Chapter XV: )

Alcohol in large doses may also have a degenerating effect on the sexual glands. Small doses can stimulate, but large doses are decidedly harmful. Temporary impotence may result in such cases, and chronic impotence in inveterate drinkers.

Though alcohol in large doses is harmful, and if taken in very large quantities for many years can hasten old age, there is absolutely no reason to suppose that in small doses it has any etiological relation to senility. In fact, there are many cases on record of persons who have taken alcohol, especially wine in limited quantity, every day, and have lived to enjoy a healthy old age.

One of our confrères, a surgeon of Lotharingia named Politiman, lived to be 140. As Professor Pel, whom we quote, says, the historian explains that this old age was due to the medicine this worthy doctor took every day after doing his work. He had drunk his fill every night since the age of twenty-five years. Another surgeon, Espagno, lived to be 112 with no less moderate habits! Countess K——, who died in Nicolajew in Russia, a few years ago, at the age of 111 years, took daily a cordial in the form of a good drink of cognac; and about one and a half years ago the _Daily Mail_ of London brought to public notice the case of a Mrs. Anderson living in Springfield, near Glasgow, who, in spite of her 103 years, was taking daily a tablespoonful of whiskey.

A strong point against the anti-alcohol faddists is the case of Brown,[164] an Irish peasant, who, after many years of heavy beer-drinking, attained the age of 120. His tombstone exhibits the following epitaph:—

Footnote 164:

Quoted after Professor Pflüger.

“Here lies Brown, who became 120 only through the strong beer he was drinking. He was constantly drunk, and in this condition so terrible, that even death was afraid of him. When, however, one day contrary to his habits he was sober and in a quiet mood, death got courage, seized him, and thus at last was triumphant over this incorrigible drunkard.” (See, further, Chapter XLI.)

All these examples merely show what we have so often insisted upon, that everything depends upon heredity. There are many causes that produce premature senility. It seems, also, that when only a few of these causes, or only one, is acting, there is a possibility of a successful fight against it. It is a different matter when all, or several, of the causes of old age are present. As the German proverb says: “Viele Hunde sind des Hasen Tod” (“many dogs mean death for the hare”).

It is a very interesting fact that seldom are all the various kinds of immoderation united in the same person. Thus, some persons may drink and smoke heartily and, perhaps as a result of the action of these poisons upon the sexual glands, may be better able to combat their sexual instincts. This will also explain the drinking habits of some old spinsters or widows. They “drive out the Devil with Beelzebub,” as the German proverb says. On the other hand, many total abstainers from alcohol and tobacco are far less successful in combating their sexual instincts, and for such persons marriage is a necessity.

As a rule, celibatarians show symptoms of old age much sooner than married persons.

If among those addicted to drink there are many instances of long life, among smokers such instances are much fewer.

As Professor Pel says, there was only one man among many, of those over 100, who was a smoker (see Chapter XLII).

It is also of interest that among very old people we find many with very decided sexual tendencies. Evidently such persons must be in possession of very active sexual glands, which indicates also a healthy thyroid (see Chapter V).

We may class alcohol with tea and similar beverages. A small amount every day may be a good thing, but in large quantities they may all become injurious and tend to shorten life.

Tobacco, according to clinical observations (Huchard), is apt to cause arteriosclerosis, just as alcohol in large doses; and this is also proved by experiments—e.g., those of Isaac Adler and Hensel—which show that atheroma of blood-vessels can be produced in animals, experimentally, by nicotine.

Everything points to the fact that tobacco is especially injurious to the adrenals. We will treat of this subject more fully later on when discussing the hygienic treatment of old age.

Many conditions of chronic intoxication, and hence premature senility, may be caused by faulty food, especially if taken in large quantity, for a long time. Even fresh albuminous food of animal origin, if taken in large quantity every day, may prove harmful. We have seen previously, in Chapters III and IV, that meat produces by its decomposition certain poisonous substances which should be destroyed by the ductless glands.

Premature old age frequently occurs in people who live a sedentary life, and at the same time consume much rich food and alcohol. This causes obesity, and the muscles and nerves which are little used, are prone to show degenerative changes after a certain time. At any rate the processes of metabolism are diminished in these structures, since their supply of fresh arterial blood is always reduced if no work or exercise be performed.

It is a well-known physiological fact, that nerves which are inactive lose their excitability and degenerate. This holds good for motor nerves, and we can also note degeneration of muscles and organs which are not used. Thus, the nerves of an extremity, after amputation, undergo a process of degeneration. The lower limbs of people affected with infantile paralysis, or of persons obliged to remain in bed for a long time, show atrophic changes. Hence we can easily see the necessity for exercise, which increases the blood-supply to the muscles and nerves. Work of any kind, even mental work alone, is a means of preventing precocious senility; if manual exercise is combined with it, it is still more efficacious.

Plutarch, in his “De educatione puerorum,” mentions that a certain amount of work improves the mind, but excess of work is prejudicial.

We see the best illustration of this fact in American business men. There are no men in any country who do such an amount of work, and at the same time take so little recreation or exercise. They sit in their offices till dusk, with a few minutes’ interval for a hasty meal, consisting mainly of meat that has often been kept in cold storage for a long time, after which business goes on again, at high pressure, until the evening. Then, instead of walking home and taking exercise, they take a car or carriage to their house or club, and pass the evening in smoking and drinking, sometimes to excess. Day after day the same killing of body and nerves goes on till these people look old long before fifty, if, indeed, they reach that age. Arteriosclerosis, diabetes, gout, and obesity find many victims among such men. It is sad to think how many thousands of these splendid people, full of genius and talent, could be saved for their native country if only they had been taught in their youth the most elementary rules of hygienics. What joy does money afford without health?

Some of the most powerful agencies in producing old age are frequent mental emotions, especially sorrow and grief.

It is a common fact that after such emotions people soon look older. To mention an example, there is positive evidence that young persons, after a mental shock, have become gray in a single night, thus developing abruptly one of the most typical symptoms of old age.

That mental emotions, especially anger, grief, sorrow, fright, anxiety, etc., are very harmful to glands with an internal secretion, is shown by a series of clinical observations. Sajous has in fact termed _sensorium commune_, i.e., the center which receives all shocks, the governing center of the ductless glands, located in the pituitary body.

With mental emotion there is often disturbance of a function, interference with which is very liable to hasten the onset of old age, and this is sleep.

We frequently notice that persons who have not slept well for several nights, especially if passed on a railway journey, look worn out and older. After a good night’s rest these effects disappear and they look fresh and younger again.

There are other functional disturbances which are especially harmful as they interfere with the elimination of harmful products either introduced with the food or found in the body (e.g., uric acid). This applies also to the bowels, perspiration, and diuresis. When these important functions are checked, there is retention of poisonous products and a condition of auto-intoxication. These functions are governed by the ductless glands, especially the thyroid, as we have seen in Chapter VI. It is easy to understand that by their interruption the onset of old age is hastened, as these toxins will cause deterioration and destruction of epithelium and the formation of connective tissue in its place. Retained poisonous products play a very great etiological rôle in the production of arteriosclerosis, which is found as a typical symptom of old age in the large majority of aged persons.

We thus see that all those agencies which by common consent are usually considered the most frequent causes of old age, are also very detrimental to the ductless glands, especially the thyroid. They produce hyperactivity, with subsequent exhaustion, in these important glands. The pathological and anatomical changes indicating hyperactivity give place to those of atrophy. We have given an example of this in discussing the changes in the thyroid in infectious diseases. The formation of connective tissue is the final result. Thus a condition of the thyroid arises similar to that in myxœdema, which, as we have stated, can be produced by causes similar to those which produce old age—i.e., infectious diseases, exhaustion of the ovaries after pregnancies or sexual excesses, mental emotions, etc.

The pathological and anatomical changes in the thyroid, consisting of an increase in the connective tissue, as in myxœdema, will logically produce clinical symptoms, and these symptoms are the same as those of myxœdema.

Therefore we are justified in assuming that old age will show the same clinical symptoms as myxœdema.

We have shown that, given changes in the thyroid gland, the other ductless glands will be altered too; for instance, the liver and kidneys. These glands have an important function in freeing the organism of poisonous substances. As in old age their secreting elements are more or less atrophied, they are unable to execute their task properly, and these harmful products will accumulate. Now, there are important organs which can act as corollaries to these glands. These are the intestines and the skin. They also are under the influence of the thyroid. In diseased conditions of the thyroid they are unable to perform their functions regularly. The poisons will not be eliminated, and thus a condition of auto-intoxication must arise.

Just as after extirpation of the thyroid there is an increase of connective tissue or fat in various organs and tissues (as Demange found), so in old age there arises a condition of sclerosis in the tissues and organs.

On this account, strictures of the urethra are readily produced in old men who have had gonorrhœa scores of years ago. The prostate gland, owing to the abundant formation of connective tissue, will also enlarge, although usually sclerosis of an organ is accompanied by diminution in size. In the central nervous system, just as after extirpation of the thyroid, there is proliferation of neuroglia. Through destruction of the nerve cells those mental attributes arise that are deemed typical of old age: Egotism, enmity against all new ideas, conservatism, etc., which we described in our address on the origin of crime before the Philadelphia Medical Jurisprudence Society, April 14, 1907.[165] The same mental characteristics are also typical of degenerated conditions of the thyroid and pituitary body, as we have seen in a case of acromegaly whose history we owe to Dr. Dercum, of Philadelphia.

Footnote 165:

Journal of the Amer. Med. Assoc., May 17, 1907.

To recapitulate, we may state that old age is caused by degeneration of the ductless glands, and that there exists a condition of auto-intoxication in old age.

The symptoms of old age are the result of breakdown of the tissues and organs which, owing to shrinking of the blood-vessels, are insufficiently supplied with blood, and, owing to the disappearance of nervous elements, are devoid of proper nervous control.

Degeneration of the ductless glands and of the organs and tissues cannot be simultaneous, for the latter are under the control of the former. These glands govern the processes of metabolism and nutrition of the tissues, and by their incessant antitoxic action protect the organism from the numerous poisonous products, be they of exogenous origin, introduced with air or food, or endogenous, formed as waste products during vital processes. After degeneration of these glands the processes of metabolism in the tissues are diminished, and there is an increase of fibrous tissue at the expense of more highly differentiated structures.

The fact that the changes in the tissues are secondary and take place only after primary changes in the ductless glands, is best proved by the circumstance that they can be produced, either experimentally by the extirpation of certain of the ductless glands, or spontaneously by the degeneration of these glands in disease.

Our theory as to the causation of old age by degeneration of the ductless glands has been confirmed by several writers, some of whom had no knowledge of our existing work.

Thus Campbell, in July, 1905, published a short note in the _Lancet_, attributing old age to degeneration of the ductless glands, overlooking our previous communication to the Paris Biological Society.

Two years afterward Pineles, in an article published in the _Wiener klin. Wochenschrift_, comparing the origin of diabetes, tetany, and old age, came to the conclusion that old age was caused by the same agency (i.e., alteration of the ductless glands) as the other conditions mentioned.

Sir Herman Weber, in his interesting work on the prolongation of life, also attaches great importance to degeneration of the ductless glands as a cause of old age.

In his work on the same subject, Professor Metschnikoff admits, only partially, the truth of our theory on the causation of old age. He admits the great importance of the ductless glands in the pathology of old age, as they serve to destroy poisons. He denies, however, the relation of old age to a myxœdematous condition; but everyone who knows the pathology of myxœdema will see that the arguments of Professor Metschnikoff cannot stand, for they have no foundation.

His arguments are that there is an œdema in myxœdema, but not necessarily in old age; that the hair falls out in myxœdema, and that myxœdematous women have abundant menstruation, while old women have none; that myxœdematous persons have strongly developed muscles, and old people, on the contrary, weak and feeble muscles.

The truth is that there is often no œdema at all in myxœdema; that the hair often does not fall out in myxoedema, especially in its partial form (hypothyroidia); that myxœdematous women have, as a rule, no menstruation (atrophy of the ovaries); and that myxœdematous people have not a strongly developed muscular system, which is rather degenerated by a new growth of fat, or connective tissue, or a mucinous tissue, following the degeneration of the thyroid just as it follows its extirpation. Professor Metschnikoff also states that certain animals that soon become old do not develop cachexia after extirpation of the thyroid.

This was the belief about eighteen years ago, but now we know that they all develop cachexia if the operation is so performed that the parathyroids, or at least some of them, are allowed to remain untouched. Professor Metschnikoff’s views have been greatly weakened by the far more extensive researches of Professor Sajous which have conclusively shown that the life process, its activity and duration, is dependent upon the ductless glands, including the thyroid.

It is evident from the above considerations that all hygienic errors, be they errors of diet or any kind of excess, will bring about their own punishment; and that premature old age, or a shortened life, will be the result. In fact, it is mainly our own fault if we become senile at sixty or seventy, and die before ninety or a hundred.

It may be the privilege of a few to live until ninety, even though worshipping immoderately at the altars of Bacchus or Venus! But these are very few, and as we have seen, they have lived on the heritage of their forefathers, not merely in an illustrative sense, but also in reality, for the greater number of such persons have grown up in easy circumstances without knowing the wear and tear of care and sorrow.

Not only old age, but the majority of diseases, are due to our own fault in undermining our natural immunity against infections, and subjecting our various organs to unreasonable overwork and exertion. We do not believe that the worst slave-driver of olden days subjected his slaves to such treatment as we do our own organs, and especially our nerves. At last they must rebel, and disease, with early death or premature old age, will be the result.

It is literally true, as the German proverb says: “Jeder ist seines Glückes Schmied” (every man is the locksmith of his own happiness), and as a variation on this we would say: “Every man is the guardian of his own health.”

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