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Commentary |

Classics in Pediatrics:  A 100-Year History of Pediatrics in the United States

Jeffrey P. Brosco, MD, PhD
Arch Pediatr Adolesc Med. 2011;165(12):1064-1065. doi:10.1001/archpediatrics.2011.1070.
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We celebrated the 100th anniversary of the Archives this past year by republishing original articles that reflected key moments in the history of pediatrics. Each month a noted scholar selected a specific article and wrote a commentary placing that article in the broader context of the history of medicine. We started in the 1910s with the nation's attention to child and infant health, when our economic and military strength was threatened by infectious diseases that took the lives of 1 in 5 children.1 In the 1920s and 1930s, we witnessed the early discovery of chronic illness, as diabetes mellitus was transformed by the discovery of insulin2 and chronic orthopedic impairments emerged when lethal infectious diseases subsided.3 Widespread use of effective antibiotics4 and vaccines5 in the mid-20th century was proof that our nation's faith in scientific medicine was well placed, and by the 1960s, we hoped that even seemingly intractable conditions such as mental retardation would yield to scientific advances in understanding human metabolism.6 A peak in scientific medicine occurred in the 1970s, when the development of special care units began to yield remarkable results in survival for the smallest neonates.7 By the 1980s, psychosocial conditions such as child abuse and sexual abuse were part of the new morbidity of child health that included learning and behavioral disorders.8 Attention to poverty and environment reemerged as a common topic for academic pediatricians in the latter half of the 20th century. The 1990s brought a reconceptualization of child health, in which common aspects of chronic conditions could be studied among “children with special health care needs.”9

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