Pathot.ogical Basts of Ageing 17 



and brown atrophy of the heart and h\'er, eholehthiasis and 

 a nodular goitre. 



To all intents and purposes, therefore, these two old people 

 were healthy right up to the terminal illness, yet their bodies 

 were a collection of morbid processes, any one of which might 

 have flared up at any time during the last thirty years and 

 ended life. 



No doubt an extended search of the pathological literature 

 would bring to light further reports on extreme old age, but 

 I am not aware of such information, so I set to work to collect 

 data from the autopsy records of University College Hospital 

 which bear on the topic of ageing, and these I now present in 

 the hope that they will interest you. 



Our records over the years 1904-1953 comprise 13,630 

 autopsies among which are 1,872 on old people. Examinations 

 w^ere conducted by five pathologists who were, on occasions, 

 assisted by juniors; however, it is safe to claim that autopsy 

 technique has altered very little during the fifty years, for 

 each of us, with one exception, has been trained by his prede- 

 cessor. In many instances microscopy on the most important 

 organs was performed and such reports have been available 

 for study. I am greatly indebted to two of my research 

 colleagues, V. Udall and K. C. Basu Mallik, who sorted out 

 the cases for me. 



Reports on males from sixty-five years onwards and females 

 from seventy years onwards have been scrutinized. Since 

 there were very many more males than females (1,328 against 

 544) most of my remarks wdll be confined to the former. 



Let me say at once that all I have endeavoured to do is to 

 find out what was the pathological condition responsible for 

 the decline and death of the individual. In many instances, 

 of course, the immediate cause of death was some terminal 

 accessory event, such as an acute infection, a severe haemorr- 

 hage, septicaemia or uraemia. It is therefore more correct to 

 speak of morbidity rather than mortality. I must first of all 

 explain that our hospital is a teaching institution, and I 

 gather from conversations with our senior clinicians that the 



