Squinting is a want of parallelism or equal action of the two axes of the eyes. One of the muscles is weaker than the other, so that the eyeballs do not look in the same direction. Each eyeball is acted upon by a set of muscles which pull the ball forwards, upwards, downwards, inwards. When each pair of muscles in the eyes is equally strong the eyes work uniformly. In squinting, however, one eye appears to be turned inwards or outwards when the other is looking straight, or both may be affected in either of these ways. Thus there may be a convergent squint when the eyeballs both look inwards, or a divergent squint when they look away from each other.
Squinting is fairly common in children, and it may be due to weakness of one muscle or over action of another from some error of refraction. When it occurs in adult life it is due to some paralysis of a muscle. Squinting should always be attended to as early as possible, as if it persists for years without treatment an operation will be necessary upon the muscle affected.
In the early stage, however, proper glasses to correct the error of refraction will probably answer the purpose. A slight squint is very often visible in infancy, the reason being that the eye muscles are not strong enough to act uniformly. Mothers are sometimes anxious in case the squint will persist, but in most cases it passes off in early infancy. It is wise, however, not to allow strong light to be placed on one side of a child or to have any object hanging from the perambulator or cot likely to make the child squint in an effort to focus it. When squinting persists in childhood have the eyes examined by an oculist and any error of refraction corrected by glasses.
Stammering is a spasmodic affection of the muscles that have to do with speech and respiration. It is most evident in pronouncing words commencing with an explosive or labial letter such as B, D, P, T, K, or G. There are various varieties of the condition.
First, there may be difficulty in commencing to speak, or the stammer may be in the form of "syllable stumbling," in which one letter or syllable is constantly repeated before proceeding to the next. In several cases the spasm may spread to other muscles of the face, with the result that the face is screwed up or the mouth kept open before any sound can be uttered.
The condition is in a sense a bad habit, but there is generally some hereditary nervous condition or neurotic tendency. Stammering is, however, infectious. A child will contract the habit from association with a friend who is given to stammering. Unless in bad cases, stammering is not evident when singing or whispering. It is when the sound of the word is uttered in ordinary speech that the spasmodic affection becomes apparent. It appears to be much less common nowadays, partly because we have excellent teachers of elocution who make a speciality of studying its treatment.
In every case careful re-education of the muscles is necessary. The child must be made to read aloud slowly, to recite verses, to sing. He should be given deep breathing exercises and taught how to manage the breath properly before difficult words. He must be made to speak very slowly and distinctly, and stop distinctly, and stop whenever stammering begins. A sing-song method of speaking is a great help until better habits are acquired. In the case of nervous and delicate children attention to the general health must form part of the treatment.
Startings in sleep are due to some irritable condition of the nervous system. The symptom is fairly common in neurasthenia and in children who are of the neurotic type or who are improperly fed. It may amount to night terrors, the child starting up in fright, in fear of some unknown evil. In many cases the cause is irritation of the central nervous system by some poisons in the blood such as the poisons of imperfect digestion. When the digestion is imperfect poisons are developed in the canal; these are absorbed into the blood and carried to the brain, where they cause the irritation of the nervous centres and nerve cells. Another form of poison is contained in the blood when a child is suffering from adenoids. In such a case the blood is improperly aerated because the air passages are blocked. It contains the poisons of respiration, which irritate the nervous centres and cause startings in sleep.
In every case the cause should be investigated and dealt with. The child may require to be properly dieted, or he may need treatment for adenoids. When the condition occurs in neurasthenia the patient should be under the care of a nerve specialist.
Stings. The pain and irritation of the stings of such insects as bees, wasps, ants, and hornets is due to the presence of formic acid beneath the skin. Thus, treatment must consist in neutralising this acid by applying an alkali such as soda, ammonia, or the homely blue-bag. First the sting should be removed. This can be done by means of a watch-key or by pressing it out with a penknife. If there is swelling and irritation a compress of a
When a sting occurs in the mouth or throat it should be extracted and the mouth rinsed with hazeline and water in equal parts, or with sal volatile and water. Until the doctor arrives, hot compresses should be applied to the throat outside and the patient given warm oil to sip.
Jelly-fish stings irritate the skin and produce an itching red rash. The hairy caterpillar acts in the same way by reason of the poisoned hairs on the surface of their bodies. The irritation in these cases is alkaline, so that either vinegar or acetic acid should be applied to the part, after bathing with hot water to ease the pain.
Stone. The word stone is used to denote the formation of certain solid substances in various parts of the body. This may occur in the gall bladder or gall duct leading from the liver (see Gall-stones). Stones are also found in the kidney and bladder, due to the depositing of certain solids which are normally held in solution in the blood or in the urine. Their presence is due in most cases to excess of food, and especially excess of butcher's meat, and they are frequently found in gout. They are associated with hyper-acidity in many cases. Stone in the kidney may cause no symptoms for a long time, or it may produce a dull or stabbing pain in the back. Occasionally, if the stone moves downwards, the pain may be excruciating and accompanied by vomiting or fever. Stone in the bladder produces pain and irritability. The symptoms are not uncommon with children, and require medical treatment at once.