| THE CONSERVATION OF ENERGY IN THOSE OF ADVANCING YEARS. II. |
By J. MADISON TAYLOR, A.M., M.D.,
PHILADELPHIA, PA.
Developmental Processes in Ageing Tissues; Physiology of Decadence. Senile Involution.
THE brevity of this communication does not warrant a discussion of senility from the standpoint of the physician, but rather a presentation of such facts to the person who is growing old as may prove helpful and suggestive in postponing the more serious results of advancing years. It is, however, important to glance at the manner and processes by which the inevitable end is reached. The clinical picture of approaching death is divided by Tessier into those structural degenerations involving, first, the heart and blood vessels; second, the lungs; third, the kidneys; fourth, the digestive organs, and fifth, the brain. First of the heart, which is now recognized to be the organ which plays the chief part in the ending of life. Before we knew much about the subject it was natural to infer that the heart was chiefly at fault and the common phrase was often used of death by 'heart failure,' one which we now know to be scientifically correct but aforetime vaguely employed. Then discoveries were made that the arteries in the aged were nearly always diseased, and medical thinkers went so far as to assert that all instances of death in old age resulted from the hardening of the arteries. It is true that this is an accompanying phenomenon in most instances, and perhaps in all, but it is recognized to be not the most potent factor in a certain large proportion.
What is to be said here is not meant for a guide to the aged individual by which he may be encouraged to form independent judgments for himself, but rather to act as items of useful information, through which he can better interpret the statements and appreciate the importance of following the directions of his physician.
The heart of a healthy old person has become fatigued in its structure through a decadence of its nerve supply. The pulse is rather quicker than during middle life; it is more or less irregular and becomes increasingly so. In a healthy heart there is, however, a regular irregularity; a normal sequence of alterations in the rhythm and force which is only significant when studied by the trained physician. The phenomenon which is one of the most constant and inevitable, as the effects of age
