GENERAL PROPHYLAXIS IN DISEASES OF CHILDREN prophylactic measures every physician should endeavor to protect from danger and disease those intrusted to his care and should consider it his foremost duty to cooperate in the great questions of hygiene, not only in public life, but especially in the smaller circle of his activities as family adviser. The children's physician is called upon, in exceptional measure, to give advice to mothers in regard to the care of the child's health and to offer his knowledge and experience in its behalf, so that the innumerable dangers which threaten its health and life may be warded off, and an existing predisposition may early be combated and suppressed, thereby bringing about the conditions neces sary for perfect health. By collating the numerous data gathered from the observation of the child in health and sickness, valuable indices for the prophylactic rules and measures may be obtained.
The slow growth and development of certain organs and systems in infancy and early childhood, especially the digestive apparatus and the osteal and nervous systems, which have not yet attained the adult type; and the fact that in the early years of life the skin and mucous membranes, because of their greater susceptibility to infections and poisons, are a fruitful field for the various injurious influences which are always at work, compel the physician to give these organs particular care and attention in his endeavor to preserve their normal function. In much the same way, great vigilance is demanded of the pediat rist during the mental and physical development of the child, in ward ing off the dangers to various organs (e.g. the heart and the vascular and nervous systems), due to their inability to meet the demands made upon them, as at the beginning of school life and puberty,—epochs when the damage to them would he serious and perhaps permanent. The children's physician must therefore exert the utmost endeavor to minimize the dangers attending the frailties of this early period, brought about by rapid development and the school.
All the hygienic measures which serve as guides to the preserva tion of health in adults may be applied in childhood, in a slightly differ ent manner, and, usually, with inure care. The elements from which
these general rules are derived depend upon the proper carrying out of principles of the utmost cleanliness (asepsis), particularly in the care and feeding of the child; the younger the individual, the greater is the role played by it. Plenty of sunlight and clean fresh air are necessary, with protection front extremes of temperature, particularly against the sudden and abrupt changes in temperature which are so prolific a source of catarrhal colds. And not of least importance among these general measures for health is the careful and rational nourishment of the child, which can be accomplished by utilizing our experience and our knowledge of physiological principles based upon the course of development of the child and observation of its metabolism. It should also be our duty, in similar fashion, to build tip systematically the bodily strength and develop harmoniously the mind and intellect.
The manner in which general hygienic measures may be carried out depends very largely upon the environment in which the individual lives. The more favorable the material condition of the parents the more favorable is the hygienic condition of the child's life likely to lie. Poverty and affluence play an extraordinarily important part, particu larly in regard to the abode and food of the child. It is generally well known, and proved by statistics, that in the crowded quarters of the poor, where the living rooms are ill ventilated, the water supply is insufficient, and the food-stuffs are not beyond criticism, the infant mortality and the spread of epidemics and morbidity among children are much greater than in those quarters where the people are in better circumstances. Similarly, the care which is taken of the child, as well as the carrying out of the measures which make for its physical and mental growth, depend upon the circumstances of the parent or guardian.