478 PEDIATRICS 



we are often at a loss to bring the autopsy findings into agreement 

 with the clinical course. This lack of agreement is most marked in the 

 domain of the diseases of the gastro-intestinal tract in infancy, and it 

 was on them that the opposition, keenly led by Barrier, established 

 the "Diacrisis doctrine/' with which they steered back again into 

 the sea of humoral pathology. 



Uninfluenced by these theoretic discussions, however, both parties 

 labored to develop the new science with the newly discovered methods 

 of exact investigation of diseases and the untrod realm of statistics, 

 and thus they created the basis of a special pathology and therapy of 

 childhood, of which the work of Rilliet and Barthez forms a model 

 presentation of the whole subject. With these men the French school 

 of pediatry ceased to occupy the leading position which it had held. 

 The Vienna school became its heir just as in the realm of internal 

 medicine, where under the powerful influence of Rokitansky and 

 Skoda the same favorable conditions for development existed. Here 

 also the clinical study was mostly founded on the basis of pathologic 

 anatomy, as may be learned from the excellent work of Bednar, 

 Ueber die Krankheiten des Neugeborenen und Sauglings (On the Dis- 

 eases of New-born and Infants), and the important studies of Ritter 

 of Prague. At the same time clinical symptomatology and casuistry 

 were developed in the newly erected clinic of the St. Anna Kind- 

 erspital in Vienna under Mayr and his disciple and successor, Wider- 

 hofer, and the clinical types of disease were determined conclusively 

 from the ample material. In a similar manner worked Henoch in 

 Berlin, West in London, and Filatow in Moscow, so that at the end of 

 this period the clinical knowledge and symptomatology of pediatrics 

 were developed as far as it was possible with the simpler methods of 

 investigation. 



However important this brilliant clinical development and the 

 sharp definition of its separateness was for the recognition of pedi- 

 atrics as a distinct science, still following this direction a dead point 

 was soon reached, from which a new route had to be opened up if 

 dullness and routine were not to take the place of scientific investi- 

 gation. With this, German pediatrics in the narrower sense of the 

 word came into the foreground. At first it had to struggle with great 

 difficulties on account of the lack of separate children's hospitals and 

 of government aid, and in the first half of the century it was almost 

 entirely under French influence. Later the peculiar organization of 

 university policlinics, which were charged with the instruction in 

 pediatrics, brought it about that the care of pediatrics fell to the 

 representatives of internal medicine. I will mention here only the 

 name of Gerhardt, the founder of German pediatrics. 



It lay in the nature of this relation that in Germany, in a certain 

 contrast to the French and Austrian schools, the common points of 



