from enuresis till his seventh year, had regained complete control
till his eleventh year, when he went to school. In his dormitory at
school was a boy who had enuresis, and who was being fined and
punished by the schoolmaster. The enuresis at once reappeared and
continued unchecked so long as he was at school. As might be expected,
school life is very inimical to cure, unless the trouble can be kept
from the knowledge of the other boys. Anything which directly
increases the nervousness of the child--an illness, for example, with
loss of weight and failure of nutrition, or some mental stress, such
as the approach of an examination--is apt to accentuate the enuresis.

_(d)_ In the fourth place, the incontinence sometimes spreads to the
daytime, and the child is wet both by day and night. Further, in bad
cases it is not uncommon to find incontinence of fæces making its
appearance also. These extensions of the fault only take place when
the management continues to be very faulty, when the grown-up people
around them are more than usually distressed and pessimistic, and have
redoubled their expostulations and appeals.

Now these peculiarities of enuresis seem to me only explicable if we
assume that the want of control is due to auto-suggestion, dependent
at the beginning on the unwise attitude adopted towards the fault by
the nurses and parents, and later kept up by the sense of shame and
the mental distress involved.

The forms of treatment which have been recommended from time to time
are, as might be expected, very numerous.

_(a) Operative._--(i) Removal of tonsils and adenoids, (ii)
Circumcision.