Chapter 14 - Old Age and its Diseases
Changes Occurring in Advanced Life
Medical Treatment of the Old
Diseases of the Old
Bronchial Flux

14.1 Changes Occurring in Advanced Life

OLD AGE AND ITS DISEASES.

The Changes occurring in Advanced Life.

Growth, maturity, and decline are the three periods which divide and measure human life.
During growth, the deposit of new matter takes place more rapidly than the decay or waste which is also going on.
During healthy maturity, waste and increase are exactly equal, the one taking place just as rapidly as the other.
The decline of old age reverses the order of growth, and waste outstrips addition. The newly deposited matter comes, but not so rapidly as the old is cast away.
Declining Age may be said to extend from fifty to sixty.

Incipient Old Age from sixty to seventy.

Ripe Old Age from seventy to eighty.
Decrepitude or Second Infancy from eighty to the end of life.

Preservation of Old People's Health.
IT is proper here to speak of the hygiene of old age, or the means of preserving aged people's health.
It is natural to desire a continuance of life, and except in the case of the extremely old, there is a general wish for its prolongation. Those who are born of parents who have lived long, are more likely to attain length of days than those who have descended from short lived ancestors; yet the influence of correct habits may add quite as many years to their lives.

Regular Habits. The old feel the evil influence of irregular habits much more than the young. It is seldom that any change of habit, long indulged, is well borne by the aged. So true is this, that the attempt to correct some habits of evil tendency is sometimes dangerous to the old, so much have they lost the power of adapting themselves to change. The discontinuance of the habitual use of spirit, or tobacco, or opium, by an old person, though the use of either is of acknowledged evil tendency, will frequently prove fatal. It is almost necessary that the habits of the aged should remain as they are. What an impressive lesson this fact gives the young on the necessity of forming good habits in early life!
Even the hours of taking meals should not be changed in the decline of life. Removing to new climates, and forming new social relations by those advanced in years, is not favorable to length of days. Old trees do not often take root and live long when transferred to a new soil.

Diet. The food of old people should of course be easy of digestion. It is often the case that they bear made dishes such as , hash," so called, better than plain boiled or roasted meat. This can only be explained on the ground that the meat is chopped fine, and is more thoroughly cooked.

Mode of Cooking Meats. This leads me to speak of the best methods of cooking meats so that they may be tender.
The flesh of all warm blooded animals is identical in composition with that of human beings. That the flesh of animals used as food, therefore, may form flesh in the human body in the easiest manner, none of its essential constituents or parts should be taken from it during the process of cooking. If any one of its constituents is extracted, it will no longer be like human flesh; and that lost part will have to be resupplied before it can become a part of the frame of man.
Flesh is composed of two parts that which can be dissolved, and that which cannot. The separation between these two parts is more or less completely effected in boiling, according to the amount of water used and the length of time employed in the process.
In making soup, we have no objection to a separation between the hard and juicy parts of the meat, because the latter passes into the water and helps form the soup. Hence the proper way is to put the meat into cold water when it is put over the fire, and let it come to the boiling point very gradually; during which time the juicy part has a chance to dissolve out, and, uniting with the water, make rich soup.
But when the meat is to be boiled simply, and eaten as boiled meat, we should aim to retain the juice within it, that we may retain the whole of it. To do this, we must put the meat into water which is briskly boiling over the fire. The juice of the meat contains a large quantity of albumen, a substance just like the white of egg; and putting the meat suddenly into boiling water almost instantly hardens this albumen all around the surface, just as boiling water hardens white of egg, and this prevents all the juice of the inner portion of the meat from running out into the water and being lost. Keep the meat in the briskly...boiling water a few minutes, then pour in a little cold water to reduce the temperature slightly, and keep it in this somewhat reduced temperature until it is done through.
Broiling and roasting are pretty generally understood, and are done well enough where persons are disposed to take pains. Frying is an abomination, and should be banished from all civilized households.

Milk is an excellent article of diet for old persons. Except in some few cases where it disagrees with the stomach, it is among the very best. Sometimes, when it disagrees with a weak stomach, a little limewater added to it will make all right. Artificial ass's milk, which will generally sit well on aged people's stomachs, may be made by dissolving one ounce of pulverized sugar of milk in one pint of skimmed cow's milk.

Potatoes, beets, carrots, parsnips, and asparagus are healthful; peas, beans, cabbages, etc., had better not be largely indulged in.
Ripe Fruits, taken in moderation, are useful; but should be eaten at mealtime, not between meals. Among these, ripe apples, pears, peaches, plums, strawberries, currants, and grapes are luxuries in which not even the oldest persons need fear to indulge to a reasonable extent.

Plain Puddings and Pies are not entirely objectionable; but an rich and high seasoned articles of pastry should be strictly rejected by the old, as they should, in fact, by all classes.

Wine, etc. If any persons in the world may indulge in a little wine for their stomach's sake, it is the old. But even they, if they have not been accustomed to its use, often get along very well without it; and when they can do so it is better, for various reasons, especially that their example may have a good influence with others. When the feeble vitality of the aged seems to require it, especially if they have been in the habit of leaning upon it, they should be encouraged to use it. And if they chance to be poor, and cannot procure it themselves, for friends to withhold it from them on the ground of economy, or from the feeling of grudging stinginess, is nothing less than inhumanity and cruelty.
To these remarks upon diet, I add: the old should never eat to excess or repletion. They should eat slowly, and chew their food very thoroughly.

Susceptibility to Cold. Aged people suffer very much from cold hands and feet, and, indeed, from languid circulation and low temperature generally. The heart, like all their other muscles, has become feeble, and sends the blood very lazily along the arteries. The clothing of the old should be thicker and warmer than that of younger people. We must prevent the escape of what little animal heat there is by flannel worn next to the skin, and by woolen clothes generally they being bad conductors of heat. Unless very fleshy, they seldom suffer from heat, even when their flannels are continued through the summer.
It is during winter nights that the old are apt to suffer most from cold. On going to bed, therefore, they should be warm; and on very cold nights should have a hot water bag at their feet. The communication of animal heat, particularly from the young, is better even than this to support the vital energies of age; and some writers have recommended that the vital warmth of the old should be kept up by letting the young of our own species sleep with them. The humanity of this suggestion is very questionable The aged would doubtless be benefited by such a proceeding; but the young would be injured. Whatever vitality should be gained by one would be lost by the other. While a few might be added to the limited days of the aged, many would be quite as likely to be subtracted from those of the young. I would much sooner recommend that old people attach to themselves, and take to their bed, an affectionate, clean, and silken haired English terrier dog. Such an animal, usually as clean as a child, would. impart warmth and vitality at night, and be a true, affectionate, and amusing companion during many a lonely hour of the day. Whatever may be said against this recommendation, and of course some overnice people will object, I insist that it is in every sense far more proper than the expedient adopted with King David, when he ,was old and stricken in years," and after ,they covered him with clothes, but he gat no heat." (1 Kings i, 1.)

Mortality in Cold Weather. Far more of the old people die in winter than in summer, or, indeed, in any other season. For this reason, old people should be very careful how they expose themselves during the coldest days of the winter.
If there be any change which the old are likely to bear with impunity or advantage, it is from a cold to a warm climate in their latter years. The wealthy Romans, when they grew old, were taken to Naples.

Care of the Skin. Attention to the skin, always important to health, is very essentially so in the fatter years of life. The scarfskin of the old tends to become dry, and peel off. This may be prevented in a great measure by regular washing with tepid water, and rubbing. If the bath cannot be endured, not even the sponge bath, let friction alone be employed. For friction, either the naked hand, a piece of flannel, or the flesh brush may be used. In rubbing the belly, the hand should follow the course of the large bowel; that is, in the region of the stomach pass across from right to left, down on the left, across on the lower parts of the bowels, up on the right, etc. By this method, constipation and a windy condition of the stomach and bowels may frequently be removed, or rendered less distressing.

Exercise. Always important, in all periods of life, exercise does not lose its advantages in old age. But the aged should always exercise with moderation. The violence used in youth would break the bones, and do various kinds of mischief were it indulged by the old. Carriage exercise is very suitable for old people, but the more active exercise of horseback riding, walking, and even working in the garden, should not be omitted bearing always in mind that great fatigue is injurious.

Sleep. Aged people should get about as much sleep as nature asks for. They should retire early, and not be in haste to rise with the dawn. They require more sleep than persons in middle life. Eight or ten hours in the twenty-four is not too much.

Sleeplessness. Though the old require a good deal of sleep, it is unfortunate that many of them can sleep but little. A large proportion of persons far advanced in life, complain of inability to sleep. Many old people deceive themselves, and really sleep much more than they are aware. Yet they often persist that they sleep none at all, night after night. Their case is illustrated by an old lady whose doctor entered her room and found her sleeping very soundly and comfortably. The noise of a person entering the room awoke her soon after, when, rubbing her eyes, she turned to the doctor, and said all she wanted was sleep, that she had slept none for a month; and unless he could give her something to bring sleep, she must die.
Medical art, I am sorry to say, frequently fails to bring relief, when there is real want of sleep. Narcotics should always be avoided if possible. They do too much mischief ; yet it is necessary, sometimes, to resort to them. Much may be done sometimes by taking an earlier or a lighter supper. Early rising, and exercise in the open air, will often bring sleep at night. Occasionally a glass of wine, or a little spirit of any kind, taken just before retiring, will bring the needed sleep.

Electricity. In connection with sleep, the disturbing and the tranquilizing influence of electricity and magnetism has received some attention within a few years. A German philosopher contends that terrestrial magnetism exerts on. persons of a sensitive organization a very soothing influence, when placed in proper relations with its currents, and a disturbing impression when otherwise situated. He cites cases to show that lying from east to west is so intolerable that persons of delicacy cannot endure it; while the horizontal position from north to south, with the head south, is more agreeable; and most agreeable and tranquilizing with the bead to the north. A German surgeon is mentioned in Reichenback's Memoirs, who always woke early in the morning, and turning his head where his feet had been, invariably fell into a sound slumber, which was more refreshing than that of the night. When he chanced to omit this, he felt ill all day. Observing that the head of his bed was directed to the south, Reichenback persuaded him to turn it to the north; and ever after he slept soundly till the proper time to rise in the morning.
Without pronouncing upon the correctness of this theory, I will simply say that in my winter residence in town, the head of my bed is to the south. I sleep tolerably well; but not as well as at my summer residence a little out of town, where the head of my bed is towards the north. How much the stillness of the country and the greater purity of its atmosphere may contribute to this difference, I will not pretend to decide.

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