to be indulgent to the children in their
days of cloud and to be particularly careful not to goad them by
well-intentioned efforts into bursts of naughtiness and passion, each
one of which tends to perpetuate the condition and increase the
nervous unrest. We know how closely dependent is the sensation of
appetite upon emotional states, and we must do all in our power--and
the task is sometimes one of real difficulty--to keep the child's mind
sufficiently at rest to preserve the healthy desire for food
unimpaired. If there is no sign of appetite, but every sign of
restlessness and irritability, we must seek in the management of the
child until we find the fault.

If food is taken mechanically and without appetite, if the preliminary
changes in the stomach wall which are necessary for adequate digestion
do not take place, but are inhibited by the mental unrest, the meal is
apt to be followed by gastric pain and discomfort, or, more commonly
with children, the stomach may promptly reject its contents. At the
worst, nervous vomiting of this sort may follow almost every meal,
although, again, it is curious to note how little, comparatively
speaking, the nutrition of the child suffers. The vomiting too, as in
adults, comes very near being a voluntary act, and mothers and nurses
will often remark that they get the impression that it can be
controlled at will. If once the diagnosis is made that the want of
appetite or the vomiting is of nervous origin, the treatment of the
condition is clear. Sedative drugs directed towards quieting the
nervous excitability may be of service, but tonics, appetisers,
laxatives, and drugs with a direct action on the stomach will have but
little effect. Nor is there as a rule anything to be gained by
modifying the diet or by excluding this or that article of food. The
frequency of the vomiting is such that it is apt to have brought
discredit one after the other upon almost every article of food which
the child can take, with the result that many useful and necessary
foods have been abandoned for long on the ground that they are the
cause of the dyspepsia. A permanent cure will only be effected when
the faults of environment have been overcome, when the cause of the
nervous unrest has been removed, and when the child's mind is at
peace.

Nervous vomiting of this kind is not difficult to control, if those in
charge of the children can be made to understand that the cause lies
in the anxiety which