Chapter XIV

THE NERVOUS CHILD AND SCHOOL

At the onset of puberty childhood comes to an end, and the period of adolescence begins. Into these further stages of development it is not proposed to enter, but it may be well to consider a question which is apt to present itself for answer at this period: "Should the boy, or girl, of nervous temperament, or whose development up to this point has been accompanied by symptoms of nervous disorder, be sent to a boarding-school?" So long as the child remains at home the home environment is the force which alone is concerned in moulding his character. We have seen how plastic the young child is, how imitative, how suggestible, how prone to form habits good or bad. The diversity of type shown by the homes is reflected in the diversity of character and conduct exhibited by the children. The home is the culture medium, and in no two homes is its composition the same. For each child home influence remains to a great extent unchanged, and in great part unchangeable. Its action upon the child is constant and long sustained. Hence, it is not surprising that the growth of his character and powers is commonly unequal. At one point we may find a good crop of virtues, at another a barren tract; and the home influences which have ripened the one and blighted the other are calculated by the lapse of time to increase the contrast rather than to diminish it.

I suppose it is for this reason that the custom of sending children to boarding-schools has so firm a hold among us. The boarding-school forms an environment selected to correct the inequalities which result from the special action upon the child of individual homes. The life of a boy in one of our large public schools is well calculated to act as a corrective in this way not only by reason of its ordered routine and discipline, but still more because it is affected, perhaps for the first time, by the strong force of public opinion. It is the strength of this public opinion which gives to our public schools their peculiar character and produces their peculiar effects. That which the schoolboy most despises is what he calls "Bad Form," and he bows down and worships an idol he himself has set up, the name of which is "Good Form." Public opinion forms the code of morals observed in the school. The standard set is commonly not so high as to be very difficult of attainment. It demands many good qualities. To lie, to sneak, to tell tales, to bully, to "put on side," are bad form. In some respects the definition of what is virtuous may be a little hazy. Thus it may be wrong to cheat to gain a prize, but to copy from one's neighbour only so much as will enable one to pass muster and escape condemnation is no great sin. In short, good form demands that a boy should have all the social virtues: that he should be a good fellow, easy to live with, and possessed of a high sense of public spirit—good qualities certainly, though perhaps not those which help to make the reformers or martyrs of this world.

The school life is the life of the herd, and to be successful in it the boy must mingle with the herd, not break from it or shun it. Good form—if we came to analyse the conception that underlies it—consists only in a close approximation to the standard pattern; bad form, in any deviation from it. It is this similarity of type and community of ideals which makes it so easy for most public-school boys to get on well with one another. When in after life they are thrown among a set of men who know nothing of their conception of good form, and whose training has been on completely different lines, there may be a corresponding difficulty.

Now what is true of public-school life is of course also true of the larger life after schooldays are over for which all education is a preparation. These qualities of sociability and good sportsmanship will stand a man in good stead throughout life. Even the most ardent and active spirit will benefit by being subjected for some years to this steady pressure of public opinion. The most part will learn from it good sense, consideration for others, and self-control. As they pass from the lower forms to the higher in the school they will learn too to support authority without doing injustice, and to bring the weight of public opinion to bear upon others. And to all this training many a man owes his happiness in after life—a happiness which he could not have secured if his character had been moulded only by the environment of his home, or by the home in combination with the less-powerful corrective of a day school. For the nervous child the passage from home to school life may involve considerable mental strain. He may be morbidly self-conscious and timid, or, unknown to himself—because he has as yet no power of self-analysis and has no opportunities of comparing himself with others—he may have developed certain eccentricities. In most cases the plunge into school life will be taken well enough; in a few the little vessel will not right itself, and proves permanently unseaworthy. No doubt as a rule a private school will have preceded the public school, and this gradation should make the entrance to the public school a lesser ordeal. But it often happens that it is just in the case of the nervous child that this intermediate stage has been omitted, and that his thirteenth birthday finds him still in the home circle.

If the boy's father has first-hand knowledge of life in the lower forms of public schools, his experience may enable him to form some estimate of the effect of school life upon the nervous system of his son. It is when parents or guardians have no such experience of their own to guide them that mistakes are most liable to be made. I can myself remember the unhappy state of some solitary and eccentric schoolfellows of mine who aroused the resentment of "the Herd" by their behaviour or opinions. If it is clear that the boy has a peculiar temperament and is likely to suffer in this way, some via media must be found. The home has failed so that he must leave home and come under the influence of some one who understands the nature of the difficulty and can adapt the boy to school life. A change of environment of this sort as a preliminary to the public school is often all that is needed. If his age permits, every effort should be made in this way to obtain for the nervous child who has developed peculiarities or faults the benefits of a public-school education.

Some types of nervous children will show immediate improvement when they go to school. The boy who is passionate and disobedient, and whose parents cannot control him, is best at school. Boys who, from being much with grown-up people, have become too precocious and have acquired the habits and tastes of their elders, will dislike school at first, but it will do them good. Their fault shows that they are quick to learn and sensitive to the influences of others, and they will soon adapt themselves to their new surroundings. Boys who are dreamy and imaginative, who early adopt a "specialist" attitude towards life, who, however ignorant they may be of everything else, cultivate a reputation for omniscience in some particular subject, such as Egyptology, astronomy, or the construction of battleships, are usually nervous boys whose symptoms will disappear at school. Where undue timidity, phobia, or habit spasm is present, the question is more difficult to decide. Every individual case must be studied as a whole, and our object should be not unnecessarily to deprive the boy of the wholesome training of public-school life.

There are parents who from sheer ignorance add to the difficulties which the boy encounters in going to school. Failure to appreciate very small points may cause unnecessary suffering. To be the only boy in the school to wear combinations is not a distinction that any new boy craves, however strong his nerves may be. A friend of mine still relates with feeling how, twenty years ago, he arrived at school with shirts which buttoned at the neck! At night when every one else in the dormitory was asleep he sat for hours on his bed, miserable beyond words, removing the buttons and doing his best in the dark to bore buttonholes which would admit what every other boy in the school had—a collar stud.

With girls perhaps this question of fitness for school life does not arise in so urgent a way. Girls are usually older when they go to school, and girls' schools are perhaps less terrifying and more like home. There is, however, one important point which should be borne in mind. The date of the onset of puberty varies much in both sexes. If the boy grows to a great hulking fellow at fourteen, and even displays a desire secretly to borrow his father's razor, he is at no particular disadvantage as compared with his fellows. He is so much bigger and stronger than the others that he may thereby early enjoy the distinction of playing at "big side," or of getting a place in the school Eleven. He is probably much envied by those of the same age who, with the aid of their youthful aspect, can still occasionally extract compensation by inducing the railway company to let them travel to school at half fare. But with girls it is different. Many at fourteen or fifteen are children still; some are grown up, with the tastes, feelings, and attraction of maturity. Those who have developed fastest are often, for that very reason, kept backward in school learning. Often they are nervously the least stable. Now that large schools for girls on the model of our public schools are become the fashion, such precociously developed and nervously unstable girls are apt to find themselves in the very uncongenial society of little girls of twelve or thirteen. The elder girls commonly hold aloof, while mistresses are apt to view this precocious development with disapproval, and to attempt to retard what cannot be retarded by insisting that the young woman has remained a child. I remember being called in consultation by a surgeon who had been asked to operate for appendicitis upon a girl of fourteen. I found a tall, well-grown girl, with an appearance and manner that made her look four years older. I could find no signs of appendicitis, but I learned from her that she had been for three months at a large girls' school, and that in a few days' time her second term was due to begin. As we became friends, she agreed that her appendicitis and her resolve not to return to school, where she was unhappy, were but different ways of saying the same thing. She was an only child who had travelled a great deal with her parents, had found her interests in their pursuits, and had grown backward in school work. The little girls with whom she was expected to associate seemed to her mere children. The elder girls did not want her friendship, and snubbed her. I prescribed a change to a small boarding-school with only a few girls, where age differences would not matter so much, and where she could make friends with girls older than herself, though not more mature.

Into their school life we need not follow the children. Happily the time is past when schoolmasters and schoolmistresses were incapable of understanding their charges, and confounded nervous exhaustion with stupidity or timidity with incapacity.

And so we come back to the point from which we started:

The nervous infant, restless, wriggling, and constantly crying! The nervous child, unstable, suggestible, passionate, and full of nameless fears! The nervous schoolboy or schoolgirl prone to self-analysis, subject-conscious, and easily exhausted! And how many and how various are the manifestations of this temperament! Refusal of food, refusal of sleep, negativism, irritability, and violent fits of temper, vomiting, diarrhœa, morbid flushing and blushing, habit spasms, phobias—all controlled not by reproof or by medicine, but by good management and a clear understanding of their nature.

The hygiene of the child's mind is as important as the hygiene of his body, and both are studies proper for the doctor. Neuropathy and an unsound, nervous organisation are often enough legacies from the nervous disorders of childhood.

INDEX

Abdomen, prominent, 151 Abdominal symptoms of neurosis, 153 Accent, local, facility with which acquired, 17 Acetone, in breath and urine during cyclic vomiting, 86 Acidosis, accompanying cyclic vomiting, 85 Action, imitativeness of, 19 liberty of, in early childhood, 22 Activities in the nursery, 98 not to be restrained, 23, 24, 98 without intervention of grown-up people, 99 wonderful nature of, 24 Adenoid vegetations, night-terrors aggravated by, 136 removal of, in treatment of enuresis, 93 Adolescence, and education on sexual matters, 169, 175 Adults, child in relation to the society of, 36, 38 Æsthetic sense, in early childhood, 48 Affection, in the child, 48 Air hunger, in cyclic vomiting, 86 Air swallowing, habitual action of, 79 Albuminuria, associated with faulty posture, 152 cause of, in neuropaths, 152 Allimentary disturbances, symptom of, 157 Alkali, in treatment of cyclic vomiting, 87 Anæmia, of neuropaths, 152 Anorexia nervosa, 50 A case illustrating, 50 Apnœa, fatal cases of, 83 following burst of crying, 82 twitching of facial muscles in, 83 Appetite, emotional states affecting, 52 loss of, 51 case illustrating, 51 causes and characteristics, 56, 62 treatment, 62 means of stimulating, 53 nature of the sensation of, 52 Apprehension, causes of, 28 growth of neuroses in atmosphere of, 75 Artificial feeding, 109, 113 Aspirin, 71 Asthma, treatment of, 166 Attention, child's love of attracting, 32, 35, 59 examples of, 33, 39 Authority, delight in defying, 43-46 over-exercise of, by parents, results of, 42, 43, 45

Babies. See Newborn Baby Backward development, 56, 146 signs of, 56 "Bad form," 183 Bad habits, 77-80 Bath, baby's first experience of, 105, 106 Bed, dislike of, 28 how overcome, 28, 29 efforts to resist preparation for, 64, 65, 66 Bedroom, airing and temperature of, 69 Bedtime, 64, 66 management at, 65, 66 Bed wetting. See Enuresis Behaviour. See Conduct Bladder, hydrostatic distension of, for enuresis, 92, 93 Boarding-schools, object of, 183 Bodily ailments, and instability of nervous control, connection between, 120 See also Disorders Body, and mind, development of, 120, 121 development of, 146 environment influencing, 5 effect of mind on, 51 gradual alterations in the shape of, 146 infantile characteristics in later childhood, 145, 146 Bone, and muscle, changes in, in infantile children, 148 Books, child's attitude towards, 99 educative value of, 99, 100 kinds most suitable, 99, 100 Brachial nerve, pressure causing tetany, 81 Breast-feeding, best time for, 109 causes of failure in, 108 observations on, 106 See also Lactation Breath-holding, 81, 82 action during, 84 fatal cases of, 83 phenomena of, 82 Bromides, administration of, 71 to newborn baby, 110, 111

Cajoling, futility of, 26 Calcium bromide, in treatment of spasms, 84 Calcium metabolism, disturbance of, 82 Care, ill effects of excess of, 163 Carpo-pedal spasm, 81 Catarrhal infections, 155 connection of rheumatism with, 155 Cerebral anæmia, 140 Cerebral circulation, stagnation of, 140 Cerebral exhaustion. See Mental Exhaustion Cerebral functions, rapid growth of, 5 unstable in the child, 6 See also Mental Character, formation of, 126 during school life, 184, 186 home influence in the development of, 182, 185, 186 ideals of, how inculcated, 125 Children's parties, disadvantages of, 102 Chloral, administration of, 71 to newborn baby, 110, 111 in treatment of spasms, 84 Chorea, 155 and rheumatism, association between, 155 symptom of cerebral irritability, 156 treatment of, 156 Chvostek's sign, characteristics and nature of, 81 Circulation, cerebral, stagnation of, 140 nervous control of, 140 Claustrophobia, 180 Clothing, kind suitable, 69 new, child's delight in, 48 Coaxing, 67 futility of, 26 Cold douches, improving vasomotor tone, 154 Coldness of extremities, 141 Conduct, control of, factors in, 33, 129 errors of, and sexual instincts, 176 control of, 39 correction of, 127 due to faults of management, 127 in neuropathic children, 126 excessive introspection influencing, 139 ideals of, how inculcated, 125 influence of environment on, 131 influenced by suggestion, 13 mother's influence on, 11 of neuropaths, 132, 133 perverse, 45 suggestion in the control of, 130 Constipation, 12 mental causes of, 30, 80 negativism in, 80 perversion of suggestion a common cause of, 30 suggestion in relation to, 80 Constitution, delicacy of, 161 Convulsions, fatal cases of, 83 generalised, 81 Convulsive disorders, 149, 150 Cough, nervous, 73 Counter-opposition, child's opposition growing with, 60, 67, 179 Crying, constant, 54, 67 formation of habit of, 115 in emotional and excitable children, 82 management of, 68 mechanism of, 149 phenomena of, 67 purposeful, 68 Cyclic or periodic vomiting. See Vomiting

Day-dreams, indicating nervous temperament, 137 Deceit, 123, 124 Defæcation, inhibition of, 11, 12, 13 painful, 2 Delicacy of constitution, 161 Delirium, tendency to, 161, 162 Depolarisation of ideas, 172 Depression, recurrence of periods of, 61 Dexterity, lack of, 56 manual, advantages of, 122 toys developing, 96 Diaphragm, spasm of, 82 Diarrhoea, mucous, 142 Diet, likes and dislikes for articles of, 25 opposition to, 25 of newborn child, changes in, 113 See also Food Digestion, emotional states affecting, 52, 53 Digestive disorders, mental causes of, 51, 52, 62 Digestive neuroses, 50 Digestive system, symptoms of extreme sensibility of, 141 Dirt eating, 80 Discipline, 43 in later childhood, 118 in the school, 183 misdirected efforts at enforcing, 44 severe, effects of, 119 Dishonesty, 127 Disobedience, 43, 45 growth of, 42 habit of, 59 personality and, 58 perverse attitude of, 34 reproof and coaxing causing, 61 Disorders, ætiology of, 14 associated with neurosis, 145 common, 140-141 environment as cause and cure of, 142 of neuropaths, 145-159 treatment of, 142 trifling, 162 Diuresis, excessive, 141 Doll, child's care of, an example of imitativeness, 23 educative value of, 98 Douches, cold, improving vasomotor tone, 154 Dover's powder, 72 Dreams, 70 nature of, indicating nature of mental unrest, 137 Drugs, in sleeplessness, 70, 71 Ductless glands, in relation to infantile characteristics, 147 Dullards, 149 Dyspepsia, complications of, 54 course and effects of, 54 mental aspects of, 53 nervous symptoms of, 53, 54 symptoms in newborn infant, 116 treatment, 63

Early childhood, care during, 105 impulse of opposition in, 35 love of power in, 32, 36 Early childhood, nervousness in, 104 reasoning power in, 40 three common neuroses of, 74 toys, books, and amusements in, 96 See also Newborn Baby Education, aim of, 118-120 by games and toys, 96 on sexual matters, 169 Educative value, of books, games, and toys, 98-100 Emotional states, appetite affected by, 52 causing spasm, 83 management of, 82 of neurotics, exaggeration of, 131 physical disturbances due to, 53, 54 producing laryngismus stridulus, 82 Emotional storms, 68 Endocrine glands, 147 Enuresis, 81, 89 causal factors in, 89, 90 characteristics and peculiarities of, 90-92 condition of urine during, 93 mental aspects of, 95 mistakes in treatment of, 94 perversion of suggestion as cause of, 89 removal of tonsils in, 92, 93 treatment, essentials in, 94 hypnotic suggestion in, 95 methods of, 92-93 Environment, body moulded and shaped by, 5 change of, beneficial effects of, 13 effect in developing child's powers, 22 effect on common disorders, 142 errors of, and neuropathic children, 126 essentials of, 39 faulty contact with, in neuropathic children, 138 for neuropaths, 132 influence on conduct in later childhood, 131 influence on mental processes, 10 influence on personality, 24, 25 irritating nature of the adult mind in, 36, 38 of the home, reflected in the child, 182 of school life, 183-186 stimulus of, 22 susceptibility to influences of, 25, 31 Epilepsy, cyclical character of, 61 Evil, inborn disposition to, 130 Excitable children, management of, 82 Exercise, sleep in relation to, 69 Exhaustion. See Mental Exhaustion Expostulation, frequent, bad effects of, 124, 125 See also Reproof Expressions, to attract attention, 39

Facial muscles, twitching of, 81 associated with apnœa, 83 Fæces, incontinence of, 92 Fainting fits, 140 cause and characteristics, 140 control of, 141 of neuropaths, 152 Fatigue, mental, physical, and visceral, 143 Fats, lowered tolerance to, 87 Faults, correction of, 127 not corrected by too frequent reproof, 124, 125 Fear, 39 causes of, 28 phenomena of, 134, 135 prominent psychical symptom of neuropathic children, 132, 133 treatment of, 135 Feeding, 55 artificial, 109, 113 factors in, 57, 58 of newborn infant, regularity in, 116 Fertilisation, method of imparting knowledge of, 174 Food, force of suggestion in relation to, 25-27 healthy desire for, 62 likes and dislikes for, 25 how overcome, 26 phenomena of the desire of, 52 refusal of, 35, 50 nervous causes of, 52 persistent, factors encouraging, 57 suggestion in relation to, 57, 58 treatment of, 26, 55, 62 Force and cajoling, futility of, 26 Freud, teaching of, 176 Functional disturbances, in combination with organic disease, 4

Gait, peculiarity of, 74 Games, educative value of, 96, 98 Gastric disturbances, 54 Gastric juice, psychic secretion of, 52 Gastric symptoms, of neurosis, 153 Gastro-intestinal derangement, causes of, 141 environment as cause and cure of, 142 Gentleness, 119 inculcation of, 129 Girls' schools, 188 Glottis, spasm of, strong emotion causing, 82 "Good form," 183, 184 Grasping habit, reproof in relation to, 21 Growing pains, 167

Habit spasms, age of appearance of, 74 cause of, 74 definition of, 73 examples of, 73 spread of, 75 suggestion in relation to, 74 treatment of, 76 Habits, regulation of, 30 suggestion in relation to, 30 Habitual actions, infant's pleasure in, 77 mental unrest in relation to, 77 of the parent, reproduction in the child, 75 varieties and characteristics, 77 Habitual wakefulness, 70 Hands, control of movement of, 19, 22 expressionless, 56 Happiness and contentment, of child when playing alone, 96 Headache, periodic. See Migraine Heat and cold, newborn baby in relation to, 106 Heat and flushing, sudden sensations of, 141 Heredity, and temperament, 10 and type of child, 31 nervous disorders in relation to, 5 Home influence, in development of character, 182, 185, 186 reflected in the child, 182 Hunger, of the newborn baby, 105, 109 Hypnotic suggestion, in treatment of enuresis, 95 Hypnotics, 70, 71 Hysteria, 158 age of appearance of, 158 suggestion in relation to, 32 symptoms of, 158 Hysterical girls, characteristics of, 32

Ideals, inculcation of, 118-119 Ideas, polarisation and depolarisation of, 172 Illness. See Sickness Imagination, abnormal, correction of, 138 child's stories and tales in relation to, 137, 138 developed by toys, 98 Imitativeness, age at which apparent, 16 extent of, 23 illustration of, 17, 23 lack of, 56 of action, 19 of speech, 17, 18 tell-tale child an illustration of, 18 Incontinence of urine, 89-95 Incorrigible children, 129 Infantile characteristics, 146 ductless glands in relation to, 147 nervous system in relation to, 149, 150 Infective disorders, convalescence from, 157 producing nervous symptoms, 167 relation of neurosis to, 167 Inflammatory reactions, 147 Insomnia. See Sleeplessness Intellect, compared with physique, 120 Intelligence, in early childhood, 40, 41, 42 Intestinal disturbance, 54 of neurosis, 153 symptom of, 157 Intoxications, violent reaction to, 142 Introspection, and neuropathic children, 138 excessive, evidences of, 139 influencing conduct, 139 Irritation, child to be free from, 40

Joint pains, 167 Kindergarten school, artificial symbolism of, 24 Kindness, inculcation of, 129

Lactation, care of child during, 106, 109 care of mother during, 110 causes of failure in, 108 establishment of, 106, 107 tongue-tie in relation to, 12 Laryngismus stridulus. See Breath-holding Later childhood, infantile characteristics in, 146 management in, 117-130 mental backwardness in, 146 Likes and dislikes, 25 Lordosis, 151 and neurosis, 151 producing albuminuria, 152

Manual dexterity, advantages of, 122 Massage, improving tone of muscles, 154 Medicines, sensitiveness to, 26 Melancholy children, 157 Mental aspects, of digestive disorders, 51-54 of enuresis, 95 of management in early childhood, 31 Mental backwardness, and infantile characteristics, 146 in later childhood, 146 Mental disturbances, cyclical character of, 61 indicating neuropathic tendencies, 132, 133 irregularities of sleep due to, 68 psycho-analysis of, 177, 178 Mental exhaustion, during convalescence from infective disorders, 157 easily produced in nervous children, 143 Mental irritability, chorea a symptom of, 156 Mental life of the child, 101 Mental power, active before beginning of speech, 40 in early childhood, 40 Mental processes, development of, 5, 22, 23, 50 age at which most apparent, 16 in later childhood, 117 effect of unconscious suggestions on, 29 heredity in relation to, 10 influence of environment on, 10, 22 Mental training, 122 compared with physical training, 120 objects and advantages of, 122, 126 Mental unrest, avoidance of, 67 crying in relation to, 67 digestive disturbances due to, 62 growth of neuroses in atmosphere of, 75 habitual actions in relation to, 77 in the adult, 7 in the child, 6, 7 negativism due to, 60 of newborn infant, effects of, 107 See also Nervous Unrest Micturition, functional disorder of, 30 negativism in, 81 regulation of, 30 See also Enuresis Migraine, periodic vomiting associated with, 85 symptom of nervous exhaustion, 87 Mind, and body, development of, 120, 121 effect on the body, 51 vigour of, in relation to that of body, 120 Money, theft of, 127 Montessori system of training, 20, 23, 121 Moral degeneracy, 126 Moral standard of school life, 183 Moral training, 123 importance and effects of, 120 negative virtues and, 124 objects and advantages of, 123, 126 parents' responsibilities in, 123, 124 Morals, public opinion forming code of, 183 Morbid introspection, 139 Mothers, ability and inability to manage children, 8 attitude in regard to temperament of child, 10, 11 care of, during lactation, 110 conduct of child influenced by, 11 inability to understand nature of child's disorders, 5 influence of, on tone and manner of speech, 17 mental environment of child created by, 8 personality of, 7 relation to the child, 101 Motionless children, 157 Mouth, habit of conveying everything to, cause of, 19 Movements, precision of, 20 purposive, development of, 19, 21 self-command of, 21 Muscular atrophy, and neurosis, 151 Muscular system, changes in infantile children, 148 weak development of, 151 Muscular tone, how improved, 154 Myopathy, primary, 151

Nasal obstruction and failure of lactation, 12, 108 night-terrors aggravated by, 136 Natural history, sexual matters taught by, 174 Naughtiness, child's delight in, 45 Naughty, use of the term, 44 Negative virtues, and moral training, 124 Negativism, 3, 12, 13 cause of, 60, 61 characteristics, 50 factors developing, 56 in constipation, 80 in micturition, 81 spirit of, 45 treatment of, 60 want of sleep depending on, 64 Nerve centres, controlling movement, development of, 21 Nervous control, instability of, connection between bodily ailments and, 120 Nervous cough, 73 Nervous disorders, and psycho-analysis, 177, 178 common, causes, characteristics, and treatment, 140-142 frequency of, 50 Nervous exhaustion, cyclic vomiting and migraine symptoms of, 87 Nervous instability, stigma of, 140-142 Nervous system, abnormal in children, 149 in relation to cyclic vomiting, 85 increased irritability of, 81 infantile characteristics of, 149 Nervous unrest, environment in relation to, 142 factors increasing, 61 manifestations of, 73 recurrence of periods of, 61 symptoms of, 6, 7 See also Mental Unrest Nervous vomiting. See Vomiting Nervousness, and digestive disorders, 53, 54 and neuropathy, 132-135 in early infancy, 104 in older children, 131-144 parents' attitude causing, 31 Nettlerash, 161 Neurasthenia, 157 Neuropathic children, common symptoms of, 140-144 conduct of, 133 faulty contact with environment in, 138 fear the prominent symptom of, 133 introspection and self-consciousness of, 138 management of, 150 training of, 126 Neuropathic tendencies, evidence of, in older children, 133 Neuropaths, adult, 143 faulty management in child life leading to, 2, 14 phenomena of, 132 phobias of, 143 selection of suitable environment for, 132, 133 symptoms of, 7 Neuroses, and psycho-analysis, 177, 180 association of albuminuria with, 153 constipation frequently due to, 80 examination of, 82 growth in atmosphere of unrest and apprehension, 75 relation of, to infection of the body, 167 treatment of, 153 Neurotics, and physique, 145, 151 characteristics, 131, 132 exaggeration of emotions of, 131 Newborn baby, administration of sedatives to, 110 artificial feeding of, 109, 113 breast feeding of, 106, 107 case of, 105, 109, 114, 115 effect of mental unrest on, 107 first impressions of, 104 formation of habits of sleep and crying in, 115 heat and cold in relation to, 106 hunger of, 105, 109 induction of the sucking movements of, 106 of nervous inheritance, 105 personality of, 104 prevention of restlessness and crying, 114, 115 reduction of sense stimuli in, 105 reflex action of sucking in, 108 sense of taste of, 113 symptoms of dyspepsia in, 116 times of feeding, 116 weaning of, 113, 114 Night-terrors, aggravation of, 70, 136 causes of, 135 of neuropathic children, 134 Nursery, activities in, child's interest in, 22-23 importance of child's being alone in, 36, 38, 96, 99, 101 observations in, 16 Nursery life, advantages of, 9 Nursery psycho-therapeutics, 15 Nurses, ability and inability to manage children, 9 influence of, on tone and manner of speech, 17 mental environment of child created by, 8 personality of, 7 Nursing, during sickness, 166 of the newborn infant, 105-115

Obedience, 49 and perverse pleasure, 34 growth of, 42 Obsession of bed wetting, 89, 91 Opposition, 61 and counter-opposition, 67, 179 during sickness, 160 force of, factors influencing development, 60 habit of, 59 impulse of, 35 love of, in early childhood, 59, 60 to food, 25 Organic disturbance, in combination with functional trouble, 4

Pain, frequent loss of sense of, in neuropaths, 138, 139 Pallor, 152 sudden attacks of, 141 Palpitation, example of visceral fatigue, 143 Parathyroid glands, function of, 147 Parents, and children, conflict between, 43, 44 and silence on sexual matters, 170 habitual actions of, reproduced in the child, 75 mental attitude of, in relation to conduct, 31 over-exercise of authority by, results of, 42, 43, 45 responsibilities in moral training of child, 123, 124 suggestions unconsciously conveyed by, evil results of, 31, 164, 166 Parties, disadvantages of, 102 Patient, temperament of, physician in relation to, 4 Pelvis, development of, 146 Peripheral nerves, increase in irritability and conductivity of, 81 Personal adornment, delight in, 48 Personality, and disobedience, 58 child's own conception of, 24, 129 environment influencing, 25 in early childhood, 32, 165 of newborn baby, 104 Perspiration, abundant, sudden attacks of, 141 Phobias, 14 characteristics and varieties, 134, 135 frequency of, 134 treatment of, 135 Physical defects, accompanying neurosis, 145, 151 Physical disturbances, due to emotion, 53, 54 Physical exercise, lack of, causing want of sleep, 69 Physical fatigue, easily produced in nervous children, 143 Physical phenomena of neuropaths, 132 Physical training, 121 objects and advantages of, 121, 122, 126 Physician, and the temperament of his patient, 4 examination by, 2, 3, 13 diagnosis by, 2, 3, 13 difficulties of, 4 Physique, intellect compared with, 120 Pica and dirt eating, 80 Picture books, educative value of, 100 kinds most suitable, 99, 100 Play, happiness of child during, 96 in the nursery, 36, 37 with grown-up persons, 36, 38 Pleasure, sense of, in early childhood, 48 Polarisation of ideas, 172 Postural albuminuria, 152 Posture, faulty, 161, 162 prevention of, 154 Power, child's love of, 32, 59 Precision of movement, development of, 19, 96 Psycho-analysis, dangers of, 180 observations on, 176, 177 Public schools, character and effects of, 183 Punishment, deserved and undeserved, 126 frequent, disadvantages of, 47 observations on, 39, 46 Purity, inculcation of high ideals of, 175 Purposive movements, earliest, cause of, 19 encouragement of, 24 Pyloric spasm, 112 Pyrexia, 88 organic disease in relation to, 88

Rational hygiene, 5 Reasoning power, 40 active before advent of speech, 40 factors influencing development of, 40, 41, 117, 118 Regulation of habits, 30 Repression, by older children of younger, 47 Reproduction, method of imparting knowledge of, 174 Reproof, 20, 21, 24 cases in which useless, 60, 124 causing disobedience, 61, 124 effects of, 33, 36, 47, 124 extreme sensitiveness to, 46 perverse pleasure of, 34 too frequent repetition of, futility of, 44, 45, 47, 60, 124, 125 Restlessness, during sickness, 160 Rewards, use and dangers of, 48 Rheumatism, 155 and chorea, association between, 155 characteristics in childhood, 156 subacute, 167 treatment of, 156 Rickets, mental and intellectual condition in, 120 in infantile children, 148 occurrence with spasmophilia, 82 Right and wrong, appreciation of, in early childhood, 42 Round shoulders, 151

St. Vitus's dance, 167 Salts, excretion of, 147 School life, 182, 184 and sexual matters, 171, 175 moral standard of, 183 moral training and, 123 moulding of character during, 184 of boys, 183-187 of girls, 188 Schools, public, character and effects of, 183 Scoliosis, prevention of, 154 Secretions, anomalies of, 141 Self, child's conception of, 48 Self-conscious children, complaints of, 139 Self-consciousness, of neuropathic children, 138 Self-discipline, development of, 125, 126 Self-education, in the nursery, 96 Self-feeding, 55 Self-preservation, morbid instinct of, 134 Self-sacrifice, not to be expected in early childhood, 48-49 Sensations, acuteness of, 69 bodily, of neuropaths, 138 Sense perception, of neuropaths, 132 Sense stimuli, cultivation of perception of, 23 in newborn babies, 105 Sexual matters, education on, 168 method of, 174 errors of conduct and, 176 parents' silence in regard to, 170 psycho-analysis in relation to, 177, 178 school life in relation to, 171, 175 Sickness, 160 evil effects of suggestions unconsciously conveyed by parents during, 164, 166 management during, 160, 163 nurse and mother during, 166 opposition during, 160 temperature during, 161 therapeutic measures in, 164 therapeutic procedures concentrating child's mind on his symptoms, 163 Sleep, estimation of the amount of, 136 force of suggestion in relation to, 27, 28 formation of habit of, 115 light and broken, cause of, 68, 136, 137 of newborn infant, 114 sound, beneficial effects of, 71 Sleeping attire, 69 Sleeplessness, breaking of the habit of, 70 causes and characteristics, 64 drugs in, 70, 71 in older children, 136 lack of physical exercise causing, 69 suggestion in relation to, 27, 28, 70 treatment of, 67, 70, 137 Sleep-walking, 137 Snatching, habit of, 20 Spasmophilia, 81 ætiology of, 81 drugs in treatment of, 84 occurrence of rickets with, 82 Spasms, control of, 84 fatal, 83 Speech, beginnings of, 17, 18 facility with which local accent is acquired, 17 imitativeness of, 17, 18 infant's reasoning power present before advent of, 40 influence of nurses and mothers on tone and manner of, 17 Spinal deformity, prevention of, 154 Spinal muscles, atrophy of, 151 Spoon feeding, 113 Status catarrhalis, 150 Status lymphaticus, 150 Story-telling, 99, 100 Sucking movements, of newborn child, induction of, 106 see also Lactation Suggestion, and habit spasms, 74 appetite in relation to, 52 bed wetting in relation to, 89 bodily habits in relation to, 30 characteristics, 24 conduct influenced by, 13, 130 constipation in relation to, 80 effect on mental processes, 29 food in relation to, 25 force of, on child's mind, 27, 75 hysteria in relation to, 32 perverse influence of, 29, 30 bad habits due to, 89, 90 causing constipation, 30 want of sleep depending upon, 64 refusal of food in relation to, 57, 58 sleep in relation to, 27 susceptibility to, 29, 57 unconsciously conveyed by parents, evil results of, 31, 164, 166 Suicide, 52 Suspicions, aroused in the child, 57, 58 Syncopal attacks, causes and characteristics, 140, 141

Tactile sensation. See Touch Taste, perversion of, 26, 57 sensations of, 25 how controlled, 26 sense of, in newborn infant, 113 Teething convulsions, 148 Tell-tale child, characteristics, 18 Temperament, diversity of, 10 heredity and, 10 mother's attitude in relation to, 10, 11 of the patient, physician in relation to, 4 Temperature, during sickness, 161 inexplicable rises in, 88 Terror, causes, of, 28 Tetany, liability to, in increased irritability of nervous system, 81 pressure to brachial nerve causing, 81 Theatres, disadvantages of, 103 Theft, 52, 127 Therapeutic conversation, 124, 125 Thigh rubbing, avoidance of, 78 characteristics, 78 habitual action of, 78 Thorax, development of, 146 Thumb sucking, 78, 79 persistence of the habit, 79 Tongue-tie, in relation to lactation, 12 Tonics, 155 Tonsils, removal of, in treatment of enuresis, 93 Touch, sense of, cultivation of, 23 early development of, 19, 20 organs with greatest development of, 19 Toys, child's interest in, 36 educative value of, 96, 98 kind most suitable, 97 Training, early, importance and object of, 2 Trousseau's sign, nature and production of, 81 Truthfulness, 123, 124 inculcation of, 128 Twitching of facial muscles, 81, 83 Tyranny of tears, 116

Unkindness, habitual, of children to others, 129 Untruthfulness, 126 over-exercise of authority encouraging, 43 Urine, condition in enuresis, 93 incontinence of, methods of treatment, 92, 93 See also Enuresis increased secretion of, 141 irritation of, 148

Vasomotor instability, conditions indicating, 140, 141 in neuropaths, 152 Vasomotor tone, how improved, 154 Virtuous, definition of the term, 183 Visceral fatigue, easily produced in nervous children, 143 Vocabulary, 18 Voice, tone of, 17 Voluntary movements, development of cerebral centres controlling, 19 Vomiting, cyclic, 50, 55 ætiology of, 85 age at which it occurs, 86 case illustrating, 51 causes and characteristics, 62, 86 class of child affected by, 87 condition of the child during, 86 frequency of attacks, 86 migraine in association with, 85 nervous system in relation to, 85, 87 treatment of, 62, 63, 87

Waking states, 136 Weaning, difficulty in, 113, 114 Will, strength of, absence in childhood, 34 Work and play, differentiation between, 123 Writing, correct posture during, 155

Transcriber's Notes The following typographical errors were corrected: Page 4: 'sensisive' changed to 'sensitive'. Page 48: 'self-abnegnation' changed to 'self-abnegation'. Page 61: fixed 'and and'. Page 125: 'acount' changed to 'account'. First page of index (191): 'ullimentary' changed to 'Allimentary'; also 'ilstrating' channged to 'illustrating'.