546 POPULAR SCIENCE MONTHLY. 



I am also of the opinion, that arteriosclerosis is thus postponed, and 

 sometimes prevented, hence the same principles hold good throughout 

 the entire economy. It may not be necessary to develop this thought 

 further, but to assume the truth of what I regard as an original observa- 

 tion, that systematized effort at elasticizing of the tissues is the basis 

 upon which sclerotic changes generally can be delayed and made less. 

 The means by which this result is to be attained consist chiefly in em- 

 ploying movements taught by a skillful person, and this should be the 

 physician himself, assisted, it may be, by an expert trained by him to 

 pursue the work in detail. Free exercises in the open air, proportional 

 to the capacities of the individual, are of the greatest importance and 

 should be regulated with the same care and supervised with the same 

 conscientiousness as any other medical measures. Among those of the 

 utmost importance are prescribed movements which differ in degree 

 at least from the ordinarily employed remedial movements whose 

 main object is to improve muscular tone, and which are largely flexor 

 for the arms, with only a moderate degree of extensor activities. For 

 older people there should be a steadily increasing attention to the ex- 

 tensors and less action demanded of the flexors. First these should be 

 passive in the form of stretchings, rotations and torsions carefully and 

 deliberately applied to the limbs and trunk and the neck. These should 

 be moderately supplemented at flrst by voluntary movements in the same 

 direction. Later, as vigor improves, and the heart action is strength- 

 ened, and the blood vessels recognized to be better able to stand the in- 

 creased vascular tension induced by exercise,* these may be employed 

 more forcefully until, by and by, the patient, even when well advanced 

 in years, can endure a degree of muscular work which is surprising. 

 ISTot only so, but this results in a feeling of well-marked enjoyment, 

 not only of the restoration of sensations due to the improved circulation 

 and in increased resistance to temperature changes, but in the pro- 

 cedures themselves which come to be distinctly relished. 



In this connection let me say a word about the senile heart. It 

 is generally accepted in a fatalistic sort of way that old people are 

 unfit for activities, that they must do as they are inclined to do, little 

 or nothing but exist, like vegetables. My own experiences and con- 

 victions in this particular seem fortified by the best authorities con- 

 sulted. In my opinion the disinclination to movement and effort is 

 rather the result of under-oxygenation, a habit, or other conditions which 

 make for what one may almost call senile laziness, than an instinctive 

 economic impulse. It is obvious that the healthier and happier old 

 people are those who are reasonably active. My experience justifies the 

 conviction that where activities have been encouraged, always with full 



* This increased vascular tension as Oliver and others have shown, is 

 quickly followed by a fall. Hence the most salutary means of lowering tension 

 is by exercise to the point of skin relaxation — sweating. 



