THE FOUNDATIONS AND AIMS OF MODERN PEDIATRICS 



BY THEODORE VON ESCHERICH 



[Theodore Escherich, Regular Professor of Children's Diseases, University of 

 Vienna; Director of St. Ann's Child Hospital, Vienna, since 1902. b. Aus- 

 bach, Bavaria, November 29, 1857. Graduate, Wiirzburg Gymnasium, 1876; 

 studied at Kiel, Strassburg, Berlin, Wiirzburg; Assistant in the Medical 

 Clinic of Professor C. Gerhardt, Wurzburg, 1880-82; Assistant, Havner Child 

 Hospital, Munich, 1885-89; Privat-docent of Children's Diseases, Univer- 

 sity of Munich, 1886-90; Special Professor of Children's Diseases, Graz, 1890- 

 1902. Member of Pediatric Society, Academy of Science, St. Louis; (Honorary) 

 Society of Swedish Physicians, etc. Author of Bacteria of the Intestants of In- 

 fants ; Croup ; Diphtheria ; Serum Therapic Digestive Disorders in Infancy ; and 

 numerous other works and papers on children's diseases.] 



PEDIATRICS, as far as it is connected with directions as to the care 

 of the new-born and nurslings, belongs with midwifery to the oldest 

 branches of medicine; but in its scientific development it is among 

 the youngest. Not until the end of the eighteenth century did it 

 separate itself sufficiently from the trammels of obstetrics to allow 

 the first independent book on the diseases of the new-born and chil- 

 dren, the well-known work of Rosenstein, to appear. This contains, 

 as do similar works which appeared in the next few years, an unsys- 

 tematic account of the diseased conditions occurring in or peculiar 

 to children, and among these only those with evident symptoms and 

 concrete changes found especial or detailed consideration. It was not 

 until the French Revolution that the new school of medicine came 

 into existence, and it we must thank for the creation of scientific 

 pediatrics as well as for the birth of modern medicine. 



We will seek to sketch in a few words the origin and changes of the 

 leading ideas up to the present time, as this best gives the trend 

 which further development will take in the near future. 



Liberation from the ban of natural philosophy and humoral 

 pathology was brought about by the sobering influence of patho- 

 logic anatomy, which pointed in no uncertain w r ay to visible changes 

 in individual organs as the origin and seat of diseases. Billard is 

 the most brilliant example of this school, which erected a clinical 

 structure as a commentary to the anatomic changes determined 

 by extremely numerous and carefully performed autopsies. 



The lesions themselves he considered in Broussais' sense only as 

 different grades of inflammation, and although to this day his work 

 is still a mine of important and useful facts, it is clear that this 

 clever conception could not by itself fulfill our practical needs, at 

 least not in childhood, where the short duration of diseases generally 

 prevents the occurrence of extreme anatomic changes, and where 

 even to-day, with the help of microscopic and bacteriologic methods, 



