Geriatric medicine in Britain—the growth of a specialty

Geriatric medicine became a specialty in the UK in 1948—the year after the founding of the British Geriatrics Society. Many factors led to this achieve-ment, some of which are as follows. Care of dependant 'aged and chronic sick ' had been the responsibility of the state for about four centuries— since the dissolution of the monasteries by King Henry VHI. Much of this was carried out in workhouse infirmaries—warehouses for bedfast patients, largely undiagnosed and untreated. Marjory Warren, a medical officer at the West Middlesex Hospital, was the first to draw attention to this horrific neglect and to take steps to reverse it. She inaugurated 'rehabilitation'—starting with bed-end exercises and battling with authorities to obtain slippers, dressing gowns and chairs. Her work extended through the 1940s and was reported in several publications [1-3]. Her message was that: 1. Geriatrics is an important subject for the teaching of medical students. 2. The care of the chronic sick should comprise an essential part of the training of student nurses. 3. For the proper care of the chronic sick the full facilities of a general hospital are necessary, both for the establishment of a correct diagnosis and for treatment. 4. It was important to encourage research work on the diseases of old age which can only be undertaken with the full facilities of a general hospital. The remainder of the aged and chronic sick were housed in chronic sick wards of general municipal hospitals (there were virtually no private nursing homes at that time). The plight of these unfortunates was revealed by Amulree and Sturdee who surveyed patients evacuated from London hospitals to emer-gency medical service hospitals outwith the cities during the war. They reported their findings to a committee of the House of Lords and in the British Medical Journal [4], concluding