Читать книгу The Prolongation of Life: Optimistic Studies - Élie Metchnikoff - Страница 5

Table of Contents

Treatment of old people in uncivilised countries—Assassination of old people in civilised countries—Suicide of old people—Public assistance in old age—Centenarians—Mme. Robineau, a lady of 106 years of age—Principal characters of old age—Examples of old mammals—Old birds and tortoises—Hypothesis of senile degeneration in the lower animals

In the “Nature of Man” I laid down the outlines of a theory of the actual changes which take place during the senescence of our body. These ideas, on the one hand, have raised certain difficulties, and, on the other, have led to new investigations. As the study of old age is of great theoretical importance, and naturally is of practical value, I think that it is useful to pursue the subject still further.

Although there exist races which solve the difficulty of old age by the simple means of destroying aged people, the problem in civilised countries is complicated by our more refined feelings and by considerations of a general nature.

In the Melanesian Islands, old people who have become incapable of doing useful work are buried alive.

In times of famine, the natives of Tierra del Fuego kill and eat the old women before they touch their dogs. When they were asked why they did this, they said that dogs could catch seals, whilst old women could not do so.

Civilised races do not act like the Fuegians or other savages; they neither kill nor eat the aged, but none the less life in old age often becomes very sad. As they are incapable of performing any useful function in the family or in the village, the old people are regarded as a heavy burden. Although they cannot be got rid of, their death is awaited with eagerness, and is never thought to come soon enough. The Italians say that old women have seven lives. According to a Bergamask tradition, old women have seven souls, and after that an eighth soul, quite a little one, and after that again half a soul; whilst the Lithuanians complain that the life of an old woman is so tough that it cannot be crushed even in a mill. We may take it as an echo of such popular ideas that murders of old people are extremely common even in the most civilised European countries. I have been astonished in looking through criminal records to see how many cases there are of the murder of old people, specially of old women. It is easy to divine the motives of these acts. A convict of the Island of Saghalien, condemned for the assassination of several old persons, declared naïvely to the prison doctor: “Why pity them? They were already old, and would have died in any case in a few years.”

In the celebrated novel of Dostoiewsky, “Crime and Punishment,” there is a tavern scene where young people discuss all sorts of general topics. In the middle of the conversation a student declares that he would “murder and rob any cursed old woman without the least remorse.” “If the truth were told,” he goes on to say, “this is how I look at the thing. On the one hand a stupid old woman, childish, worthless, ill-tempered, and in bad health; no one would miss her, indeed she is a nuisance to everyone. She does not even herself know any reason why she should live, and perhaps to-morrow death will make a good riddance of her. On the other hand, there are fresh and vigorous young people who are dying in their thousands, in the most senseless way, no one troubling about them, and everywhere the same thing is going on.”

Old people not only run the risk of murder; they very often end their own lives prematurely by suicide.

They prefer death to a life oppressed by material hardships or burdened by diseases. The daily papers give many instances of old people who, tired of suffering, asphyxiate themselves by their charcoal stoves.

The frequency of suicide in the case of the old has been established by numerous statistics, and the new facts which I now cite do no more than confirm it. In 1878, in Prussia, amongst 100,000 individuals there were 154 cases of suicide of men between the ages of 20 and 50, but 295, that is to say, nearly twice as many of men between the ages of 50 and 80. In Denmark, a country in which suicide is notoriously common, a similar proportion exists. Thus, in Copenhagen, in the ten years from 1886 to 1895, there were 394 suicides of men between 50 and 70. These figures relate to 100,000 individuals. Of the suicides 36–½ per cent. were those of people in the prime of life, 63–½ per cent. those of the aged.1

In such circumstances, it is natural that politicians and philanthropists have made many attempts to ameliorate the old age of the poor. In some countries laws have been passed to bring about this. For instance, a Danish law of June 27th, 1891, established compulsory aid for the aged, enacting that every person more than 60 years old was to have the legal right to aid if required. In 1896 more than 36,000 people (36,246) were pensioned under this law, at a cost of nearly £200,000. In Belgium, the indigent old people are not pensioned until they reach the age of 65. In France, until recently, the aged poor could be supported at the public expense only by prosecuting them and sending them to prison for begging. This state of affairs, however, ceased with the application of the law of July 15th, 1905, according to which any French subject without resources, unable to support himself by work, and either more than 70 years of age, or suffering from some incurable infirmity or disease, is to receive public assistance.

It has been thought the proper course to make such laws, and to lay the burden on the general population, without inquiring if it may not be possible to retard the debility of old age to such an extent that very old people might still be able to earn their livelihood by work. Old age can be studied by the methods of exact science, and there may yet be established some regimen by which health and vigour will be preserved beyond the age where now it is generally necessary to resort to public charity. With this object, a systematic investigation of senescence should be made in institutions for the aged, where there are always a large number of people from 75 to 90 years old, although centenarians are extremely rare. I know many institutions for aged men where, from their first foundation, there has been no case of an inhabitant reaching the age of 100, and even in similar institutions for women, although women live to much greater ages than men, centenarians are very rare. At the Salpêtrière, for instance, where there is always a large number of old women, it is the rarest chance to find a centenarian. Opportunity for the study of the extremely aged is to be found only in private families.

Most of the centenarians whom I have been able to see have been so defective mentally that all that can be studied in them are the physical qualities and functions. A few years ago an old woman who had reached her 100th year was the pride of the Salpêtrière. She was bedridden and extremely feeble physically and mentally. She replied briefly when she was asked questions, but apparently without any idea of what they meant.

Not long ago, a lady who lived in a suburb of Rouen reached her 100th birthday. The local newspapers wrote exaggerated articles about her, praising the integrity of her mind and her physical strength. I paid a visit to her myself, hoping to make a detailed investigation, but I found at once that the journalists had completely misrepresented her condition. Although her physical health was fairly good, her intelligence had degenerated to such an extent that I had to abandon the idea of any serious investigation.

The most interesting of all the centenarians with whom I have become acquainted had reached an extremely advanced age, having entered upon her 107th year. It is about two years ago that a journalist, Monsieur Flamans, took me to see this Mme. Robineau who lived in a suburb of Paris. I found her a very old-looking lady, rather short, thin, with a bent back, and leaning heavily on a cane when she walked. The physical condition (Mme. Robineau was born on January 12th, 1800), of this woman of more than 106 years, showed extreme decay. She had only one tooth; she had to sit down after every few steps, but, once comfortably seated, she could remain in that position for quite a long time. She went to bed early and got up very late. Her features displayed very great age (see Fig. 1), although her skin was not extremely wrinkled.

Fig. 1.—Mme. Robineau, a centenarian. From a photograph taken on her one hundred and fifth birthday.

The skin of her hands had become so transparent that one could see the bones, the blood-vessels, and the tendons. Her senses were very feeble; she could see only with one eye; taste and smell were extremely rudimentary; her hearing was her best means of relation with the external world. None the less, Dr. Löwenberg, a well-known aurist, had assured himself that her auditory organs showed in a most marked degree, the usual signs of old age, such as complete insensibility to high notes and slight deafness for low notes. Dr. Löwenberg attributed these changes to senile degeneration of the ear which affected more and more seriously the nervous mechanism although it had caused little change in the conducting apparatus. Notwithstanding her physical weakness, Mme. Robineau retained her intelligence fully, her mind remained delicate and refined and the goodness of her heart was touching. In contrast with the usual selfishness of old people, Mme. Robineau took a vivid interest in those around her. Her conversation was intelligent, connected, and logical. Examination of the physical functions of this old lady revealed facts of great interest. Dr. Ambard found that the sounds of the heart were normal, but perhaps a little accentuated. The pulse was regular, 70 to 84 a minute, and its tension was normal. The arterial pressure was 17. The lungs were sound. All these facts testify to her general health. The most remarkable circumstance was the absence of sclerosis of the arteries, although such degeneration is usually believed to be a normal character of old age.

Analysis of the urine, made on several occasions, showed that the kidneys were affected with a chronic disease, which, however, was not serious.2

Although the sense of taste was weak, Madame Robineau had a fair appetite. She ate and drank little, but her diet was varied. She took butcher’s meat or chicken extremely seldom, but ate eggs, fish, farinaceous food, vegetables, and stewed fruit, and drank sweetened water with a little white wine, and sometimes, after a meal, a small glass of dessert wine. The processes of alimentary digestion and excretion were normal.

It has sometimes been thought that duration of life is a hereditary property. There was no evidence for this in the present case. Madame Robineau’s relatives had died comparatively early in life, and a centenarian was unknown in her family. Her great age was an acquired character. Her whole life had been extremely regular. She had married a timber merchant, and had lived for many years in a suburb of Paris in comfortable circumstances. Her character was gentle and affectionate; she was thoroughly domesticated, and had been devoted to home life with very few distractions.

At the age of 106 years, her intelligence suddenly became weak. She lost her memory almost completely, and sometimes wandered. But her gentle and affectionate disposition remained unaltered.

The appearance of aged persons is too well known to make detailed description necessary. The skin of the face is dry and wrinkled and generally pale; the hairs on the head and the body are white; the back is bent, and the gait is slow and laborious, whilst the memory is weak. Such are the most familiar traits of old age. Baldness is not a special character; it often begins during youth and naturally is progressive, but if it has not already appeared, it does not come on with old age.

The stature diminishes in old age. As the result of a series of observations, it has been established that a man loses more than an inch (3·166 cm.), and a woman more than an inch and a half (4·3 cm.), between the ages of fifty and eighty-five years. In extreme cases, the loss may be nearly three inches. The weight also becomes less. According to Quételet, males attain their maximum weights at the age of forty, females at that of fifty. From the age of sixty years onwards, the body becomes lighter, the loss at eighty being as much as thirteen pounds.

Such losses of height and weight are signs of the general atrophy of the aged organism. Not merely the soft parts, such as the muscles and viscera, but even the bones lose weight, in the latter case the loss being of the mineral constituents. This process of decalcification makes the skeleton brittle, and is sometimes the cause of fatal accidents.

The loss of muscular tissue is specially great. The volume diminishes, and the substance becomes paler; the fat between the fibres is absorbed, and may disappear completely. Movements are slower, and the muscular force is abated. This progressive degeneration has been examined by dynamometrical measurements of the hand and the trunk, and is greater in males than in females.

The volumes and weights of the visceral organs similarly become smaller, but the diminution is not uniform.

The old age of lower mammals presents characters similar to those found in man. I can now give other instances than the case of the old dog which I described in the “Nature of Man.”

I will first take the case of old elephants, described by a competent observer. “The general appearance is wretched, the skull being often hardly covered with skin; there are deep abrasions under the eyes, and smaller ones on the cheeks, whilst the skin of the forehead is very often deeply fissured or covered with lumps. The eyes are usually dim, and discharge an abnormal quantity of water. The margin of the ears, specially on the lower side, is usually frayed. The skin of the trunk is roughened, hard, and warty, so that the organ has lost much of its flexibility. The skin on the body generally is worn and wrinkled; the legs are thinner than in maturity, the huge mass of muscles being much shrunken, whilst the circumference, especially just above the feet, is considerably reduced. The skin round the toe-nails is roughened and frayed. The tail is scaly and hard, and the tip is often hairless.