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Seasons greetings
  1. CARSTEN FLOHR, Senior House Officer in Paediatrics
  1. Department of Child Health
  2. University of Newcastle
  3. Newcastle upon Tyne, UK

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In Europe, children's diseases were not considered fundamentally different from those of adults until the 15th century and the first European paediatric book was Paulus Bagellardus' (?–1492)Libellus de aegritudinibus infantum (The little book of the diseases of children), printed in 1472. However, by the 2nd century AD, Chinese medical texts had already recognised that children's ailments differed from those of adults. In particular, Chinese doctors stressed the vulnerability of infants and the natural series of benign illnesses they seemed destined to go through in early life. There is evidence of the existence of Chinese works dedicated to the treatment of children's diseases by the 3rd century AD, but unfortunately none of these paediatric texts have survived. The earliest preserved book dates back to the Song dynasty (960–1278), when Chinese paediatrics had already established itself as a subject in the state medical examinations.  The earliest preserved picture of a Chinese paediatric practice also dates back to Song times. It is part of one of the most important Chinese paintings, Zhang Zeduan's Along the River at Qingming Festival (Qingming shang he tu, 12th Century). This painting has long been studied by art historians for its realism and striking detail of daily life in the southern Song capital Kaifeng. As such, it is seen as a very important document of 12th century Song society. The fact that a paediatric practice is part of this important painting is further proof that Chinese doctors specialised in paediatrics at that time. On the doorplate on the right of the paediatrician's premises it says: “Specialising in the treatment of children's nutrition related ailments, immediate cure (guaranteed)” (Zhuan zhi xiao er gan peng shi ji li xiao.).

The world's earliest picture of a paediatric practice in a 12th century Chinese painting