This optimistic view of Fries was replacing a pessimistic view, termed the failure of success, expressed earlier by Gruenberg (38). This view, also based on limited evidence, felt that the extension of life for persons with chronic conditions, without a reduction in the incidence of these conditions,would lead to deterioration in population health. Manton (48) proposed a position somewhere between the two outlined above. His view, termed dynamic equilibrium, hypothesized that the severity and rate of progression of chronic disease would be related to mortality changes so that, with mortality reduction, there would also be a reduction in the rate of the deterioration of the vital organ systems.
