Clinical Geriatrics of Traditional Chinese and Western Medicine

Author: Chief Editor: Lin Jian
Publisher:
Publish Date: 1998-01-01
Features:
Segment: Spleen: The Lingshu·Tian Nian states, "At the age of seventy, the spleen qi is deficient, and the skin becomes dry." The Yang Lao Feng Qin Shu states, "In old age, the spleen and stomach are weak, unable to digest." The spleen and stomach are the granaries of the body, governing transportation and transformation, ascending clearness, controlling the distribution of blood, and nourishing muscles and limbs. They open into the mouth, with their essence reflected in the lips, and are paired with the stomach. In old age, if the spleen and stomach are weak and withered, one may often experience abdominal distension, poor appetite, muscle thinning and atrophy, fatigue and weakness in limbs, wrinkled skin, constipation or loose stools, loss of appetite, pale and lackluster lips, and other symptoms. The spleen and stomach are the foundation of acquired constitution and the source of qi and blood transformation. For the elderly, maintaining the normal function of the spleen and stomach is particularly important.
Lungs: The Lingshu·Tian Nian states, "At the age of eighty, the lung qi declines, and the soul departs, hence speech becomes incoherent and prone to errors." The lungs are the officials assisting the sovereign, governing qi, regulating respiration, dispersing and descending, regulating water passages, being externally paired with the skin and hair, and opening into the nose, paired with the large intestine. In old age, if the lungs are weak and withered, one may often experience shortness of breath, weak and error-prone speech, withered and dry hair, susceptibility to colds, edema, difficulty urinating, constipation, and impaired sense of smell.
Kidneys: The Lingshu·Tian Nian says, "At the age of ninety, the kidney qi is exhausted, and the meridians of the four organs are empty." The Su Wen·Shang Guo Tian Zhen Lun states, "When the kidneys decline, the body reaches its extreme." The kidneys are the officials for strength and vigor, storing essence, governing development and reproduction, controlling water, receiving qi, nourishing bones and generating marrow, with their essence reflected in the hair, opening into the ears and the two lower orifices, and being paired with the bladder. In old age, if the kidneys are weak and withered, one may experience declining physical and mental strength, reduced sexual function, gradual loss of reproductive ability, shortness of breath, loose or falling teeth, shortening of stature, curved spine, brittle bones prone to fractures, whitening and falling hair, soreness in the lower back and knees, dizziness and tinnitus, severe deafness, weak urination, and frequent nocturnal urination. The kidneys are the foundation of congenital constitution, the root of life, and the repository of primordial yin and primordial yang. If the kidneys are deficient, the qi of the kidneys declines, leading to emptiness in the liver, heart, spleen, lungs, and all meridians throughout the body. The Lingshu·Tian Nian refers to the ages of "fifty," "sixty," "seventy," "eighty," and "ninety" as indicating the gradual decline of organ function with aging. However, this should not be mechanically applied to infer the function of a specific organ. It should also be noted that individual differences in aging are significant, and the progression of aging varies among individuals. Within the same person, the degree of aging in different organs and between internal organs and orifices is also inconsistent. The aging of organ tissues and organs in the elderly is a natural law of the life process. We can recognize it as a constitutional phenomenon, primarily related to age, congenital endowment, geographical environment, dietary nutrition, and mental state. If aging appears prematurely or to a severe degree, it is a pathological phenomenon and should be avoided.
Section 3: Characteristics of Material Metabolism in the Elderly
So far, many theories or hypotheses have been proposed regarding the causes of aging, but all of them are based on fundamental principles of biochemistry. Therefore, exploring the characteristics of material metabolism in the elderly can provide specific biochemical measures to delay aging. Below, some important aspects of material metabolism are briefly described.
1. Nucleic Acids
Nucleic acids are important components of living organisms, with their primary biological function being the basis of biological inheritance. Nucleic acids are divided into two major categories: deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). RNA mainly includes messenger ribonucleic acid (mRNA), transfer ribonucleic acid (tRNA), and ribosomal ribonucleic acid (rRNA). In most tissues and cells during old age, the synthesis of nucleic acids ages, and RNA synthesis declines with increasing age. Cell division and reproduction depend on the biosynthesis of DNA, while DNA biosynthesis depends on DNA replication. If DNA replication is impaired, it will hinder cell division and life continuation. Throughout life, harmful factors in the environment, such as radiation from various rays and the action of free radicals, can damage DNA, leading to errors during DNA replication. However, errors on DNA molecules are generally corrected and repaired. It is reported that normal cells can repair 300 defects on single strands of DNA per minute. The ability to repair damaged DNA declines with age in both humans and animals. Longevity animals have stronger repair abilities than short-lived animals, and healthy individuals have stronger repair abilities than prematurely aging individuals. Due to the decline in DNA damage repair ability, if damaged DNA is not repaired in time, the accumulation of DNA damage within cells will lead to varying degrees of changes in physiological function and information accuracy, as well as the occurrence of the aging process.
2. Proteins
The likelihood of genes being activated or expressed differs at different stages of life, so the synthesis of proteins in certain tissues may change in quantity or quality during old age. Due to the reduction of mRNA in old age, the total protein synthesis is significantly lower. Some tissues also synthesize proteins that were not present in youth, such as the proteins in the lens of the eye, which are mainly crystallin proteins and can be divided into α, β, γ types and several other subtypes. The γ-crystallin protein in the lens is synthesized only during the aging process of the lens. As tissues age, crystallin proteins polymerize to form high-molecular-weight proteins, which gradually increase and become water-insoluble.