Some types of nervous children will show immediate improvement when they go to school. The boy who is passionate and disobedient, and whose parents cannot control him, is best at school. Boys who, from being much with grown-up people, have become too precocious and have acquired the habits and tastes of their elders, will dislike school at first, but it will do them good. Their fault shows that they are quick to learn and sensitive to the influences of others, and they will soon adapt themselves to their new surroundings. Boys who are dreamy and imaginative, who early adopt a "specialist" attitude towards life, who, however ignorant they may be of everything else, cultivate a reputation for omniscience in some particular subject, such as Egyptology, astronomy, or the construction of battleships, are usually nervous boys whose symptoms will disappear at school. Where undue timidity, phobia, or habit spasm is present, the question is more difficult to decide. Every individual case must be studied as a whole, and our object should be not unnecessarily to deprive the boy of the wholesome training of public-school life.
There are parents who from sheer ignorance add to the difficulties which the boy encounters in going to school. Failure to appreciate very small points may cause unnecessary suffering. To be the only boy in the school to wear combinations is not a distinction that any new boy craves, however strong his nerves may be. A friend of mine still relates with feeling how, twenty years ago, he arrived at school with shirts which buttoned at the neck! At night when every one else in the dormitory was asleep he sat for hours on his bed, miserable beyond words, removing the buttons and doing his best in the dark to bore buttonholes which would admit what every other boy in the school had—a collar stud.
With girls perhaps this question of fitness for school life does not arise in so urgent a way. Girls are usually older when they go to school, and girls' schools are perhaps less terrifying and more like home. There is, however, one important point which should be borne in mind. The date of the onset of puberty varies much in both sexes. If the boy grows to a great hulking fellow at fourteen, and even displays a desire secretly to borrow his father's razor, he is at no particular disadvantage as compared with his fellows. He is so much bigger and stronger than the others that he may thereby early enjoy the distinction of playing at "big side," or of getting a place in the school Eleven. He is probably much envied by those of the same age who, with the aid of their youthful aspect, can still occasionally extract compensation by inducing the railway company to let them travel to school at half fare. But with girls it is different. Many at fourteen or fifteen are children still; some are grown up, with the tastes, feelings, and attraction of maturity. Those who have developed fastest are often, for that very reason, kept backward in school learning. Often they are nervously the least stable. Now that large schools for girls on the model of our public schools are become the fashion, such precociously developed and nervously unstable girls are apt to find themselves in the very uncongenial society of little girls of twelve or thirteen. The elder girls commonly hold aloof, while mistresses are apt to view this precocious development with disapproval, and to attempt to retard what cannot be retarded by insisting that the young woman has remained a child. I remember being called in consultation by a surgeon who had been asked to operate for appendicitis upon a girl of fourteen. I found a tall, well-grown girl, with an appearance and manner that made her look four years older. I could find no signs of appendicitis, but I learned from her that she had been for three months at a large girls' school, and that in a few days' time her second term was due to begin. As we became friends, she agreed that her appendicitis and her resolve not to return to school, where she was unhappy, were but different ways of saying the same thing. She was an only child who had travelled a great deal with her parents, had found her interests in their pursuits, and had grown backward in school work. The little girls with whom she was expected to associate seemed to her mere children. The elder girls did not want her friendship, and snubbed her. I prescribed a change to a small boarding-school with only a few girls, where age differences would not matter so much, and where she could make friends with girls older than herself, though not more mature.
Into their school life we need not follow the children. Happily the time is past when schoolmasters and schoolmistresses were incapable of understanding their charges, and confounded nervous exhaustion with stupidity or timidity with incapacity.
And so we come back to the point from which we started:
The nervous infant, restless, wriggling, and constantly crying! The nervous child, unstable, suggestible, passionate, and full of nameless fears! The nervous schoolboy or schoolgirl prone to self-analysis, subject-conscious, and easily exhausted! And how many and how various are the manifestations of this temperament! Refusal of food, refusal of sleep, negativism, irritability, and violent fits of temper, vomiting, diarrhœa, morbid flushing and blushing, habit spasms, phobias—all controlled not by reproof or by medicine, but by good management and a clear understanding of their nature.
The hygiene of the child's mind is as important as the hygiene of his body, and both are studies proper for the doctor. Neuropathy and an unsound, nervous organisation are often enough legacies from the nervous disorders of childhood.
INDEX
Abdomen, prominent, [151]
Abdominal symptoms of neurosis, [153]
Accent, local, facility with which acquired, [17]
Acetone, in breath and urine during cyclic vomiting, [86]
Acidosis, accompanying cyclic vomiting, [85]
Action, imitativeness of, [19]
liberty of, in early childhood, [22]
Activities in the nursery, [98]
not to be restrained, [23], [24], [98]
without intervention of grown-up people, [99]
wonderful nature of, [24]
Adenoid vegetations, night-terrors aggravated by, [136]
removal of, in treatment of enuresis, [93]
Adolescence, and education on sexual matters, [169], [175]
Adults, child in relation to the society of, [36], [38]
Æsthetic sense, in early childhood, [48]
Affection, in the child, [48]
Air hunger, in cyclic vomiting, [86]
Air swallowing, habitual action of, [79]
Albuminuria, associated with faulty posture, [152]
cause of, in neuropaths, [152]
Allimentary disturbances, symptom of, [157]
Alkali, in treatment of cyclic vomiting, [87]
Anæmia, of neuropaths, [152]
Anorexia nervosa, [50]
A case illustrating, [50]
Apnœa, fatal cases of, [83]
following burst of crying, [82]
twitching of facial muscles in, [83]
Appetite, emotional states affecting, [52]
loss of, [51]
case illustrating, [51]
causes and characteristics, [56], [62]
treatment, [62]
means of stimulating, [53]
nature of the sensation of, [52]
Apprehension, causes of, [28]
growth of neuroses in atmosphere of, [75]
Artificial feeding, [109], [113]
Aspirin, [71]
Asthma, treatment of, [166]
Attention, child's love of attracting, [32], [35], [59]
examples of, [33], [39]
Authority, delight in defying, [43]-46
over-exercise of, by parents, results of, [42], [43], [45]