w that a peculiar form
of disease is produced by it, attended by symptoms, and giving rise to
appearances after death, peculiar to the form of slow starvation from
which the infant has perished. I will add, because it is not generally
known, one fresh illustration of the influence of artificial feeding in
aggravating the mortality of infants. In Berlin the certificates of
death of all infants under the age of one year, are required to state
whether the little one had been brought up at the breast, or on some
kind or other of artificial food. Of ten thousand children dying under
the age of one year, one-fourth had been brought up at the breast,
three-fourths by hand.[3]

It is, as I said in the preface, no part of my plan to enter on any
details with reference to the management of children in health. It may,
therefore, suffice to have pointed out the four great causes of
preventible disease among the wealthier classes of society; namely, the
intermarriage of near relatives, the transmission of constitutional
taint, the insanitary condition of the dwelling, and the injudicious
selection of the food of the infant.

FOOTNOTES:

[1] This is the proportion stated in Quain's _Dictionary of Medicine_,
to which the writer, Dr. Theodore Williams, adds that of 1,000 cases in
the upper classes 12 per cent. showed direct hereditary predisposition,
and 48 per cent. family predisposition.

[2] Many useful suggestions will be found in Mrs. Gladstone's little
tract, _Healthy Nurseries and Bedrooms_, published as one of the Health
Exhibition Handbooks.

[3] The actual numbers are 2,628 and 7,646. See _Generalbericht ueber
das Medizinal-und Sanitaetswesen der Stadt Berlin im Jahre 1881_. 8vo.
Berlin 1883, p. 19.

CHAPTER II.

THE GENERAL SIGNS OF DISEASE IN INFANCY AND CHILDHOOD.

The signs of disease at all ages may be referred to one or other of
three great classes: disorder of function, alteration of temperature,
complaint of pain.

In the infant it is the last of these which very often calls attention
to the illness from which it is suffering. Cries are the only language
which a young baby has to express its distress; as smiles and laughter
and merry antics tell without a word its gladness. The baby must be ill,
is all that its cries tell one person; another, who has seen much of
sick children, will gather from them more, and will be able to judge
whether its suffering is in the head, or chest, or stomach. The crie