NERVOUS DISEASES
In this chapter we shall consider a number of the more common diseases
which are associated with the nervous system of the child. Some of
these so-called nervous diseases are hereditary or congenital, while
others are the result of infection and environment.
SLEEPLESSNESS--INSOMNIA
There are many conditions which cause sleeplessness or insomnia in a
child aside from disturbance of the mental state or nervous system.
For instance, late romping, too hearty and too late a dinner, lack of
outdoor life during the day, illy ventilated sleeping rooms, too much
bedding, too little bedding which causes cold extremities, too much
sleep during the day, too much excitement (movies or receptions),
intestinal indigestion which is associated with accumulation of gas,
and constipation--any or all of these are causes of sleeplessness.
Some peculiarly nervous children--those with an hereditary strain of
nervousness--are easily upset or disturbed by any of the conditions
above mentioned.
The treatment of insomnia consists, first, in finding the cause and
removing it. Children with a nervous tendency should be let alone as
nearly as possible, and just allowed to grow up as the little lambs
and calves grow up. They should be fed, watered, kept clean and dry,
and allowed to live their lives undisturbed and without excitement.
The medicinal remedies on the market for insomnia are all harmful if
used too long or in excess, and we most earnestly urge the mother not
to seek drug-store information concerning remedies for sleeplessness.
The neutral bath is beneficial in ninety per cent of these cases. It
is administered as follows: Enough water is allowed to run into the
bath tub to cover the child. The temperature should be 99 to 100 F. It
should be taken accurately--and should be maintained. Bath tub
thermometers may be purchased at any drug store. The restless child,
after the bowels have been freely moved, is placed in the water, and,
without whispering, talking, or laughing, he remains there for at
least twenty minutes, after which he is carefully lifted out, wrapped
in a sheet and very gently dried off with soothing strokes and placed
at once into his night clothes. As before said, ninety per cent of
restless children will go at once to sleep after such a treatment.
Another method of treating sleeplessness is by the wet-sheet pack.
Three single woolen blankets are placed on the bed and a sheet large
enough to wrap the child in is wrung from warm water, about 100 F. The
child is stripped and this sheet is brought in contact with every
portion of his body, quickly followed by bringing the flannel blankets
about him and he is allowed to remain there for twenty minutes--if he
does not fall asleep before the lapse of that time. With witch-hazel
or alcohol, the body is sponged off, night clothes are put on and a
restful night usually follows. If fresh air is lacking, open the
windows. If there is too much bedding, remove some of it. Talcum
powder the sweaty back and neck and make the child perfectly
comfortable. Give a small drink of water and turn out the light.
NIGHT TERRORS
Night terrors are probably due to some digestive disturbance, with a
coexisting highly nervous temperament. They oftentimes, in older
children, follow the reading of thrilling stories or a visit to an
exciting moving-picture show. The child goes to sleep and gets along
nicely for two or three hours and then suddenly jumps up out of bed
and rushes to its mother with little or no explanation for the act. In
his dreams the thoughts and the imaginations of his waking moments are
all confounded and alarming.
We recall one little fellow who constantly feared big, black birds
coming in the window and attacking him--he had been reading about
Sinbad the Sailor and his experiences with the big bird. He so feared
this big, black bird that he could not go to sleep. For a number of
nights he did not have the courage to tell his parents that it was the
fear of the big bird that kept him from going to sleep, but finally he
confided in his mother and told her of his fear. The mother and father
both entered into a conversation with him through an open door which
connected the two rooms, after the lights were out; they laughed and
talked about the big bird, they openly talked of it and allowed their
imagination to work with the child's imagination in planning how he
could combat with the bird, should it really come, asking him how big
it really was and what color he thought its eyes were and how big an
object he thought its feet could carry. They all three planned a fairy
story they might write which would rival the fairy stories of the
Arabian Nights. In a very short time--possibly a week or ten days--the
little fellow felt quite equal to these imaginary assaults, his fears
were quieted and his slumbers were no more disturbed by visions of the
big, black bird.
Everything should be done to relieve the stomach and intestines of
laborious work during the sleeping hours, hence let the evening meal
be light and eaten early enough to be out of the way, as far as
digestion is concerned, by bed time.
NERVOUSNESS
During the formative period of the nervous system--the first few
years--under no circumstances should the children be played with late
at night, when they are tired and sleepy, or hungry, for it is at such
times that the nervous system is so easily excited and irritated. When
the baby is to be played with, if at all, it should be in the morning
or after the mid-day nap. Rest and peaceful surroundings are of
paramount importance to the nervous child, and he should be left alone
to amuse himself several hours each day. It is a deplorable fact that
the nervous child--the very one that should be left alone--is the very
child that usually receives the most attention, the very one who is
most petted, indulged, and pacified; all of which only tends to
increase his lack of self-control and to multiply the future sorrows
of his well-meaning but indulgent parents.
HEADACHE
Headache attacks old and young alike, and the young infant that is
unable to tell us he has a headache manifests it by rolling the head
from side to side, putting his hand to his head, or by wrinkling up
his brow. Headaches may be occasioned by disorders of the brain and
spinal column, such as meningitis. It nearly always accompanies fever,
and is often a result of constipation, intestinal indigestion,
overeating, as well as eating the wrong kind of food.
The treatment of headache in children (aside from removing any known
cause) consists of a hot foot bath, a brief mustard paste to the back
of the neck, a light diet--sometimes nothing but water--and the
administration of a laxative.
CONVULSIONS--SPASMS
In the very young, convulsions are easily produced. That which will
produce but a headache in an adult will often produce a convulsion in
the child. Aside from diseases of the nervous system such as epilepsy,
etc., convulsions frequently accompany gas on the bowels, intestinal
indigestion, disordered dentition, an acute illness, intestinal
parasites (worms), irritation about the genitals such as the need of
circumcision, an adherent clitoris, adenoids and enlarged tonsils,
inflammation of the ears, and poor nutrition of any sort such as
rickets.
The convulsion picture is a stiffening of the body--sometimes arching
backwards--rolling or staring of the eye-balls, blueness of the skin,
a drooling mouth (often foamy mucus at the mouth), clinched hands,
biting the teeth--if there are teeth--and even biting the tongue.
There is at first a succession of quick, jerking, convulsive movements
of the body which in a few moments grow less and less violent and
finally cease. The child begins to cry and then soon goes off into a
deep sleep, while the body seems more heavy and logy than usual. In
extreme cases, the child relaxes but for a moment of time, when he
goes off into another convulsion, sometimes going from one fit into
another until death relieves him.
Treatment for convulsions must be instituted at once. Do not wait
entirely to undress the child--pull off his shoes, place him at once
into a good warm bath, temperature about 100 to 102 F. An ice cap
should be placed to his head (cracked ice done up in a towel), and
while in the bath or immediately upon taking him out, give a warm
soapsuds enema. The bath that the child is placed in should be always
tested with the bared elbow. A half cupful of mustard may be added to
the bath. Just as soon as the child is able to swallow, give a
teaspoon of syrup of ipecac. Enema after enema should be given until
the water comes back clear. Undue excitement after the bath only
predisposes to repeated attacks, and while the mother may be very
happy that the child is himself again, under no circumstances should
she caress and fondle him. Put the little one to bed and allow his
nervous system to calm down; let him rest quietly and undisturbed.
NERVOUS TWITCHINGS
Habit spasms or "tics" are common in childhood, and are caused by an
over irritability of the nerves supplying certain groups of muscles.
It is not at all uncommon to see a child nervously blink the eyes,
twitch the nasal muscles, shrug the shoulders, constantly open and
close the hand, and execute a score of other minor habit-spasms;
which, day by day, wear deeper and deeper paths into his nervous
system as a result of their constant repetition. These minor
habit-spasms of childhood are but telltales of an unstable nervous
system, of a nervous heredity lacking poise and balance; and, mind
you, if this nervous system is studied, treated, and properly
harnessed with self-understanding and self-control, much may be
accomplished; the habit may be more or less completely eradicated. If
left to itself, unchecked, the habit deepens the "spasm-groove," and
the "energy-leaks" grow bigger and bigger until finally, in later,
adult life, all that is necessary to convert such persons into
first-class neurasthenics or hysterics is some bad news, a few
worries, or a sudden shock.
By all means study to nip all childhood twitchings in the bud;
remembering all the while that childhood--the formative period for the
nervous system of the child--presents the golden opportunity to
prevent and abort the more grave neuroses of later life. There may be
a special contraction of one or more muscles of the eyeball which
produces either a "cross-eye," when the contraction is convergent, or
a turning of one eye outward when the contraction is divergent. It is
not possible for the mother to correct this condition. The one
important thing for her to do is to take the child to a skilled
ophthalmologist early in his life, that treatment may be instituted
for the correction of the difficulty.
RETENTION OF URINE
Not an unusual condition during childhood is a temporary retention of
urine. It may follow an attack of colic or accompany any acute
illness. Increase the water drinking, and, after seven or eight hours,
hot cloths should be applied over the bladder; a large enema (enema
bag should be hung low) should also be given, retaining as much as is
possible. These simple measures usually relieve the condition. If
retention follows circumcision, due to swelling of the parts, the
surgeon should be notified.
BED WETTING
Nocturnal enuresis (bed wetting) usually is found to "run in
families." It is seldom the case to find that both the father and the
mother escaped bed wetting during childhood when the child is sorely
afflicted.
Early bad habits may be the prime factor in this distressing and
humiliating difficulty. A little child that has been compelled to lie
in wet diapers for hours at a time gradually becomes accustomed to
"being wet," and the desire to urinate is not under the keen control
of a will that has been trained by untiring patience to "sit on a
chair" at regular intervals throughout the day. This lack of training
in a child who possesses an unstable nervous system, creates the
proper environment for the habit of bed wetting--which often marches
steadily on until puberty. In the treatment of bed wetting give
attention to the following:
1. The urine should be thoroughly examined.
2. The size of the bladder should be determined.
3. The last meal of the day should not be after four o'clock in the
afternoon.
4. All during the day, in young children, systematic training should
be begun--put the child on the chair every hour, then every hour and a
half, then every two hours. Let the work be done most painstakingly
and much will be accomplished toward training the bladder to "hold its
contents" during the night. For a time it will be necessary to set an
alarm clock to ring every three hours during the night, that the
bladder may be relieved at regular intervals.
5. No liquids whatever are allowed after four P. M.; even the four
o'clock meal should be very light.
6. In older children the habit is often broken by appealing to the
pride--by requesting or demanding the child to rinse out the bed linen
and hang it up to dry himself.
Usually at puberty the trouble ends, and while no amount of whipping
will correct the difficulty, the promise of rewards, an appeal to the
pride, correction of dietetic errors, the establishment of regular
times to empty the bladder, the removal of all reflex causes such as
adenoids, need of circumcision, worms, etc.--these combined
influences--will bring results in the end, if they are faithfully and
intelligently applied.
MENINGITIS
Cerebro-spinal meningitis is not highly contagious. Children old
enough to complain of symptoms usually first complain of an intense
headache with frequent vomiting and very high fever. Great prostration
is seen, the pulse is weak, the respirations are irregular, the child
may have convulsions, or it may have chills and fever, and rigidity of
the body may be present. The position of the child is very
characteristic. It does not want to lie on its back but usually rests
on one side, with the spine more or less arched. It is a very serious
disease and demands the early attention of a physician. Some cases
are very mild and others are exceedingly grave. If the physician is
secured early, and special remedies administered that are known today,
many of the children may be saved.
INFANTILE PARALYSIS
Infantile paralysis is a serious disease of the spinal cord which
comes on very suddenly and is associated with vomiting, pain in the
legs, and a high temperature. After these symptoms have lasted a day
or two the paralysis is discovered. There may be convulsions. The
paralysis is progressive, and the wasting of the muscles increases
until by the end of a couple of months one limb is considerably
shorter than the other. Sometimes the baby goes to bed at night in
apparent good health and wakes up in the morning paralyzed.
In this disease the attention of the best physician in your community
should be called to the case at once, for there are being developed in
our large research laboratories special vaccines for this condition as
well as for spinal meningitis. But what is done must be done very,
very early, so let there be no delay in calling in medical counsel.
There are other forms of spinal paralysis which, associated with
tuberculosis of the spine and other spinal diseases, result in loss of
power to one or more groups of muscles. The only treatment that can be
given in the home is to keep all of the paralytic portions of the body
very warm by external heat, care being taken to avoid burning, and
secure medical advice. Often, later in the course of the disease, by
the aid of crutches and braces, the child can be taught to go to
school and to get around the house about his little duties.
The slight facial paralysis which is so often seen in babies that have
been delivered with forceps, usually clears up in a few days or at the
latest in a few weeks or months.
SAINT VITUS' DANCE
Saint Virus' dance (chorea) is a peculiar disorder seen in nervous
children, and which usually clears up in a few weeks or months under
proper treatment. It is characterized by irregular jerkings pretty
much all over the body, so that the child staggers as he walks, drops
his food at the table, and executes many other noticeably abnormal
movements. The child should be taken out of school at once and removed
from association with children who might make sport of him or
otherwise annoy him and thus increase these irregular jerkings. He
should at once be put under the direction of competent medical
authority. Simple food, colon hygiene, more or less complete rest, and
freedom from annoying circumstances, will usually bring about a speedy
recovery.
CONGENITAL DISORDERS
_Water on the Brain_ is characterized by an enlarged head due to an
increased accumulation of fluid within the cranium. While the face
remains small the head greatly increases in size so that oftentimes it
must be braced while the child is compelled to remain in a wheel
chair. The mentality is usually fairly normal, but the enormous weight
of the head compels the life-long occupancy of a wheel chair.
_Deaf-Mutism._ The child born deaf pays no attention whatever to
sounds. An intellectual expression is seen on his face and by six
months he is able to do all that a normal baby can do with the
exception of hearing. The child should early be taken to an ear
specialist in the endeavor, if possible, to correct the defect of
hearing. Such little ones who are destined to a life without sound,
should be given every opportunity to learn to read the lips and to
secure a good education--to be taught a vocation where eyesight is of
more value than hearing. Special institutions are in existence today
which can take these deaf mutes when small and so teach them to make
audible sounds that they can make themselves understood--at least
partially. Lip reading is a wonderful improvement over the deaf and
dumb alphabet, and should be taught early.
_Congenital Blindness._ Perhaps not until the child is six months old
can the observer distinguish between blindness and idiocy. The blind
child of course will not fix his eyes upon any object; but the general
lassitude and the inability to hold up its head, while seen in idiocy,
is not present in blindness.
_Feeble Mindedness._ A baby that is born with a weak mind is found to
be very backward in all the normal developmental attainments of the
growing child. A normal baby holds up its head at four months and
should be able to sit erect at six months. The weak-minded baby will
not do this, and often as late as two years it will not make any
attempt to walk or to talk. There is an unnatural expression--a vacant
look--to the face, while there is often much dribbling at the mouth.
_Early Training should be Instituted._ It is necessary to call the
attention of a physician to these facts, that the parents may be
instructed in regard to the early training which is so essential in
all these weak-minded little folk. In our opinion it is best to remove
these children early to special institutions, where their education
can be superintended by those thoroughly accomplished and accustomed
to dealing with this class. There are varying grades of feeble
mindedness--the backward child who requires a longer time to learn
things, and the child who is slow at school and possibly cannot get
through more than the fourth or fifth grade--but as soon as weak
mindedness is discovered, it is best to transfer the child to some
special institution.