aily question communicates itself to the child. The
difficulty is emphasised, and an attempt is made to substitute will
power for forces of suggestion which are at once inhibited by
concentration of the mind upon the process. Here also, just as in the
refusal of food, a further stage of "negativism," that is, of active
resistance with crying and struggling, is reached, so that complaint
may be made by the mother that defaecation is painful. The same
negativism may be shown in micturition, and mothers will give
distressing accounts of the suffering of the child during the passing
of water.

BREATH-HOLDING AND LARYNGISMUS STRIDULUS

In some children, in the first two years of life, we find a definite
and measurable increase in the irritability and conductivity of the
peripheral nerves. The strength of current necessary to produce by
direct stimulation of the nerve a minimal twitch of the corresponding
muscle may be many times less than the normal. Of this heightened
irritability of the nervous system, to which the name "spasmophilia"
has been given in America and on the Continent, the most striking
symptom is a liability alike to tetany or carpo-pedal spasm, to
generalised convulsions, and to laryngismus stridulus. In addition, in
most cases it is generally possible to demonstrate the presence of
Chvostek's sign and of Trousseau's sign. Chvostek's sign consists in a
visible twitch of the facial musculature, especially of the
orbicularis palpebrarum or of the orbicularis oris, in response to a
gentle tap administered over the facial nerve in front of the ear.
Trousseau's sign is the production of tetany by applying firm and
prolonged pressure to the brachial nerve in the upper arm. The
aetiology of spasmophilia is still a matter for dispute, but the
evidence which we possess is in favour of the view that we have here
to deal with a disturbance of calcium metabolism. The calcium content
both of the blood and of the central nervous system has been shown to
be much lowered. It is in keeping with this that clinically we note
how frequently spasmophilia and rickets occur in the same child. In
some families the condition recurs through many generations.

For our present purpose--the examination of some common neuroses of
nursery life--it would be out of place to enter into a detailed
consideration of this disorder of spasmophilia as a whole. The symptom
of laryngismus stridulus--the so-called breath-holding--alone need
con