3. CONCEPCIÓN DIDÁCTICA PARA EL TRABAJO CON TAREAS
3.2 Concepción didáctica para el trabajo con tareas docentes
3.2.2 Los fundamentos de la concepción didáctica
The Bodily Economy; the Exhaustion of Life
This section will turn from dementia to senility, and examine the ways in which different models and explanations of ageing were mobilised in psychiatric texts. One of the most significant was the ‘bodily economy’ model.129 The idea of that the
body operates through a fixed vital economy, spending the energy endowed to it at birth, has provided one of the most enduring explanations of the ageing process. The slowing of physical movements, the visible shrinking and contraction of the body, and the seemingly inevitable fact of death, can all be explained by a depletion, and eventual exhaustion, of an innate vital force. The idea of a fixed bodily economy was closely related to the vitalist theory of organic life – popular in the eighteenth century – which posited that organic life functions through the operation of a specific ‘vital’ or ‘animal’ power.130 This model should not, however,
be conflated with vitalism specifically; as Daniel Schäffer has pointed out, the concept of ‘successive loss of inner, inborn vital principle… through a process of self- or external consumption’ has been a feature of discussions of ageing for centuries, and cuts across quite different theories of bodily function, from the humoral to the iatro-mechanic.131 When pathological-anatomical investigations
129 This model has been referred to in various ways: Carole Haber has called it the ‘vitality model’;
Hilary Marland, the ‘fixed fund of energy’; Jesse Ballenger, ‘endogenous vitalism’; Hans-Joachim von Kondratowicz ‘account theory’; Anne-Julia Zwierlein, simply ‘vitalism’. I have chosen the term ‘bodily economy’, used by Athena Vrettos amongst others, as it avoids confusion with the more specific biological theory of ‘vitalism’, and also encompasses models which include some replenishment of the body’s energies through nutrition.
130 See for example Catherine Packham, Eighteenth-Century Vitalism: Bodies, Culture, Politics
(Houndmills, 2012).
131
brought new insights into the structure of the ageing body in the early nineteenth century, the model of the vital economy still did not disappear. According to Carole Haber, most physicians in England and America found ‘little conflict’ between the new pathological vision of the aged body and the older, vitally- exhausted one. The lesions and the bodily economy were ‘neatly combined’: ‘the tissue or cell degenerated which the organism systemically wasted away’.132
The fixed bodily economy idea endured because it was adaptable. New scientific and social ideas drew on the same economic principles. The second law of thermodynamics, developed in the 1840s, posited that energy within a closed system was not perfectly conserved, but would always eventually dissipate.133
Under this new physical law, running out of energy came to be seen as the fate of the universe, not just of the individual. Historian, Anson Rabinbach, has described the way in which the second law of thermodynamics, and the idea of the bodily economy, were used in discussions of work and labour to tie bodily efficiency to mechanical efficiency.134 The bodily economy made it easy for bodily activity, and
the effects of ageing, to be moralised and politicised. The signs of ageing could be taken as signs of an exhausting lifetime of debauched, or simply improprietous, activity. Self-preservation in old age necessitated the careful conservation of resources. Historians, Thomas Cole and Anne-Julia Zwierlein, have connected this mid-Victorian interest in prudent vital spending to similar concerns for thrift in the middle-class household and in capitalist businesses.135 An unhealthy and
impoverished old age was thus conceptualised as a consequence of wasteful expenditure, financially and vitally.
132
Carole Haber, Beyond Sixty-Five: the Dilemma of Old Age in America's Past (Cambridge, 1983), p. 65.
133
J. Edward Chamberlin, 'Images of Degeneration: Turnings and Transformations', in J. Edward Chamberlin and Sander L. Gilman (eds), Degeneration : the dark side of progress (New York, 1985), pp. 270-72; Anson Rabinbach, The Human Motor: Energy, Fatigue, and the Origins of Modernity (New York, 1990), pp. 3-4.
134
Rabinbach, The Human Motor, passim.
135 Thomas R. Cole, The Journey of Life: a Cultural History of Aging in America (Cambridge, 1992), p.
98; Anne-Julia Zwierlein, 'Exhausting the Powers of Life', in Anne-Julia Zwierlein, Katharina Boehm and Anna Farkas (eds), Interdisciplinary Perspectives on Victorian Old Age (Hoboken, 2013), p. 39.
As these examples suggest, the idea of the bodily economy was pervasive in Victorian culture. As a medical explanation of ageing, however, some nineteenth- century physicians expressed concern over the logic of the fixed vital economy. In the entry on ‘old age’ to his monumental Dictionary of Practical Medicine, James Copland explained that all visible and invisible signs of ageing were ‘more or less remote effects of the failure of the vital endowment of the frame’. At the same time, however, he pointed out that ageing could not be caused by the progressive
exhaustion of the energy endowed to us at birth, as ‘parents cannot possibly impart to the embryo more [energy] than they possess’. Copland’s alternative was to suggest that it was the processes of nutrition which failed in old age; that old bodies were less efficient at replenishing their spent reserve of energy.136 Physicians who
wrote specifically about the physical effects of ageing echoed Copland’s objections to the fixed endowment of energy model. Psychiatrists, however, showed no such qualms.137 Thomas Laycock, who held explicitly vitalist views, suggested that ‘Old
dogs and monkeys do not become irritable from experience alone, but from the decline of vital powers. It is not otherwise in man.’138 As late as 1890, Charles
Mercier described this expenditure of energy throughout the course of life in terms of classical mechanics:
The impetus, that was given to the organism at conception, has carried it on through the process of development to manhood, has sustained it in activity throughout a long life, but with each year that has passed a portion of the initial velocity has been dissipated. The friction with the world has tended constantly to bring the organism to rest, and as its career approaches
termination, it moves more and more slowly.139
This ‘slowing’ in old age, according to Mercier, had physical effects in the
‘diminished energy of movement’, and mental effects in the ‘diminished activity of
136
James Copland, A Dictionary of Practical Medicine (London, 1858), pp. 46-47.
137
Barnard Van Oven, On the Decline of Life in Health and Disease: Being an Attempt to Investigate the Causes of Longeveity; and the Best Means of Attaining a Healthful Old Age (London, 1853), p. 19.
138
Thomas Laycock, Mind and Brain (2nd edn, London, 1869), p. 419.
139
mind’. Due to this loss of energy, he suggested, the process of thought literally slowed down, the intellect becoming ‘dull’ and ‘lethargic’. The ‘inertia’ of the nervous molecules prevented new memories from being formed. The model of the bodily economy thus neatly tied together physical ageing and the decline of the ageing mind.140
The idea of the fixed bodily economy was used to describe many mental conditions, at all stages of life. ‘Neurasthenia’ was perhaps the characteristic disorder of the depleted vital economy in the nineteenth century.141 This was a
protean disorder, whose symptoms included ‘anxiety, despair,
phobias…insomnia…inattention, extreme fatigue, palpitations, migraine,
indigestion, and impotence’.142 It was, then, significantly less severe than dementia:
neurasthenia could incapacitate its sufferers, but would rarely lead to their
complete mental disintegration, and was usually entirely curable. It was also more refined than dementia, generally considered to be a disease of the middle classes. Like dementia, the heterogeneous disease of neurasthenia was held together by its aetiology: a depletion of the vital nerve force. This could be brought about by overwork or over-excitement, or anything else which taxed the body’s reserves of nervous energy. It was variously described as the characteristic condition of modern, civilised man, and as an enfeeblement brought about by the exhaustion of having a female body.143 An American physician named George Miller Beard was
widely regarded as the ‘father of neurasthenia’. He emphasised the middle-class male type of neurasthenic, exhausted by ‘the fast pace of modern life’. 144 Beard
also wrote extensively on old age, and included this research in his most famous book, American Nervousness. Beard’s view of old age, the period in which the nerve force was almost spent, was very pessimistic. Many of the world’s problems, he
140
Mercier, Sanity and Insanity, pp. 306-7.
141 For more on neurasthenia, see the essays in Marijke Gijswijt-Hofstra and Roy Porter (eds),
Cultures of Neurasthenia from Beard to the First World War (Amsterdam, 2001); Janet Oppenheim, Shattered Nerves: Doctors, Patients, and Depression in Victorian England (New York, 1991), pp. 79- 119; Andreas Killen, Berlin Electropolis: Shock, Nerves, and German Modernity (Berkeley, 2006).
142
Marijke Gijswijt-Hofstra, ‘Introduction’, in Gijswijt-Hofstra and Porter (eds.), Cultures of Neurasthenia, p. 2.
143 Hilary Marland, ‘’Uterine Mischief’: W.S. Playfair and his Neurasthenic Patients’, in Gijswijt-
Hofstra and Porter (eds.), Cultures of Neurasthenia, pp. 118-40.
144
suggested, could be put down to the ‘barbarous folly’ which allowed old, exhausted men to hold most of the power.145 For Beard, both the neurasthenic and the old
person were left mentally and physically crippled by their loss of nervous energy. Though neurasthenia was not itself conceptualised as premature ageing, the same explanatory model was used to explain why some people aged – physically and mentally – before others. ‘The powers of all are limited’, suggested Prichard in his 1835 Treatise, and ‘a life of too much activity and… mental exertion… excessive anxiety and eagerness in pursuit of business, or intense and unremitted application to studies of any kind’ was liable to bring on senile dementia at an early age.146 This
warning against over-exertion in work and business was difficult to reconcile with the Victorian values of hard work and unceasing productivity. Zwierlein argues that mid-Victorian writers circumvented this contradiction by suggesting that hard work itself promoted efficient use of energy, claiming that ‘both excess and
indolence could thus be fatal’.147 James Crichton Browne was a supporter of such
prudent expenditure of energy. In the 1870s and 1880s, he took a keen interest in education reform, with a particular concern for the nervous disease which might result from the pressures of over-education and over-examination, especially amongst the poor.148 In his 1874 lecture on senile dementia, he also warned of the
dangers of ‘feverish brain-work’ in the old, as a potential inducement to mental failure. At the same time, however, he was keen to emphasise that he did not advocate an idle life and idle old age: ‘it is not pure brain-work, but brain- excitement or brain-distress, that eventuates in brain-degeneration and disease’. Indeed, it was not the poor whom he considered to be most in danger at this time of life, but the idle rich:
145
George Miller Beard, Legal Responsibility in Old Age (New York, 1874), p. 22, as quoted in Cole, The Journey of Life, pp. 163-68. See also Stephen Katz, Disciplining Old Age: the Formation of Gerontological Knowledge (Charlottesville, 1996), pp. 88-89; W. Andrew Achenbaum, Old Age in the New Land: the American Experience since 1790 (Baltimore, 1978), pp. 45-47.
146
Prichard, Treatise on Insanity, p. 92.
147 Zwierlein, 'Exhausting the Powers of Life', pp. 41-42.
148Michael Neve and Trevor H. Turner, 'What the Doctor Thought and Did: Sir James Crichton- Browne (1840-1938)', Medical History, 39 (1995);, pp. 412-13.
No more pitiable picture can, I think, be conceived, than the retired man of business wandering about in listless ineptitude and dreary opulence… with the great burden of fatuity settling on his mind. A lively bankruptcy must be delightful when compared with the state of that man. Struggling poverty would be a positive blessing to him.149
Crichton Browne thus managed to marry a firm commitment to middle-class Victorian values of industry and forbearance, with an underlying belief in the need to conserve our vital forces.
The image of the senile dement presented here by Crichton Browne is not just middle class, of course, but male: ‘the retired man of business’. This is an interesting choice, given the prominence of the vital economy in contemporary medical discussions of women’s bodies, including those written by Crichton Browne. Women’s reproductive systems were thought to be particularly taxing on their reserves of vital energy. This reproductive exhaustion was used to explain
women’s limited mental capacity, and to endorse the need for passivity and calm in their lives.150 When it came to old age, however, this model of women as exhausted
and fragile broke down. If women’s body economies are so greatly taxed during their reproductive lives, it logically followed that women will feel the effects of this massive expenditure – and thus age and die – earlier than men. Yet nineteenth- century observers could not ignore the mortality gap: in the nineteenth century, as in the present, women generally outlived men.151 Indeed, the longer life-expectancy
of women was explained by the particular stresses placed on men’s bodily economies throughout their lives and their exhausting public roles. Crichton Browne, a great opponent of women’s education, wrote in 1891 that ‘Women, who
149 Crichton Browne, 'Clinical Lectures On Mental And Cerebral Diseases: - V. Senile Dementia', p.
603.
150
Ornella Moscucci, The Science of Woman: Gynaecology and Gender in England, 1800-1929 (Cambridge, 1990), p. 104; Hilary Marland, Health and Girlhood in Britain, 1874-1920 (Houndsmills, 2013), pp. 17-21.
151
have not yet to bear the brunt of competition as much as men, reach advanced ages in far larger proportion than men do.’152
The stereotype of the powerful, intellectual men, brought low by dementia – exemplified by poet and historian Robert Southey, adopted as a case study in Bucknill and Tuke’s Manual of Psychological Medicine - was a trope in these writings, but was not all-encompassing.153 ‘Senile dementia has been spoken of as “the last
infirmity of noble minds”’, wrote Crichton Browne (quoting Bucknill and Tuke), ‘but experience will convince you that it is also the infirmity of minds which have no pretension to nobility’.154 If men were often presented as the ideal type of senile
dement, the actual examples presented in these texts were more often women, presumably due to the greater numerical abundance of old women in the asylum, and outside it. Certainly, old women (and men) were not immune to the effects of ubiquitous Victorian gendered stereotyping but, medically speaking, the aged had ‘passed through that excitable and stormy period of nervous life which corresponds to the activity of the sexual functions’ and, in this sense, become de-gendered by their age.155 Where concerns about gendered behaviour were brought up in
discussions of senile insanity, it usually reflected concerns about a change in
habitual behaviour (which was necessarily gendered).156 Male sexuality was thought
to be more persistent into old age than female sexuality, but in a precarious state, prone to perversion: Crichton Browne warned of the ‘octogenarian celibate [who] seeks out an Abishag to comfort his chill decrepitude’.157 Certain psychiatrists
implied that senility would have a feminising effect. Advice for a mentally healthy old age often involved withdrawing from the cut-and-thrust of public life, into the quiet, rhythmic calm of the domestic sphere. Henry Maudsley – ‘the high priest of
152 Crichton Browne, 'On Old Age', p. 79. 153
Bucknill and Tuke, Manual of Psychological Medicine, pp. 127-29.
154
Crichton Browne, 'Clinical Lectures On Mental And Cerebral Diseases: - V. Senile Dementia', p. 603.
155
Francis E. Anstie, 'On Certain Nervous Affections of Old Persons', Journal of Mental Science, 16 (1870), pp.39-40.
156 This follows the argument of David Wright, ‘Delusions of Gender?: Lay Identification and Clinical
Diagnosis of Insanity in Victorian England’ in Andrews and Digby (eds), Sex and Seclusion, pp.166-67.
157
Crichton Browne, 'Clinical Lectures On Mental And Cerebral Diseases: - V. Senile Dementia', p. 602; Clouston, Clinical Lectures on Mental Diseases, pp. 564-65; Henry Maudsley, The Pathology of Mind (2nd edn, London, 1895), p. 212; W. C. McIntosh, 'On Some of the Varieties of Morbid Impulse and Perverted Instinct', Journal of Mental Science, 11 (1866), p. 525.
the fixed fund of energy’ - was particularly critical of old men who attempted to maintain their masculine public role beyond their mental capacity to perform it.158
Charles Mercier, on the other hand, used the idea of an evolutionary gender difference to express the effects of senile dementia:
When an old man's other faculties begin to fail, he becomes incapable of feelings of a high degree of elevation. On the occurrence of a cause celebre he fails to rise to the feeling of justice, but takes the feminine view that it would be cruel to punish the offender.159
According to Mercier, then, the retrogression of old age brought old men onto an evolutionary par with women.
Throughout this period, as has already been discussed, dementia was broadly conceptualised as a loss of energy leading to a loss of mental capacity. Anything which exhausted the body’s reserves of vital or nervous energy –acute emotional shock, physical illness, or another long-term mental disorder – could bring on dementia. ‘Seeing that the pathological condition of dementia is an emptiness of the storehouse of energy,’ wrote Charles Mercier, ‘it is evident that anything which produces an excessive emptying of these stores may produce dementia’.160 Thomas Clouston gave one of the most comprehensive lists of those
things which might empty this storehouse:
[Dementia] frequently occurs in and after bodily diseases, especially after fevers. It also always occurs in the process of starvation to death. It frequently is seen after the exhaustion of long journeys, great exertions, severe campaigns, and great mental tension, strains, or efforts, such as business crises,
158 Henry Maudsley, The Physiology of Mind (London, 1879), p. 537. 159
Mercier, Sanity and Insanity, p. 309.
160
sieges, etc. It also occurs after sudden or great emotional shocks, such as loss of children.161
He then described secondary dementia – ‘dementia par excellence’ – as the form of dementia brought on by the exhaustion caused by other forms of insanity.
Clouston’s list of the causes of dementia thus included physical, mental, emotional and intellectual factors. These causes could be acute or long-term. Clouston’s list also included the longest-term cause of all, ‘the process of starvation to death’. This aetiological model, of physical and mental exhaustion as the cause of dementia, allowed ageing to sit comfortably alongside these myriad other causes. In 1867, Henry Maudsley classified the dementia of old age as a form of ‘secondary dementia’, because of the ‘unanswerable argument that it is secondary to the