THE PHYSICAL EXAMINATION 33 



Nervous Affections 



A teacher is very likely to see many kinds of 

 nervous affections in every large body of children. 

 Although the cause is not generally to be found 

 in the school itself, a teacher or physical instructor 

 should be able to recognize signs of common ner- 

 vous disorders and see that children having them 

 are examined and cared for by proper authorities. 

 The troubles of this character most common 

 among children are stuttering and stammering, 

 chorea, hysteria, and epilepsy. Let us consider 

 them in order. 



Stuttering and stammering, though seemingly 

 much alike, have rather different physical condi- 

 tions behind them, and are more or less readily 

 distinguished. In stammering the child seems to 

 have difficulty with individual sounds, while with 

 stuttering the difficulty is more likely to be with 

 syllables. Besides, with the latter, a kind of spasm 

 seems to accompany the impeded utterance — a 

 condition not evident with stammering. Fur- 

 thermore, stammering is often accompanied by 

 anomalies of the lips, the tongue, or of the artic- 

 ulating organs in general, while such defects are 

 not common with stutterers. More "nervous- 

 ness" underlies stuttering than stammering. 



Either stammering or stuttering may be excited 

 by overwork, undernourishment, some unusual 

 strain or excitement, or may be the effects of a 



