that they get surface chills when they go outside if the weather is cold and as a result catch cold. The underclothing should be just heavy enough to be comfortable indoors and the extra warmth necessary when outside should be supplied by a good overcoat or furs.

F. Direct Infection.—A baby may catch cold if kissed or "hugged" by an adult who has a cold.

Catching cold while bathing is possible, but scarcely probable, if ordinary precautions are taken. It is very bad practice to permit children to use one another's handkerchiefs or the handkerchief of an adult. Certain children are predisposed to attacks of "cold in the head" or acute coryza or nasal catarrh (these being the medical names for this condition). Sometimes this is an inherited characteristic. There is no doubt, however, that most of these children acquire the habit by bad sanitary and hygienic surroundings. These children do not as a rule get enough fresh air. They are kept indoors most of the time in stuffy, overheated, badly ventilated rooms, unless the weather is absolutely perfect. The windows in their bedrooms are always kept closed, because they are "liable to catch cold." They are overdressed and perspire easily and as a result "catch cold." These conditions all tend to create an unhealthy condition of the nasal mucous membrane and of the throat, and this is rendered worse if the child lives in a damp, changeable climate, such as that of New York City. In these susceptible children the exciting cause of an attack may be trivial; exposure, cold or wet feet, inadequate head covering (as already pointed out), a draught of cold air even may excite sneezing and a nasal discharge; hence we have:

Acute Nasal Catarrh (Acute Coryza, Acute Rhinitis, "Cold in the Head", "Snuffles").—Acute nasal catarrh may accompany measles, diphtheria, influenza, and whooping cough.

Symptoms.—The onset is sudden with sneezing, and difficulty in breathing through the nose. In a few hours, or it may be not for a day or two, a mucous, watery, nasal discharge appears. There are redness and slight swelling of the nose and upper lip, caused by the discharge. There is no fever as a general rule except in very young infants, in whom the fever may be very high. The discharge interferes with the nursing and the child suffers from lack of nourishment. The inflammation may extend to the eyes and ears, causing painful complications, or to the throat and bronchi, causing hoarseness and cough. Less frequently we have disturbances of the digestive tract with vomiting, or diarrhea.

The mild form of the disease lasts for two or three days, the severe form from one to two weeks.

Repeated attacks are said to contribute to the production of adenoid growths.

An acute attack of this disease is seldom a serious affliction in older children; it may be, however, very serious and even dangerous in very young infants. The tendency of the disease to extend downward, causing bronchitis or pneumonia, explains in part the possible danger to a baby. Another reason is because it may seriously interfere with suckling and with breathing in these little patients. It may even cause sudden attacks of strangulation. An infant, therefore, suffering with an acute attack of rhinitis requires constant attention. It may be necessary to feed it with a spoon, and if necessary mother's milk should be so fed. Plenty of fresh air should be provided. It may be essential to keep the mouth open in order that it may get enough fresh air. Every effort should be made to keep the nostrils open. The secretions must be removed from time to time. Causing the child to sneeze by tickling the nose with a camel's hair brush will clear the nose for the time being. The physician may be compelled to use a solution of cocaine for this purpose.

Treatment of Acute Rhinitis ("Taking Cold", Nasal Catarrh, Acute Coryza, "Snuffles").—A child suffering with an acute attack of "cold in the head" should be kept indoors in a room with a constant, uniform temperature; the particular reason for this is, that, if a child is exposed to cold at any time during an attack of "cold in the head," it may cause the disease to invade the chest,—a tendency which it has at all times. The bowels must be kept open; if they do not move every day of their own accord they must be made to move by means of an enema of sweet oil or of soap-suds. The amount of food should be reduced to suit the circumstances and the condition of the patient.

We treat the local condition in the nose with a menthol mixture. The following is a very good one: Menthol, 30 grains; Camphor, 30 grains; White Vaseline, 1 ounce. Put some of this on the end of the finger and push it gently into each nostril. When the nostrils become blocked and the child cannot breathe through the nose, tickle the nose with a feather until it sneezes; this will clear the passage. Immediately after the sneeze place the menthol mixture in each nostril. When the child is about to sneeze place a handkerchief before the nose, as this discharge is full of germs and will infect others when dry. Internal remedies should not be used unless the child is distinctly sick and is running a fever, in which case a physician should look the child over and prescribe whatever is called for.

The upper lip and the nostrils of the child should be protected, because the discharge very quickly irritates the parts and renders them raw and painful. Vaseline or cold cream is very suitable for this purpose.

Mothers should not wash out the nose of a child with any solution advised for this purpose where force is used, as, for example, with a syringe. Any forceful irrigation of the nose is dangerous, because it would carry the infection into the deeper parts and set up a more serious condition.

If the above treatment is carefully carried out and the child unexposed to a fresh cold, two or three days will be sufficient to cure the disease.

It is not, however, the treatment of an acute attack of "cold in the head" that is important; it is intelligently to follow out a plan which will prevent these attacks from repeating themselves that is of consequence. The tendency to take cold is a real condition in childhood and a very common one. When mothers appreciate that it is possible to prevent this condition and to cure it when it is seemingly an established habit, more interest will undoubtedly be taken in the subject. Too frequently it is looked upon as an unfortunate affliction, but it is never regarded as a condition that is caused by neglect and ignorance.

It is an exceedingly common occurence to find a mother worrying over her child's cold, dosing it with cod liver oil or some other unnecessary tonic, rubbing it with camphorated oil or plastering it over with certain useless patent plasters, dressing it with extra pieces of flannel on its chest and extra clothes pinned snugly around it, then shutting it up in a warm, stuffy, unsanitary, ill-smelling room, in order to keep it from "catching a fresh cold." Can you imagine anything else she could do to defeat her purpose?

No quantity of cod liver oil, no medicine, no coddling, will remove the tendency to "catch cold." The child's life must be lived amidst sanitary surroundings and hygienic conditions first; then other expedients may be utilized if necessary. These children must be kept out of doors most of the time, unless during the severest wet weather. They should sleep in a room the windows of which are open at the top and bottom every night in the year. They should not, however, be in a draught. The rooms in which they live should be of a uniform temperature, never too hot and never too cold, between 68° and 70° F. These delicate catarrhal children should be accustomed to light clothing on their beds. Chest protectors, mufflers, cotton pads, and heavy wraps of any description should be