History of paediatrics

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The history of paediatrics deals with the historical development of the scientific, social and medical handling of children's diseases as well as the historical processing of knowledge about the normal development of children .

prehistory

Typical diseases of childhood such as rickets or the "water head" ( hydrocephalus ) have been passed down from the Stone Age . The latter has already been treated with an opening of the skullcap ( trepanation ), although it is unclear how high the proportion of superstition was in these interventions. Around this time people began to keep pets, making it possible to feed babies with animal milk.

antiquity

From most of the ancient civilizations, only a few reports on pediatric measures have survived. Most of them are evidence of the influence of magic and belief in demons on medicine at that time. The interest in baby care is evidenced by many sculptures from ancient Egypt. The Ebers Papyrus also describes some remedies for various disorders. In Brahmanic writings from India from around 500 BC. Chr. Measures for the care of the newborn are already described in great detail. A doctor examined the newborns for viability. This is probably the first historical evidence of a perinatological examination. Among the childhood diseases, dizziness, migraine , epilepsy , tetanus , smallpox , cholera , malaria , various skin diseases and intestinal parasites have already been mentioned in the medical writings. Even various surgical interventions in children are attributed to the legendary doctor Jiwaka , who can be considered the first "pediatrician". Almost 200 pediatric remarks by Hippocrates have come down to us from ancient Greece . There are very precise descriptions of febrile seizures, epilepsy ( About the Sacred Disease ) or mumps, including a description of testicular inflammation as a complication in adults. Aristotle made the observation that "most infants die before they are seven days old". Soranus of Ephesus (98–117) wrote his main work on gynecology . However, this contains 23 chapters on newborn hygiene, infant feeding, weaning, some infant diseases and other pediatric topics. So you can see him as the father of paediatrics.

middle Ages

Above all, the Persian doctor Rhazes (865–923) devoted several chapters to paediatrics in his medical treatises. When he was translated into Latin, his findings also reached Western Europe. The main topics dealt with here are diseases of the scalp, water head, sneezing, sleep disorders, epilepsy, earache, strabismus, toothache, mouth rot, vomiting, cough, diarrhea, constipation, worm diseases, fractures, bladder stones and paralysis. There are also differentiated descriptions of measles and smallpox. Avicenna (980-1037), another important doctor of the Middle Ages, wrote about newborn care, infant nutrition and various diseases in infancy, such as rhinitis, urinary pressure, anal prolapse and intertrigo . With the increasing Christian influence in Byzantium and Europe, efforts arose to counter the abandonment of children. After foundlings were first brought to church, the first facility for foundlings was probably built in Milan in 787, in which pregnant women who wanted to abandon their children were accommodated before they were born. The children were then raised there until they were seven years old.

Renaissance

The invention of the printing press by Gutenberg marked the beginning of the Renaissance , along with the fall of the Eastern Roman Empire . At the same time, it enabled the publication of numerous medical books, including, for the first time, those that were entirely or largely devoted to pediatrics. The Italian Paulus Bagellardus (also: Paolo Bagellardi a Flumine) published the first printed book on paediatrics in 1472, the Libellus De egritudinibus infantum et eorum remediis , a work written in Latin and intended primarily for medical professionals. In 1473 the first German-language treatise on paediatrics appeared: A Regiment of Young Children by Bartholomäus Metlinger . This divides paediatrics into the two periods from the earliest age to learning to walk and speak, and childhood up to the seventh year. Later works are sometimes more extensive, but only a few cite less known authors from the Middle Ages in addition to the sources of classical scholars (Galen, Avicenna, Rhazes). In the 16th century, the Italian professor published Hieronymus Mercurialis with De Morbis Puerorum Tractatus that probably best known and most independent pediatric textbook of the era, see which among other interesting knowledge about language disorders. Later the same author published a smaller volume on the hygiene and upbringing of babies. The German Hieronymus Reusner first described cases of rickets in 1582 . In the first French treatise on paediatrics by Simon de Vallambert (Poitiers, 1565), the chapter on purple fever may be the first description of scarlet fever . Felix Würtz wrote his “Children's Booklet” in the 16th century, which was published posthumously in 1612 by his brother Rudolf. In this influential and widely translated book, Würtz examined the tight swaddling of babies at length and questioned certain extreme forms of this practice.

Transition from the Renaissance to the Modern Age: the 17th and 18th centuries

Cover picture of a work on rickets from the 17th century

The 17th century heralds the age of physiology and embryology with the discovery of blood circulation and the invention of the microscope . The doctors' considerations now went beyond a pure description of symptoms. Independent clinical pictures were more and more differentiated from one another. This applies in particular to the infectious diseases that are still known today as childhood diseases. For diphtheria, not only was the uniform development of the various symptoms recognized and described, but a treatment option was also developed with the tracheostomy ( tracheotomy ). Scarlet fever, rubella and chickenpox were for the first time differentiated from other clinical pictures as disease units. Among the non-infectious diseases that were typical of childhood, rickets and pyloric stenosis in infants were clinically recognized. With the development of the smallpox vaccination - initially from arm to arm - by Edward Jenner at the end of the 18th century, the cornerstone was finally laid for preventive medicine from which children in particular should benefit. Despite all these achievements, the under-two-year mortality rate remained very high at around 40%.

The modern: the 19th and 20th centuries

After children and adults were housed in the same rooms in previous epochs, it was recognized in the late 18th and early 19th centuries that children are not just little adults and have their own diseases or react differently to diseases. Wards for children were increasingly being set up, and children's hospices and hospitals opened their doors. This was evidently progress, but the unhindered spread of infections in the thirty to forty bed common rooms and the separation of the children from the familiar surroundings resulted in new abuses. Integrating hygienic considerations into everyday clinical practice was not a matter of course everywhere at the turn of the century.

Otto Heubner

From internal medicine, pediatrics developed as a separate subject, initially under strong opposition from established medicine. In 1850 Franz von Rinecker opened the first, if only 17 years independent, university children's clinic in Würzburg and was named as a “public professor of childhood diseases”. In 1895 a full professor of paediatrics was finally appointed again in the person of Otto Heubner , head of the Charité 's children's clinic . The subject was thus established academically in Germany. Heubner's successor, Adalbert Czerny , founded the international pediatric school there. In the United States , where pioneers such as Abraham Jacobi and L. Emmett Holt worked, independent pediatrics had already emerged in the 1860s.

In Germany it was the discovery of antibiotic therapy and the development of further vaccinations that led to a significant upturn. The introduction of pasteurized milk and advances in dietetics pushed nutritional disorders into the background. Improved monitoring of pregnant women and women giving birth, as well as increased concern for newborns, has further reduced child mortality considerably, at least in developed countries.

Pediatrics owe more than any other discipline to the German Jews . In 1933, 773 of 1,418 pediatricians were “Jews” within the meaning of the Nuremberg Laws and 794 paediatricians, more than half, were expelled, deported or murdered during the Nazi era . The Freiburg medical historian Eduard Seidler has been working since the 1990s to review the résumés of persecuted paediatricians, and with the support of the German Society for Child and Adolescent Medicine , these fates could be made accessible online.

See also
Albert Eckstein
Hugo Falkenheim
Curt Falkenheim

In 1920 the Hungarian pediatrician Johann von Bókay commented on the development of paediatrics:

"In the beginning, the development of pediatrics found no rose-strewn, smooth paths anywhere, but had a difficult, thorny path to tread, and it could only progress slowly, from step to step."

Individual evidence

  1. ↑ Otto Kohlschütter , Mittheilungen über Kinder-Heilanstalten, using Franz S. Hügels "Description of all children's sanatoriums in Europe" (Vienna 1849) , in: Annalen der Staatsarzneikunde, Vol. 8 1850, pp. 21-52, [1 ]
  2. ↑ Martin Sperling: Specialization in medicine as reflected in the history of Würzburg. In: Würzburg medical history reports. Volume 3, 1985, pp. 153-184, here: p. 162.
  3. ^ Johannes Oehme: First ordinaries for paediatrics. In: The pediatrician. Volume 23, 1992, pp. 693 f.
  4. ^ Gundolf Keil: 150 years of the University Children's Hospital in Würzburg. In: Würzburg medical history reports. Volume 21, 2002, pp. 37-42, here: pp. 38-41.
  5. ^ Gundolf Keil : Pediatrics. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Encyclopedia of medical history. Walter de Gruyter, Berlin and New York 2005, p. 743.
  6. ^ Eduard Seidler: Persecuted paediatricians 1933-1945: Disenfranchised - fled - murdered . Bouvier-Verlag 2000, ISBN 978-3-416-02919-3
  7. ^ German Society for Child and Adolescent Medicine: Jewish Pediatricians 1933-1945. Disenfranchised - fled - murdered , accessed online on December 8, 2018
  8. ↑ Bókay, v. J .: History of Pediatrics, Springer Verlag, Berlin 1922

literature

  • Samuel Kotek: History of Pediatrics from its Beginnings to the End of the 18th Century. In: Illustrated History of Medicine. 1986, pp. 4899–4954 (special edition in 6 volumes: Volume V, pp. 2428–2452).
  • N. Neimann, M. Pierson: History of paediatrics in the 19th and 20th centuries. In: Illustrated History of Medicine . 1986, pp. 4955-4991.
  • Johannes Oehme: The pediatrics of Friedrich Hoffmann with special consideration of the dissertation Praxis clinica morborum infantum (1715) by Martin Geiger. In: Würzburg medical history reports. Volume 14, 1996, pp. 427-439.
  • Albrecht Peiper : Chronicle of paediatrics , Thieme, Leipzig 1951; 3rd edition ibid 1958; 4th, exp. und umgearb., ed. ibid. 1966; Reprints Stuttgart 1992 and 1996.
  • Albrecht Peiper: Sources for the history of paediatrics. Bern and Stuttgart 1966 (= Huber's classics of medicine and natural sciences , 7)
  • Daniel Schäfer: The role of the medical humanists in the cultural transfer from the ancient world to the renaissance using the example of early pediatrics and geriatrics. In: Institute for European History (Mainz) (Ed.): European History Online . Accessed November 11, 2011.
  • Eduard Seidler : Jewish paediatricians 1933-1945 - disenfranchised, fled, murdered . 2nd edition, Karger, Basel 2007, ISBN 978-3-8055-8284-1 .
  • Klaudia Tomasevic: The medical care of children in the middle of the 19th century using the example of Würzburg , Königshausen and Neumann, Würzburg 2003, ISBN 3-8260-2686-1 (Inaugural dissertation for obtaining a doctorate from the Medical Faculty of the Bavarian Julius-Maximilians University of Würzburg, January 2002, 134 pages with illustrations and graphics, 21 cm, 280 g; as an online dissertation: University Library Würzburg 2002, full text online PDF, free of charge, 138 pages, 3.5 MB, DNB 969663900 ).
  • Christoph Weißer: Pediatric surgery. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 740 f.
  • Gundolf Keil: Pediatrics (Antiquity and Middle Ages). In: Encyclopedia of Medical History. 2005, pp. 741-743.
  • Josef N. Neumann: Pediatrics (modern times). In: Encyclopedia of Medical History. 2005, pp. 743-749.
  • Susanne Hahn: Pediatric Cardiology. In: Encyclopedia of Medical History. 2005, p. 749 f.