560
SPECIAL
ARTICLE
THE
FIRST
PEDIATRIC
TREATISE
IN THE FRENCHVERNACULAR
By Wu.Tox B. MCDANIEL, 2ND, PH.D., AND SAMUEL X. RADBILL, M.D.#{176}
rfHE Philadelphia Pediatric Society has
presented to the library of the College of Physicians of Philadelphia, an important work published in 1565 entitled: Five Books on the Feeding and Management of
Chil-(Iren Front Birth by Simon de Vallambert, thereby making an outstanding contnibu-tion to the historical and pediatric literary
resources of Philadelphia, for the book is
one of the earliest classics in the history of pediatrics, the first of its kind to be written
in the French language, and one of the
earliest in any modern language.
The medical care of children in the
mod-em complete overall welfare sense is as old
as archeological records go. One of the
earliest records of mankind is a relatively short fragment of Egyptian papyrus written
in the Sixteenth Century B.C., usually
re-ferred to as the Berlin Papyrus, For Mother and Child, which consists of a collection of incantations against two diseases of infants and various charms to facilitate childbirth, as well as prescriptions and incantations for the protection of infants. This fascinat-ing text makes it possible for us to look into
the Egyptian nursery. Just as a mother
today knows lullabies with which she croons
the crying baby to sleep, so the Egyptian
mother was skillful in making amulets and
using correct soothing words for the child who was sick, restless or threatened by evil.’ Before the printing press was invented, literary efforts were transmitted in
manu-script form. Through the centuries a
num-ber of such manuscripts have endured
which pertain to matters of pediatric
inter-est. Then came the printed book and, as
soon as it did, pediatric printed works
ap-peared. During the first 50 years of the
printing press, at least four such treatises are known : Bagellardus in 1472; Metlinger in 1473; Roelans in 1483,f and the pediatric
0 Address: College of Physicians, Philadelphia, Pennsylvania.
poem by a 111011k, Ileinrich von
Louffen-berg, in 1491. The last was originally a
manuscript written by the author in 1429.
Latin was the universal language of the
learned, which is the principal reason why
the first medical books were usually in that language. But until comparatively recent times, the care of children was largely in the
hands of women. Midwives directed the
management of the newborn and, very
often, wet nurses were entrusted almost
en-tirely with bringing up the very young
infant. The first writers on pediatrics who utilized the familiar language of the people,
therefore, did so in order to acquaint the
unlettered attendants of children with the
precepts of the old authorities in medicine. Thus, the book of Metlinger, written in the
German language, besides the homely
ad-vice in regard to child management, which
was generally acceptable at the time,
quoted liberally from the ancient authors, especially the Arabians, and Rhases in par-ticular. Hippocrates, Galen, Avicenna,
Aver-roes-all were acknowledged by him as
sources.
In 1545, the first work on diseases of
children ever written by an Englishman
appeared. This was The Regiment of Life,
With the Books of Children by Thomas Phaire. In the preface, he said: “My purpose
is here to doo them good that have moste
nede, that is to saie, children; and to shewe
the remedies that God hath created for the
use of man, to distribute in Englishe to
them that are unlearned, part of the treas-ure that is in other languages, to provoke them that are of better learninge to better
their knowledge.” Then follows a long
ar-gument in defense of writing the book in
the English language. Judging from the
contumacious tone of this preface, he had
been stung by the severe censure of his
colleagues for divulging medical secrets to
SPECIAL ARTICLE 561
the laity. But he pointed out that the
ancient authorities wrote in their own
lan-guages: Galen in Greek; Avicenna in
Ara-bic; Pliny, Celsus, etc., in Latin.
As a matter of fact with the invention of
printing this tendency to publish in the
vernacular was part of a general movement
and medicine was merely following the
trend. Martin Luther published the first
translation of the Bible into the German
language in 1534. Eight years before that,
church services in Germany had been
cele-brated in the native tongue for the first
time. The different nations of Europe were
intensely proud of their own languages. The English first translated the Bible into their language in 1535 (Miles Coverdale’s
Bible). This might have inspired Thomas
Phaere to write his Booke of Children in
English 10 years later. This idea spread in-tensively throughout Europe so that we find
a Spaniard, Lobra de Avila, writing on
pe-diatrics in his native tongue in 1551, a book which was of great service to his countrymen in dealing with the ills of children in their newly founded colonies in Mexico and Peru.
By 1565, then, it was quite natural that
this book by Simon de Vallambert,
pre-sented to the College of Physicians of
Phila-deiphia, should have been printed in the
French language. The author was born at
Avallon in Burgundy, France, early in the
sixteenth century at a time when Europe
was in a political and cultural ferment.
King Francis I of France, called the
Re-storer of Letters and the Arts because of the wise and liberal patronage and encourage-ment which he gave to the revival of learn-ing and the arts, died in 1547, when de
Val-lambert must have been beginning his
medical career. Vallambert is known to
have cultivated equally both literature and medicine.
In 1558, he was physician to Marguerite
of France, sister to the Duke of Orleans
who later became King Henry II of France.
Marguerite became Duchess of Savoy and
Berry, and in 1562 had a son, the Prince of
Piedmont, later called Charles Emmanuel I,
who must have been three years old when
Vallambert wrote this treatise. As court
physician however, the doctor not only had
to supervise the care of the Duchess’ chil-dren, but also those of her entire entourage which must have been considerable.
The book is dedicated to the Queemi
Mother, Catherine de Medici, who had
married Henry, Duke of Orleans, the second son of Francis I, and who exerted a power-ful influence on the destiny of France
dur-ing the reigns of her three sons. It may be
of some interest to quote from the dedica-tion:
“To the Queen Mother of the King,
Un-ending Felicity.
“If knowledge of things published for the
common use of men should belong to kings,
fathers and guardians of the realm-then to
you, Madame, who are Queen, mother of
the King, and governor of the realm, in the first years of its majority, and head of the guardianship of public assets of its people,
I desire quite properly, that this work of
mine be presented before its publication. “It contains instruction on the
manage-ment and nourishment of the infancy and
earliest years of men, not only those who
are and will be your subjects, but also those.
who may wish to make use of and do
serv-ice to the language of France, in which it is written. In respect of its author’s insignifi-cance, it is unworthy of attaining the con-secrated hands that bear the sceptre; never-theless, contemplating that the teachings in it come from God, and that it is the province
of royal majesties to wish for the ever
greater increase of good teachings and their promulgation for their subjects’ benefit-this
leads me to think that I shall not act
im-properly in giving myself the satisfaction of
presenting the book to you, and the even
greater satisfaction of dedicating it to you. “In doing this, I had been actuated again
by another consideration-the fact that I
originally composed the book principally to
be of service to the little Prince of
Pied-mont, son of Madame the Duchess of Savoy,
your beloved sister, my patroness; thinking that, in fulfilling this obligation of my
posi-tion with her Highness, towards her
son-showing by the written word, on behalf of
man-562 McDANIEL-PEDIATRIC TREATISE
aging infamits, I could not be doimig other
than what eotmld be agreeable to you; for
how could it be otherwise than that you
and she share one heart and one soul, that
a service for one could not be separated
from service to the other?
“That alone will suffice, Madame, for
your Majesty, to excuse this bold
undertak-ing of my humble heart, and to cause you
to find good the offering of such instruction,
which very humbly I present and dedicate
to this same Majesty. But if the rude form
of its composition does not merit the favor of your eyes, at least it cannot be disdained nor rejected, since it comes from one of the
physicians of her whom you love as
your-self, who loves you as herself; who, after you,
is she whom I most revere in this world.” Literally translated, the title of the
vol-ume is : Five Books on the Way to Feed and
Raise Children From the Tune They Are Born by Simon de Vallambert, Physician to
the Duchess of Savoy and Berry, and
(lately) Physician to the Duke of Orleans. Printed in Poictiers in 1565. The contents of the five books are listed as follows:
I. The best way to choose a wet nurse.
II. Instruction of the midwife and wet
nurse in regard to the management of
the newborn infant.
III. How to feed and care for the infant
before it is weaned.
IV. How to feed and care for the infant
after it is weaned.
V. How to treat the diseases of infants.
It is evidence that a clearcut distinction
is made between the responsibilities in the care of the well baby and of the sick. This is true of pediatric writings in all periods. Yet it is only in comparatively recent times
that this concept became widely
appreci-ated. The context of the treatise follows the usual pattern of similar books on pediatrics previously published. The first book gives the reasons the mother may have to depend on a wet nurse; the qualifications of the wet
nurse-age, disposition and body habits,
manners, shape and texture of her breasts,
age differential between her baby and the
infant to be nursed; conditions necessary to
produce good milk, different qualities of
milk, composition of milk and how to
de-termine its quantity, color, odor, tastes; how to improve the composition of the milk, change its quantity, in great detail.
The American, John Ruhrah,2 and the
Englishman, Sir George Frederic Still’
found this 16th Century Frenchman surpris-ingly modern in many of his views. Of the first of the five books, Ruhrah says that: “It
gives in detail much that is taught today, a frank piece of writing with little nonsense in it.” He then analyses the text and gives a full translation of the section on diarrhea. Still devotes no fewer than six pages to the
book. Among his comments are these:
“Si-mon de Vallambert was no mere follower of
the beaten track . . . he has a mind of his
own, and a sound common sense far in
ad-vance of most of the writers of the sixteenth century. . . . His chapter on the feeding of
the infant up to the time of weaning is by
far the best that had been written up to that time. He already realizes that same affec-tion of the spine may be the result of faulty
feeding, although rickets was as yet
known. His range of diseases is wider than
that of any previous writer on diseases of
children. He has a chapter in which he says that there is fever associated with spots, like fleabites, on various parts of the body, and he says this affection is sometimes epidemic.
He is also the first writer on diseases of
children to include syphilis. Altogether,
Simon de Vallambert is in advance of his
times. There is in him something of the true clinician. One can fancy that with modern
scientific opportunities Vallambert would
have been a clinician of the first rank.”
There is more but this will perhaps
suf-flee to suggest that the book is a valuable
tool for the historian. The library of the
College of Physicians of Philadelphia is one
of the few places in the country one could
consult this book.
REFERENCES
1. Sigerist, Henry: History of Medicine, Vol. I. New York, Oxford, 1951, 564 pp.
2. Ruhrah, John : Pediatrics of the Past. New York, Hoeber, 1925, 592 pp.
