e of the children,
and in the unwise suggestions which they convey to them. The same
forces are at work in the production of enuresis, or bed wetting,
although the matter is here often complicated by the development later
on of a sense of shame and unhappiness in the child. There comes a
time when the child passionately desires to regain control and is
miserable about her failure, until the concentration of her thoughts
on the subject becomes a veritable obsession. Every night she goes to
bed with this only in her mind. Every night she falls asleep,
miserably aware that she will wake to find the bed wetted. The
suggestion impressed in the first place on the mind of the tiny child
by injudicious management has become fixed by the growing sense of
shame and the complete loss of self-confidence.

It is usually taught that a great variety of causes is concerned in
producing enuresis. It is said to be due to a partial asphyxia during
sleep from adenoid vegetation. It is said to be caused by phimosis,
and to be cured by circumcision. It is said that the urine is often
too acid and so irritating that the bladder refuses to retain it for
the usual length of time. It is said that enuresis may be due to a
deficiency of the thyroid secretion, and that it can be cured by
thyroid extract. Such a number of rival causes may make us hesitate to
accept the claims of any one of them. Certainly I have not been able
to satisfy myself that any one of these conditions exercises any
influence at all or is commonly present in cases of enuresis. I think
that if we examine a large number of cases of bed wetting in children
we can come to no other conclusion than that the cause of the trouble
is due to just such a pervasion of suggestion as we have been
considering above.

There are certain points in the behaviour of a child with enuresis
which seem to point to this conclusion.

_(a)_ In the first place, the trouble is seldom serious or very well
developed in early childhood, and the reason for this, I take it, is
that an occasional lapse in a child of perhaps two or three years of
age is usually treated lightly and in the proper spirit of tolerance.
It is only with children a little older that nurses and parents become
distressed and begin unwittingly by urging the child to present the
suggestion to her mind, that the bed may or will be wetted. Hence the
usual history is that control was partially acquired in the second
year, but that, inste