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The article reports on the diffusion of access to medical care for infants and children in selected urban centers of both Europe and the northeastern U.S., beginning with the initial concept of providing refuge for abandoned infants in the Middle Ages and ending at the turn of the 20th century. It was the opening of the Hospital for Sick Children in London, England, however, that encouraged physicians in the U.S. to open children's acute care hospitals. Over the last 50 years of the 19th century, dozens of freestanding children's hospitals and separate hospital wings for children appeared across the U.S., through philanthropic efforts.