Vol. 60, 1909 - University of North Carolina at Chapel Hill

164 THE CHARLOTTB MEDICAL JODRNAl. ,
GERIATRICS. losed, the ribs become harder and lose their I
We have long recognized the tertnpaedi- resilience, the costal cartilage, and the carat/icss-S
applying to that field of medicine tilages of the larynx and trachea become
dealing with the diseases of infancy and ossified, all through the deposition of lime
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childhood. Without actually and accurate- salts. Waste proceeding faster than re- I
ly defining the stage of senilit}' and itsdis- pair, the chest muscles atrophy, and this
eases, we have nevertheless tacitly accept- with the bone and cartilage changes de- !
ed old age as one of the physiological pe- creases the mobility and elasticity of the
riods of life. Recently Dr. I. L. Nascher, chest walls, interferring with the expansion
of New York, has proposed the term^f/vVz/- of the lungs. The lung tissue atrophies,
rics, from geras, old age, and iafrikos, re- and the alveolar septa waste and finally are
lating to the physician, to cover the same obliterated, the vesicles coalesce, and we
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field in old age that is covered
paediatrics in childhood.
by the term
That senility is a
have an enpliysematous
atrophied lung. Owing to
condition
this
in an
condition
distinct period of life having general fea- of the lung and the weak circulation of
tures normal to it and abnormal to all other senility we have an incomplete aeration of
periods is readily accepted. When any of blood an impeded pulmonary circulation, \
its manifestations appear during childhood with a tendency to hypostatic congestion
or maturity they are indicative of disease, and susceptibility to adynamic inflamma-
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and medical skill is often able to remove tion. This adynamic inflammation which
them. Occurring during the period of life is the principal cause of death in old age,
when degeneration and decay are natural differs in many essentials from the pneu-
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and inevitable medical skill may possibly monia of maturity. The sthenic type is inretard,
but death alone can stop the process- frequent and in only about fifty per cent.
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esof decay. Physicians have come to look of these are
upon the features of senility, the atheroma- toms, chill
there
and
the classical
pain.
initial
There are
sympmany
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ta, degenerations, ossifications, and calcifi- latent cases presenting no marked sympcations,
etc., as pathological features of toms, cases where the emphysematous
maturity instead of considering them nor- symptoms mask the symptoms of the pneu-
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mal features of senility, and they are treated
as diseases. Any condition, feature,
function, or circumstance which prevails
monia, and cases where the symptoms present
do not point to lung involvement. In
many cases there is little or no cough, pain,
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generally during one period of life must be dyspnoea, or expectoration. The physical
considered normal to it though it be a disadvantage
to the individual. The weaksigns
of senile
signs in pneumonia
pneumonia
of maturity,
differ from the
and there
ness of the infant and
themata are normal to
its liability to exanthat
period of life.
is a difference in the progress of the disease,
Few cases reach the stage of resolution,
The pains of labor
ture woman. I'or
are
the same
normal in the mareason
we must
and in these areas of engorgement
as foci for future inflammations.
remain
Death is
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consider the degenerated organs and altered
functions of senility normal and physiogenerally
due to exhaustion or paral.ysis of
the heart or lungs. An important feature
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logical. Childhood has received special in all diseases in senility is the presence of f
attention by physicians and a special symptoms referable to the senile conditions, i
branch of medicine has been assigned to and masking the symptoms of the disease.
it. Senility has received the attention of Dr. Nascher's article, published in the ')
but a few inve.stigators; aside from these it New York Medical Journal, certainly pre- \
receives no special consideration, its mani- sents some ideas worth consideration. His '(
festations are considered pathological con- view, so far as we are able to ascertain, is i
ditions of maturity, and its diseases are unique and the term he proposes is a dis- i
treated as though they were diseases of ma- tinct and useful addition to the medical vo- (
turity occurring in individuals who have a cabulary.
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weak constitution. Having an Individ- j
uality of its own
typhoid probuems. |l
as clearly defined as child-
hood, , with anatomical features, physiolog- For many years the medical profession 'f
ical functions, diseases, and their treat- has supinely accepted the theory that wa- 8
ment differing from maturity it should be ter is the chief means by which the germs ,t
considered apart and distinct from ma- causing typhoid fever are spread. Recent- %
turity, and as a special branch of medicine, ly however our historic beliefs have receiv- \\
To such a specialty might be applied very ed more than one effective jolt. No less is 't[
aptly the term geriatrics. Dr. Nascher this true of the method of dissemination of {i
cites the following illustration to show the typhoid fever. In some cities, Washington ,<
marked differences between the conditions for example, the elimination of the hither- |:
existing in senility and maturity. In the to-believed chief source of contamination,')!
normal senile chest the sternum is anky- namely water, has had no effect on the M
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