View report page

A study group at the University of Basle began a 'longitudinal
research programme' on aging three years ago. One hundred volunteers
participate in the programme and every two years a number of
functions or physiological criteria are examined in each subject:
visual adaptation, vital capacity, ECG, blood pressure and pulsewave
velocity, the skin, and" so on. It is hoped, in this way, to
find criteria for ascertaining how various organ systems age, and
whether the course of aging can be predicted."
My clinic can take and record measurements on the physiological
normals in old age. There is practically nothing known on this subject,
and information is urgently needed. The clinic should be in
the nature of a physiological laboratory. We need much more information
about the biological processes of aging; the progressive '
stages of physiological deterioration, both physical and mental, and
how to measure these; how to deal best with the clinical problems
of old age; and study on the social and economic aspects. These
studies will require observations on samples of the population for
both long term and short term ranges. The attendance at a clinic is
one of the ways of obtaining information. There people can be tested
if we have the instruments and means of testing them, which at
present I have not. We need to know why it is the various organs
deteriorate at different periods of life's span and how to prevent
this; and we need to know also how performance in various aspects,
such as manual dexterity,muscular activity, breathing capacity,
mental functions and so on deteriorate.
Some of these observations and measurements can be carried out
in a local clinic such as mine, but some special clinical tests
will need the more elaborate and extensive facilities of special
laboratories, and X-ray departments. It must therefore be possible
to work in close co-operation with hospital departments and one
good way of ensuring this is for the medical officer of health to be
appointed to the staff of the hospital in an honorary capacity as
a physician in community medicine and concerned with the study of
the social and preventive medical problems of various groups of the
community. There would be enormous advantages in having direct
contact with the other consultants in the hospital service; one great
asset would be the smoothing away of various ethical difficulties
when patients require the services of more than one doctor. It would
give us the right to use the hopsital technical services for special
work without having to ask several people.
Some have said that the preventive services for old people
should be part of the geriatric out-patient department of the
hospitals. I think it would be better if it were part of a department
of social and preventive medicine, both inside and outside the
hospitals. If we medical officers of health had a focal point inside
each hospital and were regarded as physicians in charge of
the department of social and preventive medicine, then our clinics
and services outside would fall into place as extensions of that
hospital service.
A Special Institute for Research.
If, as may well be the case, the hospital resources are already
strained to the full and cannot accept any more commitments for
research in community medicine, then I think we should consider
setting up a department specially equipped to carry out this sort
of work. It could be organised as part of the preventive work of
a number of district authorities or perhaps done by the County
14