Senescence, the Last Half of Life

by G. Stanley Hall

He thinks we can postpone old age by the following agencies. We should develop, not discourage, bodily exercise for without it there is a slow retrogressive change. The more nearly the diet is reduced to bread, milk and fruit, the longer the person will live and enjoy good health. Some can go for long intervals without feeding though more thrive on small quantities taken frequently. He condemns all purgatives and would regulate by salads, nuts, fruit, and thinks the best drink is buttermilk, which has salutary effects on both bowels and kidneys. Next comes koumyss. Fluids are best taken in abundance, but if the heart is weak they should be avoided before exercise, for this increases the cardiac strain. If the skin is dry, he advocates dry rubs rather than cold baths and olive oil occasionally, of which he says it is amazing how much the skin will absorb. He speaks emphatically of the dangers of chills and of the trend of all tissues to harden, stiffen, or lose their elasticity. Tissues about the neck are particularly prone to lose vigor. Regulated movements of the neck and upper truncal muscles often improve hearing, vision, cerebration, and sleep, and the same is true of friction. Most digestive disturbances, even those of early middle life, are due to relaxation of the supporting tissues of the great organs in the abdomen. This dilation is found in at least 60 per cent of adults, and it produces a long train of alterations. The kidneys are supported mainly by their blood vessels, so that if they sag their circulation is impaired, and this kind of ptosis is very common. Hence faulty attitudes are very important for all visceral ptoses, while he finds much to commend in the use of abdominal corsets, even for fleshy men. Elasticity of the ribs should receive attention and the author prides himself on exercises that increase the elasticity of the basal tissues which sclerosis is prone to assail. The capacities of individuals for exercise in the open air can generally lessen the need of medical supervision. With old people, the extensors should receive more, and the flexors, less attention and there should be sufficient stretching, torsion, etc.

As to the senile heart, it is generally assumed that the old should do no more than they are inclined to do and perhaps even lead a vegetable existence. But he believes that disinclination to movement means and makes under-oxidization and causes decay and he is severe on what he calls senile laziness. The healthier and happier old people are, the more active they become. The life of a hothouse plant is bad. Humphry found in most old people he examined little or no change in the arterial system. Allbutt says there are many old people in whom there is no arteriosclerosis. One common phenomenon of old age is the loss of vascular tone and defective lymph circulation. The bones lose weight and size and the walls of the shaft grow thin from within, especially toward the end of the bones and most near the head of the femur. Trunecek of Prague emitted the thesis that certain salts can be introduced into the blood current that aid in dissolving the calcium phosphate found in the structure of sclerosed arteries. So he injected hypodermically a strong solution of sodium phosphate and magnesium phosphate, which are normally found in the blood serum but only in minute quantities. Others have introduced this by both bowel and mouth. Anything that aids oxidation of tissues helps.

In another article[161] Taylor says almost nothing that is new although there is much that would be practical to aging people. The machinery has become a little worn and weaker in spots but the bare surfaces have been abraded to meet each other so that there is less friction and racking of the joints. The body cells are less irritable. Degenerative diseases are very insidious. They increase in the following order—liver, digestion, apoplexy, nerves, heart, kidneys. One’s enjoyment of food is greater perhaps than discriminative. Many reminders of age are overcome by warming up. Skin emanations may be offensive. Traits of a mature mind are poise, deliberation, economy and the largest output of judgment, like the Roman senators or seniors. Irritability is common. Youth wants to know; age wants to be.

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C. A. Ewald,[162] one of the most eminent of German professors of biology, gives us one of the most condensed statements on the subject of old age. He begins by contrasting the intense life of Berlin, where the lecture was given, with the fact that all paths lead to the door of death, which is nearest in war. The antique conception of death was youth with a reversed torch; the medieval, a skeletal mower taking pleasure in his work. The martyr’s love of death and even the passion for Nirvana are probably more or less pathological. If we assume 15,000 million people on the earth and a death rate of 30 million per year, we should have 81,192 deaths daily; 3,425, hourly; and 57 every minute. The baobab tree of Cape Verde shows a life of 5,000 years. Some have ascribed 500 to the swan. But nearly all data of great age are discredited. Even that of Parr (152), who married with potence at 120, and all the rest, are doubted. But the length of life is increasing. In Sweden, of every 100 children of five at the beginning of the last century, 27 reached 70; at the end of the century, 48 did so. In Bavaria the number increased from 25 to 40; in Germany, in the last twenty years, it increased from 30 to 39, so that we all have a better chance of living long than we would have had if we had been born a hundred years earlier. The average length of life in 1870 in Germany was 37 years and has now increased to 42½. In France and England it is 46 and in Norway and Sweden, 52. Cures of tuberculosis in the last twenty years have reduced the percentage of its victims from 31 to 17 per 10,000, and vaccination has reduced the death per million from smallpox to 5; while in Russia, where it is not compulsory, it is 520. A priori, death does not seem necessary and yet for even protozoa division often involves something like a very rudimentary corpse so that investigators like Götte, Hertwig, and Verworn accept the tenet of Weismann, with some slight reservation, if the corpse is to be taken as the criterion of death.

Bees and the stork and other birds of passage kill or neglect their old, while in ancient German myth old men often slew themselves for the good of the community. Certain species eat their young rather than die themselves and even this is for the interest of the species. A certain wasp lays its eggs in the female plant and its young, when covered with its pollen, fly to a male plant to fertilize it, although this means their death. Thus death is a normative factor of development and to this extent Weismann is correct. Life has three periods. In the first there is an excess of energy and growth; then comes middle age with an equilibrium, while in old age the relation of these energies is reversed, so that the first and third stages contradict each other. But everywhere life is dependent on nutrition and all death, in whatever form, is due to its lack. So we have a kind of biological circulation and a kilogram of body substance evolves a different sum of total energy in each of these periods of life. The author gives us an interesting cut of the contraction of the vertebrae and their padding, which often in the old means ankylosis in the lower part of the spinal column.

He dissents from the Conklin theory of the abatement of metabolism as a cause of old age because he thinks this activity has a wide range of play at all stages of life, monthly and even daily. Nor does he accept without modification the Schilddrüse (thyroid) theory, although admitting that the endocrine glands play a very important function. Nor does he accept Von Hansemann’s view of altruistic nutritive disturbance, namely, that single cell groups are more or less reciprocally dependent upon others for their activity so that they in a sense work for each other. The physiological (that is, without outer stimulation) collapse of groups of cells is especially connected with the generative cells and their departure reacts upon the nutrition of the whole body and in a sense weakens it (the atrophy of age). The loss of the generative cells is physiological because they, in departing from the body, represent the growth of a new organism. Hansemann gives countless examples but they affect only the fact and not the kind or method of growing old, which is a progressive process, and we still are unable to answer the question why the generative cells in the ordinary process of life are so soon destroyed or why so few of them are devoted to this purpose.

The author sees much truth in Minot’s differentiation or cytomorphosis of cells, according to which differentiation, which causes growth, is also the cause of death. Minot himself says that the biologist can no more grasp the essence of death than he can that of life. Science does not know the difference between these two despite the impulsions of our causal instinct. Horsley thinks the condition for a green old age is the conservation of a sound thyroid. With its activity is, of course, connected that of other glands.

He says it might be assumed in a period during which a whole generation dies that the whole mass of putrefaction would cause infection. But in a half-dozen German cities very carefully investigated along this line it was found that those who lived in or near cemeteries were as long-lived as others and even those who drink water that is fed by drainage from well appointed graveyards are not infected; on the contrary, in several places this water is purer than elsewhere. There is only one exhumation in Germany for criminal purposes out of 600,000 corpses, but poison that might be detected by exhumation cannot, of course, be traced after cremation.

Instead of the remorse, anxiety for friends, dread and pain, the author, who says he has seen “many, many hundreds of deaths,” never saw one that was not unconscious. There are often, perhaps even for days, physical signs of great suffering but this is never felt; and the author advocates special death rooms in hospitals because it is so hard for onlookers that it is inhuman to allow patients to die in a ward with only a screen in front of the bed. The review of life by drowning people is a myth. It is the duty of the doctor to mitigate closing pains by morphia and other means, provided these do not shorten but rather tend, as they should, to somewhat prolong life. Even in death by fire and torture the last stages are painless.