Syphilitic Lymphadenitis

(again from a friend or parent). It may be an attention-seeking device (if his complaints cause anxiety and consternation in his parents), an escape device (from arithmetic or troubles resulting from inadequately prepared homework), or be due to feelings of insecurity arising from unkindness or excessive strictness at home or school. The family doctor is in the best position to elucidate the causative factors, though he should bear in mind that a child who has 10 attacks of abdominal pain of emotional origin may still develop acute appendicitis or other acute abdominal condition-the diagnosis is not necessarily the same every time. Treatment is difficult. It includes reassurance that there is no organic disease, the reduction or removal of stress where possible, advice about the parental attitude to the symptoms (or to any disease), with special regard to the importance of avoiding suggestion of symptoms, anxiety about them, or any of the factors which may lead to psychogenic pains. But the treatment decidedly does not include purgatives, sedatives, tranquillizers, or antidepressants; and antispasmodics are apparently of no avail.