On october I, 1928, Aldred Scott Warthin, presented an influential lecture on “the pathology of the aging process” to the New York Academy of Medicine. The University of Michigan professor of pathology claimed that there were three stages (evolution, maturity, and involution) to the human “tragicomedy.” Next he detailed pathological conditions associated with growing older, especially those presenting themselves in the central nervous and cardiovascular systems. Warthin then assessed the wide array of theories about senescence competing for support in the 1920s. Some accentuated monocausal changes in pH or the accumulation of toxic wastes. Other models focused on the loss of function or decline in growth at the cellular level. According to Warthin, aging was primarily a physiological, not a pathological, process. Specific patterns of change varied from system to system, species to species. “Senescence is due primarily to the gradually weakening energy-charge set in action by the moment of fertilization.” Based on current evidence, Warthin doubted that bodily “decline” could be deferred much past age seventy-five. Contrary to the optimistic hopes of an earlier generation of scientists, chances for rejuvenescence thus far were impossible. The biological reality of enfeeblement presaged difficulties for society because the percentage of older people in the population was increasing.

Warthin's keynote lecture for the Academy's program on “the problem of aging and of old age” was billed as “an experiment in graduate medical service,” a venture planned “without previous experience.”