Page:The physical training of children (IA 39002011126464.med.yale.edu).pdf/339

 The expectoration at first is merely mucus, but after a time it assumes a characteristic appearance; it has a roundish, flocculent, wooly form, each portion of phlegm keeping, as it were, distinct; and if the expectoration be stirred in water, it has a milk-like appearance. The patient is commonly harassed by frequent bowel complaints, which rob him of what little strength he has left. The feet and ankles swell. The perspiration, as before remarked, comes on in the evening, continues all night, more especially toward morning and while the patient is asleep; during the time he is awake, even at night, he seldom sweats much. The thrush generally shows itself toward the close of the disease, attacking the tongue, the tonsils, and the soft palate, and is a sure harbinger of approaching death. Emaciation rapidly sets in. If we consider the immense engines of destruction at work—viz., the colliquative (melting) sweats, the violent bowel complaints, the vital parts that are affected, the harassing cough, the profuse expectoration, the hectic fever, the distressing exertion of struggling to breathe,—we cannot be surprised that "consumption had hung out her red flag of no surrender," and that death soon closes the scene. In girls, provided they have been previously regular, menstruation gradually declines, and then entirely disappears. 362. What are the causes of Consumption?

The predisposing causes of consumption are the scrofulous habit of body, hereditary predisposition, narrow or contracted chest, deformed spine, delicacy of constitution, bad and scanty diet, or food containing but little nourishment, impure air, close in-door confinement in schools, in shops, and in factories, ill-ventilated apartments, dissipation, late hours, over-taxing with book learning the growing brain, thus producing debility, want of proper out-door exercises and amusements, tight lacing—indeed,