Worms are most frequent between the ages of three and ten years. Girls are oftener affected than boys. A tendency to worms is hereditary. Cases occur more frequently during the spring and autumn than during the other seasons. A residence in cold, damp, unhealthy situations leads to their production in many instances.
BED-WETTING.
This troublesome disorder is not unfrequently met with in children—more especially boys—under twelve years of age. It is a mistake to suppose, as is done by some parents, that slothfulness or negligence is the invariable and only cause of this infirmity; on this point Dr. Vogel says:—'In most cases which I have observed, the children through their own sense of honor or on account of repeated punishments, had a lively interest in avoiding the accident, and yet were unable to do this without appropriate treatment pursued for months, and even years.' Dr. Tanner states:—'Very frequently this affection is the consequence of bad habits; being favored by the free use of fluids during the after part of the day, by exposure to cold in the night, and by lying on the back.'
The presence of worms in the bowels is one of the causes of this annoying ailment, and they should be sought for in all cases. Stone in the bladder sometimes occasions the affection, but in such instances other symptoms will soon point to the true nature of the trouble.
This subject is one of an importance which demands some attention from us in a work for parents. In the language of Dr. Vogel, 'the effects of this malady are unpleasant, for the psychical development in particular suffers. The repeated punishments which these children undergo blunt their sense of honor considerably; they become cowardly and deceitful, and have no personal spirit. If great and expensive cleanliness is not practised, the bed, and even the whole room, acquires a urinous odor, which contaminates the atmosphere and begets conditions by no means favorable to healthy growth. Such children may be ultimately attacked by indolent ulcers on the nates and lower extremities, the results of urinous excoriations.'
The only symptom ordinarily present is that the child towards morning or in the middle of the night wets the bed without waking. This may happen several times during the sleep, and recur every night. In some cases the act takes place only every other night, but it is rare that there is an interval of more than one night.
The cause of this failing is sometimes very simple and one easily remedied; for it is often the result of neglecting to take young children up once during the many hours they require for sleep. By attention to this matter and to the diet, the habit may be speedily broken. Unfortunately most cases are not so quickly amenable to treatment.
In the treatment of this infirmity, corporal punishment should not be thought of. It is useless, cruel, and unnatural. The child might as well be punished because it squints or has club-foot.
Care must be taken to see that the little patient eats or drinks nothing for several hours before bed-time. The child should also be awakened a little before midnight, and at a very early hour in the morning, and made to empty its bladder. It is of great importance to get the child to sleep upon its side or face, as lying upon the back is sure to increase the trouble. Indeed, it is frequently observed that the child always remains clean when it is prevented from turning upon its back during sleep. The difficulty lies in the prevention. The plan of tying a cloth or towel around the child with a knot over the spinal column, to awaken it by the pain when it rolls over upon the back, so often proposed, seems good advice easily followed. But practically it fails, as it is impossible, without making the bandage too tight, to keep it in place. The benefit which, in some instances, has followed the employment of a succession of small blisters directly over the lower part of the spinal column, is doubtless due to their forcing the child to sleep upon the face or side. The remedy is somewhat a painful one, but should be tried in obstinate cases.
The child's general health, if enfeebled, should be improved by cold baths, bitter tonics, and if possible a change of air. In no case should any mechanical means be employed to arrest the infirmity. Serious and even fatal results have followed such attempts.