Of the starvation neuroses, the commonest are muscular convulsions. Naturally enough, any muscle or any group of muscles may be affected, and the manifestations may present all the varieties of convulsive movements to which muscles are liable. Probably no child whose nutrition is perfect ever has general convulsions except as the result of actual brain disease or at the onset of some infectious process where the convulsion takes the place of the initial chill of the adult. The so-called reflex convulsions occur only in children whose nutrition is below par. In a rickety child the slight irritation produced by an erupting tooth may be sufficient to weaken the mechanism which checks explosive action, just as in the same child it may be the determining cause of bronchorrhœa. In the healthy child teething can cause no such effect. Both these manifestations, the convulsions and the bronchorrhœa, are starvation neuroses. In such children many other trivial conditions may weaken the controlling mechanism.
In older children chorea, whatever be its cause, is evidently connected with the developmental process. The beneficial effects in chorea of absolute rest in bed and forced feeding are a matter of common observation. Dysphagia as a neurosis in children is uncommon. Vomiting and diarrhœa occur so frequently in infants from a wide variety of causes, that it is very difficult to say when they are merely starvation neuroses. In rickets, diarrhœa often occurs, with no adequate explanation in the conditions present in the intestinal canal, and which is an essential feature of the disease itself.
Laryngismus stridulus is a very common manifestation of muscular starvation neurosis. Spasmodic asthma occurs in ill-nourished children. Incontinence of urine in older children is often a starvation neurosis.
The younger the child the more rapid are its processes of growth. Hence in infants the results of defective nutrition are quickly manifested, and the curative effects of food arranged to supply the nutritive deficiencies also become apparent very soon. In older children with more stable tissues a defective food supply is longer borne without apparent effect; but, on the other hand, the beneficial effect of an antidotal diet becomes apparent only after a prolonged use.
The relatively simple diet of the infant makes it easy to discover the particular kind of food which is supplied in sufficient quantity, and makes the supply of the deficiency comparatively easy. But in older children with a more varied diet the defect is less readily discovered and less readily supplied.
The effects of climate, soil, and food in the production of degeneracy are first shown in the causation of general loss of nerve tone in the ancestor, often with special local expressions. This loss of nerve tone may show itself in the offspring by any type of degeneracy from nutritive defect to loss of moral tone.
CHAPTER IX
School Strain