TUBERCULOSIS. 61 



of children by some unwise parents brings about the same result. The tuberculous 

 children are generally forward, and they begin to take notice and to prattle earlier 

 than others. This being the case, their brains are never allowed a moment's peace, 

 and incessantly during its waking hours it is made to "take notice" of this, that, 

 and the other, to answer stupid questions, and repeat stupid rhymes. All this to 

 so young a child is mental labour, and this mental labour often, we believe, is 

 answerable for the induction of tubercular disease of the brain, and the premature 

 death of the child. 



Again, undue exposure to cold or insufficient clothing may bring on bronchitis, 

 and bronchitis in these constitutions will almost certainly determine tubercular 

 disease of the lungs. Children are often insufficiently clothed, and when they begin 

 to run about their dresses not unfrequently begin so low down and end so high up 

 that the chest and legs are left practically bare. We grant that children thus dressed 

 look uncommonly pretty, and we are ready to admit that this costume is adopted by 

 parents very often from a mistaken notion about " hardening their constitutions ; " 

 but we fear there is good reason to suppose that this hardening process often ends in 

 death. These children should be very carefully clothed, and their legs, arms, and 

 chests should be kept carefully covered up, except during the summer months. If 

 the parents can afford it, it is advisable for them to pass the winter in a warmer and 

 more certain climate than is to be found in England, except in some favoured 

 localities. The skin should be kept scrupulously clean, and should be washed daily 

 with soap and water. The tendency to disease of the bowels should make one very 

 careful about the diet of such children. It should be carefully adapted to their age, 

 and should be bland and unirritating. Any unwholesome particle may lodge in the 

 bowels, set up irritation, and cause a tubercular deposit. Uncooked vegetables, 

 underdone potatoes, a piece of gristle, the outside white skin of the orange, or the 

 stones of a grape or raisin, may be sufficient to induce the trouble. Milk, soups, 

 carefully boiled or roast meat, wheaten bread (not oatmeal or brown bread), carefully 

 and thoroughly cooked vegetables, soft puddings of custard, rice, tapioca, or other 

 farinaceous articles, and cooked fruit, ought to constitute the diet of such children. 

 The actions of the bowels must be carefully looked to, and constipation or relaxation 

 must receive immediate attention. Dosing, always a dangerous proceeding, is 

 especially so in these cases, and if purgatives are necessary they must be of a very 

 mild character. The bowels may often be relieved by giving a simple injection of 

 soap and water by the bowels, but this is a measure which ought only to 

 be used occasionally, and ought never to be allowed to become a practice. The best 

 drugs to be used in these cases are the salts of soda, senna, or castor oil. Half 

 a drachm of phosphate of soda in a little broth or some hot milk is a very efficient 

 purgative, and, being tasteless, is of great service in the nursery. Half a tea-spoonful 

 of syrup of senna or a tea-spoonful of castor oil may be given when necessary, but 

 the employment of the stronger purgatives rhubarb, jalap, grey powder, or calomel 

 is not to be thought of, except with the advice of a medical man. 



Certain medicines are of undoubted service in tuberculosis, and first among these 

 we must mention that which is so useful in all conditions of disordered nutrition in 

 childhood cod liver oU. If this be given during convalescence from the infantile 



