I am also of the opinion, that arteriosclerosis is thus postponed, and sometimes prevented, hence the same principles hold good throughout the entire economy. It may not be necessary to develop this thought further, but to assume the truth of what I regard as an original observation, that systematized effort at elasticizing of the tissues is the basis upon which sclerotic changes generally can be delayed and made less. The means by which this result is to be attained consist chiefly in employing movements taught by a skillful person, and this should be the physician himself, assisted, it may be, by an expert trained by him to pursue the work in detail. Free exercises in the open air, proportional to the capacities of the individual, are of the greatest importance and should be regulated with the same care and supervised with the same conscientiousness as any other medical measures. Among those of the utmost importance are prescribed movements which differ in degree at least from the ordinarily employed remedial movements whose main object is to improve muscular tone, and which are largely flexor for the arms, with only a moderate degree of extensor activities. For older people there should be a steadily increasing attention to the extensors and less action demanded of the flexors. First these should be passive in the form of stretchings, rotations and torsions carefully and deliberately applied to the limbs and trunk and the neck. These should be moderately supplemented at first by voluntary movements in the same direction. Later, as vigor improves, and the heart action is strengthened, and the blood vessels recognized to be better able to stand the increased vascular tension induced by exercise,[1] these may be employed more forcefully until, by and by, the patient, even when well advanced in years, can endure a degree of muscular work which is surprising. Not only so, but this results in a feeling of well-marked enjoyment, not only of the restoration of sensations due to the improved circulation and in increased resistance to temperature changes, but in the procedures themselves which come to be distinctly relished.
In this connection let me say a word about the senile heart. It is generally accepted in a fatalistic sort of way that old people are unfit for activities, that they must do as they are inclined to do, little or nothing but exist, like vegetables. My own experiences and convictions in this particular seem fortified by the best authorities consulted. In my opinion the disinclination to movement and effort is rather the result of under-oxygenation, a habit, or other conditions which make for what one may almost call senile laziness, than an instinctive economic impulse. It is obvious that the healthier and happier old people are those who are reasonably active. My experience justifies the conviction that where activities have been encouraged, always with full
- ↑ This increased vascular tension as Oliver and others have shown, is quickly followed by a fall. Hence the most salutary means of lowering tension is by exercise to the point of skin relaxation—sweating.
