"Not a Little Man"

A century ago, most hospitals disliked admitting child patients; when they did, they consigned them to the women's wards. Commonest child's complaint was diarrhea. In those days, it was often fatal, frequently spread to patients throughout the wards. Innumerable youngsters were victims of malnutrition diseases such as rickets and scurvy, human or bovine tuberculosis (scrofula), malformations or infections of the bones, but few hospitals were equipped to deal with these maladies. Then three years after the Civil War had ended, a young veteran of Gettysburg returned to Boston from a postwar refresher tour of Europe's medical centers with a bold idea. To four skeptical colleagues, Dr. Francis Henry Brown explained his project: to found a hospital devoted to children.

"I am convinced that physiologically a child is not just a little man," he argued. "Our children are without proper medical consideration for their special needs." Finally impressed by his argument and enthusiasm, his colleagues agreed to join with him in founding Boston's Children's Hospital.

In Five Sizes. At first, they could offer few cures and, in most cases, little more than nursing-home care. But Dr. Brown lived to see his hospital help in the conquest of many of the great child-killers of its early days. This week, as Massachusetts' Governor Christian Herter and Harvard's President Nathan Pusey dedicated a new $5,000,000 building on Boston's Blackfan Street, Brown's hospital had grown into the Children's Medical Center, first of its kind in the world. The center now totals eight buildings, none architecturally impressive, all solid and utilitarian. The new unit, to serve as a children's and infants' hospital, is distinguished mainly by having much of its equipment scaled to its clientele, e.g., the beds come in five sizes.

More important than physical plant or gear has been the caliber of the men who have staffed the hospital and, more recently, the whole center. More than ever, they honor Dr. Brown's dictum that the child is not just a little man. In the early years of the century, Surgeon William Ladd wrote a new chapter in the history of his dexterous profession by developing ways to revamp malformed intestinal and bile tracts in infants. Neurosurgeon Frank Ingraham has devised a highly ingenious method of draining the fluid in hydrocephalic children from the spinal canal to the kidneys through a polyethylene tube. Pediatrician Bronson Crothers has probed the causes of cerebral palsy, is now preparing a book with 1,000 exhaustive case histories.

Polio presented the center with successive challenges. After the 1916 epidemic (worst in U.S. history), the center's orthopedic surgeons made striking advances in correcting the deformities left by paralysis. The hospital's close association with Harvard, begun at the turn of the century, paid a big dividend in 1928 when Professor Philip Drinker offered the doctors a respirator he had devised for polio patients: it has since become universally used and famous as the iron lung. Twenty years later, Harvard Virologist John F. Enders, a member of the center's research staff, published an obscurely worded paper describing a method of growing polio virus in tissue cultures. On that foundation, the Salk vaccine was built, and for that work. Enders (with Thomas H. Weller and Frederick C. Robbins) won Nobel Prize.

Even more retiring than Enders is Robert Gross, surgeon, who in 1938 performed the first successful operation to correct an open arterial duct near the heart, which in normal children closes automatically soon after birth. Until Dr. Cross's discovery, the defect had usually proved fatal to a child within a few years. Since then, with a combination of daring and precise skill, Dr. Gross has made several additions to the growing list of techniques for operating on the aorta and inside the beating human heart, notably improvements in arterial grafts and methods of "banking" pieces of artery.

Four-Button Man. At the head of the hospital's wide-ranging research is Dr. Sidney Farber, a pathologist by first choice, now one of the world's outstanding authorities on the chemical treatment of leukemia and related cancers in children. Sartorially so conservative that he is known to colleagues as "Four-Button Sid." Dr. Farber has pioneered in the revolutionary treatment of these diseases with nitrogenmustard derivatives and folic acid antagonists. So far, no child victim of acute leukemia has been cured. But once all were doomed to die within a few months of onset of the disease; now many live for years in apparently normal health until they become resistant to the entire battery of drugs.

These children, all under sentence of death, give the Children's Medical Center staff their severest pangs. Says Dr. Farber: "I've been here since 1927, and they don't get any easier to take. We couldn't take it at all if it weren't that we have 200 people here doing research that may some day find the answer to it." Researchers at the center have the fullest freedom in their basic research. Those working on cancer are specifically chartered to investigate anything pertaining to growth--a charter which includes the whole animate world. Says Farber: "This place is heaven for doctors and scientists."

It is not yet a heaven for children, although everything possible is done with toy trains, dolls and gay murals to make them feel at home. Some distant day, the researchers hope to work themselves out of jobs as they achieve (or help in) the conquest of one disease after another. Already there are two clinics where mothers take well children to make sure of keeping them well. "Eventually," says Dr. Farber, "this should become an institute of child care for the development and perpetuation of the normal."

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