Vol. XXVII (Absorbed the Morgan County (Ill.) Medical Journal. January 1, 1903.) JANUARY 10, 1905. Papers for the original department must be contributed exclusively to this magazine, and should be in hand at least one month in advance. French and German articles will be translated free of charge, if accepted. A liberal number of extra copies will be furnished authors, and reprints may be obtained at cost, if request accompanies the proof. Engravings from photographs or pen drawings will be furnished when necessary to elucidate the text. Rejected manuscript will be returned if stamps are enclosed for this purpose. COLLABORATORS. ALBERT ABRAMS, M. D., San Francisco. ARTHUR R. EDWARDS, M. D., Chicago, Ill Mr. REGINALD HARRISON, London, England. J. N. HALL, M. D., Denver. HOBART A. HARE, M. D., Philadelphia. CHARLES JEWETT, M. D., Brooklyn. FERD. C. VALENTINE, M. D., New York. LEADING ARTICLES THE HISTORY OF PEDIATRICS AND ITS RELATION TO OTHER SCIENCES AND ARTS.* A. JACOBI, M. D., LL.D. (UNIVERSITY OF MICHIGAN AND COLUMBIA), NEW YORK CITY, Professor Emeritus, Columbia University, New York. THE most human of all the gods ever created by the fancy or the religious cravings of mortal men was Phoebus Apollo. It was he that gave its daily light to the wakening world, flattered the senses of the select with music, filled the songs of the bards and the hearts of their hearers with the rhythm and wonders of poetry, that inspired and reveled with the muses of the Parnassus, cheered the world with the artistic creations of the fertile brains and skillful hands of a Zeuxis and Phidias-he, always he, that inflicted and healed warriors' wounds and sent and cured deadly diseases. In the imagination of a warmhearted and unsophisticated people it took a Read before the Congress of Arts and Sciences, St. Louis, Mo., September 21, 1904. No. 1 god to embrace and bestow all that is most beneficent and sublime-physical, moral, and mental light and warmth; the sun, the arts, poetry, and the most human and humane of all sciences and arts, namely, medicine. Ancient gods no longer direct or control our thoughts, feelings, and enjoyments, either physical or intellectual. The kinship and correlation of hypotheses and studies, experience and knowledge are in the keeping of the philosophical mind of man, who is both their creator and beneficiary. To demonstrate this rational affinity of all the sciences and arts, some far-seeing men planned this great Congress. The new departure-in the arrangement for it-should be an example to future general and special scientific gatherings. Indeed, some of its features were adopted by the organization committee of the International Medical Congress which was to take place at St. Louis, but was given up on account of the limited time at the disposal of the great enterprise. Congresses are held for the purpose of comparing and guarding diversified interests. A free political life requires them for the consulting of the needs of all classes. Scientific congresses are convened to gather and collate the varied opinions, experiences and results of many men, and to create or renew in the young and old the enthusiasm of youth. Their number has increased with the modern differentiation of interests and studies. Specialization in medicine is no longer what it was in old Egypt, namely, the outgrowth of the all-pervading spirit of castes and sub-classifications, but as well the consequence as the source of modern medical progress. It is difficult, however, to say where specialization ends and over-specialization begins, or to what extent specialization in medicine is the result of mental and physical limitation, or of the spirit of deepening research; or, on the other hand, of indolence or of greed; or whether, while specialization benefits medical science and art, it lowers the metal horizon of the individual, and either cripples or enhances his usefulFor that is ness in the service of mankind. what medical science and art are for. José de Letamandi is perhaps correct when he says a man who knows nothing but medicine does not even know medicine. What shall we expect, then, of one who knows only a small part of medicine and nothing beyond? Congresses in general have been of two kinds. They are called by specialists for specialists, or they meet for the purpose of removing or relieving the dangers of limitation. This is what explains the great success of international and of national gatherings, such as the German, British, American, and others, and what has given the Congress of American Physicians and Surgeons with its triennial Washington meetings its broadening and chastening influence. Nor are medical meetings the only attempts at linking together what has a tendency to get disconnected. Look at our literature. The rising interest in the history of medicine as exhibited in Europe and lately also among us, and individual contributions, such as Gomperz's great book on Greek thinkers; or even lesser productions, such as Eymin's Médecins et Philosophies, 1904; or the important pictorial works of Charcot, Richet and Hollander, prove the correlation of medicine with history, philosophy and art. Our special theme is the history of pediatrics and its relations to other specialties, sciences and arts. Now Friedrich Ludwig Meissner's Grundlage der Literatur der Pädiatrik, Leipzig, 1850, contains on 246 pages about 7,000 titles of printed monographs written before 1849 on diseases of children, or some subject connected with pedology. Of these, two were published in the fifteenth century, sixteen in the sixteenth, twenty-one in the seventeenth, seventy-five in the eighteenth P. Bagellardus, de aegritudinibus puerorum, 1487, and Bartholomeus Metlinger, "Ein vast nützlich pediatric literature of Europe. In the sixteenth century, Sabastianus Austrius. de puerorum morbis, Basileae, 1549, and Hieronymus Mercurialis, de morbis puerorum tractatus, 1583, are facile principes; in the eighteenth, Th. Harris, de morbis infantum, Amstelodami, 1715; Loew, de morbis infantum, 1719; M. Andry, Porthopédie ou Part de prévenir et corriger dans les enfants les difformités du corps, 1741; Nils Rosen de Rosenstein, 1752; E. Armstrong, An Essay of Diseases most Fatal to Infants, 1768; and M. Underwood. Treatise on the Diseases of Children, 1784; also Hufeland established pediatrics as a clinical entity; while Edward Jenner, 1798, An Inquiry into the Causes and Effects of the Variolae Vaccinae, opened the possibilities of a radical prevention of infectious and contagious diseases, the very subject which, a century later, is engaging the best minds and a host of assiduous workers in the service of plague-stricken mankind. In the United States pediatrics was taught in medical schools, or was expected to be taught, by the professors of obstet rics and the diseases of women and children. The reorganization of the New York Medical College in East Thirteenth Street facilitated the creation, in 1860, of a special clinic for the diseases of the young. Instead of the united gynecologic and obstetric clinics held by Bedford, Gilman, and G. T. Elliott in their respective medical colleges, there was a single clinic for the diseases of the young exclusively. When the Civil War caused the college to close its doors forever, in 1865, I transferred the clinic to the University Medical College, and in 1870 to the College of Physicians and Surgeons. Meanwhile other medical schools imitated the example thus presented. The teachers were classed amongst the clinical professors; only in those schools which are forming part of universities and are no longer proprietary establishments, a few now occupy the honored position of full professors; in a very few the professor of pediatrics is a full member of the "faculty". It In the English colonies of America the earliest treatise on a medical, in part pediatric, subject was a broadside, 12 inches by 17. It was written by the Rev. Thomas Thacher, and bears the date January 12, 1677-8. was printed and sold by John Foster, of Boston. The title is "A brief rule to guide the common people of New England how to order themsevles and theirs in the SmallPocks, or measles." A second edition was printed in 1702. Before and about the same time in which American pediatrics received its first recognition at the hands of the New York Medical College, European literature furnished a new and brilliant special literature. France, which almost exclusively held up the flag of scientific medicine during the first forty years of the eighteenth century, furnished in C. Billard's Traite des maladies des enfants nouveau-nes, 1828, and in Rilliet's and Barthez's Traite clinique et pratique des maladies des enfants, 1838-43, standard works which were examples of painstaking research and fertile observation. England, which produced in I. Cheyne's Essays on the diseases of children, gave birth to Charles West's classical lectures on the diseases of infants children in 1848, and F. Churchill's treatise in 1850. The German language furnished a masterwork in Bednar's die Krankheiten der Neugebornen und Säuglinge, 1850-53. A. Vogel and C. Gerhardt, both general clinical teachers, gave each a text-book in 1860, Henoch in 1861; and Steffen, in 1865-70, published a series of classical essays. The number of men interested in the study and teaching of pediatrics grew in proportion to the researches and wants of the profession at large. That is why three large and influential cyclopedias, the works of many authors, found a ready market, namely, C. Gerhardt's Handbuch der Kinderkrankheiten, 1877-93; John M. Keating's Cyclopedia of the Diseases of Children, Medical and Surgical, 1889-90, and I. Grancher's and I. Comby's Traite des Maladies des Enfants, in five volumes, the second edition of which is being printed this very year. The collective and periodic literature of pediatrics began at a comparatively early time. There was a period toward the end of the eighteenth century when the influence of Albrecht von Haller seemed to start a new life for German medical literature before it lost itself again in the intellectual darkness of Schelling's natural philosophy, from which it took all the power of French enthuiasm and research, and the epoch-making labor of Skoda, Rokitansky, and finally Virchow, to resuscitate it. About that early time of Haller, there appeared in Liegnitz, 1793, a collection of interesting treatises on some important diseases of children (Sammlung interessanter Abhandlungen uber etliche wichtige Kinderkrankheiten). France followed in 1811 with a collection bearing the title: La Clinique des Hopitaux des enfants, et revue retrospective medico-chirurgicale et hygienique; publiees sous les auspices et par les medecins et chirurgiens des hopitaux consacres aux maladies des enfants. Next in order are five volumes of Franz Joseph von Metzler's Sammlung auserlesener Abhandlungen uber Kinderkrankheiten, 1833-36; twelve fascioles under the title Analekten uber Kinderkrankheiten des Kindlichen Alters; la clinique des Hopitaux des enfants, Redacteur en chef Vanier, Paris, 1841; and I. Behrend and A. Hildebrandt, Journal fur Kinderkrankhieten, which appeared regularly from 1843 to 1872. It gave way to the Jahrbuch fur Kinderheilkunde, which appeared in quick and regular succession from 1858 to the present time. Three series of Austrian journals between 1855 and 1876 consisted of a dozen volumes only. They contain among other important contributions the very valuable essays of Ritter von Rittershayn, who deserved more recognition during his life and more credit after his death, for his honesty, industry and originality, than he attained. Special pediatric journals have multiplied since. The United States has two, France four, Germany five, Italy two, Spain one. As long as they are taken by the profession we should not speak of over-production. attribute their existence to the general conviction that there is no greater need than that of the distribution of knowledge of the I prevention and cure of the diseases of the young. The literature of pediatrics, seems to prove it. Not 7,000, as before 1850, not even 70,000 titles of books, pamphlets and magazines articles exhaust the number. Pediatric societies have increased at the same rate. The American Medical Association and the British Medical Association founded each a section twenty-five years ago, the New York Academy of Medicine, in 1886. The American Pediatric Society was founded in 1889, the Gesellschaft fur Kinderheilkunde connected the German Gesellschaft der Aerzte und Naturforscher in 1883, the English Society for the Study of Disease in Children, in 1900. There are pediatric societies in Philadelphia, in the State of Ohio, in Paris, Kiew, St. Petersburg, and many places, all of them engaged in earnest work which is exhibited in volumes of their own or in the magazines of the profession. If we add the annual reports of hundreds of public institutions, which are so numerous, indeed, that a large volume of S. Hugel, "Beschreibung sammtlicher inderhelianstal ten in Europa," was required as early as 1884 to enumerate them; and an enormous number of text-books of masters, and of such as are anxious to become so, and monographs, and essays, and lectures, and notes preliminary and otherwise, which fill the magazines that most of us take or see, and some of us read-we may form an idea to what extent a topic formerly neglected has taken hold of the conscience and the imagination of the medical public. Before 1769 there was no institution specially provided for sick children. They were admitted now and then to foundling institutions and general hospitals. In that year Dr. G. Armstrong established a dispensary in London, which was carried on until he died. A similar institution was founded in Vianna by Dr. Marstalier, in 1784. Goelis took charge of it in 1794, L. Politzer developed it, and it is still in existence. Before the French Republic was strangled, it founded the first and largest child's hospital in Europe, the Hopital des Enfants maladies, in 1802. The Nicolai Hospital was established in St. Petersburg, in 1834, by Dr. Friedburg; the St. Anne's Child's Hospital, in Vienna, 1837, by Dr. Ludwig Mauthuer; and the Poor Children's Hospital, of Buda-Pesth, in 1839, by Dr. Schopf, Merei, who afterwards founded and directed the Child's Hospital of Manchester, England. Since that time the increasing interest in the diseases of children on the part of hu manitarians and of physicians and teachers has multiplied children's hospitals. Most of the are small, but they are numerous enough |