Section 2—Preventive Pediatrics

Abstract

SummaryFrom the beginning of 1932 to August 1935, 6 920 children were brought to the Pediatrics O P D of Moukden Medical College and Hospital for treatment and 503 for advice. From the beginning of 1939 to the end of 1915, 17 312 children attended the Pediatrics O P D of National Kwei‐yang Medical College and Hospital for treatment, 673 for physical examination, 554 for advice, and 665 for vaccination. These children totaled 26 647 as out‐patients.The findings from breast feeding are listed below: The custom, of sending gifts to nursing mothers right after confinement is discussed. 95 percent of Chinese babies are breast fed. The composition of Chinese women's milk as determined by Tso has been mentioned. In our series, 10 percent of the cases received breast feeding every 4 hours, 20 percent every 3 hours, 70 percent irregularly. Weaning usually takes place after one year of age in most instances. Wet nurses supply 5 percent of breast feeding in Moukden, only one percent in Kwei‐yang. The probable reason being high cost of living. SummaryPediatric Surgery is now going through the same conditions that affected Pediatrics in General 50 years ago.Today General surgeons, in most hospitals in the world, – must operate without counting with services properly adapted to this technique; yet pediatric surgery has problems of its own and even those that affect both the adult and the child – have to be handled in a special way since children have their own peculiarities.The general surgeon can never arrive to have a complete control of the pre and post operatory conditions and even of the intervention itself because they lack a good solid foundation as pediatricians. They think of the child as if it were a ←little adult→ as a consequence mortality in cases of surgery among children is still very high.Professors like Ombreclanne in Paris and Ladd in Boston – have opened the way to pediatric‐surgery by devoting their – whole lives for 20 or 30 years to operate exclusively in children; but there are not many like them, therefore pediatric‐surgery is not yet generally accepted and there is even the – danger that it shall not be recognized as an specialization – inside pediatrics, because the principal exponents of this new branch have not received a foundation in pediatries.Every body agrees now in asking the surgeon to be also a well rounded clinician; with similar convictions we are asking the pediatric‐surgeon to be first a good pediatrician.The ←Hospital del Nino→ in Mexico City which is a general hospital for children, representing this new attitude, established a service for pediatric‐surgery from the first day it was opened to the public. The service counts with 250 beds (600 is the total capacity of the Institution) these are divided among: general surgery, plastic, thoraxie, urology, neuro‐surgery; – maxilo‐facial, orthopedics, endoscopy, eyes, and practice is done on cadavers and animals.The interns must have first 2 years internship in pediatrics rotating through all its services; (it is a previous requisite to have had some practice in surgery before entering) then, they have 2 years as subresidents rotating exclusively in the pediatric surgery department, then 4 years as minor resident in the same service and finally they can be resident in order to obtain the degree of ←Master in Pediatric‐Surgery→.The staff of the service counts ‐with one head resident surgeon and 42 surgeons. We have an average of 20 operations daily; there is a large variety of cases and of great interest.We have not been able to secure pediatric surgeons for the different branches as orthopedics neurosurgery etc.; but we hope in ten years from now all those places will be covered by surgeons having had the training we described above.We feel sure that children will be greatly benefited when treated by general pediatric‐surgeons instead of being operated upon by specialist who deal mainly with adults. The field of pediatrics will be enlarged, with this new line and it can – enhance all the care of the child and the adolescent.