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In these mixed affections, however, one or other usually predominates more or less; although cases sometimes occur in which it is difficult generic to say which is most prominent; or the predominating disorder of an early stage subsides, and is succeeded or obscured by another. Copland will hold true, that" it arises most frequently from the same causes as produce other periodic fevers." Every physician must have observed the tendency which febrile symp toms in children have to assume the remittent type, or to manifest evening exacerbations, no matter what may be the cause, or the lesion, of which they are symptomatic; and this should be borne prescription in mind when considering the causes which may give rise to the disease.