492 PEDIATRICS 



use. On the other hand, the smallness and transportability of the 

 childish body, the comparatively easily overcome resistance, and 

 the lack of anxiety from preconception, afford in many cases a 

 desirable ease of application. 



I cannot go into details in the subject of therapy. Only in gen- 

 eral I may say that of the flood of medicaments which has in the 

 last few years been thrown on the market by chemic industry, only 

 a few have found a lasting place in pediatrics. The use of medicines 

 is becoming justly more and more limited, and replaced wherever 

 possible by physical and dietetic methods of treatment, which by 

 long and consistent use have given brilliant results. 



We may expect a really curative effect only from those meas- 

 ures which stimulate further, or replace the naturally powerful 

 healing processes of the childish organism, as is strikingly done by 

 the diphtheria antitoxin prepared by Behring. Here the pediatrists 

 who generally are forced to travel in the beaten tracks of internal 

 medicine, were in a position to take the leading role in the testing 

 and recommending of this precious agent. A second method of 

 treatment also used in diphtheria may here be mentioned, for the 

 introduction of which the pediatrists exclusively are to be thanked. 

 I refer to intubation, recommended by your genial and modest 

 countryman, O'Dwyer, which has made the bloody operation of 

 tracheotomy superfluous in the largest number of cases. 



The greatest difference between the therapeutic problems of 

 the pediatrist and those of the internist lies in the overwhelming 

 importance and development of prophylaxis. The word prophy- 

 laxis in this sense is to some extent synonymous with care, inas- 

 much as in the education of the child because of its lacking self- 

 determination, experience, and regulating methods, care must 

 not only satisfy its bodily needs, but also guard it from all threat- 

 ening dangers. To bring this about, the experience of adults and 

 the general rules of hygiene, however, do not suffice. It requires 

 special individual instruction, which can only be given by a pedia- 

 trist cognizant of the laws of child development, and carried out 

 by persons trained in them. Clinical experience and medical sta- 

 tistics show that nothing influences the mortality and liability to 

 disease in childhood as much as a carefully conducted manage- 

 ment by experts, and in this way most if not all sicknesses may 

 be kept away, at least in young children. Pediatrists have always 

 known the great importance of protecting care, prophylaxis, even 

 if only the magnificent acquisitions of the last few decades have 

 shown them the proper way. We will attempt to sketch in a few 

 words the most important axioms of prophylaxis for the different 

 periods, and at the same time to touch on some of the questions 

 which are still unsettled. 



