, is not reproduced. The lung shrinks, the sides of the
abscess come together, and by slow degrees a dense material cuts it off
from the adjacent healthy structure, but the most complete recovery
leaves the patient with his breathing power lessened, and with his
vigour consequently more or less impaired.

When the deposit is less considerable, a different change takes place.
The material dries by degrees, and is at last converted by a purely
chemical change into a hard chalky substance, which in the course of
time becomes of more than stony hardness.

Last of all; when the deposit is smallest in quantity, it may be
completely got rid of; and a lung in which consumptive disease once
existed, may eventually regain perfect soundness.

I have dwelt on these processes as they take place in the lungs; but,
allowing for differences of locality, they resemble such as take place
elsewhere.

Three important conclusions follow from what has been said.

First. It is only in quite the early stage of consumptive disease that
absolutely perfect recovery can be hoped for. There is a euphemism, more
amiable than honest, which doctors not seldom make use of, saying that a
child's lungs are not diseased, but only tender. They mean by this, that
on listening to the chest, they detect such changes in the sounds of
breathing as their experience tells them are usually produced in the
early stage of consumptive disease of the lungs. If the opinion is
confirmed by a second competent medical man, _then, and not later_, is
the time for precautions, for removing the child from school, and for
selecting, as far as may be, a suitable winter climate. When the signs
of disease are well marked, a reprieve, perhaps a long one, is all that
can be confidently reckoned on.

Second. When softening of the consumptive deposit has taken place, of
which certain sounds attending breathing are all but conclusive,
recovery, even the most complete, always implies loss of a certain
amount of lung-substance, and consequently loss of a certain amount of
breathing power.

Third, and this is most important, as well as most cheering;
consumption, which is at no age the absolutely hopeless disease that it
was once supposed to be, admits of far more cheerful anticipations in
children than in grown persons, or, for that matter, than in the youth
or maiden.

The principal _causes_ of consumptive disease are, hereditary
predisposition, and improper feeding in infanc