rm a vicious
circle, and attempts must be made to break it at all points.

Chloral occupies the first place as a hypnotic for young children. In
combination with bromide its effects are wonderfully constant and
certain. Two grains of chloral hydrate and two grains of potassium
bromide with ten minims of syrup of orange, given just before bedtime,
will bring sound sleep to a child of a year old. At three years the
dose may be twice as great, and three times at six years. It is seldom
that other means are required. Aspirin for children seems relatively
without effect. For children who are both sleepless and feverish, a
grain of Dover's powder, and a grain of antipyrin, for each year of
the child's age up to three, is very helpful. Lastly, if chloral and
bromide cannot break the insomnia, and the condition of the child is
becoming distressing, we can almost always succeed if we combine the
prescription with an ordinary hot pack for twenty minutes.

CHAPTER V

SOME OTHER SIGNS OF NERVOUSNESS

HABIT SPASM

Next to refusal of food and refusal of sleep perhaps the most frequent
manifestation of nervous unrest is provided by the group of symptoms
which we may call, with a certain latitude of expression, Habit
Spasms. By a habit spasm is meant the constant repetition of an action
which was originally designed to produce some one definite result, but
which has become involuntary, habitual, and separated from its
original meaning. The nervous cough forms a good example of a habit
spasm. A cough may lose its purpose and persist only as a bad habit,
especially in moments of nervousness, as in talking to strangers, in
entering a room, or at the moment of saying "How do you do" or
"Good-bye." Twitching the mouth, swallowing, elongating the upper lip,
biting the lips, wrinkling the forehead so strongly that the whole
scalp may be put into movement, and blepharospasm are all common
tricks of little children which may become habitual and uncontrolled.
In worse cases there may be constant jerking movements of the head,
nodding movements, or even bowing salaam-like movements. In mild
cases we may note hardly more than a restless movement of mouth or
forehead, or constant plucking or writhing of the fingers whenever the
child's attention is aroused, when he is spoken to, or when he himself
speaks. In nervous children these movements, which should properly be
confined to moments of real emotional stress, become habitual, and ar