With infinite care and gentleness, Dr. Earl cut down through the cast, and took it off. The fracture was perfectly knit, but there was a slight swelling about the knee, and as Earl examined it Silvia saw him compress his lips in a hard, straight line. Without looking up, or changing his tone, he asked the child if she had had a fall since the cast had been changed. She answered readily that about a week before her crutch had slipped as she was coming indoors, and she had fallen, striking the injured leg against the stone step, and she winced as he touched the thin knee. "It's too bad," he said, "but there will have to be another cast about this knee, and you must be more careful, little girl." The tears came to her eyes, and her mother turned to him with an expression of anxiety. His cheerful face reassured her. "We'll hope it won't be for long," he said, "but there's no use taking chances. Has her health generally been good?" he asked Mrs. Bell. "The diseases common to childhood went rather hard with her and she had considerable trouble with her neck and throat a few years ago," Mrs. Bell replied. He made an examination of the glands of her neck, but said no more. In spite of many insistent calls elsewhere, Dr. Earl remained long enough to help lend an air of festivity to the small party, which Silvia presided over with infinite tact, and with a last admonition to Mrs. Bell to keep the little girl in bed until he came again, and as quiet as possible, he took his departure, and Silvia went with him. "Tell me what is the matter?" she said, with her usual directness, when they were out on the street. "What makes you think anything is?" he parried. "I beg your pardon," she said, a trifle coldly. "I should not have asked." He turned to her and stopped, mute reproach in his eyes. "There isn't a shadow of doubt that tuberculosis has developed in that knee, and while I hope to arrest it, and perfect a cure in time, I am very anxious, nevertheless." "But the break has united?" she asked. "Oh, yes, and that goes to show that this condition is very recent, and mild, but with her antecedent history no one can tell what may happen," he said. "Antecedent history?" Silvia said, rather puzzled. "I thought you did not know the family?" "I didn't," he answered, "but you may remember that I looked very carefully at the bruises about the knee when I set the leg, and I asked Mrs. Bell some general questions but received no very definite replies until to-day, and what you heard indicates that the child has already had a slight attack of tuberculosis. I had counted on my treatment to overcome the weakening influences of confinement to bed and crutch for so long a time." Silvia was silent, as if thinking out some plan, and said suddenly, "Then it will all resolve itself into a contest between health and disease, with a considerable handicap against the patient?"