Prolongevity

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PROLONGEVITY

In the Western tradition, at least since the time of the ancient Greeks, physicians, philosophers, and lay practitioners have advocated diverse means to obtain a long and healthy life. Although they hardly formed a unified group, or advocated a single method or approach, the authors together voiced a recurring belief in the idea of prolongevity: that, following specific regimes and methods, individuals could live to extreme old age, well beyond the seemingly preordained limit of three score and ten. (The term prolongevity was first coined by Gerald Gruman, whose exposition of the idea appeared in 1966). By the seventeenth and eighteenth centuries, and often following the lead of Luigi Cornaro, such writers repeatedly challenged the notion that the body was inexorably destined to age and decay. In their eyes, the years beyond sixty or seventy were not necessarily a time of disease and suffering but could indeed be a period of activity and vitality. With the correct behavior and a strictly defined regimen, no tottering old man would exist only through the benevolence of relatives; no suffering aged woman would experience a loss of each of the senses. Instead an individual would live an extremely long life, "without loss of physical power and energy," as the leading prolongevity writer Christopher William Hufeland wrote in 1797, only to die when all organs ceased to function in a single painless instant.

Although often varying in remedies and medications, prolongevity literature can be organized generally along an important chronological divide, reflecting the impact of medical understanding. Until the nineteenth century, writers often harked backed to a primitive past, when ancient patriarchs supposedly counted their days in centuries rather than years. Pointing to a loss of vital energy as the cause of old age decay, they searched for the means to maintain the body in an active state, uncorrupted by a loss of vitality. By the nineteenth century, however, while this theory still existed among some authors, numerous prolongevity advocates voiced a new "scientific" optimism. The key to longevity, they argued, lay in the findings of science and medicine. Rather than seeing the past as a time of long-lived individuals, they looked to a future in which new medicines and theories would eliminate the many sources of early mortality and lead to unlimited life extension. And, rather than solely advocating hygienic prescriptions that might be given to preserve the middle aged, they eagerly promoted experimental procedures that would turn back the ravages of even advanced old age.

Early prolongevity writers

Although individuals had for centuries searched for magic potions and fountains of youth, without question the most influential early prolongevity advocate was Liugi Cornaro, an Italian nobleman who, in 1550 wrote The Art of Living Long. Translated into English, French, Dutch, and German, the work became the bible of many early prolongevity advocates. By the nineteenth century, the English version alone had gone through more than fifty editions. Received warmly by the popular press, it based its argument on two simple premises: First, men and women were not destined to die at sixty or seventy, but with care and a good constitution could live extremely long lives. Second, the key to longevity lay in simple reforms to an individual's lifestyle. Giving up excesses in all things, Cornaro preached the religion of extreme moderation.

Cornaro's own history became the basis for many of his prescriptions. Between the ages of thirty-five and forty, and after having lived a life of excess, Cornaro was warned by leading doctors that his death was imminent. Suffering from a variety of illnesses including gout, fever, and dehydration, he immediately decided to reform his lifestyle. "Since old age is exactly the opposite of youth," he wrote, "just as disorder is the reverse of order, it becomes imperative for [an individual] to change his habits of life with regard to eating and drinking, upon which a long and healthy life depends." (p.96) Swearing off heavy food and drink, Cornaro established a regime based on a limited amount of bread, soup, and eggs. Within a year, he found, he "grew most healthy." No longer did he regularly become ill, nor did he experience any type of mental distress; even accidents did not leave him bruised and suffering. "Any man," he wrote, "who leads the regular and temperate life, not swerving from it in the least degree where his nourishment is concerned, can be little affected by other disorders or incidental mishaps" (p. 53).

By the time Cornaro first wrote his manuscript, at age eighty-three, he sang the praises of his diet and the life he created. Having lost neither his senses nor his vitality, he declared "he had never known the world was beautiful until I reached old age." In his view, and under his regime, Cornaro argued that old age was a time of great wisdom and productivity during which he could pass important knowledge to the young and inexperienced. Aging, he declared, did not imply an inevitable loss of reason or activity. "Indeed," he wrote, old age. . .is the time to be most coveted, as it is then that prudence is best exercised, and the fruits of all the other virtues are enjoyed with the least opposition; because, by that time, the passions are subdued, and man gives himself up wholly to reason." With proper attention to diet and behavior, individuals with good constitutions could live healthy lives until their deaths at 120; even those who were less robust could look forward to one hundred years of active living.

For those who read Cornaro's work or followed him in advocating a defined regime, proof of these theories was not hard to find. Many pointed to the biblical stories of ancient patriarchs who lived numerous centuries. Adam, for example, had lived 930 years; Noah survived until 950. Blessed by God, and not subject to the debilitating routine of modern life, their long and active lives seemed ample evidence that the life cycle did not end with debilitating disease at sixty or seventy. Even in more modern times, many pointed to the long life of Thomas Parr as evidence of the reality of prolongevity. In 1635, Parr died, purportedly at the extreme age of 152. As his autopsy was performed by the eminent physician William Harvey, few doubted the legitimacy of the claim. Here was actual proof that an extremely long life was not simply the province of the patriarchs but could be achieved by modern men and women.

Following the work of Cornaro and the seemingly indisputable evidence of Parr's long-lived existence, many joined in advocating the benefits of a hygienic life. Individuals such as the James McKenzie, William Temple, and William Sweetser shared Cornaro's enthusiasm for the reality of extending the life cycle. At the end of the eighteenth century, the most famous advocate of prolongevity was undoubtedly the German physician Christopher William Hufeland. Where Cornaro set the limits to an individual's life at 120, Hufeland declared that, with proper care, individuals could live for two centuries. In his Art of Prolonging Life, written in 1797, he, like Cornaro, developed hygienic rules based on the notion of moderation in all things. The chief enemy of a long life, he declared was modern life; rural society provided the best likelihood for longevity. "The most extraordinary instances of longevity," Hufeland wrote, "are to be found, however, among those classes of mankind who, amidst bodily labor, and, in the open air, lead a simple life agreeable to nature, such as farmers, gardeners, hunters, soldiers, and sailors. In these situations man still attains to the age of 140, or even 150."

Hufeland, like many of the other prolongevity writers, based this assumption on a belief in the body's natural bank of vital energy. According to this widely accepted model, at birth an individual was endowed with a finite amount of vitality. During childhood, the body used this vital energy for growth and activity. By adulthood, it did well to maintain its supply. With old age, however, the amount of vital energy was clearly in decline. The obvious result was the elderly individual's tendency toward increasing illness and general debility. "Man," wrote Hufeland, "during the period of old age, has a much smaller provision of vital power, and much less capacity for restoration. If he lived with the same activity and vigor as before, this provision would soon be exhausted, and death would soon be the consequence."

Given this model, then, the seemingly obvious goal of early prolongevity writers was to preserve a person's store of vital energy. In advocating for less food, alcohol, or sexual activity, the writers shared their belief that such temperate behavior was essential for existence. "The decrease in the intensity of the vital processes," wrote Hufeland, "as age increases, prolongs . . . vital duration." The aim, he argued, was to live life extensively rather than intensively. As vital energy could not be manufactured or restored, additional years of life were possible only with constant attention to maintaining the body's limited supply.

Yet prolongevity writers such as Hufeland were hardly arguing for the extension of a debilitated old age. Although Cornaro had sung the praises of the final stage of life, few shared his reverie of the qualities of the senescent. Their goal instead, as Hufeland wrote, was "to preserve oneself in a state of youth until an advanced period of life." They generally had little advice or sympathy for the aged individual who had already experienced debility and disease. Cornaro, as prolongevity writers repeatedly reminded their readers, had not waited until old age to reform his habits or retain his critical energy. Instead, by focusing upon the young and middle-aged, these authors advocated the creation of a new life cycle that greatly extended the length and qualities of middle age until a painless and instant natural death ended an individual's life.

Scientific prolongevity

By the end of the eighteenth century, this vision of an extended middle age was shared by a growing number of philosophers. Yet, instead of linking their hopes for prolongevity to the simplistic lifestyles of the past, they placed their faith in the future discoveries of sciences. For individuals such as Benjamin Franklin, William Godwin, and Antoine-Nicolas de Condorcet, it was not the careful herdsman or the earnest farmer who had the best hope for a long life but the modern-day scholar and scientist. Rather, only with progress did they hope to envision a century-long existence. "The rapid progress true science makes," wrote Benjamin Franklin in 1780, "occasions my regretting sometimes that I was born so soon.. . .All diseases may by sure means be prevented or cured, not excepting even that of old age, and our lives lengthened at pleasure even beyond the antediluvian standard." Condorcet shared a similar vision placing the extension of life as part of the advance of civilization. "[T]he day will come, he wrote, "when death will be due only to extraordinary accidents or the decay of the vital forces, and that ultimately, the average age span between birth and decay will have no assignable value.. . .Certainly man will not become immortal, but will not the interval between the first breath that he draws and the time when in the natural course of events, without disease or accident, he expires, increase indefinitely?"

Although the philosophers only envisioned this future, in the nineteenth and early twentieth century, new generations of prolongevity writers experimented with a variety of procedures for attaining a long life. Although some still discussed the importance of hygiene and diet, others advocated more extreme approaches to the eradication of old age. Their work generally reflected the medical community's rejection of the notion that old age was simply an inexorable decline in vital energy. Rather, by the middle of the century, elite physicians began to link old age to specific physiological changes, first in the tissues of the body, and then in the cell. If, as these medical authorities argued, old age was a disease caused by pathological changes in the body, the key to longevity lay in deterring this pathological process or restoring senile cells to their adolescent condition.

Clearly influenced by the discovery of the germ theory and the finding of cellular pathology, prolongevity advocates such as Arnold Lorand, Elie Metchnikoff, and Charles A. Stephens sought to find a way to stop the cell from aging, and, ultimately, to eliminate old age entirely. Although these writers shared the language of the new scientific age, the range of their prescriptions was wide. Stephens, for example, declared that aging was linked to the imperfections of aging cells. With proper cellular nutrition, he believed, the aging process could be eliminated. Elie Metchnikoff argued that the cause of aging, and the destruction of the aging body, were cells termed phagocytes that poisoned the body and led to its decline. Advocating a diet rich in lactic acid, he promised the elimination of intestinal putrefaction and the destruction of microbes that led to the body's decay. In contrast, Arnold Lorand found that "senility is a morbid process due to the degeneration of the thyroid gland and of other ductless glands which normally regulate the nutrition of the body." He established a system of hygienic and therapeutic measures that were designed to improve the functions of the glands.

Other prolongevity writers took a more experimental and invasive approach. For C. E. Brown-Sequard, for example, the aging of the body was directly linked to a weakening of the sexual function. While previous generations of advocates had argued for celibacy in old age, in order to preserve vital energy, Brown-Sequard declared that these glands could be rejuvenated scientifically. In 1889, at the age of seventy-two, the neurologist announced that he had restored his own youthfulness with a mixture of animal sexual glands. Receiving widespread popular interest and acclaim, the lay press in both Europe and America reported the success of his program. One drug company in 1889 even began producing a toxin called Spermine, composed of semen, bull's testicles, calf's liver, and calf's heart.

Although patients lined up for injections, the initial popularity of the product and Brown-Sequard's approach failed to lead to long-term success. Nonetheless, throughout the early twentieth century, toxins and operations promising to remove the effects of old age continued to reach an eager market. In the 1920s, L. L. Stanley injected a mixture of crushed testicular substance into patients, and Eugene Steinach performed an operation that tied off the vas deferens and redirected sperm from the testicles back into the body. Although some in the scientific community greeting the supposed efficacy of these procedures with skepticism, by 1928 one researcher estimated that the Stanley procedure had been performed effectively with over fifty thousand patients.

Regardless of their prescriptions, these "scientific" prolongevity writers agreed that aging was a disease that caused specific decline. Although they tended to see the characteristics of old age in far less positive terms than had Cornaro, they did not feel that the process for delaying old age had to begin at an early age. Many actually intervened in the lives of even the extremely old, hoping to restore energy or renew the senile cells. They had little doubt that once the proper scientific research had been completed old age would disappear; people would live in a state of middle age until the end of life.

Anti-longevity literature

Not everyone, however, found these statements viable or the prescriptions likely to meet the desired results. Even in the eighteenth century, anti-prolongevity writers questioned the wisdom of increasing the proportion of aged individuals in a society. For Thomas Malthus, for example, such pronouncements only further intensified the question of overpopulation. Already concerned that available resources could not support a geometrically increasing population, he hardly endorsed the notion of additional generations of aged individuals.

Others found the data on which the prolongevity advocates based their claims to be highly suspect. Biblical life spans were discounted as metaphor; even the case of Thomas Parr, as well as that of Henry Jenkins who supposedly lived to 169, found numerous critics. "The theory based upon their supposed abnormal longevity," wrote critic William Thoms in 1873, "necessarily falls to the ground." He seemed amazed at the "simple child-like faith with which men of the highest eminence in medical science accept without doubt or verity statements of the abnormal prolongation of life." Moreover, as statistician Edward Jarvis noted in 1872, little evidence existed that progress meant a rise in the average life span. Instead, he argued that an increase in mortality, and a decline in longevity, actually accompanied the urbanization of England.

In addition, some critics believed that even if longevity were lengthened, they doubted that the ills of old age would ever disappear. Questioning whether the weakness and debilitation of old men and women could ever really be eradicated, they dismissed the notion that individuals could live in perpetual middle age. For them, the promise of longevity was simply the threat of scores of needy and diseased aged individuals making increasing demands on society.

Conclusion

In recent times, the hope of prolongevity advocates appears to have some factual support. In the twentieth century, for the first time, the increase in life expectancy has occurred at the end of the life cycle, rather than simply being the result of decreasing child mortality. In 1995, the average life expectancy for men was 72.5; for women, it was 79.3. As the number of centenarians continues to rise, the fastest growing segment of the American population has become those over the age of eighty-five. Moreover, large segments of the elderly population are believed to be in far better health than earlier generations. Such advances have led a new generation of prolongevity advocates to foresee a time when aging might be genetically deterred or obliterated. According to science writer Albert Rosenfeld, "the science of genetic engineering would one day progress to the point where genes could be modified, transferred, or deleted so that a genetic 'clock of aging'. . .might thus be adjusted in any way we chose to define as beneficial" (p. xiii). Like Franklin or Condorcet two hundred years earlier, such advocates of prolongevity are sure that the findings of science will virtually restructure the life cycle. And, while they wait, advocates such as Rosenfeld continue to endorse dietary prescriptions that hark back to the dictates of Cornaro.

As in the past, however, this confidence has not been without its critics. Many question the desirability of increasing the proportion of society's aged population, or the benefits of extending the life of the extremely debilitated. Despite all the changes brought by science, and while life expectancy has risen, they argue that the maximum life span of the individual has not changed: it appears rather set at 110, or at most, 120. Yet, clearly the hope of extending the life span will not be deferred by such criticisms. From Cornaro through Rosenfeld, the prolongation of life continues to engage the popular imagination and challenge the limits of science.

Carole Haber

See also Age; Geriatric Medicine; Life Span Extension; Longevity; Oldest Old; Status of Older People: Modernization; Status of Older People: Preindustrial West; Status of Older People: Tribal Societies.