attempts to overcome it by manipulation of the diet, is very readily
amenable to treatment directed to quiet the nervous system.

Where a primary dyspepsia exists for any length of time, the growth
and the nutrition of the child is clearly altered for the worse. The
character of the stools, their consistency, smell, and colour, is apt
to be changed because the bacterial context of the bowel has become
abnormal. Rickets, mucous disease, lienteric diarrhoea, infantilism,
prolapse of the rectum, and infection with thread-worms are common
complications. No doubt children with primary dyspepsia are often
nervous and restless, and the elements of infection and of neurosis
are frequently combined. Yet often we meet with cases in which the
gastric or intestinal disturbance comes near to being a pure neurosis.
The nutrition, then, seldom suffers to any very great extent, or to a
degree in any way comparable to that which is characteristic of
dyspepsia from other causes. Emaciation, wrinkling of the skin,
dryness and falling out of the hair, decay of the teeth, are not as a
rule part of the picture of nervous dyspepsia. The child may be slim
and thin and nervous looking, but as a rule he is active enough, with
a good colour and fair muscular tone, so that one has difficulty in
believing the mother's statements, which are yet true enough, as to
the trouble which is experienced in forcing him to eat, or as to the
frequency of vomiting.

In early childhood the difficulty of the refusal of food often passes
or diminishes when the child learns to feed himself with precision and
certainty. To teach him to do so, it is not wise to devote all our
attention to making him adept at this particular task. The fault is
that the brain centres which control the movements of hands, mouth,
and tongue have not been developed, because his activities in all