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23
Most of us have experienced in our own persons the
effect of worry and. tension on appetite and bowel action —
here we may truly speak of 'functional' disorder. But
how this produces pain is still a mystery. It is
impossible - even were it desirable - to bring up
children without anxieties or exaltations: so the most
we can do is to try antispasmodics such as belladonna
and its derivatives, or the new anticholinergics such as
merbentyl or probanthine; or we can use the specific
psychic sedatives, of which chlorpromazine is probably
best suited to children. It must be admitted at once
that none of these is very effective.
" In the second group, the children are suffering
from " the cyclical disease of childhood", here showing
itself by abdominal pain. Other symptoms can present
themselves - fever, headache, vomiting (perhaps the
commonest), usually in nore regular fashion than the
emotion-triggered bellyache just discussed. Our
ignorance of this illness is quite complete. We can
often help by symptomatic treatment, but there is no
suggestion of removing the cause or preventing
recurrences.
"It remains to add, that although neither of these
two sorts of pain have anything to do with appendicitis,
yet of course this common disease of childhood can and
does, occur in children subject to bellyache. This can
lead to confusion, and the doctor must be on his guard
that he does not miss the major disease.
" I should like to thank my colleagues in the School
Health Service for sending the children to me, and the
family doctors for authorising the referral. I am
grateful to Dr. P. Tettmar, radiologist, and Dr. W.
Walther, pathologist, at Whipps Cross Hospital, for
making me free of their services."