Medical knowledge and medical practice: geriatric medicine in the 1950s.

This article examines the development of medical knowledge and practice with regard to sickness in old age in the early years of the National Health Service. It suggests that the creation of a speciality of geriatrics was inspired by the need to prevent hospital beds being blocked by long-stay patients. Thus, the efficient use of hospital provision required the diagnosis, treatment, and rehabilitation of elderly patients. The publication of medical texts on sickness in old age, provided the basis for a more interventionist approach to the care of sick, elderly people, but the development of geriatrics as a separate speciality was hindered by professional disputes over administrative responsibility, funding, private practice, and medical training. One key area of debate was whether sickness in old age was primarily a social rather than a medical problem. This needs to be considered with regard to the relationship between the hospital and the local community and the article examines the contribution of social and medical surveys of elderly people at home to the discourse on sickness and old age.