fall again to sleep. A few minutes later he stirs again more strongly,
and is wider awake and for longer. It may only be after a third
waking, by a summation of stimuli, that he is finally roused and
breaks into loud crying. The nurse who is on the watch, who, sleeping
beside him, wakes at the slightest sound and is quick to turn him over
and settle him into a new position of rest, will probably report in
the morning that the baby has had a good night. The nurse who lets the
child grow wide awake and start crying loudly, will spend perhaps many
hours before quiet is again restored. Of the voluntary, purposive
crying of infants a little older I am not here speaking. Infants in
the second six months are quite capable of establishing a "Tyranny of
Tears" and feeling their power. Fortunately it requires no great
experience to distinguish one from the other, and to adopt for each
the appropriate treatment.

Again, in elementary teaching upon the management of infants stress is
laid, rightly enough, upon the importance of regularity in the times
of feeding, and on the observance in this respect also of a very
strict routine. But in the case of the very nervous infant a certain
latitude should be allowed to an experienced nurse or mother. We may
wreck everything by a blind adhesion to a too rigid scheme, which may
demand that we leave the child to scream for an hour before his meal,
or that, when at length he has fallen into a sound sleep after hours
of wakefulness, we should proceed to wake him.

Symptoms of dyspepsia which are due to continued nervous excitement
demand treatment which is very different from that which would be
appropriate to dyspepsia which is due to other causes, such as
overfeeding or unsuitable feeding. The temporary restriction of food,
which is commonly ordered in dyspepsia from these causes, is very
badly supported by the nervous infant. Hunger invariably increases the
unrest, and the unrest increases the dyspepsia.

The difficulties of managing a nervous infant are very real, and call
for the most exemplary patience on the part of the mother and the
clearest insight into the nature of the disturbance.

CHAPTER IX

MANAGEMENT IN LATER CHILDHOOD

In the early days in the nursery the actions of the infant, for the
most part, follow passively the traction exercised by nurses and
mothers, sometimes consciously, but more often unconsciously. We have
now to consider a period when the child be