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
The relation between ageing of the cells on the one hand and the
development of carcinoma on the other hand is a subject of great
interest. According to Karl Pearson’s[130] statistical enquiry the
incidence of carcinoma reaches its maximum at the age of 46 years in
women and 56 years in men; Lazarus-Barlow[131] concluded that the
range of years over which cancer is likely to occur is practically the
same in the two sexes, namely 46 to 64, and that among 4659 cases of
malignant disease there were only 35, or 0·7 per cent, over 80 years
of age.[132] The cancer age, therefore, coincides with the waning of
maturity and the onset of old age; that carcinoma is rare in very
old persons is also shown by the occurrence of one case only among 71
centenarians collected by Sir George Humphry. Laurent[133] considered
that whereas longevity depends on a condition of vital equilibrium,
the development of cancer is due to a want of this equilibrium, to a
state of anarchy, and that the factors disposing to orderly vitality
are conducive to longevity and antagonistic to the development of new
growth. The reason why malignant growths are prone to appear with
the onset of old age has naturally been the subject of much debate.
According to Thiersch degeneration lessens the controlling influence
normally exerted by connective tissue on epithelium, the inherent
proliferative capacity of which then runs riot. Ribbert believed
that from loss of resistance or diminution of surface tension in the
connective tissues post-natal “rests” of epithelium were produced
as the result of irritation and that these displaced cells then
grew because there was no controlling opposition. Adami suggested a
reversion of the highly specialized epithelial cells to a simpler form
with powers of proliferation, the cumulative habit of growth taking
the place of the habit of work, and practically anticipated the more
modern view. According to Hastings Gilford[134] malignant disease is
a premature cell senility and the result of the partial reversion of
immature or adult cells to an embryonic or quasi-embryonic state.
From a study of senescence in dogs Goodpasture[135] concludes that
degenerative changes in the cells lead not only to death of some
cells but to dedifferentiation of others, which, becoming simpler in
structure and function, recover their juvenile power of growth in
varying degrees, and that hence metaplasia and tumour growths occur as
accidents of commencing old age. A little later Oertel[136] insisted
on his view that cancer is not an embryonic reversion or a specific
change in the cell but a phenomenon of senescence--a degenerative
proliferation depending upon disturbances in the nucleus plasma
relations, specifically upon the loss of nuclear chromosomes; from age
or degeneration the tumour cell loses the higher functional chromosomes
and retains the genetically older and more resistant ones controlling
reproduction and vegetative activities; thus there arises a race of
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