Practical medicine and medical diagnosis / by Byrom Bramwell.

  • Byrom Bramwell
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Practical medicine and medical diagnosis / by Byrom Bramwell. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    :u) critical period be sately past, the special precautionary measures may be relaxed, for alter the critical age the tendency to the disease declines.^ In estimating the age ot an individual, his expectancy of life, the period at which the diseases ol old age are most likely to arise, and other questions ot a similar nature, the absolute age in years is of much less importance than the relative age of his organs and tissues. Some men at 50 are as old as others at 70. The pregnant remark of Dr ilks, that ‘ a man is as old as Ids arteries,’ .should never be lost sight ot. Everyone with atheromatous vessels is an old man, liowever healthy and fresh he may appear. I have known several instances in whicli young-looking, wiry, and unusually active people, have died about the age of 70 trom cerebral lucmorrhage; to look at them you would have said that they had every chance of living for many years ; a diseased condition of the minute cerebral vessels is not, therefore, incompatible 'with activity and great apparent freshness. In estimating the probable duration of life, therefore, in any given case, the condition of the vas- cular system, more especially of the perqrheral ve.ssels, is a point of the greatest importance. The jiresence of an arcus senilis, diminution or loss of sexual activity in the male, the cessation of tlie menstrual function in women, diminished sensibility of the retina, and early presbyopia (Gairdner), are other indications that the period of activity has passed, and that decline is commencing, or has already advanced. It must also be remembered that some patients (in hospital and dispensary practice more especially) are ignorant of their exact age. Further, the tendency which the members of the female sex in all ranks of life, sometimes have to underestimate their age, is well known to everyone. Sex.—Some diseases are more common in men than in women, and vice versd. This is partly owing to differences in organisation, constitu- tion, and temperament, and partly to differences in occupation, habits, and mode of life. Abdominal tumours, for example, are much more common in women than in men, because of the presence of the uterus and ovaries in tlie former. Women are, as a rule, more nervous than men, more subject to hysteria and all forms of emotional manifestation. Diseases due to exposure (such as acute rlieumatrsm and bronchitis); ex- ternal injuries; diseases produced by strain (such as aneurisms); the many different affections which result from over-indulgence in alcoholic liquors (sucli, for example, as delirium tremens and cirrhosis of the ' I have met with two separate families in wliich there was a strong tendency to the development of chronic Bright's di.scase (tlie contracted form of kidney) ahont tlie ages of 20 and 23 respectively.
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