The Nervous Child

CONTENTS

CHAP. PAGE

I. DOCTORS, MOTHERS, AND CHILDREN 1

II. OBSERVATIONS IN THE NURSERY 16

III. WANT OF APPETITE AND INDIGESTION 50

IV. WANT OF SLEEP 64

V. SOME OTHER SIGNS OF NERVOUSNESS 73

VI. ENURESIS 89

VII. TOYS, BOOKS, AND AMUSEMENTS 96

VIII. NERVOUSNESS IN EARLY INFANCY 104

IX. MANAGEMENT IN LATER CHILDHOOD 117

X. NERVOUSNESS IN OLDER CHILDREN 131

XI. NERVOUSNESS AND PHYSIQUE 145

XII. THE NERVOUS CHILD IN SICKNESS 160

XIII. NERVOUS CHILDREN AND EDUCATION ON SEXUAL MATTERS 169

XIV. THE NERVOUS CHILD AND SCHOOL 182

INDEX 191




THE NERVOUS CHILD

CHAPTER I

DOCTORS, MOTHERS, AND CHILDREN


There is an old fairy story concerning a pea which a princess once
slept upon--a little offending pea, a minute disturbance, a trifling
departure from the normal which grew to the proportions of intolerable
suffering because of the too sensitive and undisciplined nervous
system of Her Royal Highness. The story, I think, does not tell us
much else concerning the princess. It does not tell us, for instance,
if she was an only child, the sole preoccupation of her parents and
nurses, surrounded by the most anxious care, reared with some
difficulty because of her extraordinary "delicacy," suffering from a
variety of illnesses which somehow always seemed to puzzle the
doctors, though some of the symptoms--the vomiting, for example, and
the high temperature--were very severe and persistent. Nor does it
tell us if later in life, but before the suffering from the pea arose,
she had been taken to consult two famous doctors, one of whom had
removed the vermiform appendix, while the other a little later had
performed an operation for "adhesions." At any rate, the story with
these later additions, which are at least in keeping with what we know
of her history, would serve to indicate the importance which attaches
to the early training of childhood. Among the children even of the
well-to-do often enough the hygiene of the mind is overlooked, and
faulty management produces restlessness, instability, and
hyper-sensitiveness, which pass insensibly into neuropathy in adult
life.

To prevent so distressing a result is our aim in the training of
children. No doubt the matter concerns in the first place parents and
nurses, school masters and mistresses, as well as medical men. Yet
because of the certainty that physical disturbances of one sort or
another will follow upon nervous unrest, it will seldom happen that
medical advice will not be sought sooner or later; and if the
physician is to intervene with success, he must be prepared with
knowledge of many sorts. He must be prepared to make a thorough and
complete physical examination, sufficient to exclude the presence of
organic disease. If no organic disease is found, he must explore the
whole environment of the child, and seek to determine whether the
exciting cause is to be found in the reaction of the child to some
form of faulty management.

For example, a child of two or three years of age may be brought to
the doctor with the complaint that defæcation is painful, and that
there has existed for some time a most distressing constipation which
has resisted a large number of purgatives of increasing strength.
Whenever the child is placed upon the stool, his crying at once
begins, and no attempts to soothe or console him have been successful.
It is not sufficient for the doctor in such a case to make an
examination which convinces him that there is no fissure at the anus
and no fistula or thrombosed pile, and to confine himself to saying
that he can find nothing the matter. The crying and refusal to go to
stool will continue after the visit as before, and the mother will be
apt to conclude that her doctor, though she has the greatest
confidence in him for the ailments of grown-up persons, is unskilled
in, or at least not interested in, the diseases of little children.