Excerpt from Geriatrics: The Diseases of Old Age and Their Treatment; Including Physiological Old Age, Home and Institutional Care, and Medico-Legal Relations
The generous reception of the first edition by the medical profession is an encouraging indication that the field of geriatrics is not a barren waste, that with more wide-spread interest and more extended research it may become one of the most fruitful fields in the realm of medicine.
Containing features new in thought and elaboration and views differing radically from existing views, it was expected that the work would be severely criticised. Reviewers, generally, have been gracious in their criticisms, pointing out errors and questioning opinions. The basic proposition that "Senility is a physiological entity analogous to childhood and not a pathological state of maturity," has been questioned on the grounds that there is no senile norm and no point at which we can fix the beginning of the senile state. All anatomical and physiological standards are based upon averages, drawn in some cases from widely separated normal limits. In childhood we fix standards year by year. We could, in the same manner, fix yearly norms in old age although the limits would be more widely separated as some age sooner than others. And just as we fix the limit of childhood at puberty, although the period of development continues until the third decade, we can fix the beginning of old age at the menopause and male critical period, although some organs begin to degenerate before this time. The basic proposition is being accepted by those who have given thought to the subject and who realize that in dealing with senile diseases the object must be to restore the organism to the normal senile state and not to the normal state of maturity.
It is hardly necessary to justify the new classification of diseases. The ordinary classifications, based partly upon etiology, partly upon functions and physiological relations, partly upon anatomical position, partly upon the supposed nature of pathological states, is unscientific and irrational. The classification in this work is based upon the relation of the diseases to the senile processes. This can be elaborated by making subdivisions of the five groups. In this edition the third and fourth groups of the first edition have been transposed.
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