OCR Text |
Show Jjfl BY JAMES J. WALSp. -X V '; illtK (CopjT"rtt, 1012. Yj the New York Hcrnld Co, AU rlrtts wmM.) t&H T lost medical science hat tH J wakened up to the fact that tliH l,Pcc'',l caT,i needs to be taken of 4H the old. There arc now one-fifth t&MH ' more people alive .rbove the age bjH of sixty, it is eaid, than was (be ''9ii case a generation ago. The average a! length of life has increased about onc- J7H fourth, and as the avcracc is greatly dc- VH) creased by the excess of deaths under live UJjhT it is particularly because of much longer ?JjlH- life than before thnt our mortality avor- H flce hax improved so much. Scientific (jLM medicine has been occupied for many 'iSH years with the question of reducing tlm t-tn death rate ainong children. A special de- SXH partment of medicine, called pediatrics, 2jH from tlic two Greek words meaning child sijHl and healing, was established about half :B a century ago and a special chair created JH for it in nil the medical schools. Those 'H who know the statistics of the death rate H among children will appreciate very well 9t'h4H how much has been accomplished bv tlu's fe!H departure. There are literally thousands olB of children alive now in our large cities jgM that would not be alive if the infantile tB death rate of even twenty years ago had 'sl maintained itself. p Now medical science and, above all, tljrH medical education is coming to recognize tH that a similar benefit can be conferred lUlB upon mankind by the careful specialty of jjH the diseases of the old. It has been too iHfc much the custom to think that old age ffBv must necessarily be associated with suf- HJ2 fering and that the inevitable progress 5?H f toward death, with its accompanying JRMM manifestations, must be accepted calmly JH without any possibility o mucli relief for tSM them. A great change has come over the scientific attitude toward old age, ,5- however. Metchnikoff, at the Pasteur i5j Institute, calmly discusses the possibil- IJ jty of man living on to 120 or, perhaps 5L? Io0, if only the disharmonies of bfc can pj be corrected. Distinguished thipkers in i psychology have quite seriously dis- H I cussed the question as to whether death . $ may not really be a process of anticlpa- iSfM tiou in human life because of the con- S viction that has come to so many minds f that almost any affection occurring after itjtl sixty is likely to caTry the patient off. I Certain it is that by will power men 6omctimcs live long after physicians arc ready to declare that death is Inevitable. On the other hand, it is well known that death takes the "quitters" and that men who give up in such diseases as pneumonia pneu-monia or kidney disease do not last long. Tuberculosis, it has often been said, takes only the "quitters," and every man "who t ill will to live in the early stages of the disease can almost without exception sc- ' cure many years of life for himself. r Food, Rest and Air. The great reduction in the death rate among childrei. and the corresponding lengthening of life has come as a result of attention particularly to three things food, air and rest. Overfeeding is only a Httlo bit more ecrious than too little air icJW or sleep. Sometimes the details with re- , bi gnrd to these seem very trifling, but long lSj ago Michael Angclo said, "Trifles make r"U ' perfection, though perfection is no trifle." Jji Certainly this may be paraphrased, both 3l as regards the health of the young and P the old, "Trifles make health, though tj? health is no trifle." It is the food, its dm- g. proper preparation, and especially care p5f that there shall not be an excess of it. ij the amount of air, and watchfulness that ' JJJ there shall be an abuudancc of it, and the 21 amount of sleep, and precautions to ob- 1 tain the proper amount of it, that makes I all the difference between health and disease, dis-ease, which, after nil, means only dis-1 dis-1 comfort, though it may have serious con-: con-: sequences for the old r.s well as for the young. What we have learned in recent" years is the definite application of principles of treatment to the old so as to obtain these indispensable requisites to as great an extent as possible, and particularly to the drgreo required for the special individual, for, after all, it is a question, not of treating treat-ing old age, but of treating old persons, each one of whom Is very different from the others, Tt is only appropriate, then, that the new special department of clinical clini-cal medicine should be called by a name analagous to pediatrics. Geriatrics from the Greek gcras (an old man) ami iatricR (healing) has been very properly adopted for it. There are certain noteworthy differences differ-ences between those who arc beyond sixty and those who are in middle life as regards physiology, pathology, tendencies tenden-cies to disease and resistive vitality. This is particularly noticeable with regard to the two most important functions of animal ani-mal life eating and sleeping. Long ago Hippocrates declared in one of bis apho-lisms, apho-lisms, "The old 6tnd fasting much better bet-ter than those of middle age, and those of middle ngc much better than the young. Children are very easily hurt by luck of food." This is the keynote of eating among the old. They need less food Uia.u in earlier years, and if they insist on eating eat-ing as much ns formerly they suffer from it. It is rather easy to understand the reason for this. They are not nearly so active qs in middle life and their heat processes within the body arc much lower. As a consequence they do not burn up so much fuel, and if the fuel continues to be provided in excess for this heat engine that the animal part of man is, it will not be long before the fire box will be clogged and before processes of various kinds within the body will be seriously disturbed. dis-turbed. Moderation in Eating. Above all, it is important that long established habits of eating shall not be disturbed in the older years, especially in tho direction of more abundant eating than before. Many a man who after a reasonably long life of simplicity in eating eat-ing comes into conditions of life where dining becomes a function and course dinners and luncheons and breakfasts a . routine suffers severely from it. It is in , those cases literally that men sometimes , ''dig their graves with their teeth." Mod- eratjon in eating is of first importance j for the old. An extremely interesting story is told of the physician of the late Pope Leo XIII. and his arbitrary regulation of cer- , tain of the habits of the great pontiff. . The Pope is baid to have announced to his physician one day that he -was think- j ing of getting a new set of teeth and ,thut a dentist should be summoned for that purpose. Leo XIII. had been one 1 of the most abstemious of men in the matter of food and had always done an i enormous amount of work. His physi- cjan, well pleased with the state of the : Pope's health, which enabled him to ac- I compjish so much in spite of his ycurs, j naturally hesitated about the change in 1 bis diet I hat might come with the iutro- ! ducfion of new teeth He dcclaicd at 1 once:-t"Xo, Holy Father, I shall not I permit you to get a new set of teeth Wc 1 shall have the old ones repaired, but no more. You have been getting on very well with the old ones, and 1 have grave fenrs as to what might happen to your old stomach because of the work that might be set for it by the new teeth." The Pope did not get the new teeth. After eating, the most important factor for the retention of health in age is Bleep. Those above sixty need more sleep than they did in middle life, or at least need to spend more of their time in a reclining position. It is not nbso-utely nbso-utely necessary that they should sleep all the time, but ihey ought to spend at least sight hours lying down with all portions f the body on about the same level, so !is to save their hearts the necessity for pumping blood against the force of gr.n-ity. gr.n-ity. It must not be forgotten that sonic two gallons of blood- that is, sjxtccn pounds goon through (he heart about ?vcry miiiuif. The merely mechanical labor performed by the heart muscles is jiiornious. The saving of a considerable portion of the heart by lying down is in extremely favorable factor for old hearts. Besides, the old should lie down for some time about the middle of their vorking day. If they get up ;i little after ;even o'clock and stay up until nearly Mcven the sixteen hour day should be liroken between to and four o'clock by 1 prolonged interval of lying down. In p'The New Department of Medicine, Which Has to Dowitfi the Treatment of the Agen ' "IC :-L 1 ,,; By Material MethodsDeath TafciUhe Quitters" H dr. ; ,. 1 1 Europe many men have the practice of reclining re-clining for a1 while at this'tinKyiuidin1 good nirfnv of tho'ie who have lived 'long llvc.Vha'vc bad this habit of breaking'thc day for a time about it middle - - In recent years public attention has been very widely attracted to the question ques-tion of the hardening of the arteries that occurs almost normally in old age. Arteriosclerosis Arte-riosclerosis has comu to lie considered a dread disease that shortens men's lives As a matter of fact, it is almost an inevitable inevi-table development of the changes consequent conse-quent upon the growiug old of the tissues. For some reasons, such as overwork in youth, the. deteriorating effect of certain diseases, ' ovcrstreiiiiOuslty of life, the abuse of .stimulants drugs and tobacco and the influence of heredity, some meu develop hardening of, the, arteries p'rema-turely p'rema-turely that is, much sooner thau it should normally come. A man is literally as old as his arteries nnd tho arteries of tlose individuals have growii old before their time. There has beeniqiicslion of ouresl for artcrio-sclerois. bntr-it is an affection to be prevented.' not cured. Oliver Wendell Wen-dell Holmes gaiil thatVa physician could cure any diM;asc if it'nly came to him in time, but that the diseases of many of his palieuts ought lo have come for treatment treat-ment in the persons of their grandfathers. Someihing very similar ought to be said of artTio-sclcrods. It needs to be treated not when it is already fully developed, but twenty or forty years before, when the abuse, in enting, driuking, working, and, above all, worrying, werVmaking themselves them-selves felt upon the arterial system. It is extremely important that the old should -lloep up thfir oceup?itions, so as lol prevent occupation of mind with it-M it-M to a harmful degree. Men, like machines ma-chines will rust out sooner than they -will wear out. Many a man at thp age of sixty or Icsk gives up his occupation in life, thinking that now it is time for him to take 11 rest, and finds before long that there is no rest for him in the sense of being satisfied with doing nothing, but that if he has been much occupied during the prccediug years then for peace of mind for himself he must continue to have Youth Has a Magnetism of Its Own Whictf It Imparts to-the.Old, Lifting Them Out of Depression De-pression and Despondency. 1upnt.1I occupation. Some one once said, very well, c must occupy our minds 'nilh doing things or else they will do us. That is literally true. After occupation of mind the most important im-portant preservative for the old is association asso-ciation with the young. Xothing so keeps a man from brooding over the troubles of life, and even impending dissolution, dis-solution, than occupation with those much .ounger than himself in which he is deeply Interested, Many grandfather fiod tho very best tonic for his vita lit j in intimate, association with his grandchildren. grand-children. Youth has ,1 magnetism of its own which it imparts to the old, lifting them up out of depression and de-pon-deney. Curiously enough, associations with those of mature or middle age have not so much benefit for fhe old. Often they emphasize the impossibility and incapacity in-capacity for accomplishment which age moro or loss necessarily brings v it Ii it When a miiu cnu help young people and be much with thm, then his older years are likely to have more of happiness and health than -under any other circumstance. circum-stance. It has been found that it i extremely important for old ngc not to lapse Into habits of inactivity. Thon is the tempta-tion tempta-tion of a man well on in years to give up walking to a great extent, to ride in carriages car-riages and to sit in the house a great deal. What ha6 been learned about the heart in recent years shows very clearly that unless un-less it gets a certain definite amount of exercise it docs not da its work as wo!l as it otherwise would. At Xauheim, the greatest health resort for heart cases In the world, while the baths const'tutc the attraction, it Is iwell recogui7ed Ij the medical profession that the gridi'.iioil exercise ex-ercise up tho low grade hills winch surround sur-round Xauheim which is always carefully prescribed- constitutes. the most successful success-ful part of the treatment. Str.kcK, the greatest of English authorities at the. middle of the nineteenth certturj, Insisted that even for fatty hearts gr.idnally increased in-creased exercise is extremely important. It Is recognized now that the tendency of the old to drop into flesh 5 particularly unfavorable for them. Their obesity is due to a great extent to the inactivity to which their yoara predisposes them, hut the accumulation ac-cumulation of fat has had two bad effects. Fitst, because of the weight St requires the individual to carry around It further discourages dis-courages activity. Second, it accumulates accumu-lates around important organs, especially around the heart, though also in tho abdomen, ab-domen, and hampers their activity. Great care must be exercised, then, not to permit the accumulation of fat. There is only one way to do this, cat no more than is required for the amount of exercise taken. Just as soon as the weight begins to go up beyond the normal weight for height there must be less eating and more exercise. Care must begin not when the patient is already thirty or forty pounds over weight, but when five per cent more than the normal weight for height is noted. It is not hard to get a tabic that will show exactly what that is. Difficult to Reduce Weight. When older people .have once put on weight it is rather difficult lo take io off. Much can be done, however, by regular exercise nnd proper limitation of food. This need not moan that they shall be denied de-nied all starchy substances and most of the food products that they like best, hut that everything that they cat shall be I somewhat limited and that certain specially spe-cially fattening articles like puddings, ice cream and butler shall to a great extent be taken out of (heir diet. With regard to exercise they will probably need considerable encouragement. There are forms of exercise, however, that are particularly good for old people. Golf is one of these, walking, especially in I company Tllh a friend or friends, is another, an-other, and then in recent years the value I of walking down stairs has been rccog-Inizcd. rccog-Inizcd. Wc probably owe the suggestion (of this to some of the German specialists, but American experience has shown it lo be a vory valuable form of exercise in taking off weight from those who are pretty well on in years. For older women (how much weaker the comparative is hon. than the positive) posi-tive) probably the worst possible feature in their emiroumenl is the presence in the house with them of several unmarried unmar-ried daughters. They take all the responsibility re-sponsibility off mother's shoulders and try to do everything for her, keep her from going out in case there has been the slightest change in (he weather and want to make arrangements by which she shall be saved all fatigue. Xow.j fatigue is a valuable conservative pro- Cf.ss in nature. It means that a certain IH amount of energy Jias been used up, and there is always a certain satisfaction in it. It has often been called to attention I that muscular exercise is really only IH satisfying and pleasurable when it jH leachos a point where it is properly fa- ' H tiguiug. Unless mother is allowed to have proper occupation of mind with H many things that she has to do for her- H self and unless she is. encouraged to ex- crcise, to get out for herself, to do many H things, there is danger that she may rust out sooner than wear out. Any one who knows conditions in households where IH tho daughters try to mako things too jH easy -for mother will appreciate these remarks. Any nbysician Is likely to havo H sceu a number of cases in which over- H solicitude for mother on the part of the j daughters has, if not actually shortened H life, certainly made the closing years of mother's life more full of meatal and 'even physical discomfort than it other- V'isc would have been. Exercise of Legs. H It has come to be realized vory clearly H in recent years that a great many of the H paius and aches of tho old, and especially those in the legs, arc due more to inac- H tivity than to any other factor. Old men who have to stnud much suffer a great H deal. As these pains and aches are worse in rainy weather, they have usually been H set down to rheumatism. It has come to be recognized, however, that the word rheumatism should only be used whenever H .there has hecu an acute elagc with fever lH and redness and swelling of joints. The I other pains and aches arc due to long use H I of muscles. Sometimes they arc due to flat foot, often to enlargement of the veins of the leg, spoken of as varicose H veins, sometimes to standing without any H proper exercise of leg muscles. In the . H upright position the leg muscles are firmly H contracted and the circulation in the thin I H walled veins is considerably hampered. 1 H Venous circulation Is greatly helped by ) fH muscular contractions. Hence the neccs- jH sity for some definite exercise of the legs, ' by walking downstairs and the like, IH which thoroughly empties the veins. I jH While the return circulation is moat im I j portant in the legs, sometimes the direct IH circulation through the arteries is dis- turbed. The feet of the old rather easily H become cold, and it may require 11 good H deal of warmth to restore circulation. At 1 the end of a long day if an old person ' lies down with cold feet they may cause jf wakefulness for several hours. Sir Henry , I Thompson, (he distinguished English sur- H gcou, who lived to be well beyond eighty H H and wrote a book on old age when he was Kl past fourscore, had the custom of putting '1 his feet for at least five minutes just be- jJ fore going to bed into water gradually jJ made as hot as he could stand. This dis- jH I tended the veins, brought a large quail- thy of blood down to the legs, and .so pre- H vented insomnia, .fter he had been out H at a meeting or a diuuer, or any other oc- H casion that might possibly make him ' B wakeful, he extended the time of this pcdiluvium and slept undisturbed for H from .seven to eight hours afterward. H Iu general it may he said that all our Hl advance in the care of the old has come , JH from a greater attention to hygienic dc- ' H tails of living. There must be full occu- IH pat Ion of mind, considerable activity of H liody and attention to details of health IH iu the matter of air, water, food and H bodily exercise. These, with the definite IH ersuasion that life by no means ncces- H sarily cuds with the seventieth year and H only accidentally with anything less than H that, and in the words of Bismarck, that H while mankind is persuaded that all the jH good things happen in the first seventy IH years of life there are many pleasures IH in the second EConty, there seems no H reason why men should not live healthy H and happy considerably beyond three- H sore and ten without necessarily incur- jrmg any of the unhappiness suggested H by the Psalmist. jH |