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Page 57
_How should a young child addicted to bed-wetting be managed?_
At three or four years of age, punishments are sometimes useful,
especially when it seems to depend more upon the child's indifference
than anything else. They are of no value in older children, rewards
being much more efficacious. In all cases one should give a child
plenty of milk and water early in the day, but no fluids after 4 P.M.,
the supper being always of solid or semi-solid food. The child
should be taken up regularly at ten o'clock or thereabouts. It often
happens that the formation or continuance of the habit is due to the
child being in poor general condition, to some irritation in the
urine, or in the genital organs. Unless the simple means mentioned are
successful the child should be placed under the charge of a physician.
_What is masturbation?_
It is the habit of rubbing the genital organs with the hands, with the
clothing, against the bed, or rubbing the thighs together. Sometimes
the child sits upon the floor, crosses its thighs tightly and rocks
backward and forward. Many of these things are passed over lightly and
are regarded for months as simply a "queer trick" of the child. It may
be seen at any age, even in those not more than a year old, and in
both sexes.
_How should such a child be treated?_
Masturbation is the most injurious of all the bad habits, and should
be broken up just as early as possible. Children should especially be
watched at the time of going to sleep and on first waking. Punishments
and mechanical restraint are of little avail except with infants. With
older children they usually make matters worse. Rewards are much more
efficacious. It is of the utmost importance to watch the child
closely, to keep his confidence, and by all possible means to teach
self-control.
Some local cause of irritation is often present, which can be removed.
Medical advice should at once be sought.
VACCINATION
_Nowadays when small-pox occurs so seldom is it necessary to have
every child vaccinated?_
It should by all means be done. It is only by the practice of general
vaccination that small-pox is kept down. In countries or in
communities where vaccination is neglected, frightful outbreaks of
small-pox occur every now and then just as in olden times.
_What is the best time for vaccination?_
The time usually selected is from the third to the sixth month. It may
be deferred in a very delicate child who is not likely to be exposed
to small-pox, or in a child suffering from any form of skin disease.
_Which is preferable for vaccination, the arm or the leg?_
The part which can be most easily protected and kept at rest is to be
chosen. In infants who do not yet walk or creep, the leg is to be
preferred? in older children, in most circumstances, the arm. If older
children are vaccinated on the leg, they should not be allowed to walk
much while the vaccination is active.
_When should vaccination be repeated?_
An unsuccessful vaccination proves nothing and should be repeated in
two or three weeks. If success fully vaccinated in infancy, a child
should invariably be revaccinated before puberty. If exposed or likely
to be exposed to small-pox at any time vaccination should be repeated.
[Illustration: Weight chart for the first year; the curved line
indicates the average rate of gain.]
[Illustration: Weight chart, one to fourteen years. The upper line
indicates the average for boys; the lower (dotted) line that for
girls.]
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