begin to make themselves felt, is shortness of breath on exertion. This has to do more with faults in the action of the circulation and the vasomotor nerves than in the lungs. The old man finds himself distressed in his breathing while undergoing a degree of exertion which aforetime would produce no noticeable effects. The heart muscle is old, relaxed and softened and contracts imperfectly and readily shows exhaustion. This need not produce alarm, but if the condition rapidly increases it may be significant of some important change and should be referred to the medical adviser. In fact, it can not be repeated too often that the more constantly the aged person remains under observation of a wise physician, the more safely can it be promised that he will live happily and long. There is a symptom which is most terrifying and frequently occurs in the aged, and that is a sudden agonizing chest pain, during which the sufferer, unless he be of unusual mental equipoise, feels that he shall instantly die. This may come on suddenly without previous warning and requires the best medical advice, but it almost always passes and may recur many times and is capable of much relief. It may be a symptom of chronic myocardial degeneration.
The lungs also, in most instances, share in the process of death. The changes which occur in the aged lung are degenerative and need have nothing to do with any previously disordered processes in them. Again it may happen that certain changes common in old age take place and prove to be most distressing; the chief of these are asthma, chronic pneumonia and bronchitis. Pneumonia in the aged is a very serious affection, and it is stated that the largest number of deaths in old people are caused, or accompanied by, acute broncho-pneumonia.
The digestive organs sometimes give away while the rest of the organism remains in fairly good condition. Sir William Thomson has written most charmingly upon the digestive disorders of elderly folk, and it would be well for every old person to read his suggestive essays. Unless care is observed in regulating the diet (and the chief point here is rather a reduction in the amount than particularizing as to the items of food taken), distressing phenomena will constantly arise. Fortunately this is easily avoided, although not so readily cured. Sir William Thomson makes the assertion that the disappearance of the teeth is a plain indication of the return to a second childhood, and therefore the food should be of such a character as may not require the assistance of the teeth in mastication. He advises most wisely, although his recommendation can not be taken literally, that the teeth be not replaced by artificial ones, for thereby is a peril lest more food be taken than the organism can dispose of. The fact that the various organs concerned in the elaboration of food share very early in the degenerative changes of age makes it clear that the character of the food taken should be so simple in kind that no great strain would be
