There is, however, another side to the question. The relation of neurosis in childhood to infection of the body is complex. I have said that with the nervous child a trivial infection may produce symptoms disproportionately severe. Persistent and serious infection, however, is capable of producing nervous symptoms even in children who were not before nervous, and we must recognise that prolonged infection makes a favourable soil for neuroses of all sorts. The frequency with which St. Vitus’s dance accompanies rheumatism in childhood forms a good example of this tendency. The child who, from time to time, complains of the transient joint pains which are called “growing pains,” and who is found by the doctor to be suffering from subacute rheumatism, is commonly restless, fretful, and nervous. Appetite, memory, and the power of sustained attention become impaired. Often there is excessive emotional display, with, perhaps, unexplained bursts of weeping. The child is readily frightened, and when sooner or later the restless, jerky movements of St. Vitus’s dance appear, the usual explanation is that some shock has been experienced, that the child has seen a street accident, has been alarmed by a big dog jumping on her, or by a man who followed her—shocks which would have been incapable of causing disturbance, and which would have passed almost unappreciated had not the soil been prepared by the persistent rheumatic infection.
The management of the nervous child whose physical health remains comparatively good is difficult enough, but these difficulties are increased many times when the physical health seriously fails. To steer a steady course which shall avoid neglecting what is dangerous if neglected, and overemphasising what is dangerous if over-emphasised, calls for a great deal of wisdom on the part both of the mother and her doctor.
NERVOUS CHILDREN AND EDUCATION ON SEXUAL MATTERS
In this chapter I approach with diffidence a subject which is rightly enough occupying a great deal of attention at the present time: the instruction of our children in the nature, meaning, and purpose of sexual processes. It is a subject filled with difficulties. Every parent would wish to avoid offending the sense of modesty which is the possession of every well-trained child, and finds it difficult to escape the feeling that discussion on such matters may do more harm than good. There is certainly some risk at the present time that, putting reticence on one side, we may be carried too far in the opposite direction. The evils which result from keeping children in ignorance are well appreciated. We have yet to determine the effect upon them of the very frank and free exposure of the subject which is recommended by many modern writers. Nevertheless, it must be granted that it is not right to allow the boy or girl to approach adolescence without some knowledge