acteristic of oases occurring in the uneducated or peasant class.
In children, hysterical pain, hysterical contractures or palsies,
mutism, and aphonia are the most usual symptoms. Hysterical deafness,
blindness, and dysphagia are manifestations of great rarity in
childhood.

CHAPTER XII

THE NERVOUS CHILD IN SICKNESS

In time of sickness the management of the nervous child becomes very
difficult. Restlessness and opposition may reach such a pitch that it
may be almost impossible to confine the patient to bed or to carry out
the simplest treatment. Sometimes days may elapse before the
sick-nurse who is installed to take the place of the child's usual
attendant is able to approach the cot or do any service to the child
without provoking a paroxysm of screaming. In such a case any
systematic examination is often out of the question, with the result
that the diagnosis may be delayed or rendered impossible. There is
only one reassuring feature of a situation, which arises only in
nurseries in which the management of the children is at fault; the
doctor has learned from experience that this pronounced opposition of
the child to himself, to the nurse, and even to the mother, is of
itself a reassuring sign, indicating, as a rule, that the condition is
not one of grave danger or extreme severity. When the child is more
seriously ill, opposition almost always disappears, and the child lies
before us limp and passive. Only with approaching recovery or
convalescence does his spirit return and renewed opposition show
itself.

Extreme nervousness in childhood carries with it a certain liability
towards what is known as "delicacy of constitution." The sensitiveness
of the children is so great that they react with striking symptoms to
disturbances so trivial that they would hardly incommode the child of
more stable nervous constitution. For example, a simple cold in the
head, or a sore throat, may cause a convulsion or a condition of
nervous irritability which may even arouse the suspicion that
meningitis is present. Or, again, a little pharyngeal irritation which
would ordinarily be incapable of disturbing sleep may be sufficient to
keep the child wide awake all night with persistent and violent
coughing. The little irritating papules of nettlerash from which many
children suffer are commonly disregarded by busy, happy children
during the day, and even at night hardly suffice to cause disturbance.
The nervous child, on