Senescence, the Last Half of Life

by G. Stanley Hall

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M. L. Price, M.D.,[158] attacks Metchnikoff’s theory of old age by assuming that in addition to all toxins and inflammations there is always an old-age exhaustion of a vital principle that he calls bioplasmine, that may, to be sure, be mainly caused by Metchnikoff’s agencies but is equally affected by effort, exposure, growth, and reproduction. He sagely predicts that the solution of the problem of old age, which he thinks is the central theme of all medicine in the sense in which he conceives it, because every disease brings senile phenomena to some part of the organism or to the whole of it, will be solved by biochemistry, although he admits that it may take many generations of investigation to achieve this final solution.

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George S. Keith, M.D.,[159] after a long life of practice, has grown suspicious of current methods. “I purge, I puke, I sweat ’em; and if they die I let ’em.” As to foods, he believes that the old should only eat when they are far hungrier than they usually are and leave off eating when they now habitually begin a meal. Appetite, which seems to give momentum to all the assimilative processes, is never utilized to its full extent. Sick animals often go off alone and succeed in recovering and he believes humans have the same instinct. He is, therefore, bitterly opposed to forced feeding, even for the insane, save under very exceptional conditions. The sick should generally be allowed to eat whatever they wish, perhaps in moderation, or to go entirely without food. Probably primitive man and all animals had to undergo occasional long fasts and this serves to tone up not only the nerves but the entire digestive system. Instinct is a far truer guide than doctors who interfere with it think. Once the fevered patient who reveled in dreams of cold was kept warm; now we know better.

This author has, thus, an almost implicit trust in the cravings and dislikes of the sick and would indulge them almost to the limit, as the German hygienist, Sternberg, would do to a perhaps even greater degree. He is also a great believer in rubbing and massage. Hot water plays an important rôle, too, while he attaches very special value to licorice. Doctors are often too anxious to save patients from all pain, perhaps by the use of means that entail worse consequences. Pain has its place in nature and the doctor should also try to have the patient apply the cure of patience. Pain is nature’s cry for help, to which she often responds as she does not to other stimuli; and benign as is the rôle of anæsthesia, it should not blind us to the tonic effects pain often exercises. So sleeplessness may not be an unmixed evil in certain cases and sleep artificially induced is usually of poorer and less restorative quality. He has found fixating, spontaneous retinal phosphenes a good soporific method. He believes that very many diseases would cure themselves if the patient could be induced to simply rest and starve. Although he is not a homeopathist, he nevertheless believes that dosages of medicine are far too large. He insists that old and experienced physicians ought to, and that the best do, learn a great deal from experience in keeping themselves well, and that every physician should accumulate thus a store of knowledge based on self-observation, and may well, with profit, always be mildly experimenting upon himself. As age advances he would regulate diet and treatment largely to the avoidance of accumulation of uric acid in the system. He found great reinforcement for himself in making a breakfast of coffee only, etc.

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J. Madison Taylor[160] notes the paucity of literature on this subject that he found in trying to read up on it and thinks it warrants far more attention. The foundations for longevity are laid in the first few months of life and bottle-fed babies are shorter-lived and much less likely to reach old age. Those who spend their infancy and childhood, too, in large centers are less long-lived than those brought up in the country. A serene mental view and capacity for deliberate enjoyment of whatever betides he places first of all and advises self-education in serenity. The less we eat and the less variety, the longer we live, and on this the author lays great stress. We must put aside, as we advance, some articles of diet of which we are fond.

He believes dentists have greatly interfered with longevity because man was meant to be more or less toothless and thus to be reduced in old age to childish diet and fluids, while the dentists enable us to eat anything we ever did, which is against Nature. He speaks of fads and their dangers, for example, one old lady thought she prolonged her life by eating a great deal of salt. The indolence and indifference of age is a great difficulty. If one persists in trying to keep up indefinitely, the results are often amazing. Medical aid should be sought more constantly for lesser ills. Man is like an old horse—if he once gets thoroughly out of condition it is hard to bring him back. G. M. Gould has believed that unfit glasses have shortened the lives of many eminent men. But open air is a sine qua non always.

Tessier gives a clinical picture of approaching death—(1) heart and blood vessels, (2) lungs, (3) kidneys, (4) digestive organs, (5) the brain. Most agree that the heart plays the chief rôle in ending life and many used to think that nearly all old-age diseases were from arterial hardening. But this was doubtless much exaggerated. Old age is a progressive diminution of all functional activities. All clinicians recognize diatheses or a tendency toward disease and we can detect them in their incipiency now far more than formerly. Age diathesis means a lessened coefficient of resistance, quick exhaustion, and weak repair. The author devotes great attention to obesity, which shortens life, and he advocates various exercises of the extensor muscles, deep breathing, and thinks much can be done to tone up and increase the activity of the heart.

He thinks the effects of the menopause have been rather overestimated. Exhaustion, especially induced by emotions, fatigue, anger, grief, and fear, weaken the protective powers of the mysterious agents of immunity. The mind is very liable to become fixed upon some ailment and hyper-conscious, particularly near the menopause, and this is due to failure of the organism to offer the same degree of resistance to toxins and to a general lessening of functional activity.