n two years of
age, had an enlargement of the left knee joint. For some weeks previous
to this time, there had been a degree of heat about the part; but as no
pain apparently existed, it was not regarded as of any consequence, and
nothing was done. The child, living in the neighbourhood of London, was
afterwards placed under medical treatment. Two or three months having
elapsed, it was brought to town, and shown to me, in consequence of a
slight tumefaction over the lower part of the spine. This soon
disappeared under the measures employed, and eventually the disease of
the knee (evidently scrofulous) was arrested, so that now the case
promises to be cured; but the joint will for ever be stiff, and the
limb thus affected shorter than the other.

Case II.

G. B., the brother of the above, a handsome boy, with light hair, fine
blue eyes,--indeed, very much like his little sister,--in the year
1836, had enlargements of the glands in his neck, which were relieved
by the treatment resorted to.

In April, 1839, being then eight years old, he was observed by his
mother to limp slightly in walking, but complained of little or no
pain. From the caution, however, which had been given to the parent at
the time I was consulted about the previous case, to notice at an early
period any symptom of this nature in her children, the fact was
immediately attended to. The affection was evidently in the hip; there
was imperfection in the gait, and pain upon pressing over the joint. A
blister was applied, perfect rest to the limb enjoined, and steel
medicines ordered; and in a fortnight the motions of the joint were
restrained more effectually by the application of strips of soap
plaster and a bandage. In three months the child was ordered to the sea-
side, and eventually was able to walk without the slightest limp or
pain, and may be said to be quite well.

I would not say that in the first case, if the disease had been
discovered early, and at that time met by judicious medical treatment,
a stiff knee and shortened limb would have been prevented, although
this is my belief; but in reference to the latter case, I have no
hesitation in saying, that without the disease had been early detected
by the mother, and as promptly attended to by her, the remedial
measures might have failed,--certainly the result would not have been
so highly satisfactory as it was.

Chap. V.

ON WHAT CONSTITUTES THE MATERNAL MANAGEMENT OF THE DISE