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and Dr.J.H. Sheldon in his presidential address to the Third Congress of the International
Association of Gerontology to mention only a few.
In the aged the skin often tends to become dry and inelastic, coupled with
deformities usually found this leads to lesions over pressure points, the nails become
hard and thickened with accumulation of debris in the sulci. In particular is this seen
in osteoarthritic and rheumatoid patients. Here in old age it is not the primary lesions
which cause the main disability but the secondary lesions arising from deformity of
dysfunction.
In my report for 1954 I wrote:-
I mentioned earlier the waiting period between treatments is seven weeks.
This is too long to leave the majority of old people with bad feet. A chronic corn
can cause breakdown of tissue and consequent ulceration, an uncut nail pierce an
adjoining toe, or the matrix become infected through backward pressure, numerous
other minor conditions through want of attention, assume proportions beyond the
sphere of chiropodist and become a burden on the doctor or a hospital which more
frequent chiropodial attention could have prevented.*
In "Chiropodial Co-ordination in Geriatric Practice" (Chiropodist Vol.8 No.6) it
states:-
'The advantage of examining and treating these patients at an interval of three
weeks was the means by which early indentification of the more serious conditions such
as ulcerations, arterio-sclerotic and diabetic gangrene and other forms of circulatory
disturbances, was made.'
In "Schemes for the Elderly" published by the Society of Chiropodists 1959 we
read:-
'Chiropodists cannot be expected to accept the responsibility for treating old
people, with perhaps a serious peripheral vascular disturbance if they cannot see them
as frequently as they wish.'
I am hoping that the registration of Chiropodists under The Council for Professions
Supplementary to Medicine, which begins in January, 1963, may admit into the Health
Service many at present excluded by the 1954 Regulations and this may help to alleviate
our acute staffing difficulties. However, with nearly every Authority in the Country
needing chiropodists whether we will benefit or not remains to be seen.
If more staff is not available in the near future I feel the Committee will have
to consider very seriously limiting treatment to children, physically handicapped and
the elderly."
Semi-permanent appliances
With this service patients are supplied with semi-permanent padded insoles, made
to the individual needs of the patient. This is beneficial from the hygienic aspect
and also affords relief from pressure for a much longer period than just padding. The
supply of these, which began in 1959, continues to be very successful. 182 semi-permanent
appliances were issued during the year as follows:-
Males - 54 Females - 126 Children - 2
(52)