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CONCEPTS OF AGING: AN HISTORICAL REVIEW RICHARD L. GRANT, M.D.* Certain, when I was born, so long ago, Death drew the tap oflife and let it flow; And ever since the tap has done its task, And now there's little but an empty cask. Chaucer I. Introduction The aged, and the problems ofaging, have been ofconcern to man from his very beginnings. In common with all other macroscopic living things, he has a limited life span. Man alone, however, aware ofhis destiny, and by virtue ofhis powers ofthinking, is able to speculate on the cause ofthis limitation. As he has slowly discarded the limitations offormer days, man has been increasingly rewarded with augmented insight into the causes ofthe manifestations ofaging. He is now able to elucidate a vast number ofthese in terms oftheir micropathology, biochemistry, biophysics, physiology, and psychology. This is not because he is more intelligent thanhis predecessors, but merely because he has accumulated greater knowledge and technical ability—accumulated, in fact, as a direct result ofhis predecessors' efforts. On one question, however, modern man is no closer to an answer than were the sages ofthe past. Although presently he can discard as unfounded or foolish many ofthe previous attempts at solutions to the question ofthe * This paper is condensed from a longer monograph, unpublished, detailing a study supported by a grant from the United States Public Health Service, National Institute ofMental Health. I am indebted to Ilza Veith, Associate Professor ofthe History ofMedicine at the University of Chicago, whose helpful guidance and encouragement provided a needed integrative factor in the prepatation ofthis papet. Many others assisted in assembling materials and technical work, and I am happy to acknowledge their help. They include: Robert Rosenthal, director ofthe Department ofSpecial Collections, Miss Angela Rubin, Mrs.Josephine Elliott, Miss EleanorJohnson, Miss Sabina Wagner—all ofthe University ofChicago Libraries; and Mrs. Dorothy H. Grant, Mrs. SusanJ. Grant, and Mrs. Kathryn lloare. 443 ultimate or primary cause ofaging, out ofwhich grow the derangements that cause the manifestations ofaging so thoroughly studied today, he is unable to offer other than a metaphysical answer—that aging is a natural process inherent in the individual, ifnot in the species. The reasons given to support this are varied and ideological. It may be that the solution to this problem partakes ofthe nature ofthe inexplicable mystery ofman's existence and should rightly remain in the realm ofmetaphysics, at which level it has been discussed in the past. Our predecessors may not have been at as great a disadvantage as we might suppose. But it is not my intention to imply that the question ofthe cause ofaging is not answerable, or that an answer may not result from the many fruitful andproductive endeavors directed to the general problems ofgerontology and geriatrics. I mean only that, as yet, there is no clear indication that the answer to why man and other living beings age will be forthcoming from science or any other discipline. The purpose ofthis review is to place in historical perspective previous endeavors to explain the process ofaging. II. Preliterate, Egyptian, and Eastern Contributions In times past, a man was thought to be aging when he showed the signs usually associated with old age. As man has gained more insight into the processes ofgermination, growth, and senescence, he has pushed the onset ofold age further and further backward toward the beginning oflife. In recent times, senescence has been referred to as merely one aspect of the developmental process, which would place senescent inception coeval with the conception oflife. This conclusion, first made in the Greco-Roman period as speculation, and later formulated from knowledge made available by scientific advancement, can be stated today as an accepted fact. It is merely a descriptive fact, however, and there is no implicit notion of causation. The first full, explicit theory of the causation of aging is found in Greco-Roman medicine. Before this time, a theory ofaging must be extracted from thought which was mainly concerned with death and its causes. A survey ofthis pre-Greekmaterial, scanty as it is, will provide the basis on which the theories oflater ages can be more easily understood. The difficulties encountered in...
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