If, during the third and fourth years of the child's life, it asks continual questions, it is absolutely essential that all these questions be correctly answered, with no further detail or explanation than necessary with due consideration to its limited powers of compre hension. If the question is answered correctly and concisely no false and unreal conceptions will be developed in its mind, and the child's imagination will not move upon false lines.
After a time, of course, there will come to the child a thirst for knowledge. followed sooner or later by the emergence of the mighty in instinct for occupation, for imitation. and for the society of its kind. To direct and guide these so that they shall move in proper channels and shall not be followed too intensely, requires the most solicitous thought and observation of the parents. In this way, by careful individualiza tion, the early training will make for a strong and healthy sentiment, and for the establishment of strong will power, of self control, and of the ability to bear pain and disappointment.
Particular adroitness must be exercised in answering questions regarding the sexual life. The physician should assist the parents by his advice upon this subject, or. if opportunity offers, should give the child at the right time a natural explanation of the question, which will bring it into harmony with the spiritual life of the maturing child, and make it of inestimable value during its years of development. In which manner, at what time, and how best to approach the sexual question, I will not discuss here. If the parents through proper bringing up have gained the confidence of the growing child, it will generally, and partic ularly in this matter, sometimes earlier and sometimes later, come to its parents, usually the mother, and freely discuss the question. Its queries should be answered openly, honestly. and naturally, with proper regard to its mental development and its ability to comprehend. If this is done, the harm which results from confused ideas and lustful thoughts :nay be prevented, and the practice of onanism and masturbation reduced to a minimum. There are many other measures which may be taken in the care of the mental and spiritual development of the child, which I will touch upon only superficially: these are, guarding against satiety (avoidance of gifts and toys of too costly a character and of too great a number); care as to arousing too early the mind and imagina tion by premature and too frequent participation in children's parties, musical performances, and the theatre; the avoidance of too continuous an association with adults; and, the prevention of the reading of evil and unhealthy literature.
Another subject to be considered by the physician is the occupation of the child during its spare time, or of any special branch of knowledge to which this time is devoted, either through talent and inclination, or by the wish of the parents. In this category air included music, draw ing, painting, and handicraft. In order that the later life of the child may not be hindered through injury to the mental state by overbur dening and overtaxing its mind in these early years, due consideration should be. given to its age and the proper hours for the pursuit of these and equally important occupations. The physician should also deter mine whether, in particular instances, the child is not so overtaxed by school work and the consequent home studies as to make it necessary to give up some of them, or perhaps to abandon them fora while and dispense with the school altogether. This relief from school work should also be insisted upon when necessitated by excessive mental strain, or when the tax upon the physical strength is too great, as I have pointed out elsewhere.
For the psychical equilibrium of the child, upon which the founda tion and steadfastness of its character are reared, there is nothing of such extreme importance as the good example of the parents. self respect and good precept are the mainsprings of a healthy and effective method in the bringing up of children. Example is more potent than are exhortation and correction: unity and peace in the household pro duce equanimity and harmony in the child: indecision and discord, on the other hand, produce uncertainty and heedlessness. Quarreling and scolding frequently call forth, in sensitive children, a feeling of sadness and loneliness. which may even lead to a state of melancholy. The family physician who conies and goes in such a household has truly not only the physical but the spiritual needs of the child to look after, so that there may be a healthy foundation upon which the intellectual and moral being may develop. The totality of the spiritual training is to be found in a complete, harmonious development of all the psychical facul ties, the powers of observation, of discrimination, of memory, of will, of sentiment il.nd soul, and an appreciation of the noble and beautiful.
The foregoing chapter upon the general prophylaxis of childhood can, naturally, merely touch upon many of the injuries and dangers which may threaten the child's health during the various periods of its life. It has been possible only to hint and suggest regarding the care to be taken. More specific rules and details will he found in the special prophylaxis of the individual diseases, and in the chapter relating to their treatment.