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
_Skeleton._--The atrophy characteristic of senescence is well shown
in the fixed tissues of the bony skeleton. Though the bones do not
as a rule alter materially in size or shape, they do so markedly in
substance from rarefaction and absorption, the latter taking place
mainly from the inside of the bones and especially the cancellous
tissue, the medullary cavity and the Haversian canals becoming larger
(senile osteoporosis). Hence fractures near the joints, particularly
intracapsular fracture of the neck of the femur, are favoured. The
absorption of the alveolar border of the jaw is intimately connected
with the loss of the teeth, and brings the mental foramen to the top
of the edentulous mandible. The angle of the jaw at the junction of
the body and the ramus now opens out and comes to resemble that of an
infant. It is often stated that the angle of junction of the neck and
shaft of the femur becomes less, more of a right angle, but Humphry
regarded this as exceptional.
From muscular weakness the back becomes bent and as a result the
vertebrae become altered in shape. Ossification of the anterior common
spinous ligament--a change analogous to rheumatoid osteophytes around
the more movable joints--is an added and not uncommon change but, like
calcification of the costal and laryngeal cartilages, it is a morbid
process, and when advanced constitutes spondylitis deformans. The
intervertebral discs undergo some loss of elasticity and atrophy,
thus contributing to the loss of height. The cranial bones are usually
thinned, and the parietal bones may show symmetrical or nearly
symmetrical oval areas of excessive absorption of the outer and even of
the inner table, so that the epicranium and the dura mater may be in
contact. These areas which are close to the longitudinal fissure must
not in the case of ancient skulls be mistaken for examples of early
trephining. The bony sutures tend to become obliterated. Instead of
thinning and loss of weight the skull, especially the vault, may show
thickening and be heavier than normal--a change involving chiefly the
inner surface and ascribed by Sir George Humphry to shrinkage of the
brain.
Calcification of the costal and laryngeal cartilages, which have
a yellow tint from fatty change, is, like a similar change in the
arteries, pathological and not part of the process of senescence. Thus
among 10 recorded necropsies on centenarians the costal cartilages were
calcified in 2 only. Calcification of the costal cartilages interferes
with the respiratory movements and was regarded by Sir George Humphry,
who tested for it by estimating the elasticity perceived when gentle
pressure is exerted on the lower part of the sternum, as a bad omen
for the future.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account