[Dr. Robson Roose, an eminent physician of London, is the
author of standard works on Gout on Nerve Prostration, on
Waste and Repair in Modern Life. The _Fortnightly Review_,
1889, contained the admirable article which follows: it is
reprinted with the kind permission of the author and the
editor.]
The doctrine that a short life is a sign of divine favour has never been
accepted by the majority of mankind. Philosophers have vied with each
other in depicting the evils and miseries incidental to existence, and
the truth of their descriptions has often been sorrowfully admitted, but
they have failed to dislodge, or even seriously diminish, that desire
for long life which has been deeply implanted within the hearts of men.
The question whether life be worth living has been decided by a majority
far too great to admit of any doubt upon the subject, and the voices of
those who would fain reply in the negative are drowned amid the chorus
of assent. Longevity, indeed, has come to be regarded as one of the
grand prizes of human existence, and reason has again and again
suggested the inquiry whether care or skill can increase the chances of
acquiring it, and can make old age, when granted, as comfortable and
happy as any other stage of our existence.
From very early times the art of prolonging life, and the subject of
longevity, have engaged the attention of thinkers and essayists; and
some may perhaps contend that these topics, admittedly full of interest,
have been thoroughly exhausted. It is true that the art in question has
long been recognized and practiced, but the science upon which it really
depends is of quite modern origin. New facts connected with longevity
have, moreover, been collected within the last few years, and some of
these I propose to examine, and further to inquire whether they teach us
any fresh means whereby life may be maintained and prolonged.
But, before entering upon the immediate subject, there are several
preliminary questions which demand a brief examination, and the first
that suggests itself is, What is the natural duration of human life?
This oft-repeated question has received many different answers; and
inquiry has been stimulated by skepticism as to their truth. The late
Sir George Cornewall Lewis expressed the opinion that one hundred years
must be regarded as a limit which very few, if indeed any, human beings
succeed in reaching, and he supported this view by several cogent
reasons. He pointed out that almost all the alleged instances of
abnormal longevity occurred among the humbler classes, and that it was
difficult, if not impossible, to obtain any exact information as to the
date of birth, and to identify the individuals with any written
statements that might be forthcoming. He laid particular stress upon the
fact that similar instances were altogether absent among the higher
classes, with regard to whom trustworthy documentary evidence was almost
always obtainable. He thought that the higher the rank the more
favourable would the conditions be for the attainment of a long life. In
this latter supposition, however, Sir George Lewis was probably
mistaken: the comforts and luxuries appertaining to wealth and high
social rank are too often counterbalanced by cares and anxieties, and by
modes of living inconsistent with the maintenance of health, and
therefore with the prolongation of life. In the introduction to his work
on "Human Longevity," Easton says, "It is not the rich or great ... that
become old, but such as use much exercise, are exposed to the fresh air,
and whose food is plain and moderate--as farmers, gardeners, fishermen,
labourers, soldiers, and such men as perhaps never employed their
thoughts on the means used to promote longevity."
The French naturalist, Buffon, believed that if accidental causes could
be excluded, the normal duration of human life would be between ninety
and one hundred years, and he suggested that it might be measured (in
animal as well as in man) by the period of growth, to which it stood in
a certain proportion. He imagined that every animal might live for six
or seven times as many years as were requisite for the completion of
its growth. But this calculation is not in harmony with facts, so far,
at least, as man is concerned. His period of growth cannot be estimated
at less than twenty years; and if we take the lower of the two
multipliers, we get a number which, in the light of modern evidence, can
not be accepted as attainable. If the period of growth be multiplied by
five, the result will in all probability not be far from the truth.
If we seek historical evidence, and from it attempt to discover the
extreme limit of human life, we are puzzled at the differences in the
ages said to have been attained. The longevity of the antediluvian
patriarchs when contrasted with our modern experience seems incredible.
When we look at an individual, say ninety years of age, taking even the
most favourable specimen, a prolongation of life to ten times that
number of years would appear too absurd even to dream about. There is
certainly no physiological reason why the ages assigned to the
patriarchs should not have been attained, and it is useless to discuss
the subject, for we know very little of the conditions under which they
lived. It is interesting to notice that after the Flood there was a
gradual decrease in the duration of life. Abraham is recorded to have
died at one hundred and seventy-five; Joshua, some five hundred years
later, "waxed old and stricken in age" shortly before his death at one
hundred and ten years; and his predecessor, Moses, to whom one hundred
and twenty years are assigned, is believed to have estimated the life of
man at threescore years and ten--a measure nowadays pretty generally
accepted.
There is no reason for believing that the extreme limit of human life in
the time of the Greeks and Romans differed materially from that which
agrees with modern experience. Stories of the attainment of such ages as
one hundred and twenty years and upward may be placed in the same
category as the reputed longevity of Henry Jenkins, Thomas Parr, Lady
Desmond, and a host of others. With regard to later times, such as the
middle ages, there are no precise data upon which any statements can be
based, but there is every reason to believe that the _average_ duration
of life was decidedly less than it is at present. The extreme limit,
indeed, three or four centuries ago, would appear to have been much
lower than in the nineteenth century. At the request of Mr. Thoms, Sir
J. Duffus Hardy investigated the subject of the longevity of man in the
thirteenth, fourteenth, fifteenth, and sixteenth centuries, and his
researches led him to believe that persons seldom reached the age of
eighty. He never met with a trustworthy record of a person who exceeded
that age.
To bring the investigation down to quite recent times, I can not do
better than utilize the researches of Dr. Humphry, Professor of Surgery
at Cambridge. In 1886 he obtained particulars relating to fifty-two
individuals then living and said to be one hundred years old and upward.
The oldest among them claimed to be one hundred and eight, the next one
hundred and six, while the average amounted to a little more than one
hundred and two years. Many interesting facts connected with the habits
and mode of life of these individuals were obtained by Dr. Humphry, and
will be referred to in subsequent paragraphs.
A short account of the experience of a few life-assurance companies will
conclude this part of my subject. Mr. Thoms tells us that down to 1872
the records of the companies showed that one death among the assured had
occurred at one hundred and three, one in the one hundredth, and three
in the ninety-ninth year. The experience of the National Debt Office,
according to the same authority, gave two cases in which the evidence
could be regarded as perfect; one of these died in the one hundred and
second year, and the other had just completed that number. In the tables
published by the Institute of Actuaries, and giving the mortality
experience down to 1863 of twenty life-assurance companies, the highest
age at death is recorded as ninety-nine; and I am informed by the
secretary of the Edinburgh Life Office that from 1863 onward that age
had not been exceeded in his experience. In the valuation schedules,
which show the highest ages of existing lives in various offices, the
ages range from ninety-two to ninety-five. It is true that one office
which has a large business among the industrial classes reports lives at
one hundred and three, and in one instance at one hundred and seven; but
it must be remembered that among those classes the ages are not nearly
so well authenticated as among those who assure for substantial sums.
There is, moreover, another source of error connected with the valuation
schedules. When a given life is not considered to be equal to the
average, a certain number of years is added to the age, and the premium
is charged at the age which results from this addition. It follows,
therefore, that in some cases the age given in the schedules are greater
by some years than they really are.
Taking into consideration the facts thus rapidly passed under review, it
must, I think, be admitted that the natural limit of human existence is
that assigned to it in the book of Ecclesiasticus, "The number of a
man's days at the most are an hundred years" (chapter xviii. 9). In a
very small number of cases this limit is exceeded, but only by a very
few years. Mr. Thoms's investigations conclusively show that trustworthy
evidence of one hundred and ten years having been reached is altogether
absent. Future generations will be able to verify or reject statements
in all alleged cases of longevity. It must be remembered that previous
to the year 1836 there was no registration of births, but only of
baptisms, and that the registers were kept in the churches, and
contained only the names of those therein baptized.
Whatever number of years may be taken as representing the natural term
of human life, whether threescore and ten or a century be regarded as
such, we are confronted by the fact that only one-fourth of our
population attains the former age, and that only about fifteen in one
hundred thousand become centenarians. It is beyond the scope of this
article to discuss the causes of premature mortality, but the conditions
favourable to longevity, and the causes to which length of days has been
assigned, are closely connected with its subject.
A capability of attaining old age is very often handed down from one
generation to another, and heredity is probably the most powerful factor
in connection with longevity. A necessary condition of reaching advanced
age is the possession of sound bodily organs, and such an endowment is
eminently capable of transmission. Instances of longevity characterizing
several generations are frequently brought to notice. A recent and most
interesting example of transmitted longevity is that of the veteran
guardian of the public health, Sir Edwin Chadwick, who was entertained
at a public dinner a few weeks ago on the occasion of his reaching his
ninetieth year. He informed his entertainers that his father died at the
age of eighty-four, one of his grandfathers at ninety-five, and that two
more remote ancestors were centenarians.
It is difficult to estimate the influence of other contingencies which
affect longevity. With regard to sex, Hufeland's opinion was that women
were more likely than men to become old, but that instances of extreme
longevity were more frequent among men. This opinion is to some extent
borne out by Dr. Humphry's statistics: of fifty-two centenarians,
thirty-six were women. Marriage would appear to be conducive to
longevity. A well-known French _savant_, Dr. Bertillon, states that a
bachelor of twenty-five is not a better life than a married man of
forty-five, and he attributes the difference in favour of married people
to the fact that they take more care of themselves, and lead more
regular lives than those who have no such tie. It must, however, be
remembered that the mere fact of marrying indicates superior vitality
and vigour, and the ranks of the unmarried are largely filled by the
physically unfit.
In considering occupations as they are likely to effect longevity, those
which obviously tend to shorten life need not be considered. With
respect to the learned professions, it would appear that among the
clergy the average of life is beyond that of any similar class. It is
improbable that this average will be maintained for the future; the
duties and anxieties imposed upon the clergy of the present generation
place them in a very different position from that of their predecessors.
Among lawyers there have been several eminent judges who attained a
great age, and the rank and file of the profession are also
characterized by a decided tendency to longevity. The medical profession
supplies but few instances of extreme old age, and the average duration
of life among its members is decidedly low, a fact which can be easily
accounted for. Broken rest, hard work, anxieties, exposure to weather
and to the risks of infection can not fail to exert an injurious
influence upon health. No definite conclusions can be arrived at with
regard to the average longevity of literary and scientific men, but it
might be supposed that those among them who are not harassed by
anxieties and enjoy fair health would probably reach old age. As a
general rule, the duration of life is not shortened by literary
pursuits. A man may worry himself to death over his books, or, when
tired of them, may seek recreation in pursuits destructive to health;
but application to literary work tends to produce cheerfulness, and to
prolong rather than shorten the life even of an infirm man. In Prof.
Humphry's "Report on Aged Persons," containing an account of eight
hundred and twenty-four individuals of both sexes, and between the ages
of eighty and one hundred, it is stated that forty-eight per cent. were
poor, forty-two per cent. were in comfortable circumstances, and only
ten per cent. were described as being in affluent circumstances. Dr.
Humphry points out that these ratios "must not be regarded as
representing the relations of poverty and affluence to longevity,
because, in the first place, the poor at all ages and in all districts
bear a large proportion to the affluent; and, secondly, the returns are
largely made from the lower and middle classes, and in many instances
from the inmates of union work-houses, where a good number of aged
people are found." It must also be noticed that the "past life-history"
of these individuals showed that the greater proportion (fifty-five per
cent.) "had lived in comfortable circumstances," and that only
thirty-five per cent. had been poor.
Merely to enumerate the causes to which longevity has been attributed in
attempting to account for individual cases would be a task of some
magnitude; it will be sufficient to mention a few somewhat probable
theories. Moderation in eating and drinking is often declared to be a
cause of longevity, and the assertion is fully corroborated by Dr.
Humphry's inquiries. Of his fifty-two centenarians, twelve were recorded
as total abstainers from alcoholic drinks throughout life, or for long
periods; twenty had taken very little alcohol; eight were reported as
moderate in their use of it; and only three habitually indulged in it.
It is quite true that a few persons who must be classified as drunkards
live to be very old; but these are exceptions to the general rule, and
such cases appear to be more frequent than they really are, because they
are often brought to notice by those who find encouragement from such
examples. The habit of temperance in food, good powers of digestion,
and soundness of sleep are other main characteristics of most of those
who attain advanced years, and may be regarded as causes of longevity.
Not a few old persons are found on inquiry to take credit to themselves
for their own condition, and to attribute it to some remarkable
peculiarity in their habits or mode of life. It is said that Lord
Mansfield, who reached the age of eighty-nine, was wont to inquire into
the habits of life of all aged witnesses who appeared before him, and
that only in one habit, namely, that of early rising, was there any
general concurrence. Health is doubtless often promoted by early rising,
but the habit is not necessarily conducive to longevity. It is, as Sir
H. Holland points out, more probable that the vigour of the individuals
maintains the habit than that the latter alone maintains the vitality.
If we pass from probable to improbable causes of longevity we are
confronted by many extravagant assumptions. Thus, to take only a few
examples, the immoderate use of sugar has been regarded not only as a
panacea, but as decidedly conducive to length of days. Dr. Slare, a
physician of the last century, has recorded the case of a centenarian
who used to mix sugar with all his food, and the doctor himself was so
convinced of the "balsamic virtue" of this substance that he adopted the
practice, and boasted of his health and strength in his old age. Another
member of the same profession used to take daily doses of tannin (the
substance employed to harden and preserve leather), under the impression
that the tissues of the body would be thereby protected from decay. His
life was protracted beyond the ordinary span, but it is questionable
whether the tannin acted in the desired direction. Lord Combermere
thought that his good health and advanced years were due, in part at
least, to the fact that he always wore a tight belt round his waist. His
lordship's appetite was doubtless thereby kept within bounds; we are
further told that he was very moderate in the use of all fluids as
drink. Cleanliness might be supposed to aid in prolonging life, yet a
Mrs. Lewson, who died in the early part of this century, aged one
hundred and six, must have been a singularly dirty person. We are told
that instead of washing she smeared her face with lard, and asserted
that "people who washed always caught cold." This lady, no doubt, was
fully persuaded that she had discovered the universal medicine.
Many of the alchemists attributed the power of prolonging life to
certain preparations of gold, probably under the idea that the
permanence of the metal might be imparted to the human system. Descartes
is said to have favoured such opinions; he told Sir Kenelm Digby that,
although he would not venture to promise immortality, he was certain
that his life might be lengthened to the period of that enjoyed by the
patriarchs. His plan, however, seems to have been the very rational and
simple one of checking all excesses and enjoining punctual and frugal
meals.
Having thus endeavoured to show the extent to which human life may be
prolonged, and having examined some of the causes or antecedents of
longevity, the last subject for inquiry is the means by which it may be
attained. Certain preliminary conditions are obviously requisite; in the
first place there must be a sound constitution derived from healthy
ancestors, and in the second there must be a freedom from organic
disease of important organs. Given an individual who has reached the
grand climacteric, or threescore and ten, and in whom these two
conditions are fulfilled, the means best adapted to maintain and prolong
his life constitute the question to be solved. It has been said that "he
who would long to be an old man must begin early to be one," but very
few persons designedly take measures in early life in order that they
may live longer than their fellows.
The whole term of life may be divided into the three main periods of
growth and development, of maturity, and of decline. No hard and fast
line can be drawn between these two latter phases of existence: the one
should pass gradually into the other until the entire picture is
changed. Diminished conservative power and the consequent triumph of
disintegrating forces are the prominent features of the third period,
which begins at different times in different individuals, its advent
being mainly controlled by the general course of the preceding years.
The "turning period," also known as the "climacteric" or "middle age,"
lies between forty-five and sixty; the period beyond may be considered
as belonging to advanced life or old age. The majority of the changes
characteristic of these last stages are easily recognizable. It is
hardly necessary to mention the wrinkled skin, the furrowed face, the
"crow's feet" beneath the eyes, the stooping gait, and the wasting of
the frame. The senses, notably vision and hearing, become less acute;
the power of digestion is lessened; the force of the heart is
diminished; the lungs are less permeable; many of the air-cells lose
their elasticity and merge into each other, so that there is less
breathing surface as well as less power. Simultaneously with these
changes the mind may present signs of enfeeblement; but in many
instances its powers long remain in marked contrast with those of the
body. One fact connected with advanced life is too often neglected. It
should never be forgotten that while the "forces in use" at that period
are easily exhausted, the "forces in reserve" are often so slight as to
be unable to meet the smallest demand. In youth, the reserve powers are
superabundant; in advanced life, they are reduced to a minimum, and in
some instances are practically non-existent. The recognition of this
difference is an all-important guide in laying down rules for conduct
in old age.
In order to prolong life and at the same time to enjoy it, occupation of
some kind is absolutely necessary; it is a great mistake to suppose that
idleness is conducive to longevity. It is at all times better to wear
out than to rust out, and the latter process is apt to be speedily
accomplished. Every one must have met with individuals who, while fully
occupied till sixty or even seventy years of age, remained hale and
strong, but aged with marvelous rapidity after relinquishing work, a
change in their mental condition becoming especially prominent. There is
an obvious lesson to be learned from such instances, but certain
qualifications are necessary in order to apply it properly. With regard
to mental activity, there is abundant evidence that the more the
intellectual faculties are exercised the greater the probability of
their lasting. They often become stronger after the vital force has
passed its culminating point; and this retention of mental power is the
true compensation for the decline in bodily strength. Did space permit,
many illustrations could be adduced to show that the power of the mind
can be preserved almost unimpaired to the most advanced age. Even
memory, the failure of which is sometimes regarded as a necessary
concomitant of old age, is not infrequently preserved almost up to the
end of life. All persons of middle age should take special pains to keep
the faculties and energies of the mind in a vigorous condition; they
should not simply drift on in a haphazard fashion, but should seek and
find pleasure in the attainment of definite objects. Even if the mind
has not been especially cultivated, or received any decided bent, there
is at the present day no lack of subjects on which it can be agreeably
and profitably exercised. Many sciences which, twenty or thirty years
ago, were accessible only to the few, and wore at best a somewhat
uninviting garb, have been rendered not merely intelligible but even
attractive to the many; and in the domain of general literature the
difficulty of making a choice among the host of allurements is the only
ground for complaint. To increase the taste for these and kindred
subjects is worth a considerable effort, if such be necessary; but the
appetite will generally come with the eating. The possession of some
reasonable hobby which can be cultivated indoors is a great advantage in
old age, and there are many pursuits of this character besides those
connected with literature and science. Talleyrand laid great stress on a
knowledge of whist as indispensable to a happy old age, and doubtless to
many old people that particular game affords not only recreation but a
pleasant exercise to the mind. It is, however, an unworthy substitute
for higher objects, and should be regarded only as an amusement and not
as an occupation.
Whatever be the sphere of mental activity, no kind of strain must be
put upon the mind by a person who has reached sixty-five or seventy
years. The feeling that mental power is less than it once was not
infrequently stimulates a man to increased exertions which may provoke
structural changes in the brain, and will certainly accelerate the
progress of any that may exist in that organ. When a man finds that a
great effort is required to accomplish any mental task that was once
easy, he should desist from the attempt, and regulate his work according
to his power. With this limitation, it may be taken for granted that the
mental faculties will be far better preserved by their exercise than by
their disuse.
Somewhat different advice must be given with regard to bodily exercises
in their reference to longevity. Exercise is essential to the
preservation of health; inactivity is a potent cause of wasting and
degeneration. The vigour and equality of the circulation, the functions
of the skin, and the aeration of the blood, are all promoted by muscular
activity, which thus keeps up a proper balance and relation between the
important organs of the body. In youth, the vigour of the system is
often so great that if one organ be sluggish another part will make
amends for the deficiency by acting vicariously, and without any
consequent damage to itself. In old age, the tasks can not be thus
shifted from one organ to another; the work allotted to each
sufficiently taxes its strength, and vicarious action can not be
performed without mischief. Hence the importance of maintaining, as far
as possible, the equable action of all the bodily organs, so that the
share of the vital processes assigned to each shall be properly
accomplished. For this reason exercise is an important part of the
conduct of life in old age; but discretion is absolutely necessary. An
old man should discover by experience how much exercise he can take
without exhausting his powers, and should be careful never to exceed the
limit. Old persons are apt to forget that their staying powers are much
less than they once were, and that, while a walk of two or three miles
may prove easy and pleasurable, the addition of a return journey of
similar length will seriously overtax the strength. Above all things,
sudden and rapid exertion should be scrupulously avoided by persons of
advanced age. The machine which might go on working for years at a
gentle pace often breaks down altogether when its movements are suddenly
accelerated. These cautions may appear superfluous, but instances in
which their disregard is followed by very serious consequences are by no
means infrequent.
No fixed rule can be laid down as to the kind of exercise most suitable
for advanced age. Much must depend upon individual circumstances and
peculiarities; but walking in the open air should always be kept up and
practiced daily, except in unfavourable weather. Walking is a natural
form of exercise and subserves many important purposes: not a few old
people owe the maintenance of their health and vigour to their daily
"constitutional." Riding is an excellent form of exercise, but available
only by a few; the habit, if acquired in early life, should be kept up
as long as possible, subject to the caution already given as to violent
exercise. Old persons of both sexes fond of gardening, and so situated
that they may gratify their tastes, are much to be envied. Body and mind
are alike exercised by what Lord Bacon justly termed "the purest of
human pleasures." Dr. Parkes goes so far as to say that light garden or
agricultural work is a very good exercise for men past seventy: "It
calls into play the muscles of the abdomen and back, which in old men
are often but little used, and the work is so varied that no muscle is
kept long in action." A few remarks must be made, in conclusion, with
regard to a new form of exercise sometimes indulged in even by elderly
men. I allude to so-called "tricycling." Exhilarating and pleasant as it
may be to glide over the ground with comparatively little effort, the
exercise is fraught with danger for men who have passed the grand
climacteric. The temptation to make a spurt must be often irresistible;
hills must be encountered, some perhaps so smooth and gradual as to
require no special exertion, none, at least, that is noticed in the
triumph of surmounting them. Now, if the heart and lungs be perfectly
sound, such exercises may be practiced for some time with _apparent_
impunity; but if (as is very likely to be the case) these organs be not
quite structurally perfect, even the slightest changes will, under such
excitement, rapidly progress and lead to very serious results. Exercise
unsuited to the state of the system will assuredly not tend to the
prolongation of life.
With regard to food, we find from Dr. Humphry's report that ninety per
cent. of the aged persons were either "moderate" or "small" eaters, and
such moderation is quite in accord with the teachings of physiology. In
old age the changes in the bodily tissues gradually become less and less
active, and less food is required to make up for the daily waste. The
appetite and the power of digestion are correspondingly diminished, and
although for the attainment of a great age a considerable amount of
digestive power is absolutely necessary, its perfection, when exercised
upon proper articles of diet, is the most important characteristic.
Indulgence in the pleasures of the table is one of the common errors of
advanced life, and is not infrequent in persons who, up to that period,
were moderate or even small eaters. Luxuries in the way of food are apt
to be regarded as rewards that have been fully earned by a life of
labour, and may, therefore, be lawfully enjoyed. Hence arise many of the
evils and troubles of old age, and notably indigestion and gouty
symptoms in various forms, besides mental discomfort. No hard and fast
rules can be laid down, but strict moderation should be the guiding
maxim. The diet suitable for most aged persons is that which contains
much nutritive material in a small bulk, and its quantity should be in
proportion to the appetite and power of digestion. Animal food, well
cooked, should be taken sparingly and not more often than twice a day,
except under special circumstances. Dr. Parkes advocates rice as a
partial substitute for meat when the latter is found to disagree with
old persons. "Its starch-grains are very digestible, and it supplies
nitrogen in moderate amount, well fitted to the worn and slowly repaired
tissues of the aged." Its bulk, however, is sometimes a disadvantage; in
small quantities it is a valuable addition to milk and to stewed fruits.
The amount of food taken should be divided between three or four meals
at fairly regular intervals. A sense of fullness or oppression after
eating ought not to be disregarded. It indicates that the food taken has
been either too abundant or of improper quality. For many elderly people
the most suitable time for the principal meal is between 1 and 2 P. M.
As the day advances the digestive powers become less, and even a
moderately substantial meal taken in the evening may seriously overtask
them. Undigested food is a potent cause of disturbed sleep, an evil
often very troublesome to old people, and one which ought to be
carefully guarded against.
It is an easier task to lay down rules with regard to the use of
alcoholic liquors by elderly people. The Collective Investigation
Committee of the British Medical Association has lately issued a "Report
on the Connection of Disease with Habits of Intemperance," and two at
least of the conclusions arrived at are worth quoting: "Habitual
indulgence in alcoholic liquors, beyond the most moderate amount, has a
distinct tendency to shorten life, the average shortening being roughly
proportional to the degree of indulgence. Total abstinence and habitual
temperance augment considerably the chance of death from old age or
natural decay, without special pathological lesion." Subject, however,
to a few exceptions, it is not advisable that a man sixty-five or
seventy years of age, who has taken alcohol in moderation all his life,
should suddenly become an abstainer. Old age can not readily accommodate
itself to changes of any kind, and to many old people a little good wine
with their meals is a source of great comfort. To quote again from
Ecclesiasticus, "Wine is as good as life to a man, if it be drunk
moderately, for it was made to make men glad." Elderly persons,
particularly at the close of the day, often find that their nervous
energy is exhausted, and require a little stimulant to induce them to
take a necessary supply of proper nourishment, and perhaps to aid the
digestive powers to convert their food to a useful purpose. In the
debility of old age, and especially when sleeplessness is accompanied
by slow and imperfect digestion, a small quantity of a generous and
potent wine, containing much ether, often does good service. Even a
little beer improves digestion in some old people; others find that
spirits, largely diluted, fulfill the same purpose. Individual
peculiarities must be allowed for; the only general rule is that which
prescribes strict moderation.
It is not to be inferred from the hints given in the preceding
paragraphs that the preservation of health should be the predominant
thought in the minds of elderly persons who desire that their lives
should be prolonged. To be always guarding against disease, and to live
in a state of constant fear and watchfulness, would make existence
miserable and hasten the progress of decay. Selfish and undue solicitude
with regard to health not only fails to attain its object, but is apt to
induce that diseased condition of mind known as hypochondriasis, ["the
blues,"] the victims of which are always a burden and a nuisance, if not
to themselves, at least to all connected with them. Addison, in the
_Spectator_, after describing the valetudinarian who constantly weighed
himself and his food, and yet became sick and languishing, aptly
remarks, "A continual anxiety for life vitiates all the relishes of it,
and casts a gloom over the whole face of nature, as it is impossible
that we should take delight in anything that we are every moment afraid
of losing."
Sleep is closely connected with the question of diet; "good sleeping"
was a noticeable feature in the large majority of Dr. Humphry's cases.
Sound, refreshing sleep is of the utmost consequence to the health of
the body, and no substitute can be found for it as a restorer of vital
energy. Sleeplessness is, however, often a source of great trouble to
elderly people, and one which is not easily relieved. Narcotic remedies
are generally mischievous; their first effects may be pleasant, but the
habit of depending upon them rapidly grows until they become
indispensable. When this stage has been reached, the sufferer is in a
far worse plight than before. In all cases the endeavour should be made
to discover whether the sleeplessness be due to any removable
cause--such as indigestion, cold, want of exercise, and the like. In
regard to sleeping in the daytime, there is something to be said both
for and against that practice. A nap of "forty winks" in the afternoon
enables many aged people to get through the rest of the day in comfort,
whereas they feel tired and weak when deprived of this refreshment. If
they rest well at night there can be no objection to the afternoon nap;
but if sleeplessness be complained of, the latter should be discontinued
for a time. Most old people find that a reclining posture, with the feet
and legs raised, is better than the horizontal position for the
afternoon nap. Digestion proceeds with more ease than when the body is
recumbent.
Warmth is very important for the aged; exposure to chills should be
scrupulously avoided. Bronchitis is the malady most to be feared, and
its attacks are very easily provoked. Many old people suffer from more
or less cough during the winter months, and this symptom may recur year
after year, and be almost unheeded. At last, perhaps a few minutes'
exposure to a cold wind increases the irritation in the lungs, the cough
becomes worse, and the difficulty of breathing increases until
suffocation terminates in death. To obviate such risk the skin should be
carefully protected by warm flannel clothes, the outdoor thermometer
should be noticed and winter garments should always be at hand. In cold
weather the lungs should be protected by breathing through the nose as
much as possible, and by wearing a light woolen or silken muffler over
the mouth. The temperature of the sitting and bed-rooms is another point
which requires attention. Some old people pride themselves on never
requiring a fire in their bed-rooms. It is, however, a risky practice to
exchange a temperature of 65° or 70° for one fifteen or twenty degrees
lower. As a general rule, for persons sixty-five years of age and
upward, the temperature of the bed-room should not be below 60°, and
when there are any symptoms of bronchitis it should be raised from five
to ten degrees higher.
Careful cleansing of the skin is the last point which needs to be
mentioned in an article like the present. Attention to cleanliness is
decidedly conducive to longevity, and we may congratulate ourselves on
the general improvement in our habits in this respect. Frequent washing
with warm water is very advantageous for old people, in whom the skin is
only too apt to become hard and dry; and the benefit will be increased
if the ablutions be succeeded by friction with coarse flannel or linen
gloves, or with a flesh-brush. Every part of the skin should be thus
washed and rubbed daily. The friction removes worn-out particles of the
skin, and the exercise promotes warmth and excites perspiration. Too
much attention can hardly be paid to the state of the skin; the comfort
of the aged is greatly dependent upon the proper discharge of its
functions.
Such, then, are the principal measures by which life may be prolonged
and health maintained down to the closing scene. It remains to be seen
whether, as a result of progress of knowledge and civilization, life
will ever be protracted beyond the limit assigned to it in a preceding
paragraph. There is no doubt that the _average duration_ of human life
is capable of very great extension, and that the same causes which serve
to prolong life materially contribute toward the happiness of mankind.
The experience of the last few decades abundantly testifies to the
marked improvement which has taken place in the public health.
Statistics show that at the end of the septennial period, 1881-'87,
400,000 persons were alive in England and Wales whose death would have
taken place had the mortality been in the same proportion as during the
previous decade. It may be reasonably expected that as time goes on
there will be an increase in the proportion of centenarians to the
population as a whole.
The question whether long life is, after all, desirable does not admit
of any general answer. Much depends upon the previous history of the
individual, and his bodily and mental condition. The last stages of a
well spent life may be the happiest, the shuffling-off of the mortal
coil, though calmly expected, need not be wished for. The picture
afforded by cheerful and mellow old age is a lesson to younger
generations. Elderly people may, if they choose, become centers of
improving and refining influence. On the other hand, old age can not be
regarded as a blessing when it is accompanied by profound decrepitude
and disorder of mind and body. Senile dementia, or second childishness,
is, of all conditions, perhaps the most miserable, though not so painful
to the sufferer as to those who surround him. Its advent may be
accelerated by ignorance and neglect, and almost assuredly retarded or
prevented by such simple measures as have been suggested. No one who has
had opportunities of studying old people can shut his eyes to the fact
that many of the incapabilities of age may be prevented by attention to
a few simple rules, the observance of which will not only prolong life
and make it happier and more comfortable, but will reduce to a minimum
the period of decrepitude. Old age may be an incurable disease,
admitting of but one termination, but the manner of that end, and the
condition which precedes it, are, though not altogether, certainly to a
very great extent, within our own power.