Pædiatrics in This Changing World

I BELIEVE that there are times when it is useful and helpful to review certain aspects of medicine, and the changes that have occurred in paediatrics during the past four decades are such, I think, as to warrant some evaluation of the present position and an attempt perhaps to forecast the future position of paediatrics within the framework of general medicine. Certain diseases which were common in infancy and childhood a few decades ago are now infrequently seen; others which were relatively rare are now relatively common. The pattern of disease has changed, so that the course of many of the diseases which we are called upon to deal with has altered. Modern techniques and modes of treatment have brought about profound changes not only in prognosis but in our whole approach to our patients. The place of paediatrics within the sphere of medicine has changed, its position and influence in the curriculum of a teaching school have altered, and it now has a recognised place of its own. Paediatricians themselves are of a somewhat different type from that of the past, and even our own speciality has become reorientated. Let us consider these points, and then think about what the future may hold.