INTRODUCTION

Abstract

One of Saul Krugman's favorite photographs recalls the day in 1965 when he handed his predecessor at New York University, L. Emmett Holt, Jr., a copy of the Festschrift in his honor. Some 25 years later, it is our privilege to similarly honor Saul. It continues a long tradition at Bellevue Hospital. A Festschrift was dedicated to Abraham Jacobi, the first Director of Pediatrics, some 100 years ago. Tradition plays an important role in Saul Krugman's life and in the history of medicine in New York City. New York hospitals have long been involved with the sequestration and care of patients with infectious diseases. In fact, many municipal hospitals were established because of epidemics of smallpox, measles, typhus, yellow fever, cholera, and typhoid fever. To protect the general population from infections arriving on ships, quarantine sites were established on islands in New York Harbor and the East River. These quarantine hospitals became the pest houses. The word "pest" derives from the first of the three great scourges of mankind: pestilence, famine, and war. As New York's municipal hospital system became better established, the pest houses evolved into infectious disease hospitals. The most famous of these was Willard Parker Hospital located on the East River on Manhattan's lower East side. Saul was discharged from the Air Force in 1946 and joined an army of veterans seeking hospital training. Because of a delay in procuring a Pediatric residency at NYU-Bellevue, he took an interim position as resident physician at Willard Parker for six months. At the time all patients with infectious diseases in New York were funnelled into three specialty hospitals. Waves of children arrived at Willard Parker with scarlet fever, measles, pertussis, croup, and polio, filling wards to overflowing. Saul became an expert in infectious disease even before he began his pediatric residency! He maintained his affiliation with Willard Parker until it was closed 10 years later, signaling the end of an epoch as the result of medical advances. During those momentous years, Saul sharpened his clinical skills to an extraordinary degree, laying the groundwork for his future career in research and accumulating the experience that made the Krugman and Ward text, Infectious Diseases of Children, now in its 9th edition, an international success. The past 100 years has seen the conquest in this country of most of the dreaded infections that concerned us at the opening of the century. Saul Krugman participated in many of those advances. It is part of the irony of medical progress that, as we congratulate ourselves on our success, a new threat has emerged which will tax our energies and resources for many years to come. The frightening dimensions of AIDS will stalk the 21st century.