Friday, August 30, 2013

The Father of American Pediatrics

Dr. Abraham Jacobi, 1830-1919

From: faqs.org

The father of American pediatrics, Abraham Jacobi championed children's care in both academic and medical spheres. During his life, every medical school in the United States established a department of pediatrics.

Jacobi earned his medical degree at the University of Bonn in 1851. When he traveled to Berlin to take his state medical exams, he was arrested and held in prison for nearly two years on a charge of promoting political and social reform in the German revolution of 1848. Though he viewed his imprisonment as a badge of honor, he left Germany in 1853 to avoid being arrested again.

Jacobi arrived in New York later in 1853, where he practiced general medicine, surgery, and obstetrics, as was the custom of most of his contemporaries. Medical specialization was frowned on as being degrading, making physicians too much like tradesmen.

Jacobi wrote prolifically, publishing 200 articles and books during his career. His early contributions to the New York Medical Journal helped establish the field of pediatrics. In 1857, Jacobi lectured on childhood diseases of the larynx at the College of Physicians and Surgeons, his first formal pediatric lecture.

In 1860, Jacobi accepted a position as professor of infantile pathology and therapeutics at New York Medical College (not connected with the modern medical school of the same name). This appointment signaled a turning point as it was the first pediatric medical position and launched pediatrics as a medical and  academic discipline in the United States.

In his first year at New York Medical College, Jacobi established a method of bedside clinical teaching, a landmark in medical education. Up to that point, physicians did not conduct teaching rounds on medical wards. In the same year, Jacobi also founded the first pediatric free clinic.

Jacobi accepted the position of clinical professor of diseases of children at New York University Medical College in 1865. The College of Physicians and Surgeons (Columbia University) appointed Jacobi as professor of clinical pediatrics in 1870. Jacobi worked at almost every hospital in New York, but he concentrated on the Jews Hospital (later Mount Sinai Hospital), where he set up the first outpatient pediatric clinic in 1874. By 1878, the Jews Hospital had the first department of pediatrics in a US general hospital. Jacobi declined several invitations to accept prestigious medical appointments in Germany.

Throughout his career, Jacobi took care to balance professional success with social commitment, and he advocated medical care for children on the basis of social justice. Though he tempered his socialist views later in life, he corresponded with Karl Marx through the 1860s. Jacobi is best recognized for his achievements in infant nutrition. He studied breast feeding and safe breast milk substitutes. After the safety of pasteurization (Louis Pasteur) was proven, he fought to dispel the old belief that raw milk was beneficial. He advised parents to boil milk until bubbles appeared and advocated diluting milk. His support of boiled milk was thought to have saved more lives than any measure besides antibiotics.

Jacobi also studied diphtheria, gastrointestinal disorders, dental disease, and treatment of pediatric diseases. He invented the first laryngoscope but never patented it. He was one of the early advocates of birth control. Jacobi wrote about medical history and specialized in topics of pediatrics in the era of 1800, meningitis, tracheotomy and nursing. Jacobi's best known text is Intestinal Diseases of Infants and Children, published in 1887.

Jacobi was one of the first to treat diphtheric croup with intubation,the passage of a tube down the throat to help the patient breathe. Previously, physicians had been treating diphtheric croup by cutting into the larynx to establish an airway. Jacobi used diphtheria antitoxin as soon as it was available and advocated its use. In 1880, he published monograph on diphtheria.

Jacobi, who had been widowed twice, married the physician Mary Corinna Putnam in 1873. Mary Putnam Jacobi worked tirelessly with her husband on issues of child welfare and aid for the needy. They coauthored an article on infant feeding and Mary Putnam Jacobi published nearly 100 articles on her own, in addition to receiving the Boyleston Prize from Harvard. In 1883, the Jacobis were devastated to lose their 7-year-old son to diphtheria.

Professional recognition of pediatrics took another leap forward when Jacobi established the Pediatric Section of the American Medical Association in 1880, and the Pediatric Section of the New York Academy of Medicine followed in 1885. With the founding of the American Pediatric Society in 1888, Jacobi setup the first independent medical specialty society in the United States. Jacobi also served as president of the American Medical Association in 1912. Throughout his career, he pressed for regular attendance at medical society meetings. He wrote for numerous medical journals and lobbied Congress to publish the Index Catalogue of the Library of the Surgeon General's Office.

Jacobi had nearly completed his autobiography when a 1918 fire destroyed his only manuscript, along with his personal papers, letters and notes. He died within a year. Jacobi was honored with pediatric divisions named after him at Lenox Hill and Roosevelt hospitals in New York City. The Albert Einstein College of Medicine established the Abraham Jacobi Hospital as a memorial.

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