desirable way to give the inhalations.

External Applications.—Counter-irritation by means of mustard pastes are the best applications. They should be put back and front—one on back and one on the chest, overlapping at the sides beneath the arms. They should cover the entire body from the waist line to the neck. These pastes are made as follows:—Mix the mustard (English) and the flour in the following proportions, using a quantity according to the size of child and area to be covered; one tablespoonful mustard to three tablespoonfuls of flour. Mix with lukewarm water until a paste is formed, not too thick and not too thin. Spread on a cloth (put plenty on) and cover with one layer of cheesecloth and place the cheesecloth side next the skin. In order to guard against burning the skin it is advisable to rub the skin with vaseline, before and after putting on the paste. The paste should be left on until the skin is uniformly red. It may be applied from two to four times in the twenty-four hours according to the severity of the case. Mustard pastes are most effective during the first two or three days of the disease.

Drugs.—Drugs are of very little value in the treatment of bronchitis. In the first stage of the disease, when the cough is hard and dry, small doses of castor oil and syrup of ipecac may be given to good advantage. The following dosage should be followed closely: 1st year, 2 drops castor oil, 2 drops syrup of ipecac, every two hours; 3rd year, 3 drops castor oil, 3 drops syrup of ipecac, every two hours; over 3 years, 4 drops castor oil, 4 drops syrup of ipecac, every two hours.

The benefits from this treatment will be obtained in the first two or three days, when it should be discontinued. The cough under this treatment and the use of the mustard paste and inhalations of creosote will be soft and loose in two or three days and the fever will be distinctly on the mend. The disease lasts from five to ten days. It may, however, last much longer according to the condition of the child, etc.

There are other drugs that can be given, with good effect, but when other remedies are indicated a physician should be called to prescribe them according to indications.

SUMMARY:—

Bronchitis is one of the commonest diseases of childhood.

It is the cause of many deaths.

A large number of children have a tendency to bronchitis.

These children need careful attention and "building up."

Do not neglect a "little" cold. It means trouble.

Chronic or Recurrent Bronchitis.—Bronchitis becomes chronic when the treatment of an acute attack fails to cure the condition. The failure usually is dependent upon the condition of the child. It may be suffering with some disease resulting from poor nourishment or poor sanitary and hygienic surroundings or both. The bronchitis, in other words, is dependent upon some other condition, and will not get wholly better until the cause is cured. These children should lead an active outdoor life when the weather is favorable. Their sleeping-room should be well aired and ventilated. Red meats are allowed twice a week only. Sugar is cut down to the lowest limit. Skimmed milk only should be taken—the cream being too rich for them. They can eat freely of fruits in season, green vegetables and cereals. The bowels must move freely every day. Patients must be given a lukewarm bath, followed by a brief spray of cold water, daily. The cold spray should not be too cold; about 60 degrees F. is the suitable temperature of the water.

An absolute change of climate, to a warmer inland atmosphere, is imperative before some of these patients will begin to improve.

SUMMARY:—

A child with chronic bronchitis, or with frequent attacks of bronchitis (or chronic colds), is usually suffering from some other diseased condition.

The bronchitis, or the cold, will not get better until you find out what that "other diseased condition" is.

It takes a physician to find that out.

Having found the cause, cure it, and the bronchitis will disappear and the general health of the child will immediately improve.

PNEUMONIA

Pneumonia is a very common disease in childhood. It is the most frequent complication of the various acute infectious diseases. Pneumonia is an exceedingly important factor in the mortality of infancy.

There are two kinds of pneumonia:—

1. Broncho-pneumonia.
2. Lobar-pneumonia.

Acute Broncho-Pneumonia.—Up to the fourth year this is the form of pneumonia always present. It is the form that always complicates other diseases all through childhood.

It is most apt to occur during the spring and winter months.

It affects all classes, but especially those whose hygienic surroundings are poor. Catching cold is the exciting cause in a large percentage of primary pneumonias.

Symptoms.—Broncho-pneumonia has no regular course. It may or it may not follow a cold or an attack of bronchitis. As a rule it begins suddenly with a high fever, frequently accompanied by vomiting, rapid respiration, cough, and prostration.

The child does not maintain a high fever continuously; it varies considerably throughout each twenty-four hours. It lasts from one to three weeks, and subsides gradually.

The respirations vary between 60 and 80 per minute, though they may be much more frequent than this. The child breathes with apparent difficulty, the soft parts of the cheeks and nose rising and falling as it breathes.

The prostration becomes, as the disease progresses, more and more marked, until the child looks profoundly sick.

Cough is a constant and incessant symptom. It disturbs rest and sleep and may cause frequent vomiting. There is no expectoration. A strong cough is a good symptom; if it stops it is a bad symptom.

Pain is seldom present.

Blueness of the skin is a bad sign and indicates failure of respiration and suggests constant and careful watching.

Delirium may be present during the disease. It is not necessarily a bad sign. Accompanying stomach troubles are frequent if the patient is very young, and are very important. The bowels may be loose; they may be green in color and contain much mucus. Large quantities of gas may accumulate in the intestines and may cause much distress and convulsions. Death may occur at any time or the process may be arrested and recovery take place at any stage of the disease. Broncho-pneumonia is not necessarily a fatal disease in a fairly healthy child. It is, however, always a serious disease.

Various complications may occur in the course of the disease. The most frequent are: pleurisy, emphysema, abscess of the lung, meningitis, heart disease, stomach troubles, thrush, intestinal disease.

How to Tell When a Child Has Broncho-Pneumonia.—If a child develops a high fever, breathes rapidly, coughs, and is content to lie in bed because of the degree of prostration, broncho-pneumonia is almost certain to be the disease present. If in addition to these symptoms there is any blueness of the fingers or around the mouth it is more strongly suggestive of pneumonia.

If the child has been suffering with bronchitis it is sometimes difficult to tell just when the pneumonia begins. The child will appear more profoundly sick, the fever will go higher, and the respiration will be more frequent when pneumonia sets in on top of bronchitis.

Treatment.—The nursing of a little patient with pneumonia is the most important part. He must get plenty of fresh air; consequently he should be kept in a well-ventilated room. It is an excellent plan to change the patient twice daily from the sick room into another