dious ailment. Now it is well to remember that St. Vitus's dance does
not begin with twitching of the muscles of the face, but that its
earliest symptoms are involuntary movements of the arms and twitching of
the fingers, and that contortions of the face do not come on till
afterwards. Movements of this sort too, even when not limited to the
face, vary in the course of a few days in the parts which they affect,
and show themselves, now in winking the eyes, then in grimacing, in
twitching of the muscles of the face or neck, or in some awkward gait or
manner. These are all best left unnoticed, for they are almost
invariably made worse if the child's attention is called to them. They
are, or at least before the days of Board Schools they were, scarcely
ever met with among the children of the poor, for they almost invariably
depend on mental strain; not of necessity on undue length of the hours
of study, or on the difficulty of the tasks imposed, but often on a
child's anxiety to make progress and to keep up with his schoolfellows.
In corroboration of this being their cause I may say that, contrary to
the rule which obtains with St. Vitus's dance, these movements are more
frequent in boys than in girls, for the over-mental strain of boys comes
earlier; that of girls seldom occurs before the time of transition to
womanhood, and its results are then different, though much graver. In
cases of this kind, lessening the mental strain is almost always
followed by a cessation of the movements; change of air, country
amusements, and a generally tonic treatment perfect the cure, and
dancing and gymnastics overcome the remains of any awkward habit.

The movements in real St. Vitus's dance do not shift about as these do
from one part to another, but tend to involve various parts in
succession, without previously ceasing where they had begun.

The relative share which the parents and the doctor take in the
treatment of these cases depends to a great extent on their severity.
While attention to the state of the bowels, and a generally tonic
treatment are almost always needed, gymnastics and drill are often of
very great service in the slighter cases; and a very distinguished Paris
physician was accustomed to send children thus affected to march round
the Place Vendome, keeping step while the band was playing. The utility
of gymnastics turns very much on the degree in which the child is able
by attention to control his movements, and when