whose case
we are now considering, to be troubled by bad dreams, nightmares, or
night-terrors. If these should occur, obstructed breathing due to
adenoid vegetations is sometimes at work as a contributory cause.

Finally, we should always remember that refusal of sleep is, for the
most part, caused and kept up by harmful suggestions derived from
mother and nurse, who allow the child to perceive their distress and
agitation, who speak before the child of his habitual wakefulness, who
unwittingly focus his attention on the difficulty. It is cured in the
moment that the suggestion in the child's mind is reversed, in the
moment when he comes to regard it as characteristic of himself not to
make a fuss about going to bed, but to sleep with extraordinary
readiness and soundness. Let every one join together to produce this
effect. Let the suggestion act strongly on his mind that all these
troubles of sleeplessness are diminishing, that night after night sees
an improvement, and soon his reputation as a good sleeper will be
established, and, as always with children, it will be rigidly adhered
to.

In assisting to break the habit of sleeplessness, and in the process
of altering the character of the suggestions which act on the child's
mind, we can be of the greatest assistance to the mother by
prescribing a suitable hypnotic. As to whether it is right in insomnia
in childhood to prescribe depressant drugs is a question on which very
various opinions are held. That it is wrong and probably ineffective
to trust entirely to the drugs is certainly true, but as a temporary
measure, to break the faulty suggestion and the bad habit, their use
is both legitimate and successful. The dose required in children
relatively to the adult is much smaller. In grown people, some
specific distress of mind, whether real or imaginary, may suffice to
resist very large doses of hypnotic. In children it is rare to find
the same resistance, and comparatively small doses have a very
constant effect. With deeper and more refreshing sleep, the conduct of
the child during the day almost always changes for the better. A sound
sleep, for a few nights in succession, will produce apparently quite a
remarkable change in the whole disposition of the child. When good
temper and interest take the place of fretfulness and restlessness, we
may confidently expect that the symptom of sleeplessness will begin to
abate. Sleeplessness by night and fretfulness by day fo