Letter by Dr. Margaret Lowenfeld to the
medical journal The Lancet
Sir,
This correspondence and a sentence in your leading article of Feb. 19 (“We are not so
well equipped to treat enuresis that we can ignore any promising technique”) prompts
me to write of some conclusions I have formed from twenty years of dealing, in the main
successfully, with enuresis in children.
Does not the cause of our lack of success lie in the tendency for the specialist to treat
enuresis as a phenomenon of the urinary system alone, and for the general practitioner
to take the opposite line and tell the mother that the child needs no help and will “grow
out of it”?
It is, of course, true, as you state, that in a certain proportion of children the situation
arises from specific pathological conditions of the urinary system, but these cases
amount to a very small proportion of those suffering from this very common complaint,
Elaborate urinary investigations, on the other hand, tend directly to increase the child’s
difficulties in gaining control, and to hinder the achievement of understanding by
physician, mother, and child of the part played by delayed bladder control in any
individual child.
Surely the kernel of the whole problem lies in the power of the body to use its normal
functions both to side-track and express emotional strains?