304 Mayow 



the whole of England, though more rarely in the 

 northern parts. 



It is, then, infants that specially suffer from this 

 disease ; it is pretty frequent among those from six 

 months to a year and a half old, most frequent 

 between the ages of a year and a half and two years 

 and a half, so that the chief time of attack comprises 

 the two years immediately following the age of six 

 months. 



The diagnosis of this disease, as of others, depends 

 on a knowledge of the symptoms, which are the 

 following. 



The proportion of parts is irregular, namely : the 

 head larger than normal, the face in better condition, 

 the intelligence very acute for the child's age, the 

 external parts (especially the muscles), slender and 

 thin, the skin lax and flaccid, the bones for the most 

 part bent, and round the joints prominent and nodose, 

 the spine also variously curved, the chest narrow, the 

 sternum indeed acuminated, the ends of the ribs 

 knobbed, the abdomen somewhat tumid and tense : 

 so far for what is to be seen externally. 



Internally, the liver is seen to be above the normal 

 size, as are nearly all the parenchymata ; the stomach 

 and intestines present a greater mass than in health ; 

 the mesenteric glands are larger than normal, even if 

 they are not strumous : so far as to the abdomen. 



In the thorax the lungs are observed to be in- 

 farcted and tumid, sometimes purulent and strumous, 

 and very often adherent to the pleura. The jugular 

 veins and the carotid arteries are sometimes found larger 

 than normal, but the brain is normal except in propor- 

 tion and size. 



To these has to be added a weakening of nearly 

 all parts of the body, also a certain torpor, and 



