Wayne State University School of Medicine - Yearbook (Detroit, MI)

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gl T: 1 .1 M ' I Q Michael P. Goodman Arthur A. Gorman I L, , Susan Gorman Stephen Goryl Michael Gottfurcht P 5 -.-s '-5. . . .Y

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,Ji il 'TV' -r sif5FT:l1f.i T... f-' Y tfftfi .ji ' ' The Bettmann Archive Children's Clinic at the New York Polyclinic School of Medicine, 1890. The medical care of children is characterized by peculiarities not encountered to major degree in other areas of practice. First can be mentioned the phenom- enon of growth itself with all of the metabolic, nutri- tional, and environmental strains it entails. Our civiliza- tion was surprisingly slow to appreciate the fascinating biologic and philosophic problems imposed by growth in Man where some 30lXJ of life span is devoted to reaching maturity. In our heritage probably Francis Galton, one of the great mathematicians and human biologists of the 19th century, is foremost in constructing concepts upon which we base present day studies. Second has been the impact of contagious disease on childhood. Only a century ago we could look upon the adult population literally as those who had contended, more or less successfully, with the various enanthems and exanthems of childhood. While Jenner had pointed the way before the beginning of the 19th century, we owe to Louis Pasteur, and thc giants he stimulated, our greatest debt. Understanding a problem is but a fraction of success without implementation and application. It is here that our heritage widens to encompass a myriad of workers, both medical and lay, who pushed pure milk, better facilities for hospitalization, compulsory vaccina- tion, free diphtheria antitoxin, and the many other ad- vances which reduced the risks of childhood much more dramatically than any active therapeutics. Of the 42 men who founded the American Pediatric Society in 1888, over half were active participants in these public health measures and some of the more militant-Victor Vaughn, Abraham Jacobi, and L. E. Holt, for instance, -were the real founders of modern preventive medicine. Third among childhood problems is nutrition. The fact that we, here at Children's, can rarely show rickets, scurvy, or protein deprivation to our students, should not detract from the issue that this, globally, is still the major pediatric problem. Chemical studies of cows milk, late in the last century, prepared the way for present day feeding practices while education has resulted in almost universal administration of accessory substances, especially vita- mins C and D. Parenthetically we appear to have reached a complete roadblock in the prevention of iron deficiency anemia and possibly a study of the methods of our fore- bearers and application of these will be the answer. The last three major areas of conventional pediatric problems are the prevention and correction of congenital defects including inborn metabolic anomalies, minimiza- tion of problems connected with birth, and a better understanding and control of the childis relations and position in the home and community. Our heritage varies in each category. Garrod, an English pediatrician, estab- lished current principals for understanding and investi- gating metabolic defects over a half a century ago but we have made little progress toward treatment and even less in prevention. Some of the most ingenious advances in surgery have been achieved through consideration of anatomic abnormalities and yet we have done little toward a better basic understanding of abnormal devel- opment. The less said about our heritage and present practices centered around the newborn, the better, this country ranks low high on the list of civilized nations where prevention of infant mortality in prematurity is concerned. Finally, we are seeing a multidiscipline approach to sociologic, psychologic and educational problems of childhood truly reminiscent of our heritage in the battle for safe milk and water. Time will tell whether we can be as successful as these earlier crusaders. 75

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a J 4 -5 3 -I 1 if? ' ' Q ii: 2 L' ,li ' ' , 1-1 I I, X - Nl w A L14 Dennis H. Grant Leonard L. Griffiths , Gay. 'ir Leonard A. Haduck ' 5' , l ' i , 31 I Q V W- 1 , - . AL D. L Nikolas F. Hansen Terry K. Hargrove .T x. 1 -t xl. J