Crying is the chief if not the only method that the young infant possesses of making known his displeasure, discomfort or suffering and affords almost the sole means of determining the characters of the voice at this early age. Again, even long after the powers of speech have been developed, the cry continues to be the main channel of complaint.

One rarely hears a healthy child cry, unless a harsh word, a fall or a blow cause a passing storm of grief, anger or pain. Hence, frequent, peevish crying points to some disturbance of the healthy balance.

The sound of the voice, whether in crying or speaking, should have a clear ring, without either muffling, hoarseness or nasal tone. Weeping should accompany crying, after the establishment of tear secretion. Cough, although not a normal vocal sound, is also worthy of attention.

Examples of Variations in Disease. - Incessant, unappeasable crying is usually due to earache or hunger; it frequently, too, is caused by the constant pricking of a badly-adjusted safety-pin or other mechanical irritant.

If crying occur during an attack of coughing it is an indication of some painful affection of the chest; if just before or after an evacuation of the bowels, of intestinal pain.

When the cry has a nasal tone it should suggest swelling of the lining membrane of the nose, or other obstructing condition. Thickening and indistinctness occur with throat affections. A loud, brazen cry is a precursor of spasmodic croup, and a faint, whispering cry, of true or membranous croup. Hoarseness points to disease of the lining membrane of the larynx, either catarrhal or syphilitic in nature.

Finally, a manifest unwillingness to cry can be seen in pneumonia and pleurisy, when the disease is severe enough to interfere materially with breathing.

Tear-secretion having been established, it is a bad omen if the secretion be arrested during the progress of an illness, but an equally good one if there be no suppression, or if there be a reestab-lishment after suppression.

The cough, like the voice, may be brazen in spasmodic croup, hoarse in laryngeal catarrh, and suppressed in true croup. The qualities "tight-ness" and "looseness" are readily appreciated and give a good idea of the progress of lung affections, especially bronchitis, the former being an evidence of the beginning, the latter of the favorable termination of an attack.

Cough is always unproductive, that is, unattended by expectoration, in children under seven years of age.