sue infiltrated, and its fibres separated by innumerable exudation corpuscles, and the proper corpuscles of the gland are similarly surrounded and imbedded. As the parenchyma is nearer to the whitish matter, so proportionally do the proper corpuscles of the gland become more indistinct, the filamentous tissue more obscure, the blood-vessels irregularly dilated and filled with red globules, and they at last disappear insensibly. The exudation corpuscles are more numerous, but irregular in size and shape, and interspersed with minutely granular matter (p. 45). DIFFERENT ORGANS OF THE ADULT BODY, much interesting information has been adduced by MM. Louis, LOMBARD, and ANDRAL-(a) The lungs hold the first place, in respect of frequent liability to the disease; next, the small intestines. M. Louis found (leaving the lungs out of the calculation) in 358 adult subjects, tubercles in the small intestines in a third of them; in the great intestines, in a ninth; in the mesentric glands, in a fourth; in the cervical glands, in a tenth; in the lumbar glands, in a twelfth; in the prostate, in a thirteenth in the spleen, in a fourteenth; in the ovaries, in a twentieth; in 133. A. The modifications and associations of the kidneys, in a fortieth; in the uterus, in one scrofula and tuberculosis are to be ascribed chief- case of them only; in the cerebrum, in one case; ly to the pre-existence or association of various in the cerebellum, in one case; and in the uregrades of capillary congestion, sometimes pass-ter, only in one case. There was no account ing into chronic inflammatory irritation, in the taken, in those cases, of the occurrence of this seats of the tubercular exudation. But it may production in the testicles or in the bones, which be asked whether or not this exudation ever is not uncommon. Out of all of them, M. Lovis occurs without these antecedent states of con- found only one case in which tubercles were gestion or of inflammatory irritation. There is found in different other organs without existing no sufficient reason to infer that this deposit in the lungs. may not take place without either of these al- 136. In one hundred adult subjects, Dr. Lowterations of local vascular action; for miliary BARD found, not counting the lungs, tubercles tubercles and gray granulations are often found in the intestines in 2 cases; the mesenteric in tissues, the capillaries of which present no glands in 19; in the bronchial glands in 9; in material alteration. It may, therefore, be infer- the cervical glands in 7; in the spleen in 6; in red that tuberculosis may appear, 1st. Inde- the lumbar glands in 4; in the sub-peritoneal pendently of locally increased vascular or cap-cellular tissue in 4; in the maxillary glands in illary action; 2d. Consequently upon capillary 3; in the glands of the anterior mediastinum in congestion; 3d. In connexion with inflamma-3; in the sub-arachnoid cellular tissue in 2; in tory irritation, or inflammatory congestion, of the part; and, 4th. Where the inflammatory diathesis is associated with the scrofulous, or where tuberculosis is associated with inflammation of a subacute or chronic kind. While, however, either of these states of local vascular action may precede or accompany the morbid deposit or exudation constituting tubercles, it is not improbable that this deposit as often becomes the cause, as shown above (§ 110,111), of the vascular disorder, inducing such disorder where it has not previously existed, and increasing or developing it where it had already commenced. the spinal chord in 2; in the false membranes of the pleura in 2; in those of the peritoneum in 2; in the intercostal muscles in 2; in the ovaries in two; and in the parietes of the gallbladder, in the liver, cavity of the pleura, posterior mediastinum, vertebræ, ribs, omentum, uterus, prostate, sub-mucous tissue of the bladder, cerebrum and cerebellum, medulla oblongata, kidneys, and vesiculæ seminales, one each. 137. M. ANDRAL states, that his observations as to the relative frequency of tubercles in the different organs of the body observe nearly the same order as that indicated above, excepting that he has found in more cases than M. Louis, tubercles in other organs without detecting them in the lungs. He has also discovered them in the false membranes of the pleura and peritoneum in a greater proportion of cases than M. LOMBARD. M. ANDRAL has found them in the intervertebral cartilages in one case; and he adds very interesting information respecting the relative frequency of tubercles in the different organs of children. 134. B. The complications of tuberculosis are so diversified that a particular notice of them cannot be given at this place. It must be obvious that the state of constitution described above to constitute the scrofulous diathesis will favour the occurrence of various disorders, both without or independently of any tubercular deposit, and in more or less intimate association with it. It has been shown (§ 123, et seq.) that the scrofulous taint favours the occurrence of 138. (b) Tubercles in children more frequently several diseases not actually scrofulous or tu- affect a number of organs at the same time than bercular, and that it modifies the course and in adults. They occur more commonly in this termination of others; and various affections class of subjects, in other organs, without exhave been enumerated above (§ 119-121) as be- isting in the lungs. It will, moreover, be seen, ing met with in delicate constitutions, which from the following results furnished by M. Loware not scrofulous, in the scrofulous diathesis, BARD, that the parts most commonly affected in without evidence of tubercular deposits, and in adults are not altogether those which are so this diathesis complicated with these deposits in children. In a hundred young subjects, he in one or more organs. A knowledge of such found tubercles in the bronchial glands in 87 occurrences, either as now stated, or as partic-cases; in the lungs in 73 cases (in 30 of which ularly noticed above, is sufficient to suggest the chief indications of treatment which these associations will require in respect of their individual forms. 125. X. THE COMPARATIVE MANIFESTATIONS OF TUBERCULOSIS-A. AS TO THE COMPARATIVE FREQUENCY OF TUBERCULAR FORMATIONS IN THE but one lung was affected, viz., the left in 13, and the right in 17 cases); in the mesenteric glands in 31 cases; in the spleen in 25; in the kidneys in 11; in the intestines in 9; in the nervous centres in 9; in the cervical glands in 7; in the membranes of the brain in 6; in the pancreas in 5; in the gastro-hepatic glands in 5; in the sub-peritoneal cellular tissue in 5; in the spleen in 4; in the inguinal glands in 3; in the cellular tissue under the pleura in 2; in the lumbar glands, in the sub-mucous tissue of the bladder, in the omentum, in the parietes of the gall-bladder, and in the false membranes of the pleura, one case each. It may be remarked that, in these hundred cases, tubercles were not found in the liver in a single case; and in all the cases of adults the liver contained tubercles in one case only. | don and Paris. There can be no doubt of the fact mentioned by this writer, that at the age of four or five years a greater number of organs are simultaneously affected with tubercles than at either an earlier or later period of life. I be lieve that these tubercles begin to form about the period of dentition and weaning, the change which is then made in the diet of infants being the chief cause of their formation; and that the fatal effect most commonly does not occur until about the fourth or fifth year. 143. 4th. From the sixth to the sixteenth year tubercles are much less frequently met with than from the third to the sixth, but they occur more frequently than under the age of two years. The results which I have stated in the preceding paragraphs differ much from those furnished by M. LOMBARD; but they are in many respects confirmed by the researches of M. PAPAVOINE 139. M. PAPAVOINE found, in 50 children in which the seat of tubercles was ascertained, 49 in which they existed in the bronchial glands; 38 in the lungs; 26 in the cervical glands; 25 in the mesenteric glands; 20 in the spleen; 17 in the pleura; 14 in the liver; 12 in the small intestines; 9 in the large bowels; 9 in the peritoneum; 5 in the brain; 3 in the cerebellum; 3 in the cerebral membranes; 3 in the pericar-made at the Hospital for sick Children at Paris. dium; 2 in the kidneys; 1 in the pancreas; 1 in the vertebræ ; 1 in the stomach. In 10 instances tubercles were present in the bronchial | glands without having been found in the lungs. The relative frequency of tubercles in the abdominal organs is very different in M. PAPAVOINE'S table from that furnished by M. LoмBARD. The above show that they are more frequent in the bronchial glands of children than in the lungs; while in adults the proportion is much greater in the latter than in the former. Besides, in this class of subjects, they are seldom met with in these glands without being observed in the lungs; but they are often found in adults, in the lungs, without there being any in the glands. 140. B. AS TO THE RELATIVE FREQUENCY OF TUBERCLES AT The different PERIODS OF LIFE, without reference to the organs in which they are seated, the following inferences may be adduced: 1st. Tubercles are very rarely developed in the fœtus; but several instances have occurred to me, particularly in the lungs of those whose mothers were suffering from phthisis during gestation. This physician found, in 408 children under four. teen years of age affected with tubercles, 73, or 1-5-1-2, under two years; 64, or 1-6, from two to three years of age; 46, or 1-9, from three to four; 35, or 1-12, from four to five; 32, or 1-13, from five to six; 29, or 1-14, from six to seven; 24, or 1-16, from seven to eight; 16, or 1-25, from eight to nine; 18, or 1-23, from nine to ten; 12, or 1-31, from ten to eleven; 24, or 1-16, from eleven to twelve; 10, or 1-41, from twelve to thirteen; 11, or 1-40, from thirteen to fourteen; and 14 whose ages were not as. certained. 144. 5th. After puberty tubercles again be come more frequent, but only as regards the lungs, the intestines, and some parts of the lym phatic system, especially the lungs. Does this increased frequency arise from the new source of exhaustion which comes into action in the development of the genital organs? I think that it does. According to M. ANDRAL, males are particularly subject to tubercles between the ages of twenty-one and twenty-eight; while fe. males are more subject to them before the age of twenty. After these periods, tubercles are much less frequently met with until from about the 38th to the 45th year in females, and from about the 40th to the 55th year in males, when a slight increase is again remarked, particular 141. 2d. During the first months after birth, tubercles are likewise rare. In the lungs of an infant (attended by Mr. NICHOLSON of Davies's Street and myself) born of a mother far advanced in consumption, affected with coughly in females. from the moment of birth, and that died in- 145. C. AS TO THE COMPARATIVE LIABILITY stantly from profuse hæmorrhage from the lungs under three months, the lungs were so studded with tubercles, many of them large and softened, as not to collapse upon opening the thorax. Tubercles existed nowhere else. This state of disease in so young a subject was rare, and the nature of the result still rarer. 142. 3d. From nine months to five or six years, tubercles are very frequent. According to M. LOMBARD, tubercles are found in only one eighth of the children who die between the ages of one and two; in two sevenths of those between two and three; in four sevenths of those who die between three and four years of age; and in three fourths of those who die between the ages of four and five years. From my experience at the Infirmary for Children, I am of opinion that M. LOMBARD calculates the proportions as too high in respect of children between the ages of three and five, and too low in respect of those below two years. However, the results may vary somewhat between Lon OF THE SEXES, it has been generally admitted that the female is more frequently the subject of tubercles than the male sex, and this certainly holds in respect of children. But according to the data furnished by M. LOMBARD, the difference of liability of adults is extremely small. He states, that in 52,857 persons who died of tubercles in the lungs, 26,124 were males, and 26,733 females. M. Louis, however, found the proportion of adult males to females affected to be 70 to 92. M. PAPAVOINE considers the difference to be still greater between the two sexes in children. According to the returns of the Registrar General, the proportion of deaths by tubercular consumption is about 24 males to 28 females. 146. D. WITH REFERÈNCE TO THE OCCURRENCE oF TUBERCLES IN THE LOWER ANIMALS, M. ANDRAL observes, that "several animals have, in common with man, the tendency to tuberculous affections. Among the mammalia, animals using the most different kinds of food are equally sub ject to these affections-the carnivorous as well as the herbivorous. Among the carnivorous, however, there is one species in which, though we frequently examine their bodies, genuine tubercles have never been discovered: I mean the canine species Is this because the dog lives in freedom in a climate that agrees with him, and where he can enjoy exercise in proportion to his strength? And is it because the lion happens to be in opposite circumstances, that he dies in this climate affected with tubercles? Most of the animals in which we have proved the existence of this affection are either transported from a hot to a cold climate, where they are deprived of liberty and exercise (as is the case with monkeys and parrots), or confined in damp places, without sun, and almost without air (cows, pigs, house-rabbits), or exposed either to continual alternations of heat and cold, or to constrained and violent exercise, as the horse." The want of due ventilation, or a too frequently respired air, a too hot or close, or a too cold and humid atmosphere, and the close confinement so opposite to the habits of these animals, are not without their influences. quire enumeration. The subject is sufficiently illustrated by the calm consideration of every thinking mind. 148. IV. THE PREVENTION OF SCROFULA AND TUBERCULOSIS.-It is obvious that the prevention of a constitutional taint, which is not limited to the individual thus tainted, but which is very commonly propagated to his offspring, in some one or other of its forms or contingent effects, is much more important than even the cure of these effects, when they come under the eye of the physician; and it is equally obvious that the prevention consists in the avoidance of the causes producing this taint-these causes being fully exposed above (§ 13, et seq.), with the implied object of enabling the medical adviser, or whoever is concerned in the matter, carefully to avoid them-this avoidance having reference to the parent or parents, and to the offspring for successive generations. By no class of diseases are the misconduct, the imprudence, and the want of judgment of the parents more severely punished than by this-by none so distressingly, hopelessly, extensively, and successively, until the tainted race is almost or altogether extinguished. Instances illustrative of the misery-of the numerous miseries-resulting from the thoughtless, the ignorant, the worse 147. xi. ARE SCROFULA AND TUBERCULOSIS than culpable intermarriages of scrofulous perMORE PREVALENT NOW THAN FORMERLY? This sons, or even by the marriage of a healthy perquestion hardly can be answered in the present son with one who is thus tainted, crowd upon state of knowledge, as the data on which ra- my recollection, and are too common-too well tional speculation respecting it either are alto-known to every one who may read this-to regether wanting, or are of so loose a kind as to prevent the possibility of arriving at a sound conclusion on the subject. Mr. PHILLIPS has, indeed, entertained the topic, but with reference 149. Several of the causes which I have dischiefly to external scrofula, or the 'King's cussed above require only to be known to be evil," as so denominated in former times. The guarded against, and certain of them may readiprincipal data he has adduced are the loose re-Ïy be avoided by careful persons. Others canports of the bills of mortality of former years, not be avoided by those most concerned, or who and the numbers said to have received the roy-are about to become their victims; but they al touch during the reign of the second Charles. may be altogether removed by those who have It is obvious that no conclusion can be drawn the power of inflicting them. Richly-endowed from these respecting the comparative preva- public institutions or schools may be so manlence of the several forms of tuberculosis in aged, and have been so managed, as to become former and recent times. A careful considera-hot-beds for the generation of scrofulous or tution of the relative influence of the principal berculous diseases. The same remark often causes of scrofula in past ages and at the pres- applies to private as well as public schools, and ent day, may suggest vague ideas on the sub- not merely as respects food and clothing, but ject; but as certain of these causes were, per- also as regards ventilation, exercise, light, sunhaps, more influential formerly than now, while shine, and purity of air. The constitutions of others were less so, and while some have even the industrious poor are sacrificed on the altar recently come into operation, others have nearly of gain, and governments lend their aid to the or altogether disappeared, the question must be immolation, that they may receive the unrightviewed as not admitting of solution, however eous support of the priests of mammon in perimportant the considerations which it involves.* petuating their power, their patronage, and the [* It is well known that the active causes of disease and aggrandizement of their satellites. The physical death are increasing in this country, and that the average and moral ameliorations, which salutary measduration of life is not as great now as it was 40 or 50 years ures would impart to those most in want of them, ago. It will be found, on examining bills of mortality, that cannot be afforded out of the luxuries and patdeaths by scrofula and tuberculosis have equally increas ed. For example, the deaths in Boston, in 1830, were 1 ronage which aristocratic governments bestow in 48; in 1845, 1 in 39. The deaths under 5 years of age, on their supporters and themselves. The ineviin Boston, in 1830, were 5.96 per cent.; in 1840, 7:32 per table tendencies of extreme taxation and of an cent.; and in 1845, 9 per cent.-nearly doubling in less than immense national debt are to reduce the mid20 years; and in all the years under 40, there also appears an increased mortality. The same holds true, so far as dle classes to the lowest, to render the poor still we have data, throughout New England and New York. poorer, more wretched and more debased, to Thus the average age of all that died in Boston, in 1810 to 1820, was 27-85 years; while in 1840 to 1845 it was 21-43 augment the wealth and the influence of capiyears only, showing a difference of 6-42 years. In New talists and contractors, to render these last more York, in 1810 to 1820, it was 26-15 years; and in 1840 to dishonest and over-reaching; and, as the gen1843, it was 19-69, a difference of 6-46 years. In Philadelphia, in 1810 to 1820, it was 26-25; and in 1840 to 1844, iteral result, to multiply beyond calculation the was 22-01, a difference of 4-24 years. Since then the dura chief sources from which scrofulous and tubertion of life has declined in each of these cities. It is found that the average age of our clergymen is seven years less than it was 30 years ago, and that of physicians is 9 years less; and the same decline has occurred among all ranks and professions. So that, although medical skill has in creased, and science advanced, yet the active causes of disease have increased faster than the appliances for their prevention and cure, as shown by Mr. SHATTUCK, in his "Sanitary Report," p. 104, 105.] cular maladies, the physical curses of society, | enic treatment should be adopted as early as derive their origins. Dishonesty, moreover, in possible. If the taint exist on the mother's side, professions, trades, and the several relations of life-the necessary consequence of the foregoing-is daily increasing, and leaving its victims physically and mentally reduced, thereby favouring still more the invasion of the most hopeless forms of the maladies under consideration. These are results which are manifest to the common-sense thinker, however they may be controverted by political economists, and by political and statistical haranguers, who will prove or disprove whatever may suit their arguments, their purposes, or their motives, and even bring an array of figures and numbers to their support, without caring for the accuracy of the amounts which they thus imposingly marshal * 150. The hygienic treatment of scrofula should, however, not be limited to the careful avoidance of the causes above described, whenever this object can be attained; but be extended to the use of such rational means as may prevent the full development of the scrofulous taint, and of its consequences, in those who may evince it in any grade, in childhood or infancy, and more particularly in the children of scrofulous parents. If this latter indication be carefully pursued, and if judicious means be employed, much may be accomplished, especially if the tainted subject be early submitted to these measures. spects the infants of scrofulous parents, hygei As re [* It is abundantly evident that the great objects of investigation connected with scrofula and tuberculosis are the causes and means of prevention. These can only be ascertained by an extensive series of systematic, uniform, and exact observations of the external circumstances, atmospheric, local, and personal, occurring in each case. The American Medical Association could not engage in a more useful labor-one promising more beneficial results to humanity-than in an energetic and united effort to ob tain such observations in regard to as many cases of these affections as possible. These, tabulated in due form, would lead, by an easy induction, to general facts and principles, which could be readily applied to the prevention of these wide-spread and fatal maladies. To show the influence of the seasons upon tuberculosis we quote the following ta ble from Mr. SHATTUCK'S "Report of the Sanitary Čommission of Massachusetts." Months. January. April May June Massachusetts, except Boston. 68 Boston. RUFAHRSU Year. 1849. 6 Years. B'h sexes. 7 Years. 4 Years 1845–48. Male. Female. 1,113 273 446 888 1,134 296 439 43 484 59 75 270 410 49 July 1,159 302 434 62 855 923 917 50 799 711 698 925 2,041 2,314 Total.... 13,711 3,443 5,384 4,350 3,911 2,776 3,720 7,666 14,824 12,964 15 to 60.... 9,735 2,226 3,935 3,437 3,111 1,822 2,623 6,116 11,897 10,092 2,621 753 916 364 269, 563 617 625 Under 15... 1,355 464| Male. 396 172 151 110 93 116 144 240 255 97 791 123 119 87 82 194 208 65 79 157 136 84 70 247 Under 99 289 1819 Over 60.... From this table we learn that tuberculosis is most frequent from 20 to 30, and next, from 30 to 40, that, at the ages of 20 to 30, the number of females who die of consumption is nearly double that of males, being 1409 of the former to 708 of the latter, while from 30 to 40 the number of each sex is nearly similar. The following table of Mr. SHATTUCK shows the relative population of the sexes, victims of tuberculosis, in different places and countries. It thus appears that, while the disease destroys more males than females in New York and London, it destroys nearly the same of both sexes in Philadelphia, and in the country towns of Massachusetts, the proportion of the sexes is as 39-01 males to 60-96 females; in New York, as 42-08 to 57-92; and in England, except London, as 46·13 to 53-87, a striking difference appearing in all ages over 20. What are the particular causes which render the disease so much more rife relatively among females in the country than in the city, remains to be shown, as well as the different causes existing in cities to aggravate the disease in the other sex. If we turn our attention to locality as influencing this disease, we find, for example, that the proportion of deaths in the four western counties of Massachusetts from it does not vary much from that on the seacoast, being from 18-29, to 21-67 per cent., or as 1 in 5-43 690 to 1 in 4-61 of all the deaths; the lowest number in the 751 state having occurred in Boston, from 1830 to 1840, 14-04 9,471 per cent, or 1 in 7.11. In New York city, from 1811 to 3,495 886 1,369 168 1820, the mortality from tuberculosis was 23-40 per cent., 2,676 3.521 849 1,357 174 2,427 or 1 in 4-27; while throughout the state, in 1847 and '48, the Summer 3,626 932 1,406 163 2,161 mortality was 25 per cent., or 1 in 4. A superficial survey Autumn.. 3,385 835 1,326 149 of this subject would seem to show that the prevalence 2,207 of tuberculosis is, to a considerable extent, independent Thus it appears that the largest number of deaths occur of those causes above mentioned, for we have seen that it in September, though they are nearly the same in March sweeps off nearly as many among the scattered country and April; while the smallest number occur in November population of New England as among the crowded deni. and the autumn quarter, a law which seems to prevail in zens of our large cities. There would, indeed, appear to Great Britain as well as this country. Such tables, how-be some constitutional taint, predisposing about one fourth ever, throw no light upon the causes of the disease; nor, as the disease is indefinite in its duration, do they indicate the seasons when the seeds of the malady are most extensively planted in the constitution, which are doubtless the autumn and winter. That age and sex have a greater influence in modifying the operation of its causes, is demonstrated by the following table, for which we are also indebted to Mr. SHATTUCK. of our population to this fatal malady; and this, too, when surrounded by circumstances apparently the most favourable to health and longevity. Our manufactories are not so managed, as in England, as to develop scrofula or tu berculosis to any great extent; while labour is so well rewarded, that the poorest can obtain an abundance of wholesome food. What, then, are the specific causes which predispose so many of the female sex to these mal ed.* a wet-nurse of healthy constitution, and suitable | erages, of pork and indigestible meats, of sug- means. 151. The support of animal warmth, and the animal heat derived from a young healthy nurse, are most beneficial to delicate, and more especially to scrofulous infants, and the more so the younger the child. An emanation of organic nervous power, as well as of warmth, may be furnished from this source to the delicate infant. The lower animals afford this protection to their young until growth is considerably advanced; and yet the young animal which is most helpless in infancy, and requires this the most, is the oftenest deprived of it, or is allowed to remain no longer in the bosom of its nurse than when it is suckled. During the coldness or coolness of night, and often in a chamber much below the usual temperature of the sitting apartment, the infant is often allowed to sleep in a cot altogether apart from the curtained and warmer bed of the nurse. 153. As puberty advances, the utmost care should be exercised in all matters which may affect the sexual feelings or desires. A proper superintendence of both sexes ought to be instituted, in order to prevent the tendency to masturbation, which is greater among scrofulous constitutions, at this epoch of life, than in others; and which, if practiced at all, will certainly develop this diathesis into actual tubercular disease, especially tubercular consumption. A careful supervision should also be exercised, after puberty, in order to prevent attachments being formed between scrofulous persons, or between an individual of this diathesis and one who possesses a healthy constitution. This intention, however, will frequently fail; but where it is attempted among the well-informed classes, and the evils consequent upon the neglect of it are duly explained by members of the profession, it will receive attention, and the good results will ultimately become apparent. 154. V. THE MEDICINAL TREATMENT OF SCEOFULA AND TUBERCULOSIS.-The medicinal treatment of scrofula consists, 1st. In aiding the hygeienic or regimenal treatment above discussed, when the scrofulous taint is suspected or apparent, especially in early life; and, 2d. In employing such medicinal agents as are most likely to arrest the progress of the mischief when scrofula or tuberculosis is more or less manifest. In the first case, medicines are chiefly brought in aid to hygeienic means; in the second, they are the principal agents, regimenal means being aids to their operation. 155. i. In scrofulous cases devoid of any very manifest local lesion, in connexion with the hygeienic means now mentioned, various medicines possessing an alterative and tonic influence may be used. One of the earliest indications of scrofulous taint is furnished by the weak state of the digestive functions-a state evident power; and hence occur indigestion, flatulency, der, with soda or other antacids, were given for 152. Change of air, or the migration from one locality to another, according to the circumstances of the case, the age of the patient, and the season of the year; removal from crowded towns or situations; residence near the seacoast, in a temperate and dry air, and on a grav-ly caused by the low condition of organic nervous elly or sandy soil; sea-voyaging in some cases; sleeping in large airy chambers; exercise in the open air, the enjoyment of light and sunshine during the waking hours, and limiting sleep to the hours of darkness, are generally of great serv-merly small doses of blue pill, or of gray powice, especially in advanced childhood, and during the progress to puberty. Cold-bathing, particulary sea-bathing, frictions of the surface, a generous diet, with a due proportion of animal food, and regular meals, are also most beneficial in the early periods of life. While these means are pursued, the digestive and assimilative functions should be promoted, whenever they are insufficiently performed, by stomachic and tonic aperients, as the compound decoction of aloes with the compound steel mixture, or the compound infusions of gentian and senna; and the use of unnecessary stimuli or stimulating bev-characterizes atrophy without any manifest cause, has adies? We suppose it will not be disputed that they are often, at least, to be traced to a violation of some of the laws of health; as sleeping in close, ill-ventilated apartments; neglect of out-door exercise; tight lacing, and the present monstrous and absurd modes of dress; inattention to the functions of the skin and bowels; sitting in rooms heated by air-tight stoves; sleeping in feather beds, beneath thick cotton quilts; reading works of fiction, &c., &c. In short, all causes which lower the vital forces, and tend to the deterioration of the general health, must predispose, to a greater or less extent, to the development of these diseases.] [* We have seen great benefit result from the use of the been removed; a complete renovation has taken place; |