The Senile Climacteric

The rediscovery and elaboration by Renaissance authors of "the dangerous graduall yeares, called climactericke," seldom referred to the bodies of women.^[82] Climacterics were periodic points along the life course—at ages that were usually multiples of seven or nine—when the body was particularly susceptible to humoral excess and its accompanying emotion and morbidity. The ungendered (and thus inevitably male) climacteric continued to be cited well into the nineteenth century, the Irish physician Kennedy remarking in 1844 that

from the time of Galen to the present period it has been nearly universally believed, that certain epochs of human life are very liable to be accompanied by disease of a certain character. A good deal of trouble has been taken to ascertain at what exact periods of life such a disease shows itself, and particular years, such as the forty-second and sixty-third, have been determined on: the latter of these periods has indeed been called the grand climacteric, as being the time above all others when the disease is apt to declare itself.^[83]

Increasingly for nineteenth-century analysts, the existence of this grand climacteric and in particular the usefulness of its particular multiplication of sevens and nines was questionable. Kennedy himself concludes the above description by not-

ing that "in the cases of climacteric disease which have come under my own notice, I have not been able to confirm any of these points. ... " Well before Kennedy's time, the ungendered grand climacteric was becoming less tied to the chronological precision of a magical multiplication of sevens and nines and more to the emerging and gendered obviousness of what grew increasingly medicalized as "the menopause."^[84] On the one hand, the life course is disenchanted through a process of its rational feminization. On the other, the shift reflects the larger transformation Thomas Laqueur has suggested in European medical constructions of the sexual body, from a unitary anatomy in which the female body is a partial or degenerate but not qualitatively different variant of the male to a binary anatomy in which male and female bodies are mirroring opposites, qualitatively different things.^[85] The increasing taken-for-grantedness of the menopause replaces the invocation of Galenic tradition as proof of an ever more elusive and paradoxically ever more male climacteric. Whereas eighteenth-century arguments for the existence of the menopause invoked the Galenic climacteric, by 1865 the climacteric has been unambiguously speciated into male and female varieties and the gendering of what is obvious in the decline of old age has been inverted and split. C. M. Durrant can derive the male climacteric solely through the female: "We are so much accustomed to regard with interest and anxiety the peculiar changes which take place in the constitution of the female at mid-age, that we are apt to forget and overlook the phenomena which, in a more or less marked manner, attend the turning point towards a downhill course in the opposite sex."^[86]

The gendered shift in what was obvious and what derivative begins in Britain early in the nineteenth century. In 1813, Henry Halford wrote what became a classic text on the climacteric, splitting the crisis along gendered lines and placing the two newly distinct phenomena side to side. Halford contrasted the different embodiments of each: the male climacteric being a "deficiency in the energy of the brain itself," leading, if not negotiated with care, to chronic mental deficiency. The female transition was not of the brain but of the body, and it was of a sufficiently marked character as to "render subsequent alterations less perceptible"; that is, female energy was so closely tied to the womb as to render the question of mental crisis irrelevant.^[87]

Nineteenth-century discussions of the dual climactera continued to cite Halford as the author of the split.^[88] The characterization of the male climacteric as cerebral and progressive and the female as visceral and acute lingered for over a century: in 1933, Edward Podolsky could still write that "there is a definite male climacterium in the same sense that there is a female climacterium, with the notable exception of course that in a man there does not occur those physical changes which serve as a visible means of indicating the change of life. In the male real and definite changes take place, but the physical element is negligible; the mental upheaval is quite considerable."^[89]

As the obviousness of this male climacteric begins to unravel in turn, in the first decades of the twentieth century, numerous explanatory models are floated by its

proponents to explain the reasons for the dual climactera. Heredity, arteriosclerosis, toxemia, and neurasthenia were invoked.^[90] Endocrine explanations dominated, reflecting both the emergence of the gland as a key concept in medical research and more generally the incorporation of evolutionary (climacteric as involution) and ecological (climacteric as reorientation of relations between body and environment) narratives. Gonadal endocrine models exploited the radical differences in the signification of ovaries and testes. Galloway in 1933 argued that involution is a paired process: "the homologous organs which show the changes of involution first in one sex should be those which degenerate first in the other." This principle of equivalence must break down, however, because "in the human female there is no need to follow the subject, the symptoms being so distinctive, culminating in the only objective sign we possess, the cessation of menstruation. It is some centuries since the great Belgian physician, Jean Baptiste Helmont, said 'woman is made what she is by her ovaries.' Thus attention is at once concentrated on them and the ductless glands under whose dominance they act."^[91] Men were complex and not uniglandular; Galloway describes a network of testicular, adrenal, and pancreatic secretions. Hormonal logic separated the simpler pelvic and ductless female embodiment of the transition to old age from its more layered and polysemically ducted male embodiment. As male hormones were interacting within a rationally ordered system rather than simply drying up, the male climacteric occurred later than the female.^[92]

Nascher turned to the climacteric to help resolve the tension between the normal and the pathological, particularly in regards to the senile mind. In his discussion of normal aging, Nascher offered images of old people as weak, willful, dependent, and decaying. In simultaneously moving to free old age from pathology, he constructed what one might term a subaltern physiology, legitimating the study of the old body as both normal and different by framing its normality in terms of other classes of subordinate bodies. To construct a senile physiology, Nascher drew upon other alternative physiologies, those of the child and of the woman. Old people were normal in the same way women and children could be normal.

In the case of the child, discipline as metaphor was supplanted by disciplinary object as metaphor. Less relevant for the new geriatrics were the formal congruencies between the child and the old person, and more relevant were substantive similarities between their behavior, their demeanor, and the degree of autonomy of which they were or should be capable. Nascher opened Geriatrics by declaring: "Senility is often called Second Childhood."^[93] He used the term loosely, as a synonym for old age; elsewhere in Geriatrics he defined it more narrowly as the domain of those oldest old who have passed through the "senile climacteric." In equating very old age with second childhood, Nascher did not so much demonstrate the common structural concerns of pediatrics and geriatrics, as play on a powerful sign of the mentally impaired elder as legitimation for a new field of knowledge. In appropriating the child, Geriatrics positioned childish behavior at the center of the new physiology.

Nascher explored the climacteric at length in a 1915 article, "Evidences of Senile Mental Impairment." The piece is a discussion of both normal and pathological old minds through the presentation of eight cases, a progression of stock characters: "The oldest in this series of eight is a retired minister; of the others, one is a retired merchant, one is a manufacturer still in active business, one is a physician, one is a lawyer, and one is a humble shopworker. There are two women (widows), one living alone, the other living with her daughter."

The eight exhibit "various phases of senile mental impairment": the physician's mind is "extremely clear and alert"; both the minister and manufacturer are egotistical and forgetful; the lawyer is similarly so, and additionally "becomes confused or rambles"; the shop worker has "moments where the mind seems like a mental blank"; and the merchant is in the terminal stages of senile dementia. Nascher finds it difficult to place the two women along this progression; their vignettes stress less cognitive status than demeanor and the type of relationships the women have created.^[94]

In delineating a "senile" as opposed to a "male" climacteric, Nascher attempted to routinize the senile body within a rational and ungendered discourse of geriatrics. Yet the possibilities of the normality he articulated remain rooted in a gendered logic. Unlike Galloway, he did not contrast the simple gonadal decline of women with the higher glandular embodiment of men. Rather than both sexes declining—albeit in different sites and at different rates—old men and old women, in Geriatrics , approached one another: "In childhood the growth force is exerted in two directions, or rather with two distinct purposes, accumulation of tissue and differentiation of the sexes. In old age ... this growth force is now mainly exerted toward the approximation of the sexes and in old age they approach a neutral type."^[95]

Not quite neutral, for the process "is more pronounced in the virilescence of the female." In noting the heightened masculinity, of old women, Nascher may have been responding to more than their mustaches (to which, however, he had a tendency to return throughout Geriatrics ). Whether the enhanced power of old women has been a universal archetype^[96] or a culturally and politically located strategy of resistance,^[97] it presented for Nascher a concern that challenges the central meaning of old age and its physiology of decline. He responded by interpreting the strong female old body as performative health, the failure of women to look as senile as they really are: "The obvious manifestations of senility appear later in the female, for the reason that she makes an effort to remain attractive, the psychic factor involved in the production of the senile slouch in the male being overcome by her vanity."

Beyond strategic vanity, the performance of the wrong normality was an indication of a woman's cognitive limitation: "Women being more impressionable than men, they are more amenable to religious teachings, they become more readily resigned to the inevitable through their faith and hope of eternal life hereafter, and being more cheerful they do not present the disagreeable, gloomy appearance of aged men." The performance of health masked the process of decline, depriving women of what limited brain power the terms of discourse granted them in

the first place. Thus "the mental changes in the female generally include all of the intellectual faculties and proceed to the extent of complete dementia far more often than in the male."^[98] One could not so easily, therefore, measure and rank women's cognitive status, it being a matter of all or nothing, performative health shifting quickly to complete dementia.

Dementia more generally is the result of the poorly negotiated climacteric. Negotiation is dependent on one's moral sense: "Occasionally there is a recrudescence of sexual desire, to gratify which he may attempt rape upon little girls. Such crimes do not arise from depravity, but through weakened mentality involving a weakened moral sense, inability to realize the nature of the act or its consequences, loss of control over conduct, and an irrepressible sexual fury."^[99] If the climacteric represents a sexual gauntlet conditioned by a moral sense, dementia is the end stage of having failed to control one's sexuality. Unlike Warthin, Nascher retains the legacy of Victorian perfectibility. Mental control is an explicitly economic process of the prudent management of limited resources. The physician—not surprisingly, the hero of the "Evidences" article—whose thinking is clear and alert, has negotiated the climacteric successfully. His old age is characterized as conservative: "more serious, less aggressive, less energetic."

The merchant and the shop worker pass through the climacteric inefficiently and at great cost. Unproductive emotional excess at their retirements depletes their vital resources and sets the stage for their poor negotiation of the climacteric. The lawyer, the minister, and the manufacturer are all still negotiating their respective climacterics. They are all emotionally excessive and somewhat egotistical. The women resist climacteric readings. The eldest

has been living alone since the death of her husband nearly twenty years ago. Before his death, she was hospitable, sociable and charitable, but soon after his demise she became irritable and suspicious. ... For the past ten years there has been coming on a slow mental impairment. Her interests in life have become restricted, until today she cares about nothing except her life and her little home, including a cat—her sole companion. ... Aside from [buying food], she does not leave her house, admits no one to her rooms, and in fact leads a hermit life.

The woman's struggle at the time of her becoming a widow is analogous to the preclimacteric dilemmas of the merchant and shop worker. But no eruptive climacteric follows, just steady decline. Has the meaning of the climacteric been exhausted in her undergoing the menopause? The one hint we have here is the archetype through which Nascher presents her, that of the crone: willfully alone, her irritable voice, the hermit hut, the telltale cat. In Nascher's offering us—through the solitary and demented old woman—a figure of the witch, we come full circle to Weyer's substitution of the witch for the doting old woman. Female physiology is relevant primarily to anchor construction of a (male) body subaltern in its old age; its climacteric language of gonadal weakness and absent cognition is exhausted in the signification of old men. There is an unsignifiable gap between this

senile physiology, predicated upon a naturalized rhetoric of gender difference, and the bodies of women Nascher encounters. If old men are normal but weak, and to be normal and weak is to be like a woman, what are old women like? They seem to be like men: independent, mustachioed. But this must be performance, a magical physiology Nascher falls back upon the archetype of the witch.

Similarly, the second widow, "82 years of age, is fond of society, especially of the young, and tries to appear young by resorting to facial artists, hair-dressers, beautifiers, and dressing in youthful garments and conducting herself like a young woman. She takes seriously the joking propositions of marriage made by young men who know her weakness."

Now "her memory is weak, she loses her way," and yet "on the whole her conversation is rational and coherent, though inappropriate for a woman of her age."^[100] Her cognitive state is difficult to assess; she is presented as alternately rational and confused. Her state in some ways seems analogous to that of the mid-climacteric "egotistical" lawyer and minister. But Nascher does not use a language of pathological selfhood—he does not call her "egotistical," as he called the three men—so much as he stresses her social pathology, her inappropriateness. She is the old bawd, and her role encompasses her pathology, more seamlessly than its mirror, the old pantaloon, can represent the experience of climacteric men. Bawd and witch: the two women are offered not as a series, not as a moral economy of aging as for the men, but as totalizing caricatures that obviate a processual physiology negotiating the normal and the pathological through moral choice. The male body is made to contain the distinction through the invocation of the taken-for-granted logic of the female climacteric. The female body is made to contain the distinction through a set of archetypes preventing counterhegemonic readings of its sexuality. Throughout, the fusion of physiology and pathology is not threatening to geriatric ideology, for it is read as difference in gender and not difference in age.