r entirely as a rule. There may not be any
desire for food, but generally little difficulty is experienced in
inducing children to take milk or broth, which is all the more
surprising as vomiting regularly follows.

The _fever_ is generally not very intense. The temperature of the head,
especially the forehead, is considerably increased in all cases and
remains so until death ensues, while the feet have great tendency to
getting cold.

The _pulse_ is characteristic in many cases. In the beginning of the
disease the pulse is quickened only to slacken after a few days. The
number of beats may be reduced to 40-60 a minute (normal 90-100),
however it does not commonly remain at a certain figure, but varies,
often inside of an hour, so that at one time 40, then 60 and again 80
beats may be counted inside of twenty-four hours.

The pulse again increases 1-3 days before death and then to such a rate
that it is almost impossible to count it. It may reach 180 and 200 beats
a minute. As soon as this rate of the pulse follows one of the
reductions described above a speedy death may be predicted.

Of great importance are the variations in respiration. In the beginning
stages of the disease breathing is normal except in such case where
tuberculosis has made great progress in the lungs and in the case of
high fever. Then of course breathing becomes more rapid. Acute
hydrocephalus influences respiration in such a way that it slackens and
becomes irregular. In one minute children may breath fifteen times, in
another thirty, then again 20 times; at one time breathing may be very
slight with almost invisible expansion of the chest and without any
noise whatever, then again it may consist of deep sighs; these are also
characteristic of this particular disease. Sometimes breathing is
completely discontinued for ten seconds and more.

If the pulse attains that extreme rate shortly before death the rate of
breathing will also be increased.

As regards the _skin_, the same is generally damp from the beginning of
the disease; severe sweats are observed on the head; with progressing
disease the skin becomes dry, brittle, comes off in flake-like scales
and only when the death-predicting increase of the pulse sets in, there
appears a profuse sweat, the cold sweat of death.

_Headache_ is also a prominent and pretty nearly constant symptom. As
has been mentioned before, it does not as a rule attend the precursory
symptoms. It generally beg