ails to appreciate the whole situation, with the best will in
the world, we are powerless to help. Fortunately with the majority of
educated mothers there is no difficulty. Their powers of observation
in all matters concerning their children are usually very great. It is
their interpretation of what they have observed that is often faulty.
Thus, in the example given above, the mother observes correctly that
defaecation is inhibited, and produces crying and resistance. It is
her interpretation that the cause is to be found in pain that is at
fault. Again, a mother may bring her infant for tongue-tie. She has
observed correctly that the child is unable to sustain the suction
necessary for efficient lactation, and has hit upon this fanciful and
traditional explanation. The doctor, who knows that the tongue takes
no part in the act of sucking, will probably be able to demonstrate
that the failure to suck is due to nasal obstruction, and that the
child is forced to let go the nipple because respiration is impeded.
The opportunities for close observation of the child which mothers
enjoy are so great that we shall not often be justified in
disregarding their statements. But if we are able to give the true
explanation of the symptoms, it will seldom happen that the mother
will fail to be convinced, because the explanation, if true, will fit
accurately with all that has been observed. Thus the mother of the
child in whom defaecation is inhibited by negativism may have made
further observations. For example, she may have noted that the
so-called constipation causes fretfulness, that it is almost always
benefited by a visit to the country or seaside, or that it has become
much worse since a new nurse, who is much distressed by it, has taken
over the management of the child. To this mother the explanation must
be extended to fit these observations, of the accuracy of which there
need be no doubt. Fretfulness and negativism with all children whose
management is at fault come in waves and cycles. The child, naughty
and almost unmanageable one week, may behave as a model of propriety
the next. The negativism and refusal to go to stool are the outcome of
the nervous unrest, not its cause. Again, the nervous child, like the
adult neuropath, very often improves for the time being with every
change of scene and surroundings. It is the _ennui_ and monotony of
daily existence, in contact with the same restricted circle, that
becomes insuppor