Lectures to the Laity; Dr. Milton J.E. Senn on the Art and Science of Growing Up; Part 1; WNYC

Good evening from the auditorium of the New York Academy of Medicine, your city station presents another of the Lectures to the Laity. These talks are given under the auspices of the Academy, are a free service to the public and attempt to present before the laymen in layman's language, the results of some of the latest work in the field of medicine. Our speaker tonight is Dr. Milton J.E. Senn. He'll discuss the art and science of growing up. To introduce the evening's presiding chairman, Dr. Sam Zachary Levine, here's the chairman of the Laity Lecture Committee, Dr. Harold, B. Keyes. Good evening, ladies and gentlemen. Again, on behalf of the Committee on Laity Lectures, it's my pleasure to welcome you here. We're in for another intellectual treat. It is now my opportunity to introduce to you the presiding chairman of the evening, Dr. Sam Zachary Levine. Dr. Levine is Professor of Pediatrics at Cornell Medical College and Pediatrician in Chief of the New York Hospital. Dr. Levine. [applause] Dr. Keyes, ladies and gentlemen, pediatrics

is vitally concerned with human growth and development. Pediatricians are aware that the so-called normal stages of physical growth, mental development, and sexual maturation follow a pattern and timetable from birth through adolescence, which are genetically determined. They also know that this pattern and timetable can be modified by environmental influences such as food, hygiene, and other conditions. Practical application of these principles has led to great advances in the promotion of somatic growth and physical health, in the prevention of disease, and in the reduction of infant and child mortality. Psychologic principles of human personality development have only recently

been applied to pediatric practice to the same extent. In the last 30 years, attention has been reawakened to the basic emotional needs of infants and children and to their gratifications and repressions by environmental influences. Expectant mothers are now inquiring about natural birth and rooming-in accommodations for their newborn babies. Lactating m-mothers again wish to nurse and the era of the rigid cry-it-out schedule an infant feeding is being replaced by the flexible self-regulation schedule. The speaker tonight is one of the pioneers who has helped to reorient our thinking about infant care and child rearing. He has pointed out that we cannot treat infants and children, unless we understand their successive stages of personality formation, respect their emotional needs, and take account of parental attitudes and social impacts.

Every person professional-professionally concerned with the ultimate well-being of children, every parent and prospective parent; in fact, the entire public is deeply interested in this subject. It is a privilege to introduce my friend and former colleague, Dr. Milton J.E. Senn, Sterling Professor of Pediatrics and Psychiatry and Director of the Child Study Center, Yale University, who will speak to us on the art and science of growing up. Dr. Senn. [applause] (Dr. Senn begins to speak) Dr. Levine, colleagues, and the Academy, and guests, I'd like to spend a short time with you discussing the history of the art and science of growing up in America. At once, I must tell you that the only claim to authority that I have and speaking on a subject of history is that I had the good fortune

in the last 40-some years to have lived at a time when there was interest in humanitarianism, and to have been to and to have been very fortunate that in the middle 1930s, I was at Cornell University, when in the midst of a financial depression, and a concern about how we were treating our children at Cornell, it seemed to some of us that we might better learn some new techniques and we might learn these techniques from the social sciences and from the humanities. I was extremely fortunate in that time and having the faith expressed by Cornell, the Commonwealth Fund, and my friends, particularly Dr. Sam Levine. So that tonight this marks in a way, a historical moment when I come back to New York City, and pay honor and respect to these institutions and these people who had faith in me

20-some years ago. One of the truly phenomenal developments in the United States has been the emergence of the social and psychologic conviction, which affirms that each child has a distinct personality, and is so to be understood and treated. This conviction is in stark contrast to the view held earlier, which represented the child as being a person occupying a position subordinate to the adult. It is the purpose of my paper, to describe briefly how this change of philosophy evolved, and how it is reflected currently in child care practices, and in trends in the fields of pediatrics, psychiatry, and public health. At the onset there must be a definition of terms. In this paper the child referred to as an individual of either sex, when age ranges from infancy into adolescence, and whose status represents the total aggregate

of his participation in the affairs of our society, and the affairs of family, school, industry, and the nation at large, each of which help to mold him, and was in turn influenced by him. The child will be spoken of as a person in general and composite terms as if there were something like the American child. This is for reasons of brevity, and does not imply lack of recognition of the existence of social status systems, and of subcultural groupings within the United States of America, which give special significance to certain children, unfortunately, sometimes to the harm and detriment of these children. Social historians delineate the time from 1700 to 1950, and to several eras such as the colonial and early federal, a period from 1700 to 1830. 30. A period of the rise of the common man from 1830

to 1850. The Civil War and Reconstruction period, 1850 to 1870. The Emergence of a Modern America, 1870 to 90. Emergence of America as a World Power, 1900 to 1920. And finally, the so-called modern age 1920 to the present. The study of these periods reveals overlapping of one with another and a continuity of certain events and trends which extend from one era into the other. Such a temporal quality may be credited to the broad sweep of trends in child care, and rearing. A survey of the changing status of the American child reveals that from the colonial period of the seventeen hundreds to the present day three major epochs stand out clearly. These are the three epochs that I would like to look at closely with you. The first of these may be said to have extended into the 1830s, and may be

designated as the era of Calvinistic religiosity. The second from the 1830s to the 1890s, maybe called the period of industrialization. While the last, from 1890 to the present day period contemporary to many of us in this audience, is one to which a variety of names may be and have been applied. Atomic, Age of the World Wars and the Great Depression, Age of despair, and of the destruction of mankind. But for the purpose of our discussion, this period may be marked out as the one of the greatest humanitarian advance. Let us now examine more closely the first of these eras, 1700 to 1830. It is a theological age. Religion dominated the child's education, recreation, and hygienic care, quite as much as it did his manners and morals. Children were reminded of the fact that their stay on earth would be short,

as it well might be. Although families were large, often numbering 25 children, there was a high mortality of children and their mothers. The history of the clergyman, Cotton Mather, was typical. Of 16 children, only one outlived him. Nine died in infancy, one before the third birthday, and the rest before reaching the third decade. Children of the American colonies were constantly admonished to spend time preparing for the life after death, and to remember the wages of sin, and the rewards of virtue. This was a time when fears were realistically abundant, but also in fear as such was used as an instrument for teaching discipline, and for bringing about obedience of rule, and law. Repression of feelings was encouraged, especially those considered to be evidence of human frailty, such as envy, anger, hatred, and feelings of sex.

Children were to be seen but not heard. They were tolerated as passive members in a group of adults. In fact, they were considered men and women in miniature. There was a clear line drawn between the roles of the male and female, with strong preference for the former. [unintelligible] inheritance and training was permitted to occupy a superordinate position in the family, and in the affairs of the community. Books for children in this early colonial period were purely theological in content. The Bible, of course, was most popular for religious education, but quite as much for learning to read and write. Other books bore such interesting titles as Remember Thy Creator in the Days of Thy Youth, Spiritual Milk for Boston Babies, War with the Devil, and the Young Man's Conflict with the Powers of Darkness, designated particularly for the adolescent. The History of Goody Two Shoes with a means by which she acquired learning and wisdom.

Although such stories as Jack the Giant Killer were known to the early colonists, they were not recommended, because they were not purely of a religious, or moral nature. Any books which promised entertainment were considered vain and worldly. Children were not thought of as growing and developing persons with the capacity to learn, but rather as ignorant men and women. Hence, nothing was written especially for childish interest or intellect. Primers, spellers, catechisms were provided adults and children without differentiation between the needs of one from the other. Even the textbooks were flavored with pietism. Cotton Mather gave the following as the educational aim of this time: "They should read, and write, and cipher, and be put into some agreeable calling. Not only our sons, but also our daughters should be taught such things as will afterwards make them useful in their places.

Acquaint them with God, and Christ, and the mystery of religion, and the doctrines and methods of the great salvation." Now, medical care of children was based largely on folklore and superstition, with much of the treatment carried on by laypersons, old women particularly, who are credited with intuitive understanding of children, and their needs, and with skill, because of the fact that they had taken care of many children, Even though many of their patients died in spite of, or even because of their ministrations. This did not detract from their reputation as healers, In spite of deadly epidemics of smallpox, typhoid fever, malaria, and dysentery, there was apathy in matters of public health among lay people, and controversies raged between physicians about the contagiousness, or non-contagiousness of disease. This was characteristic of the general indifference of the colonists to the scientific progress which is beginning on the Continent. Seventy-one years

after Harvey had described the circulation of the blood, his work was still the basis of question debate at Harvard. This is no slam at the Mother Institute of Yale University. Much of the disinterest in medical science stem from the belief that scien- that illness was of divine origin, with intent to punish the child, and to teach him that suffering made him courageous, humane, and better aware of the dangers of life in general. Spiritual values were placed on sickness, and suffering. The shocking record of infant mortality was accepted as part of God's work, and the dosing with household remedies was believed Providence inspired. This is not the place to give a lengthy account of the eating habits of the American colonies, but it may be pointed out that even some foods symbolized morality. Confections were forbidden, not so much because they undermined the health, but because they "destroyed the tone

of the mind and made ungrateful and discontented citizens." Moral reformers said eating of sweets for pleasure paved the way for later evils such as eat-such as using strong tea and coffee, snuff, tobacco, and fermented liquors.