[The development of dual specialization: the clinical geriatrician and the nursing home practitioner, 1945-1990]

Why are there in the Netherlands two geriatric disciplines and how have the professions of clinical geriatricians and nursing home practitioners been developed? Only written sources have been used for the research: articles, annual reports, archives of scientific associations and umbrella organisations. For the elderly chronic patients increasingly less space was available in hospitals after 1945. These patients obstructed circulation in this institution, which focused more on treatment rather than nursing. Although everyone acknowledged the need for more medical attention for this old age group, there was a lot of opposition against the development of special geriatric units in hospitals. Other specialists agreed that they could effectively treat the elderly patient and felt no need for a geriatrician. Contrary to the geriatric units in hospitals, the development of nursing homes flourished. In these facilities, the nursing home medicine evolved and, as opposed to geriatrics in hospitals, less resistance was encountered. The system of registration of medical specialists made it impossible to recognise only one geriatrician, since they worked in both hospitals as well as in nursing homes. The professional development of nursing home practitioners and clinical geriatricians was delayed partly as a result of the general hesitation of the KNMG in acknowledging new medical disciplines and as a result of internal domain discussions.

A historical perspective on the care of the aged in medieval times

Although aging had already been treated among the classical writers of Antiquity, the late Middle Ages and the Renaissance obviously must be regarded as the chief source and inspiration, as well as the starting point of the history of gerontology. Nevertheless, the treatment of aging in medieval medicine remains relatively unexplored, in contrast with other fields such as obstetrics, gynecology, and even pediatrics, where the literature has become prolific. This contribution focuses on some of the most interesting medieval regimina and consilia, dealing with health and its preservation. It especially informs the reader about the most popular pathogenetic theories concerning normal and pathological aging, and also gives an impression of the most vivid clinical descriptions of the pathology of old age by fifteenth century physicians.

Aging, the fishy side: an appreciation of Alex Comfort's studies

Many years ago, Alex Comfort experimentally refuted Bidder's hypothesis that fish potentially were immortal. Later morphological and physiological studies, together with observations from fish populations in the wild, revealed that fish age in a way similar to that in other vertebrates. More recently, assessments of the age of fish have been revised, and have shown that some species live much longer than was estimated. These findings, together with the difficulties of demonstrating any increase in the rate of mortality with age in the long-lived, heavily exploited populations of fish, revived Bidder's ideas. I briefly review some of the more recent literature, and conclude that there is no evidence to suggest that fish are exceptional; like other vertebrates, sooner or later they grow old and die.

Alex Comfort's biology of ontology: implications for gerontology, phenomenology and the philosophy of science

Alex Comfort's explorations into the biology of the human experiences of self-consciousness and the Oceanic opened avenues of investigation and speculation that deserve reconsideration. His work on the biology of ontology remains valuable, and especially noteworthy is his challenge to make such approaches the basis for a new paradigm of science.