If this diagnosis is made, then a full and clear explanation should be
given to the mother, or at any rate to such mothers--and fortunately
they are in the majority--who are capable of appreciating the point of
psychology involved, and of correcting the management of the child so
as to overcome the negativism. To attempt treatment by prescribing
drugs, or in any other way than by correcting the faulty management,
is to court failure. As Charcot has said, in functional disorders it
is not so much the prescription which matters as the prescriber.

But the task of the doctor is often one of even greater difficulty.
Often enough there will be a combination of organic disturbance with
functional trouble. For example, a girl of eighteen years old suffered
from a pain in the left arm which has persisted on and off since the
olecranon had been fractured when she was two years of age. She was
the youngest of a large family, and had never been separated for a day
from the care and apprehensions of her mother. The joint was stiff,
and there was considerable deformity. The pain always increased when
she was tired or unhappy. Again, a girl had some slight cystitis with
frequent micturition, and this passed by slow degrees into a purely
functional irritability of the bladder, which called for micturition
at frequent intervals both by day and night. In such cases treatment
must endeavour to control both factors--the local organic disturbance
must if possible be removed, and the faults of management corrected.

It is a good physician who can appreciate and estimate accurately the
temperament of his patient, and the need for this insight is nowhere
greater than in dealing with the disorders of childhood. It can be
acquired only by long practice and familiarity with children. In the
hospital wards we shall learn much that is essential, but we shall not