History of geriatric medicine in the UK: early publications
One of the first publications on the subject of geriatric medicine was by George Day, whose Diseases of Advanced Life was published in 1849. Day documented some of the modern day “geriatric giants”, including incontinence and dementia. He also described vascular dementia, which “ . . .follows slight attacks of apoplexy and paralysis; its progress is then very rapid”.
In 1881 Charcot was the first physician to advocate a specialty of geriatric medicine, based on his observations of a poorhouse-like institution in Paris. French physicians had previously used the phrase “Gerocomie”—a term used to describe the need for a separate facility for elderly people, where they could be adequately cared for and treated. They recognised that segregation of elderly people could help in improving their health and wellbeing.
The word “geriatrics” comes from two Greek words; “iatros”, a healer and “geros”, an old man. Nascher, a Viennese immigrant to the US, first used the word geriatrics in 1909. His seminal paper not only was the first to name the specialty, but also considered the need for a separate specialty to deal with the problems of “senility”. He used the analogy of medicine of childhood, which had been “assigned to a special branch of medicine” and suggested that geriatrics should be considered in a similar fashion. Nascher also focused on drug prescribing and warned of the harmful effects that medications (such as antidepressants) could have on the ageing heart. He also described the symptoms and mode of death in older people with pneumonia.
Though our specialty was first conceived and named in the US, it was in the UK that geriatric medicine was born over 30 years later.
A Barton, G Mulley
Extract courtesy of the Postgrad Med J2003; 79:229-234 doi:10.1136/pmj.79.930.229