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80
Total attendances (old and new cases) 337
Number of sessions 25
% attending—boys 59.7
girls 40.3
2. Procedure.—At each Clinic the original procedure has been
adhered to and is as follows: —
(a) Examination of urine is carried out by a Health Visitor (for
sugar, albumin, reaction and specific gravity).
(b) History of Enuresis is taken (including that of any relevant
illnesses). Particular attention is given to the child's routine prior to
and at bedtime.
(c) Physical Examination. This has sometimes been deferred until
the second interview if the child has been particularly nervoiii or ill
at ease.
(d) The approachability of the child and parent is noted. A child
who is interested and keen is, of course, more responsive than the overmothered,
shy or defiant little patient.
(e) General advice to the child and parent is given, and one would
stress again the value found in discussion directed towards individual
problems, particularly discussion at the child's level.
As has always been the practice at this clinic, more time is spent
talking to the child, thus gaining his or her confidence, than in talking
to the parent. Results have proved that suggestions made to the child
have often been acted upon more faithfully by the mother, than when
more general advice has been given. The mother has invariably caught
the atmosphere intended quite quickly, and has been able to uphold
the feeling of reassurance and confidence in the child, at home.
(/) Charting of all dry nights is explained by use of pencil and
paper for older children, and by the use of gummed coloured paper
shapes for younger ones.
(g) Medicinal treatment is issued or prescribed (vide No. 3).
3. Treatment.—The treatment issued or prescribed is as follows:—
No. of
Cases
(a) Amphetamine sulphate (2 5 mgni.—10 mgm.) at night, at a
time decided upon for each individual child 56
(fc) Phenoharbitone gr. | at night or during the day (including
usage for certain cases failed under (a) above) 3
(c) Charting and advice only 8
67
Also
(d) Hospital investigation (failed under (a) or (b) above) 1
(e) Child Guidance Clinic (do. do.) 1
(/) Other treatment (ephedrine gr. ½ + or — Mist, potassium
citrate, etc.) (failed under (a) or (b) above) 3
(N.B.—As before, only the amphetamine sulphate was issued
by the Area Health Office.)