Thread by @DrKate_Miller

Roots of geriatric medicine stretch back 5000 years ago, in the Nile Valley, Egypt. Demonstrating a hieroglyph for the world 'old'. It's a bent over person with a gait aid! #ANZSGM2021 Dr William Browne - The Unexpected History of Geriatric Medicine

(I am loving this talk SICK). Ptah-Hotel 2000 BCE - "Old age makes a man miserable". #ANZSGM2021 Dr William Browne

Ancient Greek depiction of 'Geras' the god of old age - the root of the word geriatric. #ANZSGM2021 Dr William Browne

Hippocrates 450-370BC. On ageing: Fever less marked in old age (true!) and argued to "leave your drugs in the chemist's pot"! #ANZSGM2021 Dr William Browne

Aristotle (Macedonia) - he defined the concept of optimal ageing "eugeria". Old age brought vulnerability to disease processes, and that older people were a distinct patient population. #ANZSGM2021 Dr William Browne

Cicero 106-43 BC. Wrote 'De Senectute' - "On Old Age". Argued that our minds are rendered buoyant by exercise (true!) and described the anorexia of ageing.
"No man is so old that he does not think himself able to live another year!" #ANZSGM2021 Dr William Browne

Galen - 140 BC. Shocking narcissist "It is I and I alone who have revealed the true path of medicine" BUT developed proto-geriatrics, or "gerocomics" and focussed heavily on diet and exercise. #ANZSGM2021 Dr William Browne

Built in Byzantium in 1000 AD "Gerocomeia" - the first oldest institute of the old, aka the worlds first nursing home (now a mosque), followed on from Galens ideas. #ANZSGM2021 Dr William Browne

Roger Bacon 1214-1294 on The Cure of Old Age and the Preservation of Youth. His cure for ageing? Diet, rest, exercise, moderation, hygiene...and "breath of young virgins". 5/6 ain't bad 😂 #ANZSGM2021 Dr William Browne

Francis Bacon - 1623 part of QE1s court. On the prolongation of life: Don't get excited, avoid the sun, take baths, eat sweet but not acidic food, take physical exercise but do not overdo it. Argued for a failure of repair mechanisms in the body. #ANZSGM2021 Dr William Browne

George Edward Day - 1851. Described Dementia, vascular dementia and incontinence among others. Argued that the care of older people had been overlooked for the last half a century. What happened between Bacon and Day? #ANZSGM2021 Dr William Browne

The Industrial Revolution. Movement of large extended families in rural settings into major setting and redefined worth of people as only being useful if they were productive. This left behind desperately poor, older people. #ANZSGM2021 Dr William Browne

Developed workhouses - to simultaneously punish and support the older poor. The idea of poverty as moral failure. My god. #ANZSGM2021 Dr William Browne

Charcot in disgust at these workhouses, developed the specialty of Geriatric Medicine. Described "decubitus ominosus" (sacral pressure wounds), which were later properly identified by Brown-Sequard. #ANZSGM2021 Dr William Browne

Brown-Sequard in later life tackled older age. Injected himself a solution concocted from dog and cat testicles. This was not well received by the medical community, but the public LOVED it. #ANZSGM2021 Dr William Browne

Voronov, Brown-Sequards registrar took up this cause and began transplanting human testes into older men and then started xenografting from monkeys...this was popular. Published before and after shots...😳 And became very rich! #ANZSGM2021 Dr William Browne

Osler comes along with a speech at his farewell address at John Hopkins and argued that men over the age of 60 are essentially useless and euthanised with chloroform! Plot twist: It was a joke. Plot twist twist: People took him seriously.. #ANZSGM2021 Dr William Browne

..which demonstrated the pervading sense of ageism from the industrial revolution. #ANZSGM2021 Dr William Browne

Ignatz Leo Nascher goes on to coin term geriatrics, intended to sound like paediatrics. "The idea of economic worthlessness instills a spirit of irritability if not positive enmity against the helplessness of old age". #ANZSGM2021 Dr William Browne

And in comes our hero and specialty mother. Marjorie Warren! Completed surgical training in the 1900s (unheard of), couldn't get a job because female, but got a job as an assistant physician and made to look after 714 people at a general hospital. #ANZSGM2021 Dr William Browne

Went and changed interiors to bright colours, examined everyone and categorised. Insisted everyone gets out of bed. Establishes multidisciplinary team and geriatric ax. Discharge planning (completely novel concept). Went from 714 to 240 people. #ANZSGM2021 Dr William Browne

Ministry of Health gets involved. Lord Amelry (?sp) goes to investigate and is converted to the cause and becomes her biggest advocate. Together they establish geriatric medicine in the UK. #ANZSGM2021 Dr William Browne

Marjories primary focus was on restoring independence and function. Died far too young in the sixties in a car accident on the way to a conference on Women in Medicine. Her spirit lives on. #ANZSGM2021 Dr William Browne

I might wrap it up there because this is getting long, but Dr Browne continues to tell us about more champions. I did not know that stroke units were started by geriatricians!! Such an excellent talk, thankyou. #ANZSGM2021 Dr William Browne