p of symptoms which in a sense
are the reverse of those which characterise cerebral irritation and
chorea. The healthy child is a creature of free movement. The children
we are now considering will sit for a long time motionless. The
expression of their faces is fixed, immobile, and melancholy. If the
arm or leg is raised it will be held thus outstretched without any
attempt to restore it to a more natural position of rest for minutes
at a time. The posture and expression remind us at once of the
katatonia which is symptomatic of dementia praecox and other stuporose
and melancholiac conditions in adult life. Symptoms of this sort are
especially common in children with intestinal and alimentary
disturbances of great chronicity.

The symptom is so frequently met with that it is strange that it
should have attracted so little attention as compared with the
contrasting condition of chorea. And yet it is of more serious
significance, more difficult to overcome, and with a greater danger
that permanent symptoms of neurasthenia will result. In early
childhood a careful dietetic regime, suitable hygienic surroundings,
and a stimulating psychical atmosphere will often effect great
improvement. As in chorea, however, relapses are frequent, and there
are cases which for some unexplained reason are peculiarly resistant
to all remedial influences.

(5) HYSTERIA

In hysteria, in contrast to the types previously described, the
infective element may be completely absent. Except in some special
features of minor importance the symptoms of hysteria do not differ
from those of adults, and, as in adult age, the condition of hysteria
may be present although the physical development may be perfect. We
cannot here speak of any physical characteristics which are associated
with the nervous symptoms.

The third or fourth year represents the age limit, below which
hysterical symptoms do not appear. Thereafter they may be occasionally
met with, with increasing frequency. At first, in the earlier years of
childhood, there is no preponderance in the female sex. As puberty
approaches, girls suffer more than boys.

It may be said to be characteristic of hysteria in childhood that its
symptoms are less complex and varied than in adult life. The naive
imagination of the child is content with some single symptom, and is
less apt to meet the physician half-way when he looks for the
so-called stigmata. Similarly mono-symptomatic hysteria is
char