Parotitis after Injury or Disease of the Abdomen or Pelvis
Authors: S. Paget
Journal: BMJ (1887)

The slight increase in the weight of the lungs observed by Boyd in males is probably due to some thickening of their mucous and other tissues, associated with the lowered respiratory capacity which is caused, in great measure, by the diminished elasticity of the thora- cic walls and of the lungs, and a consequent limitation of the respi- ratory range.This is evinced by the measurements of the chest girth of our centenarians, which, on the average, do not show more than half an inch difference between inspiration and expiration (see table and analyses and remarks with JOURNAL of December 11th, 1886).The degenerative changes in the arteries-a substitution of fibrous, atheromatous or calcareous matter, for the elastic and muscular tissue, attended with thickening, dilatation and roughening-are less than might be expected.Though marked in Holyoke and Miles, and spoken of as a cartilaginous condition in Keill's case, they were con- fined to the commencement of the aorta in Rolleston's, and are not mentioned by Harvey.Of 28 returns in our table, the arteries are reported "knotty" in 6, "even" in 18, and appear to have been large, tortuous or visible in 15.The loud systolic bruit in No. 13 of the table indicated a roughening of the aorta, which was unattended with any obvious ill-effect; and the arteries were even, though tortuous and vi6ible, in this person.There was nothing of the kind in the other two persons (12 and 23) whom I examined, and it is not men- tioned in any of the other cases reported in the table, which possibly may be because attention was not specially directed to this point;The cartilages of the ribs were ossified in Miles and Holyoke, but were as soft as natural in the cases reported by Harvey, Keill, Rol-leston4 and myself.The brain was found shrunken, with widened cerebral fissures ; "hydrocephalus in vaczo," in Holyoke, also in the woman aged 103 examined by me.It was firm and hard in Parr and in Keill's cas3; and the convolutions were rounded and, to some extent, atrophied in Rolleston's.This shrinking of the brain, common in old age, and observed also in persons wasted by long illnesses, in habitual drinkers, and some others, is to be associated with the inability to maintain active and strong bodily and mental exertion, which, as our tables show, is commonly first manifested by fatigue, by weakening of memory for recent events, and is further manifested by impairment of control over emotions and thoughts and impulses as well as over bodily movements, and may go on to complete imbecility, with er without tremor or loss of muscular power, the latter being usually first observed with regard to the urinary bladder.The kidneys were cystic in Parr, Holyoke, and Pratt, and contained grains of sand in the last and in Keill's case.In Pratt the bladder was fasciculated, the prostate large and its ducts large, and pediculated growths projected from the third lobe.It will be observed that, out of 33 returns in the table, the micturition is reported to be natural in 25.It is also stated to have been so in most of the cases which I have since received (BRITISH MEDICAL JOURNAL, March 5th, p. 502) ; and it is not reported to have been difficult or painful in any.All this is confirmatory of the statement that the