nxiety, so
long as when the child lies upon its back the abdomen is uniformly soft,
nor so long as even if tense it is not tender, and as it everywhere
gives out a hollow sound like a drum when tapped with the finger.

It is not for a moment meant that no notice is to be taken, nor opinion
asked, as to the cause of excessive size of the abdomen, for its
distension may be due to real disease; but it is yet worth while to
remember that its mere size is not of itself evidence of disease, nor
cause of grave anxiety.

=Worms.=--There is no mistaking or overlooking the existence of _worms_
when they are really present. Their presence, however, is often
suspected without any sufficient reason. Ravenous or uncertain appetite,
indigestion, flatulence, undue size of the abdomen, a dark circle round
the eyes, itching of the nose and of the entrance of the bowel, a coated
tongue, and offensive breath are no real proof of the presence of worms,
and do not justify the frequent repetition of violent purgatives or of
so-called worm medicines. The only real proof of the presence of worms
is their being seen in the evacuations.

The worms commonly found in children are either the round-worm, which
resembles the earth-worm, the thread-worm, or the tape-worm; the
appearance of each of which is clearly indicated by its name. None of
them are spontaneously generated in the body, but they are all
introduced from without; their eggs, or, as they are technically called,
their ova, being swallowed unperceived in some article of food, or
drink. A proof of this is afforded by the fact that an infant, so long
as it is nourished exclusively at the breast, never has worms.

The _round-worm_ occasions the fewest symptoms, and is rather an object
of disgust than of grave importance, at least in this country, where it
seldom happens that more than two or three are present. In other
countries, as some parts of Italy, for instance, where the drinking
water is bad and stagnant, they are sometimes found in great numbers, as
thirty or forty, and it is then not easy to determine whether the
symptoms which accompany them are produced by the worms, or by the
unwholesome character of the water in other respects.

They appear to live on the contents of the intestines, and do not adhere
to them, as the tape-worm does, and hence their comparative
harmlessness, and they have no power, as has sometimes been mistakenly
imagined, of perforating the bowels, and of