e on the child's part, for it is not hard for those who
have had charge of it from babyhood to bring it up to quiet pursuits and
quiet amusements, till it seeks no others, and, like the little
cage-bred bird, does not care to emulate the flight of others stronger
on the wing.

=Inflammation of the Heart.=--The above remarks do not comprise all
that is to be said about heart-affection in early life. _Inflammation_
may attack the investing or the lining membrane of the heart at all
ages, may produce in the child the same suffering as in the grown
person, and may tend to destroy life in a similar manner. The causes,
indeed, which produce heart disease, are far more frequent in the grown
person than in the child, and advancing age brings with it changes
which, wholly apart from active inflammation, produce grave forms of
disease unknown in early life. There is, however, one cause of heart
disease which is far more frequent in childhood and early youth than in
later life, namely, rheumatism. Eight out of ten of all cases of heart
disease under the age of fifteen are of rheumatic origin, and in
eighteen out of twenty cases of acute rheumatism under that age, whether
slight or severe, the heart becomes more or less involved. Now and then,
though rarely, the heart becomes affected in the course of scarlatina,
and still more seldom in the course of the other fevers, and every now
and then affection of the heart is associated with some other form of
inflammation of the chest.

Pain is by no means a constant attendant on it, but fever, more or less
considerable, a quickened pulse, and hurried breathing are all but
invariable, and one great reason for seeking the immediate help of the
doctor is, that his skilled ear may at once detect by the altered sounds
the heart-affection at its very outset, and employ the measures
calculated to arrest its progress.

Death in the acute stage of a first attack of inflammation of the heart
is of extreme rarity, but the damaged heart is liable to returns of
acute mischief, any one of which may prove fatal. Independently of this,
life with diseased heart is one of suffering, attended as it is by
symptoms similar in kind, though not identical with those which I have
already mentioned as attendant on malformation of the organ.

The hopeful element, however, to which I have already referred as
present in cases of malformed heart, exists here in even a greater
degree; since repair of injury is poss