The purpose of this communication is to augment the recorded clinical experiences concerning the effect on babies born of mothers with active varicella. It is based on 18 of these mothers whose lesions were first noted in the period 14 days prior, to three days after delivery (Table).
ObservationsThe diagnosis was based on inspection of the type and course of the skin lesions. With one exception all the mothers were of Puerto Rican extraction, relatively recently arrived in New York City. The data were accumulated over the seven-year period 1956 through 1962.
Congratulations on your stimulating editorial "Can the New Pediatrics be Practiced?" I ask your indulgence to rephrase it to "Can the New Medicine be Practiced?" because my remarks embrace the entire field.
Progress in medical knowledge has occurred, will continue to occur, and consequently has and should continue to improve available medical care. As a necessary corollary there must occur better training of physicians. This makes it necessary to re-orient the classification of physicians along the following lines, to optimally utilize the skills of the better and highly trained physicians that this newer medical knowledge demands:
1) General practitioners in the younger age group—old terminology = pediatricians.
2) General practitioners in the older age group—old terminology = internists.
Lest some unwarranted doubts may arise regarding the therapeutic efficacy of sulfadiazine in the treatment of meningococcal infections (excluding the fulminans type) or the emergence recently of resistant strains, from the article "Meningococcal Disease Due to a Sulfadiazine Resistant Strain" which appeared in Pediatrics, 34:124 (1964), I hasten to point out that both in this article and the reference that it draws upon heavily (J.A.M.A., 186:139, 1963), the only warranted deduction from the data detailed is that Group B meningocci are relatively more resistant or less sensitive to sulfadiazine compared to Group C meningococci on testing in vitro.
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