VI. THE EYES, ETC- The special senses, as those of sight and hearing, frequently, and sometimes at a comparatively early period, give evidence of approaching decay. The Arcus Senilis, a circumferential opacity of the cornea, resulting, it is thought, from fatty degeneration, and sometimes associated with a like degeneration of the heart, is, as its name implies, an affection incident to the aged. Cataract opacity of the crystalline lens, or its capsule, or both seems to be the consequence of impaired nutrition, and is met with in elderly persons only, except as the result of inflammation or injury. But the most frequent cause of impaired or perverted vision is alteration in the form of the lenticular bodies of the eye the cornea and the lens which, losing their natural convexity, interfere with the correct impression on the retina at the proper fixed point of the object of vision.
Defective hearing is another not infrequent attendant upon old age, and may result from various causes, the most frequent being impairment of the acoustic nerve.
VII. MENTAL FACULTIES- Associated with these important physical changes, the mental faculties partake of the general deterioration. That the mind retains its vigour and clearness of perception, while the body undergoes decay, is to some extent, a poetic fiction; the brain shares inevitably in the physical disorganizations we have noted. This is proved by the effects of disease. During recovery from wasting diseases, especially from those in which the phosphates have been carried off without a corresponding reproduction, the exercise of the brain is not only difficult but dangerous, and it has not infrequently happened that death has resulted from complete breakdown of the nervous system through too early mental work during convalescence.
GRADUAL DECAY- The various forms of man’s decay are gradual and progressive. Death may take place suddenly from Heart-disease, Apoplexy, rupture of an Aneurism, etc. but it is only the termination, not the disease, that is sudden. For years before the fatal issue, the organ was undergoing degeneration of structure. Death under such circumstances has been compared to the fall of towering cliffs, which crush everything beneath. The catastrophe is terrible, and occurs unexpectedly; but it was the slow disintegration of many preceding winters’ frost that hurled it down the steep. Sudden death is a misnomer in language, except as it takes place from accident or poison.
By the use of the ophthalmoscope the character and extent of brain and nervous degeneration can often be detected. Several cases have been recorded in the medical journals from practice, in which Atrophy of the optic nerve was found to accompany disease of the central nervous system. The detection of the particular form of decay from which the life of an aged person may be jeopardised is valuable, not merely for the sake of diagnosis, but because it often affords a clue to the direction treatment should take.
WINTER AND SENILITY- The climatic conditions of winter are highly favourable for the development of all kinds of weakness and tendencies to organic disease, especially of the brain, heart, blood-vessels, kidneys, and liver. Facts on a large scale prove that defects in these organs manifest themselves most frequently and severely in cold weather. The whole constitution is lowered by the conditions of winter, and, to an extent, devitalized; and medicine can only exercise an indirect power over these conditions, except to prescribe such remedial or preventive measures as we have suggested in this Section artificial heat, clothing, food, etc., to forestall, if possible, the effects of cold, and to counteract any of the organic leakages we have enumerated.
PREMATURE OLD AGE- In alluding to the decay of nature, we may add that we refer rather to the vital decay of individuals than to the mere lapse of years; vital conditions cannot always “be measured by number of years.” It is well known that some persons at fifty, or even earlier, are in this respect older and more shattered in constitution than others who have attained to the age of seventy or upwards.
Our present manner of life, business haste, or anxieties, tend to induce premature decay (see Section 94). Probably as the result of improved sanitary measures, a more correct and general recognition of the laws of health, to say nothing of Homoeopathic treatment, the attainment of a vigorous old age without a premature feebleness and decay, hitherto so generally observed, will be more common.
MODE OF DYING- Some particulars of the different modes of dying will here be appropriate. Diseases terminate fatally in one of two ways; either by suspending the heart’s action, called Syncope, or by interrupting the functions of breathing, called Asphyxia, or suffocation.
I. Death from Syncope may arise from an insufficient supply of blood to the heart, as from a sudden copious haemorrhage, or from more slowly acting causes, as deficient food, or defective assimilation. This is Anaemia, and its symptoms are dimness of vision, dilated pupils, vertigo, restlessness, a slow and feeble pulse, pallor of the face and lips, coldness of the extremities, cold sweats, irregular gasping respiration, and, finally, insensibility, with or without convulsions. If the heart is examined after death, it is found nearly or quite empty, and contracted.
Death from syncope may also arise from failure of the contracting power of the heart, as occurs in Pericarditis, Peritonitis, and in some forms of poisoning. This is Asthenia, and the symptoms are quick, feeble or imperceptible pulse, cold extremities, and clammy sweat of the general surface, the intellect usually remaining clear to the last. After death the right cavities of the heart may be found full of dark blood, while the left are distended with red blood.
II. Death from Asphyxia may result in three different ways. First, by obstruction to the entrance of air into the lungs, as in drowning, strangulation, oedema of the glottis, Croup, etc. The change of venous blood into arterial in the pulmonary capillaries is stopped, while the unchanged blood circulating in the arteries paralyzes the nervous system. The symptoms are quickened, laboured breathing, violent action of the auxiliary muscles of respiration, protruded eyeballs, swollen and livid countenance, distension of the veins of the neck, and soon loss of consciousness, often with muscular twitchings or convulsions. The heart and arteries continue to beat after breathing has ceased, and if the lungs are examined after death, the right cavities are found distended with dark blood, but the left empty.
Secondly, the nervous system may be primarily at fault from structural disease in the brain, or of the circulation through that organ of poisoned blood, as happens in Uraemia and various specific fevers; a state of stupor, or insensibility to external impressions, is induced, the medulla oblongata, and through it the nerves of respiration, are paralyzed, the respiratory movements become embarrassed, and, finally, entirely cease. This is Coma. Here too, the blood is not aerated, and similar consequence ensue. But there is this difference; the mechanical movements of respiration suffer before its chemical functions, and the brain is primarily affected, and the lungs secondarily. In Coma, loss of consciousness preceded difficulty of breathing, and the respirations become slow, irregular, and stertorous from diminished sensibility. Thirdly, this mode of dying may be occasioned by blocking the pulmonary artery, and, in consequence, stoppage of the supply of blood to the lungs. A fibrinous clot is carried into the pulmonary artery, and suddenly and completely arrests circulation in the lungs, or if the obstruction is incomplete, the patient may survive for several hours. This is Embolism. The symptoms are extreme dyspnoea, coming on suddenly, with pallor and faintness.
But under whatever circumstances death may take place, it is in keeping with those ceaseless changes which characterize the general world of matter; the body no longer being of service in its material capacity, is transformed to reappear in other conditions, or in other combinations. The earth itself upon which we tread, and from which we derive our food, the solid rocks from which we rear our habitations, are ever-varying theatres composed of the fragments of pre-existing organic beings, out of which are constantly springing forth new forms of utility and beauty. As the body is resolved into its original dust, and the simple elements of which it is composed pass into other combinations and other forms, we believe man himself because disengaged from the physical, and passes up from a lower to a higher form of life. The disentanglement takes place slowly, as the body wears out by age, or at any time of life, as the result of disease or violence.
TREATMENT OF THE AGED- There are many ailments peculiar to the approach of old age which require special medical treatment, or the application of particular measures in which we are often rewarded for the timely use of appropriate remedies, and the prompt employment of judicious means, by seeing the flickering flame rekindled, and valuable life considerably prolonged. On two or three points only can we make some general observations.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."