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January 23, 1897


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JAMA. 1897;XXVIII(4):166-168. doi:10.1001/jama.1897.02440040022001h

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In all ranks of life there are two well marked forms of senile decay; and every one will at once, I think, recognize the truth of the following sketch by Paget:

"Some people, as they grow old, seem only to wither and dry up—sharp featured, shriveled, spinous old folks, yet withal wiry and tough, clinging to life and letting death have them, as it were, by small instalments slowly paid; such are the 'lean and slippered pantaloons' and their shrunk shanks declare the prevailing atrophy."

Others, women more often than men, as old and as ill nourished as these, make a far different appearance. With these the first sign of old age is that they grow fat, and this abides with them till, it may be, in a last illness sharper than old age, they are robbed of even their fat. These too, when old age sets in, become pursy,

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