their offspring: they would have made everything give way to the preservation of their health: and, they would, in many instances, have been amply repaid, by having the lives of their children spared. We frequently hear of patients, in confirmed consumption, being sent to Madeira and other foreign parts. Can anything be more absurd or more cruel? If there be any disease, that requires the comforts of home and good nursing, more than another, it is consumption.

285. At what age does consumption most frequently occur? Are girls more liable to the disease than boys? What are the symptoms of consumption?

Consumption most frequently shows itself between the ages of fourteen and twenty-one: after then, the liability to the disease gradually diminishes; until, at the age of forty-five, it becomes comparatively rare. Boys are more prone to this complaint than girls. Some of the most important symptoms of pulmonary consumption are indicated by the stethoscope; but, as I am addressing a mother, of course it would be out of place to treat of such signs in Conversations of this kind. The symptoms it may be well for a parent to recognise, in order that she may seek advice early, I will presently describe. It is perfectly hopeless to expect to cure consumption, unless advice be sought early, as the only effectual good, in this disease, is to be done at first. It may be well to state, that consumption creeps on insidiously. One of the earliest symptoms of this dreadful scourge is a slight dry short cough, attended with tickling and irritation at

the top of the throat. This cough generally occurs in the morning; but after some time, comes on at night, and gradually, throughout the day and night. Frequently during the early stage of the disease, a slight spitting-of-blood occurs. Now, this is a most dangerous symptom; indeed, I may go so far as to say, that in the majority of cases of spitting-of-blood in young persons, it is almost a sure sign, that the patient is in the first stage of consumption. There is usually hoarseness, not constant, but coming on if the patient be tired, or towards evening; there is also a sense of lassitude and depression; shortness of breathing; a feeling of being quickly tired, more especially on the slightest exertion. The hair of a consumptive patient usually falls off, and what little remains, is weak and poor; the joints of the fingers become enlarged; the patient loses flesh; and, after some time, night-sweats make their appearance; then, we may know, that hectic-fever has commenced. Hectic begins with chilliness; which is soon followed by flushings of the face, and burning heat of the hands and feet, more especially of the palms, and soles of the feet. This is soon succeeded by perspirations. The patient has generally two decided paroxysms of hectic-fever during the day: the one at noon, which lasts about five hours; the other in the evening, which is more severe, and ends in violent perspirations. which continue the whole night through. During the day, he may have several attacks of hectic flushes of the face; especially after eating: at one moment, the patient complains of being too hot, and rushes to the cool air; the next moment, he is too cold, and almost

scorches himself by sitting too near the fire. Whenever the circumscribed hectic flush is on the cheek, it looks as though it had been painted with vermilion ; then is the time when the palms of the hands are frequently burning hot. The expectoration, at first, is merely mucus; but after a time, it assumes a characteristic appearance: it has a roundish flocculent woolly form; each portion of phlegm keeping, as it were, distinct; and, if the expectoration be stirred in water, it has a milk-like appearance. The patient is commonly harassed by frequent bowel-complaints; which rob him of what little strength he has left. The feet and ancles swell. As before remarked, the perspiration comes on in the evening; continues all night, more especially towards morning, and while the patient is asleep: during the time he is awake, even at night, he seldom sweats much. The thrush generally shows itself towards the close of the disease, attacking the tongue, tonsils, and soft palate, and is a sure harbinger of approaching death. Emaciation. rapidly sets in. If we consider the immense engines of destruction at work, viz., the colliquative (melting) sweats, the violent bowel-complaints, the vital parts that are affected, the harassing cough, the profuse expectoration, the hectic-fever, the distressing exertion of struggling to breathe-we cannot be surprised that death soon closes the scene. In females, provided they have been previously regular, menstruation gradually declines, and then entirely disappears.

286. What are the causes of consumption? The predisposing causes of consumption are, the

scrofulous habit of body; hereditary predisposition; narrow or contracted chest; deformed spine; delicacy of constitution; bad and scanty diet, or food containing little nourishment; impure air; close in-door confinement in schools, in shops, and in factories; illventilated apartments; dissipation; late hours; overtaxing the growing brain with book-learning, thus producing debility; want of proper out-door exercise and amusements; tight-lacing; indeed, anything and everything, that will debilitate the constitution, or interfere with or impede the proper action of the lungs, will be predisposing causes of this fearful disease. The most common exciting causes of consumption are, slighted colds; neglected inflammation of the chest; long continuance of influenza; sleeping in damp beds; allowing wet clothes to dry on the body; unhealthy employments, such as, needlegrinding, pearl-button making, etc.

287. Supposing a youth to have spitting-of-blood, what precautions would you take to prevent it from ending in consumption?

I should let his health be the first consideration; I should throw books to the winds; if he be at school, take him away; if he be in trade, cancel his indentures; if he be in the town, send him to a sheltered healthy spot in the country; or to the south-coastas, for instance, to St. Leonards-on-the-sea, to Torquay, or to Barmouth. I would be particular in his clothing, taking especial care to keep his chest and his feet warm. Let it be winter or summer, if he did not already wear flannel waistcoats, I would recom

mend him immediately to do so; if it be winter, I would advise him, also, to take to flannel drawers. The feet should be carefully attended to; they should be kept warm and dry; the slightest dampness of either shoes or stockings should cause them to be immediately changed. If a boy, he should wear double-breasted waistcoats; if a girl, high dresses. The diet should be nutritious and generous; he should be encouraged to eat plentifully of beef and mutton. There is nothing better for breakfast than milk, where it agrees; indeed, it may be frequently made to agree, by previously boiling it. Good home-brewed ale, or sound porter may be taken in moderation. Wine and spirits should on no account be allowed. parents in this particular, as many have an idea, that wine, in such cases, is strengthening, and that rum and milk is a good thing either to cure a cough, or to prevent one! If it be summer, let him be much in the open air, avoiding the evening and night-air. If it be winter, he should keep within doors, unless the weather be mild for the season. Particular attention should be paid to the point the wind is in, as he should not be allowed to go out if it be either in the north, or east, or north-east: the latter is more especially dangerous. If it be spring, and the weather favorable,

*

I caution

* The following eloquent description of the north-east wind is a little overdrawn, but, notwithstanding, there is a great deal of truth in it :-" Boreas is a ruffian and a bully, but the north-east is a rascal. Æolus has not such a vicious, ill-conditioned blast in his puffy bags. It withers like an evil eye; it blights like a parent's curse; unkinder than ingratitude; more biting than for