The falling birth rate, the relative decrease in the number of children under 5 and the doubling of the number of persons over 65 have caused a shift of population into the older brackets, and the indications are that this shift will continue. The otologist as well as the physician in general practice will therefore be confronted with more aging people and more aging ears than in the past. The great difficulty in gerontology is to determine which processes, if any, are physiologic and which are pathologic and how these two interact in causing what for lack of a better name we call "normal aging" and "premature aging."
There has been much speculation as to the fundamental cause of aging, with few convincing conclusions, owing largely to the fact that every living thing inherits limitations, deformities or constitutional weaknesses and is exposed to inevitable detrimental influences during life, and these