JAMA. 1903;XL(22):1504-1508. doi:10.1001/jama.1903.92490220028001f.
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The condition to which I would direct your attention within the brief limits of this paper is by no means rare to those who have considerable clinical experience among children, and deserves to be qualified by the words "of infancy" inasmuch as the great majority of the cases occur in children under 2 years of age. At this period of life the lymphatic system is especially vulnerable and the lymph nodes in the cervical region particularly liable to infection and suppuration.

While in a few of the cases met, the infection of the gland has been preceded by and is traceable to some infected cutaneous lesion, in the vast majority of the most typical cases it seems evident that they are dependent on absorption from the nasopharyngeal space. The degree of inflammation in the nasopharynx seems to bear but little relation to the occurrence of the glandular swelling, many young


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