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JAMA Revisited
November NaN, 2016

Problems Confronting Medical Investigators

JAMA. 2016;316(20):2157. doi:10.1001/jama.2015.17111

In a recent address at the fiftieth anniversary celebration of Stanford University, Dr. Walter B. Cannon1 presented some questions which deserve careful study. The shift in age grouping of the population, with increasing percentages of the elderly and the aged, now widely recognized as a fact, has presented the medical profession with a series of new problems. As one grows older, Cannon points out, the fires of life burn less vigorously and the adjustments of bodily organs to emergencies tend to be impaired—the breath is shorter, the heart beats less effectively, blood pressure gradually rises as the years pass and becomes ill adapted to critical requirements. Are these features essential attributes of the elderly or are they the consequences of comfortable and habitual indolence? In middle age some of these effects may result from inactivity alone and can be reversed by training; is this true in the later decades? If so, should attempts be made to alter them? What, Cannon says, would be the effects if they were altered? These questions offer possibilities for useful research. Almost none of the most prominent disorders of senescence are thoroughly understood. The prevailing ignorance, it may be assumed, is largely due to lack of systematic study. The challenge presented by realization of this fact will doubtless receive many answers. Severe demands on the nervous system, which may have arisen in part from the remarkable shift in the occupation of the citizens, often result in calls for medical attention. A disorder of the brain may fail to be revealed at necropsy or under the microscope. And yet emotional upsets which leave in the nervous pathways no visible trace have concrete and obvious effects and may be the occasion for profound misery and suffering. The gradual onset of disabilities, bodily and mental, in the later years of life demands, Cannon believes, long range studies on the possible influence of inheritance, early injuries, severe infections in childhood and youth, frustrated plans, the demands of labor and probably many other conditioning experiences.

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