III
NATURAL DEATH AMONGST HUMAN BEINGS
Natural death in the aged—Analogy of natural death and sleep—Theories of sleep—Ponogenes—The instinct of sleep—The instinct of natural death—Replies to critics—Agreeable sensation at the approach of death
The death of old people, which has often been described as natural death, is in most cases due to infectious diseases, particularly pneumonia (which is extremely dangerous) or to attacks of apoplexy. True natural death must be very rare in the human race. Demange[91] has described it as follows:—“Arrived at extreme old age, and still preserving the last flickers of an expiring intelligence, the old man feels weakness gaining on him from day to day. His limbs refuse to obey his will, the skin becomes insensitive, dry, and cold; the extremities lose their warmth; the face is thin; the eyes hollow and the sight weak; speech dies out on his lips which remain open; life quits the old man from the circumference towards the centre; breathing grows laboured, and at last the heart stops beating. The old man passes away quietly, seeming to fall asleep for the last time.” Such is the course of what properly speaking is natural death.
The natural death of human beings cannot be regarded as due to exhaustion from reproduction or from inanition, as in the case of Monstrilla. It is much more likely that it is due to an auto-intoxication of the organism. The close analogy between natural death and sleep supports this view, as it is very probable that sleep is due to poisoning by the products of organic activity.
It is more than fifty years since sleep was explained as the result of auto-intoxication. Obersteiner, Binz, Preyer, and Errera are among the competent men of science who have taken this view. The first two attributed sleep to an accumulation in the brain of the products of exhaustion which are carried away by the blood during repose. The attempt has been made even to discover the nature of these narcotic substances. Some investigators think that an acid, produced during the activity of the organs, is stored up in quantities that cannot be tolerated. During sleep, the organism gets rid of this excess of acid.
Preyer[92] tried to put the problem upon a more exact basis by the theory that the activity of all the organs gives rise to substances which he called ponogenes and which he regarded as producing the sensation of fatigue. According to him these substances accumulate during the waking hours, and are destroyed by oxidation during sleep. Preyer thinks that lactic acid is the most important of the ponogenes, and lays stress on its narcotic effect. If his theory were correct, there would be a remarkable analogy between the auto-intoxication by lactic acid in the cases of man and animals, and the case of bacteria which produce the same acid and the fermenting activity of which is arrested as the acid accumulates. Just as sleep may be transformed to natural death, so also the arrest of lactic fermentation may be followed by the death of the bacteria which form the acid.
So far, however, there has been no confirmation of Preyer’s theory. Errera[93] has brought forward against it another theory according to which the cause of sleep is not acid products, but certain alkaline substances described by M. Armand Gautier under the name of leucomaines. Gautier laid down that these substances act on the nervous centres and produce fatigue and sleepiness. According to Errera they might very well be the cause of sleep, as that comes on at a time when there is the greatest accumulation of these leucomaines in the body. He thinks that their action in producing sleep is a direct intoxication of the nerve centres. During sleep they are removed, and the disturbance which was produced in the organism is arrested.