oftened bone, nor flabby muscle with
rigid and well-formed bone.

In the nervous system, the conditions are somewhat different. In skin,
in bone, and in muscle new cell elements are constantly being formed,
and the life of the individual cell is relatively short. In the
nervous system, on the other hand, the individual cells are long
lived. Their life-history may even be coterminous with that of the
individual, and if destroyed they are not replaced. Nevertheless, they
do not escape undamaged in the general disturbance. In a deprivation
of calcium we have, in all probability, the explanation of the
increased irritability of peripheral nerves and of the tendency to
convulsive seizures of all sorts which is a common accompaniment of
the condition. Convulsions, laryngismus stridulus, tetany, or
carpopedal spasm are all frequently met with. In crying, the children
hold their breath to the point of producing extreme cyanosis, ending,
as the spasm relaxes, with a crowing inspiration, which resembles and
yet differs in tone from both the whoop of whooping-cough and the
crowing inspiration of croup.

Apart, however, from this tendency to convulsive seizures the nervous
system of these children is abnormal. As a rule they are excitable,
and develop late the power to control their emotions. Lagging behind
in physical development and in the capacity to interest themselves in
the pursuits of normal children, their emotional state remains that of
a much younger child. In the infant classes at schools they are
recognised as dullards, learning slowly, speaking badly, and lacking
co-ordination in all muscular movements.

The clinical picture so depicted is encountered with extreme frequency
among the children of the poor in our large cities. To find a name for
the condition is no easy matter. To call it "rickets" is to place an
undue emphasis upon the bony changes which, though common, are by no
means invariable. Elsewhere I have suggested the name status
catarrhalis, on an analogy with the name status lymphaticus, which in
the post-mortem room is used to describe the secondary overgrowth of
lymphatic tissue which is found in these catarrhal children. In the
present connection it is of interest to us to note how commonly the
nervous system is involved in the general picture and the frequency
both of convulsive disorders and of neuropathy.

The nervous symptoms of both sorts are to be allayed only by improving
the general hygiene o