onable, and forward for their age, and
who, when well, throw themselves into work or play with a great
expenditure of nervous energy. Often their physical development is
unsatisfactory, and we must set ourselves to correct this as the first
step in prevention. It is highly important that children suffering in
this way should have free opportunities for exercise in the open
country, and that all the excretory organs--the skin, kidneys, and
bowels--should be acting freely and efficiently. The child should live
a life of ordered routine. Sleep should be sound and sufficient in
amount. The diet must not exceed the strict physiological needs. Many
of these children appear to have a lowered tolerance for fats of all
sorts, and it may be necessary to limit strictly the consumption of
milk, cream, butter, and so forth. A daily administration of a small
dose of alkali by the mouth is credited with preventing attacks. In
the present connection, however, we shall not do wrong to emphasise
the part played by the nervous system in the production of the
attacks. In all cases of cyclic vomiting it should be our endeavour to
recognise and remove the elements in the daily life of the child which
are proving too exhausting.

UNEXPLAINED PYREXIA

In nervous children we sometimes meet with inexplicable rises of
temperature. The pyrexia may have the same periodic character as that
just noted in cases of cyclic vomiting. At intervals of three, four,
or five weeks there may be a rise of temperature to 103 deg. F., or even
higher, which may last for two or three days before subsiding. In
other cases the chart shows a slight persistent rise over many weeks
or months. That in nervous children the temperature may be very
considerably elevated without our being able to detect much that is
amiss does not of course make it any the less necessary to be careful
to exclude organic disease. Pyelitis, tuberculosis, and latent otitis
media occur with nervous children as with others and must not be
overlooked. If, however, organic disease can be excluded, and if the
pyrexia is the only circumstance which prevents the decision that the
child is well and should be treated as well, then the thermometer may
be overruled and the pyrexia neglected.

CHAPTER VI

ENURESIS

I have dealt in previous chapters with certain common disorders of
conduct in childhood, which show clearly their origin in the
apprehensions of the grown-up people who have charg