Children's Ailments A PARENTAL victim of " children's ailments "
gave utterance in the Spectator, not long ago, to the feelings of millions of parents. Here are these wretched infections, apparently inevitable, one following another, costing time and trouble and money and anxiety, often leaving deplorable sequelae in the ears and else- where, whilst the medical profession appears to take them for granted, has no remedies, no suggestions, and is seemingly lacking in any interest in the subject. The indictment is formidable.
In considerable measure the charge is true. These diseases are not profitable to the profession. The ambi- tious young practitioner will make money and titles in surgery, or in the intensive study of the maladies of elderly wealthy men, whereas the laboratory or clinical study of measles, whooping-cough, mumps, chicken-pox, and the rest, offers very few rewards of any but the most truly exalted, not to say ethereal kind. Now that we are beginning to understand the importance of early developmental years, now that the ideal of medical science is coming to be perceived as the making and maintenance of fine men and women, and now that the number of children born has immensely declined, the real import- ance of children's ailments is beginning to be perceived. In this brief article, the essentials of the reply, as I see it, to the victimized and naturally indignant parental reader, will be stated under two heads : first, bacterio- logical, which is technical, expert, complex, largely uncertain and prospective ; and, second, domestic- scholastic, simple, evident, easy, certain and immediate.
Bacteriological or immunity methods have done much and will do more. The first place is taken by vaccination against small-pox, which was the scourge of infancy until Jenner's day in our country, and is so still wherever vaccination is not practised. Then, at the end of the nineteenth century, came the antitoxin treatment of diphtheria. Pasteur, who died in 1895, lived just long enough to see the first few thousand children thus saved. Much more recently, the antitoxin treatment has been
• M. Venizelos, although born in Crete, comes of en old family of Sparta.
extended in such wise that preventive doses of prepara- tions derived from the diphtheria bacillus may be used for the protection of children. The results have been and are magnificent.- We can largely achieve the preven- tion of diphtheria. Alas ! that in this field our own country should lag so far behind the United States. 'The theme is large and fascinating, and can only be named at this moment. Also to the United States we owe great advances in respect of the control of scarlet fever ; and in this field also we lag behind in this country. Very recently, admirable results in the treatment of measles have been obtained by the curative administration of blood serum from someone who has had the disease and has recovered from it. Many very delicate children, of the type who so often succumb to measles, have been, and are thus being, saved. Far more will be achieved on these lines when those who control medical education in this country require that the study of the health and the diseases of children shall take, in the medical curri- culum, the primary place which belongs to it by natural right and evident logic. At present a perfunctory summer course of a few weeks, as an alternative to " ear, nose and throat," or " eyes," or " medical electricity " or what-not, is all that we find by way of recognition of children's ailments in the medical schools. But it is several scores of years since most of the members of tiro General Medical Council were children, and everyone knows the kind of work that mostly interests them and occupies their sessions. The name of Dr. Axham is not yet forgotten. When at last the existing medical curri- culum is fundamentally remade, the health and diseases of children will be recognized as cardinal, together with the health and diseases of maternity, at present most calamitously subordinated, as we saw in a recent article.
But no future discovery, in any laboratory or hospital, will ever compare in value with an utterly simple and certain truth, already fully known and proved by a tiny handful of pioneers in many parts of the world. The domestic-scholastic truth is simply this : the infec- tious diseases of children are conveyed in conditions of shadow and crowding. They are indoor diseases. They are amongst that vast and deadly category to which a decade ago I gave the name, now in general use, the diseases of darkness. The proofs are manifold and extensive. Here only two kinds of evidence need be quoted.
The first is that these children's epidemics do not occur at the school in the sun, which Dr. Rollier started near Leysin in 1910, and about which I have written and lectured, here and elsewhere, incessantly, for the past seven years. His experience has been repeated wherever children have been cared for under conditions of open air and sunlight, whether in this country or elsewhere, The democratic idea that what one has all should have becomes criminal when we apply it, as we do, to children's diseases, taking the susceptible and the infected out of the antiseptic sunlight and the moving open air, which would respectively destroy and dilute the infective agents, and crowding them together so that everything which leaves the nose and throat of any will shortly be dis- tributed to all. The next generation will think all this as wicked and palpably idiotic as we think the treatment of consumption in the middle of the nineteenth century, or the treatment of the insane until the day of Pinel and Tuke.
The other piece of evidence is recent, English - and official. It shows that the distribution of infection varies with the distance between the cots or beds-of boys in, for instance; naval institutions. The -more room the less disease. The moral is that everyone should have a bed- to himself or herself; and, better -still, a bedroom,. But, evidently, here is a theme for a separate article and I _must make an end. • We shall continue to destroy or damage immense hosts of our children everywhere so long as we imprison the healthy in crowded shadow in house or school, calling the process education, and then imprison the ill, thus made ill, in crowded shadow in hospitals, calling the process medicine. Children were not meant to live in prisons, whether called houses, schools or hospitals, but in gardens. Go to Chailey and learn from Mrs. C. W. Kimmins, or to Deptford and learn from Miss Margaret McMillan, or to Leysin and learn from Dr. Bonier, if you doubt : and you will doubt no longer.
The alternative is the pseudo-charitable cruelty and imbecility of covering the entire country with children's hospitals. And in England now there are hundreds of thousands of persons interested in one way and another in children and hospitals, their extension and maintenance: but only two persons entirely devoted to teaching the saving truths about air and light—a world-famous laboratory student, and the present CRUSADER.
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