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pediatrics(pēdēă`trĭks), branch of medicine dedicated to the attainment of the best physical, emotional, and social health for infants, children, and young people generally. Pediatrics became a specialty in 1930 when the American Academy of Pediatrics was founded with the idea that children have special developmental and health-care needs. Pediatricians devote much of their time to regular health examinations, as well as to preventive medicine and health practices. They routinely immunize children against such infectious diseases as influenza, meningitis, measles, mumps, and chickenpox. In addition to their immediate health-care duties, pediatricians act as advocates for children in endorsing public education, access to health care, and services to children. These measures have led to better development and health of young people as well as a dwindling of morbidity and mortality rates. The American Academy of Pediatrics maintains 41 sections consisting of members who have interests in specialized areas of pediatrics such as immunology, adolescent health, cardiology, emergency medicine, surgery and diseases of special organs and systems. A number of surgeons specialize in pediatric surgery, and pediatricians known as neonatologists specialize in the care of premature babies, critically ill children, and those with congenital malformations.
See historical study by S. Halpern (1988).
a medical discipline that studies the anatomy and physiology of children and the nature, treatment, and prevention of children’s diseases. Childhood and adolescent hygiene studies living conditions that promote the successful development of the physical and mental faculties of children.
Pediatrics took shape as an independent clinical discipline in the second half of the 19th century, although advice on the feeding and care of children and treatment of some children’s diseases can be found as early as the works of Hippocrates, Soranos of Ephesus, Galen, Chang Chung-ching, and Avicenna. The first books devoted specifically to child pathology appeared in Europe between the 15th and 17th centuries. In the 18th century, the British physicians W. Cadogan, G. Armstrong, M. Underwood, and E. Jenner made major contributions to the development of pediatrics. The first children’s hospitals, which were staffed by the first specialists in children’s diseases, were organized in the early 19th century. The school of pediatricians that was based in Paris, whose adherents included N. Jadelot, L. Guersant, and M. Billard, was the European center for training pediatricians until the end of the 19th century. Schools of pediatric thought arose in other countries in the early 20th century, including the school of W. Mautner and F. Mayr in Vienna and that of J. Camerer and his colleagues in Germany. These were followed by similar schools in the Scandinavian countries, Italy, the United States, and Canada.
In Russia, the first research on health care for children was conducted by S. G. Zybelin, N. M. Ambodik-Maksimovich, N. I. Novikov, and K. I. Grum. In 1836 the first Russian pediatrician, S. F. Khotovitskii, taught a complete course in children’s diseases in the St. Petersburg Medical and Surgical Academy and wrote the first textbook on the subject, Pediatrics, which was published in 1847. The first children’s hospitals—the Nicholas Hospital in St. Petersburg and the Olga Hospital in Moscow—were opened in 1834 and 1842, respectively. In 1869 the Medical and Surgical Academy officially established Russia’s first department of children’s diseases, which was headed by V. M. Florinskii from 1865 to 1870, N. I. Bystrov from 1870 to 1896, and N. P. Gundobin. In 1869, K. A. Raukhfus built the world’s first hospital designed specifically for the care of children in St. Petersburg. He also organized the First All-Russian Congress of Pediatricians in 1912. In 1866, N. A. Tol’skii established a children’s clinic at Moscow University that later became a center of pediatrics; such noted physicians as A. N. Filippov, N. S. Korsakov, and N. F. Filatov, the father of clinical pediatrics in Russia, worked there. The first societies of pediatricians were organized on the initiative of Bystrov in St. Petersburg (1885) and Filatov in Moscow (1892).
The organization of the children’s health care system was radically changed after the Great October Socialist Revolution. Pediatrics was gradually divided into separate and narrower specialties. An extensive network of institutions for the prevention and treatment of children’s diseases was created. Research institutes and the world’s first departments for training pediatricians were organized. For instance, the department of pediatrics at the Second Moscow Medical Institute was established in 1930. State systems for the care of mothers, children, and adolescents were created in the early days of Soviet power. They helped to greatly reduce the incidence of child mortality.
Whereas only 19,000 pediatricians were working in the USSR in 1940, more than 84,000 were working by 1973. Research is conducted at the Institute of Pediatrics of the Academy of Medical Sciences of the USSR, at 14 republic institutes of pediatrics, and in about 300 pediatrics departments of medical institutes and universities. The world’s first nationwide system for prenatal care was created in the USSR. Every child is under the supervision of a district physician from birth to about age 15. A child can receive care in a consultation clinic, special children’s hospital, or sanatorium. An extensive network of facilities for children exists, including kindergartens and nurseries, forest schools, Pioneer camps, and children’s playgrounds and playing fields.
Soviet pediatricians have contributed much to the growth of pediatrics; the most famous include G. N. Speranskii, V. I. Molchanov, A. A. Koltypin, and A. A. Kisel’, as well as M. S. Maslov, Iu. F. Dombrovskaia, A. F. Tur, and O. D. Sokolova-Ponomareva. The organizers of the children’s health care system include Z. P. Solov’ev, V. P. Lebedeva, O. P. Nogina, V. M. Velichkina (Bonch-Bruevich), and D. K. Skorniakova.
Urgent problems in pediatrics include reactivity of the growing child in health and sickness, children’s reactions to immunologic preparations, and elucidation of the etiology of chronic children’s diseases. Other areas of interest are the mechanisms and residual effects of disturbances in the interaction of mother and fetus and the most efficient ways of providing specialized care for children. Among the best known foreign pediatricians are G. Fanconi and A. Wallgren in Sweden, D. Nelson and B. Spock in the United States, G. de Toni in Italy, M. Lelong in France, B. Bratanov in Bulgaria, J. Houštek in Czechoslovakia, E. Kerpel-Fronius in Hungary, M. Mikhalo-wicz in Poland, and P. Peiper in East Germany. The All-Union Society of Pediatricians was organized in 1925 and joined the International Paediatrics Association (founded 1950) in 1955.
The specialized Soviet journals in pediatrics include Pediatriia (Moscow, since 1934), Pediatriia, akusherstvo i hinekolohiia (Kiev, 1938–40; published as Okhorona materynstva i dytynstva since 1945), and Voprosy okhrany materinstva idetstva (Moscow, since 1956). The most important foreign journals are American Journal of Diseases of Children (Chicago, since 1911), Pediatrics (Evanston, Ill., since 1948), Archives of Disease in Childhood (London, since 1926), Pédiatrie (Lyon, since 1912), Pediatria Polska (Warsaw, since 1949), and Československá pediatrie (Prague, since 1946).
REFERENCESKonius, E. M. Istoki russkoi pediatrii. Moscow, 1946.
Speranskii, G. N. Moskovskie pediatricheskie shkoly. (Historical survey.) Moscow, 1949.
Fankoni, G., and A. Walgren. Rukovodstvo po detskim bolezniam. Moscow, 1960. (Translated from German.)
Mnogotomnoe rukovodstvo po pediatrii, vols. 1–10. Edited by Iu. F. Dombrovskaia. Moscow, 1960–65.
Gol’dfel’d, A. Ia. Ocherki po istorii pediatrii v SSSR. Moscow, 1970.
Manannikova, N. V. Okhrana zdorov’ia detei v SSSR. Moscow, 1973.
M. IA. STUDENIKIN