HISTORY OF PEDIATRICS 507 



which are seen in the newly-born, is made up mostly of develop- 

 mental diseases, scrofula, rachitis, chlorosis. The actual or 

 alleged ailments connected with dentition, most forms of stomatitis, 

 Bednar's so-called aphthae, the ulceration of epithelial pearls along 

 the raphe, amygdalitis, pharyngitis, adenoid proliferations, latero- 

 and retro-pharyngeal abscesses belong here. Infectious diseases, 

 such as variola, diphtheria, scarlatina, measles, pertussis, and 

 tuberculosis of the glands, bones, joints, and peritoneum, have 

 been most successfully studied by pediatrists or those clinicians 

 who have paid principal attention to pedology. Meissner prints the 

 titles of more than 200 actual monographs on scarlet fever pub- 

 lished in Europe before 1848. Pleurisy and pneumonia of the young 

 have their own symptomatology. Empyema is more frequent and 

 requires much more operative interference. Tracheotomy and 

 intubation are mostly required by the young, both on account of 

 their liability to edema of the larynx and to diphtheria, and of the 

 narrowness of the larynx. Of invagination, 25 % occur under one 

 year, 53% under 10. Appendicitis, sometimes hereditary and a 

 family disease, would long ago have been recognized as a frequent 

 occurrence in the young if it had not been for the difficulty, mainly 

 encountered in the young, and sometimes impossibility of its diag- 

 nosis. That is what we have been taught by Hawkins and by Treves, 

 and lately by McCosh. Operations on glandular abscesses, osteo- 

 tomies, and other operations on the bones and joints, particularly 

 in tuberculosis, and on malformations such as have been men- 

 tioned, require the skillful hand of the operating physician in a 

 great many instances. Omphalocele, exstrophy of the bladder, 

 undescended testicle, spermatic hydrocele, multiple exostoses, 

 imperforate rectum, atresia of the vagina, or an occasional case 

 of stenosed pylorus, belong to that class, some requiring immediate 

 operation, some permitting of delay. It is principally infancy that 

 demands removals of angioma, which are almost all successful, 

 and of hygroma, mostly unsuccessful, mainly when situated on 

 the neck and resulting from obstruction of the thoracic duct some- 

 times connected with thrombosis of the jugular vein. Childhood 

 requires correction of kyphosis and scoliosis, and operations for 

 adenoids and hypertrophied tonsils, and furnishes the opportuni- 

 ties for lumbar puncture and laparotomy in tubercular peritonitis; 

 also supra-pubic cystotomy, and mastoid operations. That gum- 

 lancing is no operation indicated or permissible in either the young 

 or adult, and not any more so in the former than in the latter, is 

 easily understood by those who acknowledge its necessity only in 

 the presence of a morbid condition of the gums or teeth, and not 

 when the physiological process of dentition exhibits no anomaly. 

 It scarcely ever does. Altogether operating specialists would w r ork 



