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PEDIATRIC AS A SCIENCE
The major developments in pediatrics, the special branch of medical science that deals with the prevention and treatment of diseases of children, took place after the turn of the 20th century. Prior to that time there existed but little exact knowledge of the special problems of child health. Infants and young children were regarded merely as miniature adults whose physical, mental and emotional disorders required no special consideration beyond that afforded mature persons.
As a result of this attitude and the undeveloped state of medical science and practice, the incidence of disease and mortality rates among children were appalling: 20% to 40% of all infants born alive died during the first year of life. Of the total deaths in the entire population 3 out 4 occurred in children under 12 years. However, as a result of revolutionary advances in the field of pediatrics and intensive application of sound public health principles, death rates among children in the more advanced parts of the world had been reduced.
One of the most important steps in the progress of modern pediatrics was the recognition by medical practitioners of certain fundamental differences between the child and the adult. Because of his state of immaturity, the infant or young child differs from the mature person physiologically, psychologically, immunologically and anatomically. The constant changes in functional patterns incident to growth and development impose different standards for health appraisal and for nutritional medicinal and other health requirements in the very young throughout the wide range of diseases affecting infants and children, the concept of prevention predominates that the treatment in the mind of the properly oriented physician.
Fortunately, advances in the sciences of genetics, nutrition, microbiology, immunology, epidemiology, hygiene and sanitation made it possible for medical practitioners and public health officers to exercise a large measure of control over many of the most devastating physical diseases. Improvements in diagnostic laboratory techniques together with revolutionary developments in pediatric surgery and treatment with drugs and immune blood serums reduced the dire effects of certain nonpreventable diseases to a minimum as well.
The diseases that affect infants and children may be classified according in the nature of their cases, the particular organ systems primarily involved or a combination of these methods.
Since pediatrics is based upon the concepts of growth and development of the individual, the pediatric physician must take into account all factors known to influence the orderly course of these normal processes from the moments of conception throughout the periods of infancy, childhood, and adolescence. For example, such determining factors as heredity, prenatal influences (including maternal illness) and injuries incident to the process of birth explain most cases referred to as diseases of the newborn.
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