is limited to the tonsils and on the tonsils (one or both) do we find the spots or patches. In diphtheria, on the other hand, the membrane is not limited to the tonsils, but may cover every part of the throat and extend into the nose and mouth. In tonsilitis it is spots or patches we see in the throat. In diphtheria it is membrane we see always. The difficulty here again is that if we wait till the diphtheritic membrane covers the whole throat, antitoxin will not be of much use.

In diphtheria we have a characteristic odor, in tonsilitis we have no characteristic odor.

The practical lesson to be learned from this uncertainty is, immediately to get a physician as soon as you find spots in the throat of your sick child, unless you are absolutely sure that the condition is not diphtheria and you are willing to take that chance.

Treatment of an Acute Attack of Tonsilitis.—Put the child in bed at once and keep him on a light diet during the fever. Give him all the cool boiled water he wants to drink. If the fever is very high it can be controlled by sponging the body with cool water. If the patient is an infant the food should be reduced to one-half strength. Tonsilitis is a disease that runs a certain course and gets better, or the patient develops some other more serious conditions as a result of neglect or carelessness. We therefore try to make the patient comfortable and let the disease take care of itself.

The throat can be gargled or sprayed with any mild antiseptic liquid, or it can be painted with tincture of iodine or 10 per cent. solution of silver nitrate. As a rule the gargles do not aid in the cure of the disease, though they contribute to the comfort of the patient.

A cold compress made of half a dozen thicknesses of cloth, such as a table napkin, and put under the jaw (not round the neck), and covered with oiled silk and held in place with a bandage that meets and is tied on the top of the head, is of distinct usefulness.

When it is known that the child is rheumatic, the heart must be carefully watched during the fever and anti-rheumatic remedies depended upon to effect a cure.

SUMMARY:—

Tonsilitis, because of its likeness to diphtheria, must be promptly and carefully diagnosed.

A physician only is capable of making a diagnosis.

Any sore throat in a child with spots or membrane is deserving of serious and immediate attention.

A mistake may mean death. Don't take a chance.

BRONCHITIS

Bronchitis is one of the commonest diseases of childhood. It is the cause of many deaths. Exposure during inclement weather is as a rule the cause of it. It occurs in all classes and conditions of children. Poorly nourished and badly clothed children are more liable to get it than are others. It is more dangerous in young children and infants than in older children. A young child or an infant will get bronchitis quicker than those older and stronger under the same conditions.

Bronchitis is often present while children are suffering from other diseases, measles, influenza, scarlet fever, typhoid fever, pneumonia, diphtheria, whooping-cough, for example. It may accompany any disease of childhood, however.

Symptoms.—In infants bronchitis usually follows a "cold in the head," with running nose and a cough. The child is indisposed and peevish because of the cold. In a few days the cough becomes worse, fever develops, the breathing is quicker, and the baby looks and acts sick. The cough may be constant and severe; sometimes the cough does not seem to bother the baby, although this is exceptional. The breathing is quite rapid and is accompanied with a moist, rattling sound in the chest. The baby is restless and if the cough is severe it becomes exhausted. Vomiting or diarrhea may be present.

Bronchitis in Older Children.—Bronchitis in older children comes on abruptly, with fever and cough. The child may complain of headache and pains in the chest or other parts of the body. It may begin with a chill or chilly feelings. These children "raise" with the cough. The expectoration may be quite profuse; at first it is a white, frothy mucus, then yellow, and later a yellowish green; it may be slightly tinged with blood.

There is a mild form of bronchitis in these older children where the serious symptoms are absent. The children are not sick enough to go to bed, but they appear to have a "heavy cold" with, at first, a tight, hard cough, which is usually worse at night. Later the cough turns loose and the same expectoration occurs as in the severe type. It is these cases of mild bronchitis which do not receive the proper care and treatment that develop into the so-called "winter cough," which lasts for months.

Treatment.—(See page 497 under heading, "Catching Colds.") Children who acquire bronchitis easily and frequently, should be built up. Cod liver oil should be given all winter. The sleeping apartment of these children should not be too cold, but it should be well aired through the day and well ventilated throughout the night. Flannel night clothes should be worn and the feet should be kept warm always. Mild attacks of "cold in the head" should be treated vigorously and not neglected.

The following "Don'ts" may be profitably studied when your child or baby has bronchitis:—

Don't keep the windows tightly closed; fresh air and good ventilation are absolutely necessary to the patient.
Don't use a cotton jacket or oil silk.
Don't wrap the child up in blankets and shawls.
Don't carry the child around; keep it in bed.
Don't dose the child with syrupy cough mixtures.
Don't overheat the room.
Don't let friends bother or annoy the baby.
Don't reduce the diet unnecessarily.

The child should be put to bed. The temperature of the room should be 70 degrees F. all the time. The windows should be opened top and bottom according to the weather, and the room should be well aired every day, the patient being taken to another room while it is being done. The child should have its usual night clothes on, nothing more. If the child is not very sick and insists on sitting up, a bath robe can be worn but it should be always removed when it sleeps. It is advisable to change the position of the baby from time to time. Have it rest on one side, then on the other, as well as on the back. Give a dose of castor oil at the beginning of the sickness and keep the bowels open during the disease.

Diet.—The diet will depend upon the severity of the disease. If the fever is high and the cough persistent, the strength of the food of nursing infants should be reduced. We can reduce the strength of the food by giving the child a drink of cool boiled water before each feeding and shortening the length of each feeding. Older children may be given toast, milk with lime water, cocoa with milk, broths, gruels, custards, cereals and fruit juices.

Inhalations.—The value of inhalations in bronchitis is very great. The ordinary croup kettle, which can be bought in any good drug store, is the best method of giving them. Full directions come with each kettle as to the best way to use it. The best drug to use in the kettle is creosote (beechwood). Ten drops are added to one quart of boiling water and the steaming continued for thirty minutes. The interval between steaming is two hours and a half in bad cases day and night. In mild cases the night treatments can be dispensed with. Sheets rigged up over the top and sides of the crib, in the form of a tent, is the most