Tuesday, 8 November 2011

Old Age

William Harvey

This post is heavily biased to English history and is indebted to Pat Thane's Old Age in English History (Oxford University Press, 2000).

According to Psalm 90, the human life-span was 70. But in the early modern period some people lived beyond that age:Titian 1488/90-1576; William Harvey 1578–1657; Thomas Hobbes 1588-1679. The average age of death of the nine 17th century archbishops of Canterbury was 73 and the average age of appointment 60. In 1635 there was immense excitement over the death of Thomas Parr (‘Old Parr’) who died in London allegedly at the age of 153, having boasted that he had committed adultery at the age of 105. He was dissected by William Harvey who attributed his death to the sulphurous air and rich living of London. Perhaps significantly, he did not question his longevity and it was not until the 19th century that such claims were disbelieved.

Life Expectancy
These figures show that some people in the past lived to old age. In pre-industrial England life expectancy at birth was around 35 years, but the figure was pulled down by high infant and child mortality rates. Those who survived the early years had a respectable chance of living at least into their late forties.
    It is difficult to assess the numbers of old people. In an age before precise recordings of births and deaths people did not always know their chronological ages and when they were described as old in the documents, it was normally a description of their physical condition rather than their actual age. In the sources it is clear that ages are often rounded up.
    In England in 1581 about 7% of the population were aged 60 or over; by 1671 it had risen to 9%.  But this proportion rose or fell through periods of high infant mortality or disease. But ‘in most communities there were numbers of visible and active older people’. A study of twelve parishes between 1550 and 1799 concluded that there was very little difference between male and female expectations of life. It has been calculated that of the English birth cohort of 1681, 18% of men and 21 % of women were still alive at age 53.
    Most of our information refers to men because their lives were more public and they were more likely to be recorded. It is only from the beginning of compulsory registration in 1837 that we know that women live[d] longer than men. At what point in history did this happen? Or has it always been the case?
    Aristotle believed that it was natural for men to outlive women because the male ‘is a warmer creature than the female’. This was backed up by other ancient writers, though in the 13th century Albertus Magnus noted that per accidens women lived longer because menstruation purged their harmful humours, that sexual intercourse took away fewer of their bodily fluids and that they suffered less from the hazards of work. By the 14th century commentators were taking it for granted that women lived longer. In the 16th century Galenic physicians believed that women became more like men as they passed the menopause, becoming leaner, drier, stronger and healthier. In France 18th century physicians were puzzled at the way women ‘went against nature’ and outlived men.
Since medieval times the ages of 60 and 70 have been used to define the onset of old age. Sixty was the age at which law or custom permitted the withdrawal from public activities. From the Ordinance of Labourers onwards men and women ceased at 60 to be liable for compulsory service under the labour laws. In early 16th century Coventry it was believed that the average man’s life of regular work at his trade was over by age 45 or 50.  From the 13th century 70 was the upper limit for jury service. But there was no concept that reaching a certain age of itself entitled anyone to benefits.

Representations of Old Age
Following similar representations by Chaucer, Jacques in As You Like It defines old age in negative terms. But at the close of Jacques’ speech Orlando enters with Adam who is ‘almost fourscore’ and extremely vigorous. Shakespeare also depicts old age in Falstaff and Lear. Falstaff behaves inappropriately for his age.
I know thee not, old man: fall to thy prayers;
How ill white hairs become a fool and jester!
I have long dream'd of such a kind of man,
So surfeit-swell'd, so old and so profane;
But, being awaked, I do despise my dream.
Make less thy body hence, and more thy grace;
Leave gormandizing; know the grave doth gape
For thee thrice wider than for other men.
The literature of the 17th century reveals ambiguities in how old age was regarded.  It could be depicted as a season of wisdom or folly. Lear is despised as a foolish old man, but only when he has given up his powers. ‘Ever since thou madest thy daughters thy mothers; for when thou gavest them the rod and puttest down thine own breeches’. Following Aristotle, many made a distinction between active, ‘green’ old age with final decrepitude (not very different from our own attitudes). In 1621 the Huguenot Symon Goulart’s book on old age was translated into English as The Wise Veillard. Goulart distinguished three different phases of old age: from 50 to 65; from 65 to 85; and post 85. The English divine John Reading (1621) described the old age of a good man as ‘a crown of dignity’ – though this honour has to be earned; it is not an automatic right, but is the reward of a temperate life. Dr John Smith’s Portrait of Old Age (1666), which went through several editions in the 17th century, also described the three stages of old age.
    Old people were given a good deal of advice: they should dress soberly, their manners should be grave and dignified; old women should not dress like young. Some doctors thought sexual relations between couples too old to have children were harmful and immoral. The authorities – both religious and medical – were unanimous that a temperate life was the secret of a healthy old age (hence the advice to Falstaff).

Overall, a computer analysis of about 287 texts has shown that there was no consistent representation of old age as gloomy or otherwise, but ‘rather a generally realistic representation of a variety of experiences of old age, combined with an intriguing vein of satire of the gloomier representations of old age’.

Geriatric medicine can be said to have begun with Paracelsus (1493-1541) who experimented with drugs derived from herbs and minerals. Vesalius and Leonardo dissected elderly bodies. Leonardo decided that the aged who enjoyed good health died through lack of nourishment due to the thickening of the walls of the veins and the closing up of the capillaries.
    Most medical discourse was concerned with high-status men.  Physicians believed that old age affected women differently from men. Some believed that the ending of menstruation caused a poisoning of their bodies, though others noted that post-menopausal women were fitter and healthier than younger women because their bodies were more like men’s.
    The growing interest in pathology, dissection and practical anatomy from the 16th century centred on France but was widely disseminated in England. This increased knowledge of the ageing body and to some degree of the ageing neurological system. In 1627 Francois Ranchin, Professor at Montpellier published his Opuscula Medica, a plea that medicine should take the needs of older people more seriously.

Men and women without other means of support were normally obliged to ‘work till they dropped’. The Norwich census of the poor of 1570 described three widows aged 74, 79 and 82 as only ‘almost passed work’. All were engaged in spinning white warp, the normal work of the Norwich poor. Their earnings were supplemented with poor relief. Norwich’s impressive scheme of poor relief assumed that productive work was possible for those between 4 and 80. Among the Norwich poor, older women were more likely to be in paid employment than old men or women of childbearing age. Commonly old women combined casual occupations as they became available. From medieval times old people of both sexes had run alehouses.
    Employment in minor parish or manorial office was a recognizable means whereby aged, poor, and infirm men and women could support themselves. In Southwark an old man named Oliver Lee was appointed a ‘bearer’ in 1621, a job that included ‘looking to the gutters of the church’. This was a valuable post because it included subsistence, accommodation and a regular income. In Elizabethan London elderly women were appointed to inspect the sick for signs of plague. In Tonbridge in 1674 a destitute elderly couple had their butcher’s shop restocked by the parish. Active old people were also encouraged to look after parish orphans – sometimes their own grandchildren.

Poor Relief
Following the dissolution of the monasteries, there was an increase in the number of almshouse foundations. In 1582 200 aged people were sent to St Thomas’s almshouse in the City of London. St Thomas’s Hospital had primary responsibility for old people.
    The Poor Law developed throughout the 17th century. People over 60 made up almost 10% of the poor of Norwich in 1570, 20% of those of Warwick and more than 30% of two parishes in Salisbury in 1635. Poor old women outnumbered men by two to one. Most of the aged poor admitted to almshouses were also female.
    Poor relief commissioners made every attempt to keep aged paupers living as active members of the community.

Old People and their Families
Non-historians often take it for granted that the family must have been the mainstay for the survival of most poor old people. But in England there was no tradition automatically to assume that the older generation shared house-room with their offspring as they grew older. Old people retained their independence as long as possible – and here there were no social class differences. But recent research suggests that many elderly did share a home with relatives, though it is not clear how frequently and in what circumstances. Ralph Josselin housed his father-in-law until his death. William Stout’s mother lived consecutively with her sons. There was a long tradition of unmarried children staying in the home or returning to it in order to care for their parents. Sharing a household was normal when the circumstances required it.
    It was different for old people without surviving children. It has been estimated that in the highly mobile society of pre-industrial England, up to 50% of old people would have had no children close at hand. And the children of the elderly poor were highly likely to be poor themselves, and therefore a charge on the parish.
    One solution for elderly men was to marry (or remarry). In west Kent in the late 17th century a number of male pensioners had wives who were considerably younger and several of them had small children. Poor widows might live with other poor widows.
    There were some generally observed social rules about family support in early modern England.
  1. There was no obligation to shelter an elderly relative, though this clearly occurred when the generations felt they could live together amicably. This was most likely to occur at the very end of a person’s life and was often for a brief period before death. As with today, elderly people preferred to be independent.  
  2. There was a strong obligation on individuals to give what material and emotional support they could to elderly relatives even if they did not live in the same household. But this was not unlimited as the obligations of married sons and daughters were seen to be primarily to their spouses and their children.
  3. When relatives could not help or were non-existent, the poor relief system provided as much support as local resources and custom allowed. ‘The image of the solitary, impoverished, marginalized old person, usually a woman, as a relatively common feature of early modern society should be treated with caution.’