Ambroise Tardieu: the man and his work on child maltreatment a century before Kempe.

Ambroise Tardieu was an outstanding French forensic physician of the 19th century. A century before American physicians discovered child abuse as a pediatric and public health problem, Tardieu studied and described almost all forms of child maltreatment. In his "Dictionnaire d'hygiene et de salubrite" (Dictionary of hygiene and salubrity, 1862a, 1862b), Tardieu described the terrible working conditions of children in factories and mines. He also reported the ill consequences of theses conditions on the children's physical and mental health. In his "Etude medico-legale sur les attentats aux moeurs" (Forensic study on offenses against morals, 1857), he analyzed 632 cases of sexual abuse in females (mostly children) and 302 cases in males, describing physical signs according to the severity of the abuse. His "Etude medico-legale sur les sevices et mauvais traitements exerces sur des enfants" (Forensic study on cruelty and the ill-treatment of children, 1860) is a classical description of the battered-child syndrome. Thirty-two cases, 18 of which resulted in death, are described in detail. He also published "Etude medico-legale sur l'infanticide" (Forensic study on infanticide, 1868), a book of his observations on infanticide, based on the study of 555 cases, of which 60 are discussed in detail. Unfortunately, Ambroise Tardieu was unable to convince the physicians of his time of the prevalence of the maltreatment of children in their own family. Furthermore, his successors in forensic medicine did not believe children's allegations of physical and sexual abuse. Child victims were condemned to suffer abuse and neglect for another century without the support of the medical community, despite the fact that a clear-sighted and renowned physician devoted a significant part of his career to trying to open the eyes of physicians and society to this horrendous reality.