asked how he felt, he answered, "I feel fine now." required about fifteen minutes to get his history, during all of which time he was responsive and interested, constantly correcting statements of his father and volunteering other information. Eleven days after the operation he was reported to have had no more epileptic seizures. "Doesn't

talk in sleep. Doesn't snore. Doesn't toss about the bed. Has more self-control. Tries to read the paper. His immoderate appetite is not present."

While the open mouth is a sure sign of defects of breathing, it is not true that the closed mouth, when awake and with other people, is proof that there are no such defects. Children breathe through the mouth not because they like to, not because they have drifted into bad habits, not

because their parents did, not because the human race is deteriorating, but because their noses are stopped up,— because they must. A mouth breather is not only always taking unfiltered dirt germs into his system but is always in the condition of a person who has slept in a stuffy room. What extra effort adenoids mean can be ascertained by closing the nostrils for a forenoon.

For many reasons it is perhaps unfortunate that we can breathe at all when the nose is stopped up. If we could see with our ears as well as with our eyes, we should probably not take as good care of our eyes. In this respect the whole race has experienced the misfortune of the man of whom the coroner reported, "Killed by falling too short a distance." Because we can breathe through the mouth we have neglected for centuries the nasal passages. When a cold stops the nose we necessarily breathe through the mouth. Unfortunately children make the necessary effort required to breathe through the nose long before other people notice the lines along the nose and the slow mind. Mouth breathing will show with the child asleep, before the child awake loses power to accommodate his effort to the task. Therefore the importance of a physical test at school to detect the beginnings of adenoids and large tonsils before these symptoms become obvious to others.

No child should be exempted from this examination because of apocryphal theories that only the poor, the slum child, the refractory, or the unclean have defects in breathing. This very afternoon a friend has told me of her year abroad with a girl of nine, whose parents are very wealthy. The girl is anæmic. Her backwardness humiliates her parents, especially because she gave great promise until two years ago. High-priced physicians have prescribed for her. It happens that they are too eminent to give attention to such simple troubles as adenoids that

can be felt and seen. They are looking for complications of the liver or inflammation of muscles at the base of the brain. One celebrated French savant found the adenoids, assured the mother that the child would outgrow them, and advised merely that she be compelled to breathe through the nose. The mother and nursemaids nag the child all day. The poor unwise mother sits up nights to hold the child's jaws tight in the hope that air coming through the nose will absorb the adenoids. The mother is made nervous. Of course this makes the child more nervous and adds to the evil effects of adenoids. If the mother had the good fortune to be very poor, she could not sit up nights, and would long ago have decided either to let the child alone or else to have the trouble removed.

Adenoids are not a city specialty. Country earache is largely due to adenoids or to inflammation that quickly leads to adenoids. In 415 villages of New York state twelve per cent were found to be mouth breathers. For two summers I have known a lad named Fred. He lives at the seashore. Throughout his twelve years he has lived in a veritable El Dorado of health and nature beauty. Groves and dunes and flora vie with the blues of ocean and sky in resting the eye and in filling the soul with that harmony which is said to make for sound living. Yet to a child, Fred's schoolmates are experts on patent medicines and on the heredity that is alleged to be responsible for bad temper, running sores, tuberculosis, anæmia, and weak eyes. Freddie is particularly favored. His well-to-do parents have supplied him with ponies, games, and bicycles. Nothing prevents his breathing salt air fresh from the north pole but hermetically sealed windows. The father thinks it absurd to make a fuss over adenoids. Didn't he have them when a boy, and doesn't he weigh two hundred pounds and "make good money"? The mother never knew of operations for such trifles when

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she taught school; she supposes her boy needs an operation, but "just can't bear to see the dear child hurt." As for Fred, he breathes through his mouth, talks through his nose, grows indifferent to boy's fun, fails to earn promotion at school, and fears that "I won't be strong in spite of all the patent medicine I've taken." Father, mother, and Fred feel profound pity for the city child living so far from nature.

Adenoids are not monopolized by children whose parents are ignorant of the importance of them and of physical examination. Last summer I was asked by a small boy to buy some chocolate. A glance at his cigar box with its two or three uninviting things for sale showed that the boy was really begging. He had thick lips, open mouth, misty" eyes, and a nasal twang. I asked him if his teacher had not told him he had lumps back of his nose and could not breathe right. He said, "No." I explained then that he could make a great deal more money if he talked like other boys, stepped livelier, and breathed as other people breathe. He said he had "been by a doctor. onct but didn't want to be op'rated." I turned to my companion and asked, "Have you never noted those same lines on your boy's face?" Although he had been lecturing on mouth breathers, he had never noticed his own boy's trouble. He hastened home and found the infallible signs. The mother declared it could not be true of her boy. About five months before, their family physician had said of the child's earache, "The same inflammation of the nasal passages that causes earache causes adenoids ; you must be on the lookout." Although in the country, the boy's appetite was not good and his zest for play had flagged. They had looked for the trouble to back generations and in psychology books, -everywhere but at the boy's face, in his mouth, and in his nose. After the operation, which took less than two minutes, the appetite was

ravenous, the eyes cleared, and the spirit rebounded to its old buoyancy that craved worlds to conquer.

The new personal experience made a deep impression upon my friend's mind. He wanted everybody to know how easy it was to overlook a child's distress. One person after another had a story to tell him; even the janitor said : "You'd ought to have seen our John at sixteen. He spent a week by the hospital." The only people who do not seem to know more than the new convert are the mouth breathers whom he religiously stops on the street.

The indexes to adenoids and large tonsils for the teacher to read at school are:

1. Inability to breathe through the nose.

2. A chronically running nose, accompanied by frequent nosebleeds and a cough to clear the throat.

3. Stuffy speech and delayed learning to talk. "Common" is pronounced "cobbéd"; "nose," "dose"; and "song,' sogg." 4. A narrow upper jaw and irregular crowding of the teeth. 5. Deafness.

6. Chorea or nervousness.

7. Inflamed eyes and conjunctivitis.

The adenoids and large tonsils discovered at school are an index :

1. To children needlessly handicapped in school work.

2. To teachers needlessly burdened.

3. To whole classes held back by afflicted children.

4. To breeding grounds for disease.

5. To homes where children's diseases and tuberculosis are most likely to break out and flourish.

6. To parents who need instruction in their duty to their children, to themselves, and to their neighbors, and who are ignorant of the way in which "catching" diseases originate and spread.

The riot that occurred when the adenoids of children in a school on the East Side" in New York City were