeing the judiciall law is not yet receavit, and alse the man hes her
discharge of marriage under the forme of instrument before the
decreit was pronuncit against him be his awne particular kirk, all
things being trew according to the narrative? It is thocht the decreit
gine for sic ane cause may be reduced be the Superintendant, and
the man may obtaine liberty to marrie: yea, and there is injurie done
to him alreadie.
 [TWENTY-THIRD GENERAL ASSEMBLY.]
The Generall Assemblie, begun and holdin at Striviling the 6th of August
1571: In the qwhilk war present the Superintendants, Commissioners
to plant Kirks, Barrones, Ministers, Commissioners of Provinces,
Townes, Universities, and Kirks. Mr Gilbert Gairden chosen Moderator.

Sessio 1a.

Mr John Knox Epistle.

The mightie Spirit of comfort, wisdome, and concord in God, remaine
ever with yow.

Deare Brethren—If abilitie of bodie would have sufferit, I sould not

have troubled yow with this my rude inditement. I have not forgot
what was layed to my charge, be famous lybells, the last Assembly,
and what a brag of adversaries maid personall to accuse at this
Assembly, qwhilk I pray you patiently to heare, and judge of me as
ye will answer to God; ffor unto yow upon that heid, submit I myself,
being assurit that I neither offendit God nor good men in anything
that hitherto hes beene layed to my charge. And now, brethren,
because the decay of naturall strength threatens unto me certaine
and suddaine departure frae the miserie of this life; of love and
conscience I exhorte yow, yea in the feare of God I charge and
command yow, that ye take heed to yourselffis, and to the flock over
the qwhilk God hes placit yow pastors. To discourse of the behaviour
of yourselffis, I may not; but command yow to be faithfull to the
flock, I dare not ceass. Unfaithfull and tryitors to the flock shall ye
be before the Lord Jesus, if that with your consent, directly or
indirectly, ye suffer unworthie men to be thrust into the ministrie of
the Kirk, under what pretence that ever it be. Remember the Judge
before whom ye must make account, and resist that tyrannie as ye
wald avoyd hell fyre. This battell, I grant, will be hard; but, in the
second poynt, it will be harder; that is, that with the lyke
uprightness and strength in God, ye withstand the merciless
devorers of the patrimonie of the Kirk. Give men will spoyll, let them
doe it to their owne perrell and condemnatione; but communicat ye
not with their sins, of what estate that ever they be; neither be
consent nor yet be silence, but, with publick protestatione, make this
knawne unto the world, that ye are innocent of sic robberie, qwhilk
will, or it be lang, provock God’s vengeance upon the committers
thereof, whereof ye will seek redress of God and man. God give you
wisdome and stout courage in so just a cause, and me ane happie
end. Att St Androis, 3d August 1571.
Your brother in Christ Jesus,
Johne Knox.

Sessio 2a.
The haill Assembly concludit that certaine brethren,
Commissioners shall passe to my Lord Regent’s Grace, Councill, and
Parliament, to reasone and conclude upon the heids, articles, and
desynes, presentit in his Grace’s name to this Assemblie, to propone,
humblie requeist and desyre, in the Kirk’s name, the granting of sic
heids, articles, and redress of complaints, as shall be given to them
be the Kirk;—the ane and the uther to be concludit alwayes on,
conforme to the instructions to be delyverit to them. Commissioners,
John Erskine of Dunne, Knight, Superintendant of Angus and
Mernes; Mr John Spottiswood, Superintendant of Lawthiane; John
Wynrahame, Superintendant of Fyffe; John Row, Commissioner of
Nythsdale and Gallaway; Andrew Hay, Commissioner of Ranfrew and
Lennox; George Hay, Commissioner of Aberdeene and Banmff; David
Lindsay, Commissioner of Kyle, Carrick, and Cunninghame; David
Fargysone of Dumferling, John Dunkesone of the King’s Majestie’s
house, ministers: John Ogilbie, Ennerquharetie, Knight; Mr William
Lundie of that Ilk; James Johnstoun of Elphinstoune; William
Cunningham of Cunninghamheid; Hew Wallace of Carnvaill; Thomas
Kennedie of Bardgavie; John Schaw of Grinock; Alexander Forrester
of Carden, or any elevine of them, to compeir in Striviling, the 22d of
this instant, at nine howres before noone, to counsell and reasone in
the commissione given in the last Assemblie.