Читать книгу Old Age Deferred - Arnold Lorand - Страница 11

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For most arteriosclerotic persons there can be only little hope to live up to a green old age, to become 80 or 90 years old or even to pass on to still higher years. But there are exceptions not so very seldom, and it gives comfort to my patients suffering from this disease and apprehension of the future, when I tell them that nearly all the brothers and sisters of both my parents suffered from this disease for many years, which did not prevent them from attaining ages varying between 80 and 96 years and more. My father ever after his forty-fifth year suffered from attacks of asthma. As a child I was often awakened through his nightly asthmas, but in spite of many symptoms of arteriosclerosis he lived to a great age.

One of my aunts is still living, not very far from 100 years old, although suffering in a high degree from arteriosclerosis for many years. Such protracted cases generally happen in families of longevity and they are only due to, as a rule, regular habits, although it is true that my father was a great smoker in his younger years and even in his last years enjoyed one or two light cigars daily.

Such long survivals constitute, however, a great exception in arteriosclerosis, and it usually happens only in cases where there are no symptoms of that most dreaded form of arteriosclerosis, i.e., the sclerosis of the coronary arteries of the heart. These arteries are probably the most important ones of our body, for they provide the muscles of the heart with the nourishing blood without which they could not do their work. It is the sclerosis—the hardening—of these arteries which, causing an obstacle to the passage of the blood, is the most frequent cause of rapid death in arteriosclerosis, often in comparatively young people. It is a sad fact, that such a condition, as so often is the case with arteriosclerosis, can exist without exhibiting any marked symptoms of it being present. A very frequent symptom of sclerosis of the coronary arteries is attacks of genuine angina pectoris (stenocardia),—to be distinguished from the pseudo-attacks of angina pectoris of neurasthenic persons. In such attacks there are strong radiating pains in the heart region, and a feeling of great anxiety, of utter annihilation, and of instantaneous death; and indeed not so seldom such attacks may terminate in death. These attacks may be considered as a warning of nature that such persons stand on the verge of a precipice and thus urging them to the greatest precautions to avoid anything that may bring about such an attack. From my own observations, rapidly fatal attacks of angina pectoris in such cases of arteriosclerosis happen frequently after a heavy dinner. The stomach being distended, the diaphragm is pushed upward and thus impeding the movements of the heart, which has not sufficient space for the play of its muscles. Such a condition may also be often caused by the ingestion of dishes causing flatulence. In consequence heavy dinners and flatulent foodstuffs must carefully be avoided, and I declare any person who presents attacks of genuine angina pectoris as a determined suicide if he continues to indulge in them. There should be taken 5 small meals a day, so as to avoid the keen appetite which results in overloading the stomach. Foodstuffs causing flatulence such as cabbage, fried potatoes, etc., should, above all, be avoided. Food that is rich in cellulose (wood fiber) is strictly forbidden in such cases. For further details on food producing flatulence I must refer to my above-mentioned diet book, which contains a special chapter on the best food in flatulency and also a list on the amount of cellulose (wood fiber) in different articles of food. For the treatment by drugs refer to the chapter of this book on arteriosclerosis. Besides moderate habits, including the use of very light cigars in the smallest possible quantity (if smoking cannot be given up entirely), overexcitement of any kind, especially sexual, as also overexertions (hill climbing), must strictly be avoided. Transgression of these commands, especially hill climbing, may sometimes mean instantaneous death in advanced cases. Persons suffering from coronary sclerosis with attacks of angina pectoris will do very well to give up their positions if heads of companies with great responsibilities and heavy burdens resting upon their shoulders, as any stormy shareholder meeting may prove fatal to them. As already said it is a sad fact, that persons may suffer from coronary sclerosis without even knowing it, as there are also thousands of victims of arteriosclerosis who are utterly ignorant of their condition, as this disease often presents no marked symptoms. I must deplore that most stupid habit of seeking for medical aid only when the ravages of disease have gone so far that reparation is impossible. How often do people forget the wise English proverb: “An ounce of prevention is worth a pound of cure.” Just the same as children are sent every three months to the dentist to see if any of the teeth present may be decaying in order to save them, people already before feeling ill ought to at least once a year be examined thoroughly by a doctor to see if anything is wrong in the human machinery. I feel certain that in such a case many thousands of persons, instead of lying in their dark, cold graves below the earth, could still tread the soil enjoying sunshine and the scent of the flowers. There is no doubt that arteriosclerosis and especially coronary sclerosis could be avoided in many cases, through such an examination, for the onset of arteriosclerosis is generally insidious and slow, especially if it develops in the younger years, when due to syphilis, and thus, if in time recognized, it could be cured. But even without the syphilitic infection, cases in young persons are more frequent than we think.

It is to the present terrible war, raging and destroying so many lives, that we owe the observation made by many of the military doctors that a goodly number of young soldiers present symptoms of arteriosclerosis, many of them having never suffered from syphilis. Often it is but a slight elevation of the blood-pressure, but which, if persistent, may indicate a beginning arteriosclerosis.