The impact of past childhood abuse on physical & psychological illness in adulthood is not well understood. This article examines the slow response to this issue of wider clinical practice. It is argued that training in eliciting developmental antecedents of adult ill-health is essential for medical undergraduates & post graduates, & clinicians need to develop an empathetic understanding of the dynamics of the relationship between abused & abuser. The article calls for medical research which needs to be linked to research on social & environmental disposition with qualitative methods, with the inclusion of sexual abuse of males, not just females. The indirect health costs of childhood abuse are considered, particularly in relation to the social problems of youth suicide & homelessness. (10 refs)