It is a question still to be answered whether the rare conditions of
pyloric spasm and pyloric hypertrophic stenosis are not further
developments of the same disturbance. Certainly these grave
complications appear most commonly in infants with a pronounced
nervous inheritance, and, as might be expected, they are more commonly
found in private practice than among the hospital classes.

In passing, we may note that there are babies who exhibit the opposite
fault, and in whom the contrary regimen must be instituted. Premature
children, children born in a very poor state of nutrition, and
children born with great difficulty, so that they are exhausted by the
violence of their passage into the world, are apt to show the opposite
fault of extreme somnolence. They are so little stimulated by their
surroundings, and they sleep so profoundly, that the sucking reflex is
not aroused. Put to the breast they continue to slumber, or after a
few half-hearted sucking movements relapse into sleep. We must rouse
such children by moving them about and stirring them to wakefulness
before we put them to the breast.

Once the child has been got to the breast, once the milk has become
firmly established, we have overcome the first great difficulty which
besets us in the management of nervous little babies, but it is by no
means the last. Restlessness and continual crying must be combated or
digestion suffers, and may show itself in a peculiar form of explosive
vomiting, which betokens the reflex excitability and unrest of the
stomach.

The sense of taste is as acute as all other sensations. If the child
is bottle-fed, the slightest change in diet is resented because of the
unfamiliar taste, and the whole may promptly be rejected. The tendency