the child must be got to take his food, but in all our conduct to him.  Repression and reproof, and thwarting of the child’s will, and coaxing and entreaty must cease.  There is no fear that we shall thereby make the child unduly disobedient.  We have already, in another chapter, decided that negativism is not strength of will on the part of the child which must be broken, but is the result of constant attempts to oppose his nature, and the consequent nervous unrest.  If we cease to oppose, the symptoms will tend rapidly to disappear, the child will become busy and contented and happy in his play, and we shall hear no more of his refusal of food.  If sometimes it recurs for a week or two, we shall know how to deal with it.

In children, as with us, periods of nervous unrest and unhappiness are apt to recur in a sort of cycle.  This cyclical character of mental disturbance is often a marked feature.  We see it in epilepsy and in what the French have called Folie Circulaire.  We see it in the dipsomaniac, in the intermittency of his craving for drink and of his periodical outbursts, and we see it in ourselves in those periods of depression which recur so often, we know not why.  Little children too sometimes get out on the wrong side of their beds, and never get right the whole long day.  Their own experience of the vagaries of mental states should lead mothers to be indulgent to the children in their days of cloud and to be particularly careful not to goad them by well-intentioned efforts into bursts of naughtiness and passion, each one of which tends to perpetuate the condition and increase the nervous unrest.  We know how closely dependent is the sensation of appetite upon emotional states, and we must do all in our power—­and the task is sometimes one of real difficulty—­to keep the child’s mind sufficiently at rest to preserve the healthy desire for food unimpaired.  If there is no sign of appetite, but every sign of restlessness and irritability, we must seek in the management of the child until we find the fault.

If food is taken mechanically and without appetite, if the preliminary changes in the stomach wall which are necessary for adequate digestion do not take place, but are inhibited by the mental unrest, the meal is apt to be followed by gastric pain and discomfort, or, more commonly with children, the stomach may promptly reject its contents.  At the worst, nervous vomiting of this sort may follow almost every meal, although, again, it is curious to note how little, comparatively speaking, the nutrition of the child suffers.  The vomiting too, as in adults, comes very near being a voluntary act, and mothers and nurses will often remark that they get the impression that it can be controlled at will.  If once the diagnosis is made that the want of appetite or the vomiting is of nervous origin, the treatment of the condition is clear.  Sedative drugs directed towards quieting the nervous excitability may be of service, but tonics, appetisers,