It will easily be seen that the diseases which disturb the formerly evenly balanced organism tend toward what pathologists call destructive metamorphosis. Blood-changes, tissue-changes, and secretory changes, are subjecting us to constantly varying standards of health. How to maintain the equipoise as long as possible, and prevent the too rapid decline of the vital forces, as well as to suggest measures—when care and forethought can ward off the blow—is the province of the thoughtful medical man.
Threescore years and ten should certainly be reached by most of those who attain adult age, provided no inherited taint weakens the vital forces. It is difficult to determine the exact period of life at which the decline commences. In fact, there can be no absolute standard from which we can predict with unvarying certainty the gradual failure of the physical powers. Some seem to inherit a vitality which almost defies the ravages of time; but, although they are apparently in the full vigor of life, close scrutiny rarely fails to detect the fact that the scale is tipping downward. We do not grow old in a night, although we often make the remark that So-and-so has grown ten years older since the occurrence of some great grief, or some disastrous reverse in business. The eye-sight gets poorer, the hair and beard grayer and thinner; the form is more bent, the walk more uncertain, the arcus senilis appears in the cornea. After all, this is not old age; these are all warnings, but the heart is still warm, the eye still bright, the muscles still firm. The world looks as fair and inviting as it did in early manhood or womanhood—a little larger print to read, a smoother road to walk on, a few more flannels at night, and a little less labor during the day, with perhaps a greater disposition toward quiet, a greater fondness for home-life, and a disinclination to encourage the enthusiasms which time and experience have so often proved to them to be illusive.
We are to consider the physiological and pathological conditions arising during this epoch of life. Many of these are characteristic, and do not earlier manifest themselves. We have many works upon the diseases of children and adult life, but almost none pertaining to the diseases incident to age. And yet they are peculiar. The pneumonia of a child is not the pneumonia of an aged person. Slight ailments, unobserved or disregarded in the adult, become positive disease in advanced life. Our acute fevers, inflammations, fluxes, etc., are not met with among the aged.
Congestions, chronic inflammations, tumors of the brain, paralysis, rupture of blood-vessels, enlargement of the heart, chronic bronchial affections, dropsical effusions, indigestion, diseases of kidneys and bladder, especially the latter, cancers, etc., are what the physician is most often called upon to prescribe for in old people. Aside from actual disease, the conduct of the life of elderly persons is to be studied and observed. Ordinarily old age brings with it, or should,
