MIDDLE AGE

Dominion, Volume 29, Issue 101, 23 January 1936, Page 14

MIDDLE AGE

Difficulties and Dangers Stressed PROBLEMS OF HEALTH Sir Arbuthnot Lane’s Warning That middle age is one of the difficult and dangerous corners in life's race is a popular belief not without some basis in scientific fact (writes Sir Arbuthnot Lane, C. 8., M.S., F.R.C.S). Owing to changes in the activities of the ductless glands, the body undergoes a minor revolution at this period. The various organs have to readjust themselves to meet the new demands and some transient disturbance of their functioning is almost inevitable. Middle age is technically the commencement of the decadent phase of life and as sueh it is accompanied by a slight lowering of the vitality of the body cells and a diminished elasticity of the tissues. In consequence, some modification of the mental and physical activities is called for. otherwise a strain is imposed which, under the new working conditions, the body is unable to sustain. Unfortunately, middle age overtakes us so stealthily that we are generally well in its toils before we recognise the fact, and we make little attempt to alter our mode of existence until some unpleasant symptom pulls us up and makes us take stock. It may be that our customary recreation takes more out of us than it used to, and that the least exertion makes us breathless and gives us palpitations. Or perhaps we catch “cold” after “cold,” and for the first time in our lives we suffer from indigestion. If we are observant and truthful, we will probably notice that we are putting on weight and that we are beginning to look our age. We feel less springy—less inclined for outdoor sport—and become overfond of the armchair by the fire. Gradually it is borne upon us that we are “suffering” from middle age, a revelation both depressing and frightening. We have reached the stage when we look back with longing and regret at the joys of maturity, the active and vigorous habits of mind and body which made life so joyous and so desirable, and our feeling of incapacity fills us with valetudinarian apprehension. Some of us accept the sentence of middle age with resignation; we put up with its discomforts and regard its illnesses as inevitable; we make no effort to safeguard our health, and indulge our stomachs in the matter of food and drink as we were wont in the years gone by; we court premature old age and cut sho# the span of life. Those of us who are wise take heed and seek to accommodate ourselves to a new life. We awaken our health conscience which until now. has probably been dormant and we seek advice on how to keep fit. Modem Social Conditions. Under modern social conditions it is in middle age that the responsibilities of the average man are at their height. If he is a family man, the children are now about to launch forth into the world on their own, a time of anxiety for all concerned. Then he must also consider the provision for the future, both for himself and his wife. If he has not already reached the top of his particular tree, he must reconcile himself, for striving ambition in middle age is a dangerous thing. Many of the breakdowns of this phase of life—so tragic in their consequences—are directly attributable to thi s cause. If the middle-aged man is to discharge his responsibilities with credit he must safeguard his health not only of his body but also of his mind. Failure brings a penalty which is exacted from the dependants as well as the bread-winner.

It is in middle age that the results of the follies of the days of our youth and prime are apt to show themselves. When we are hardy and vigorous we may offend every canon of the health code with apparent impunity—we may eat, drink, smoke and work to excess—but the reckoning is merely delayed and we will reap what we have sown. To be spendthrift with the health resources of our body in our virile days is to leave us bankrupt at the time when they are most necessary, at the time when fitness is imperative—these critical years we call middle age. If we were sedulously careful to observe the elemental laws of health from early life onward, the health problems of middle age would be non-existent and a calm and genial contentment with the stiffest part of the battle of life behind us would be our well-earned and worthy reward.

I will now consider the most important perils to a healthy middle age though I again emphasise that a special hygiene at this time of life i s unnecessary provided healthy living has been the rule of life. Without a doubt the bane of middle-age health and the fountain-head of most of its troubles, in both sexes, is disturbed bowel functioning. How does this arise? In the first place the diet of our modern civilisation ig at fault. Our foods are refined and devitalised; they are robbed of their roughage and their vitamins—• both so necessary to stimulate brisk contractions of the intestines and so to hasten the evacuation of waste. Not nearly enough vegetables and fruits nr® consumed by the average person, while far too much meat is eaten. Then custom, unfortunately with the sanction of the medical profession, advocates one motion of the bowels per day as being adequate for health—blind to the fact that the child, the gorilla and the savage have a motion reflexly after every meal. Take into account the sedentary habits of the majority of the population which lead to lax abdominal muscles quite unfit to help in hasten. Ing on the contents of the bowels and it is easy to understand how constipation, one of the greatest evils of civilisation and the disease of diseases, arises. How Disease is Produced. How does constipation produce disease? In two ways. First, the unnatural accumulation of food remains necessitates certain structural changes in the bowel to counteract the mechanical disadvantages so produced. These changes, originally beneficial, defeat their own end and become a menace to health by kinking and distorting various parts of the digestive tube. This hinders still more free passage of the bowel contents, leading to stagnation, or stasis, while the tension of the heavy colls of bowel may cause tearing or ulceration of the mucous membrane of the duodenum and stomach. Secondly, constipation leads to disease owing :o the inevitable stagnation and putrefaction of the bowel contents and the absorption of poisons so generated Into the blood-stream. In time, degenerating changes are produced in all the tissues, and such vital organs as the heart. I

kidneys, liver, ductless glands, and brain are gravely affected. Now the middle-aged person who is despondent, seedy and “off colour” is sure to complain of his “liver” which he accuses of being “sluggish." I would like to impress on such a person that it is not his liver that is primarily at fault; he is suffering from self-poison-ing—a direct sequel to constipation—• and unless he makes vigorous efforts to relieve himself of that complaint danger looms ahead. One of the gravest dangers of selfpoisoning is its effects on the blood vessels, particularly the arteries. It causes them to lose their natural elasticity, to become hard and thickened; it hastens their ageing and makes them liable to burst. Thickened arteries mean that the various organs do not get sufficient blood and therefore they are unable to perform their duties properly. In particular, the brain suffers and mental irritability, lack of power of concentration, and sleeplessness result. We are all familiar with these trying symptoms in the middle-aged—so regrettable in that they are clearly preventable. The blood-pressure also is unhealthily increased from the same cause, straining both the arteries and the heart, and sometimes leading to such catastrophes as a “stroke” or an “apoplexy,” and to heart failure. More commonly high blood-pressure gives rise to headache, insomnia, attacks of giddiness, heart pain, easily induced fatigue and occasionally to abdominal symptoms such as flatulence and vomiting. Now the subject of high blood-pressure has excited a good deal of popular interest of late, and it is often regarded as a disease in itself! We all have. blood-pressures, for a certain force is necessary to propel the blood on its circuit of the body but some, as indicated, have too high a pressure and this is but a sign of underlying trouble which requires to be investigated by the physician. I think it advisable that all misunderstanding on this subject should be cleared up, for many middle-aged people, on the physician measuring their blood-pres-sure with an instrument, become very alarmed to find they do possess a “blood-pressure” even though it be quite normal for their years. Putting on Weight. Obesity is the next failing of middle age concerning which I wish to make observations. We recollect Shakespeare’s middle-aged justice: “In fair round belly with good capon lined.’’ The tendency to put on weight at this time is encouraged by the failure to take adequate exercise and recreation and by indulging too freely in the good things of the table. Obesity is a heavy handicap on middle-age health. It throws a strain upon the heart and blood vessels—which can ill-support a strain at this time—and it leads to a liability to “colds,” catarrhs and bronchitis. Muscle and ligaments are unduly taxed and joint inflammations often develop. Now the middle-aged who are getting agreeably plump should take themselves in hand before an ungainly stoutness makes drastic measures imperative. Diet will have to be ent down and this is best accomplished slowly and not by any harsh method of starvation.

Rheumatic troubles and neuralgias are apt to prove troublesome about this time and these are nearly always connected with “focal infection,” that is to say, small septic areas in the sockets of decayed teeth, nose sinuses and tonsils, or from bowel stasis. As the poison-destroying organs—the liver and the thyroid gland—are less able to cope with these harmful substances in middle age, the consequence of this form of self-poisoning are grave. I have commented on the most serious health difficulties of middle age and now let me proffer some advice on hew to avoid these difficulties and how generally to keep fit. Diet, I place first in degree of importance. Two good meals a day are sufficient for the needs of the middle-aged body. Fruit, vegetable, wholemeal cereals and dairy produce should form the staple ingredients. Meat should never be taken at more than one meal in the day and only then if the bowel function is adequate. It should be the aim of the middle-aged to obtain two good motions daily, three is better still. This is not to be achieved by reckless use of aperients but by natural means—dieting, exercise and, if need be, abdominal massage. Au occasional fast is highly beneficial for tlie middle-aged, especially if there is tendency to obesity.

Muscular exercises are valuable at all periods of life, but particularly so at this time; simple gymnastics should be carried out daily and out-of-doors if possible in order to gain advantage from the fresh air and available sunlight. The middle-aged must avoid all tendencies to “coddle”: they should rever over-clothe —not even in cold weather for cold is stimulating and health-giving, Coo] baths in the morning help to keep the skin function active and a responsive skin is the best protection against “chills” and “colds.” In conclusion, let the middle-aged never forget that their doctor is their best guide to the problems of their age and a periodic consultation may save much unhappiness and much illhealth. A healthy middle age is the best safeguard against a premature and aiiing old age.