hildren where we find symptoms
resulting from mouth-breathing as described below. The surgeon assures
himself positively of the existence of adenoids by inserting a finger
into the mouth of the patient and hooking it up back of the roof of
the mouth, when they may be felt as a soft mass filling the back of
the nose passages.

Other less common causes of mouth-breathing, seen in adults as well as
children, are deviation of the nasal septum, swelling of the mucous
membrane covering certain bones in the nose (turbinates), and polypi.

Deviation of the nasal septum means displacement of the partition
dividing the two nostrils, so that more or less obstruction exists.
This condition may be occasioned by blows on the nose received in the
accidents common to childhood. The deformity which results leads in
time to further obstruction in the nose, because when air is drawn in
through the narrowed passages a certain degree of vacuum is produced
and suction on the walls of the nose, as would occur if we drew in air
from a large pair of bellows through a small thin rubber tube. This
induces an overfilling of the blood vessels in the walls of the
passages of the nose, and the continued congestion is followed by
increased thickness of the lining mucous membrane, thus still further
obstructing the entrance of air. A one-sided nasal obstruction in a
child with discharge from that side leads one to suspect that a
foreign body, as a shoe button, has been put in by the child.

Polypi are small pear-shaped growths which form on the membrane lining
the nasal passages and sometimes completely block them. They resemble
small grapes without skins.

These, then, are the usual causes of mouth-breathing, but of most
importance, on account of their frequency and bearing on the health
and development, are adenoids and enlarged throat tonsils in children.
Adenoids and enlarged tonsils are often due to inflammation of these
glands during the course of the contagious eruptive disorders, as
scarlet fever, measles, or diphtheria; probably, also, to constant
exposure to a germ-laden atmosphere, as in the case of children
herded together in tenements.

=Symptoms.=--The mouth-breathing is more noticeable during sleep;
snoring is common, and the breathing is of a snorting character with
prolonged pauses. Children suffering from enlarged tonsils and
adenoids are often backward in their studies, look dull, stupid, and
even idiotic, and are often cross a