Some Medical Aspects of Old Age: Being the Linacre lecture, 1922, St. John's college, CambridgeRolleston, Humphry Davy, Sir
Science
Some Medical Aspects of Old Age: Being the Linacre lecture, 1922, St. John's college, Cambridge
Rolleston, Humphry Davy, Sir
Geriatrics; Linacre lecture, St. John's college, Cambridge; Longevity
Of the hereditary factors most concerned in longevity the inherent
vitality of the central nervous system is the most essential;
physiological death in man and the higher animals is probably due to
failure of the cells of the brain, which do not multiply after birth
and are less capable of rejuvenescence than those of the other organs.
The integrity of the cardio-vascular system is also most important; in
Sir William Osler’s[54] words much depends “on the quality of arterial
tissue (vital rubber) which the individual has inherited.” According
to Sir Clifford Allbutt[55] there are two modes of hereditary
transmission of arteriosclerosis, the direct and the indirect; the
direct which he calls decrescent or primary, consisting in an original
frailty or toxic susceptibility which like other peculiarities may
run in families; and the indirect or hyperpietic, a secondary event
due not to inherent taint in the arterial walls but to metabolic
changes causing high arterial pressure; it is in such families with
hereditary high blood pressure that cerebral haemorrhage occurs in
one generation after another about the same age (65–70). In examining
people the discovery of a blood pressure low for their age often
justifies, in the absence of any pathological condition, the suggestion
that the family is long-lived. The frequency of cardiac hypertrophy
(43 per cent of Councilman’s cases), even though it be a pathological
condition, shows that its reserve power is good. Death among the aged
very commonly depends on some morbid change in the cardio-vascular
system; thus at the Royal Hospital, Chelsea, Majors R. J. C. Thompson
and R. E. Todd[56] found that among 169 deaths of pensioners with
an average age of 77·2 years the largest number 64, or 38 per cent,
were due to this cause; lesions of the respiratory system, pneumonia,
and bronchopneumonia, coming next with 41 deaths, or 24 per cent,
malignant disease being responsible for 22, or 13 per cent. The nervous
and circulatory systems are intimately correlated with each other,
disorder or disease of one, particularly of the cardio-vascular system,
exerting an evil influence on the other. In a negative manner weakness
of the digestive system may favour longevity by preventing the excesses
which vigorous individuals may for a time at any rate indulge in with
impunity; but as a rule the digestion of the long-lived is good.
The first-born is significantly handicapped, as Karl Pearson[57] has
shown, and more subject to tuberculosis, insanity, and criminality. But
out of 71 centenarians analysed by Sir George Humphry 17, or 24 per
cent, were firstlings, and 24 per cent of 824 persons between 80 and
100 were first-born. It must be remembered that first-born are more
numerous than any others, and some of the above were only children.
The most frequent position in the family among these 895 old people
analysed by Sir George Humphry was the third.
ENVIRONMENT
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