ree
times, and is dead: sudden heart failure, due to the poisoning either of
the heart muscle itself, or of the nerves supplying the heart, by the
toxin of the disease. Moral: Keep diphtheria patients strictly at rest
in bed for at least a week after the crisis is past. Another case will
pass this period safely, though perhaps with a rapid and weak heart, for
days or weeks; then one morning the child will choke when swallowing
milk. The next time it is attempted, the milk, instead of going down the
throat, comes back through the nostrils. Paralysis of the soft palate
has developed, apparently from a local saturation of the nerves with the
poison. This may go no further, or it may extend, as it commonly does,
to the nerves of the eye, and the child squints and can no longer read,
if old enough, because the muscle of accommodation also is paralyzed.
The arms and limbs may be affected, and in extreme cases the nerves of
respiration supplying the diaphragm may be involved, and the child dies
of suffocation. In the majority of cases, however, fortunately, after
this paralysis has lasted from three to six weeks, it gradually
subsides, and may clear up completely, though not at all infrequently
one or more muscles may remain permanently damaged by the attack,
giving, for instance, a palatal tone to the voice, or interfering with
the production of singing tones. Occasionally a permanent squint may
follow.

It might be said in passing, that, with one of the charming logicalities
of popular reasoning, these nerve complications have been said to be
_caused by_ antitoxin, simply because the use of the antitoxin saves
more children alive to develop them.

The next group of nervous diseases may be roughly described as due to
the failure of some part of the digestive system, like the stomach and
intestines, properly to elaborate its food; or of one of the great
glands, like the liver, thyroid, or suprarenal, properly to supply its
secretion, which is needed to neutralize the poisons normally produced
in the body. This class is very large and very important. It has long
been known how surely a disordered liver "predicts damnation";
melancholia, or "black bilious condition," hypochondria, or "under the
rib-cartilages" (where the liver lies), are every-day figures of speech.
A thorough house-cleaning of the alimentary canal, together with proper
stimulation of the skin and kidneys, and an intelligent regulation of
diet, are our most im