Journal of Gerontology: BIOLOGICAL SCIENCES Copyright 2004 by The Gerontological Society of America

2004, Vol. 59A, No. 6, 515–522

Anti-Aging Medicine: The History

Life Extension and History: The Continual Search

for the Fountain of Youth
Carole Haber

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Department of History, University of Delaware, Newark.

The search for longevity is hardly new. Before recent times, advocates for longevity fell into two
general time periods. From the 16th century to the 18th century, individuals worked to extend the
lives and vitality of elderly people; they believed senescence was a time of considerable worth.
From the 19th century through the early 20th century, however, anti-age advocates generally
depicted old age as a time to be feared and despised, devising myriad procedures in order to
eliminate it entirely. While sharing little with the advocates of the early modern period, the recent
anti-age movement clearly mirrors many of the beliefs of the longevity advocates of a century
ago. Both groups not only see old age as a disease to be eradicated through injections and
operations, but also argue that the old constitute an enormous economic burden. These beliefs
reveal that the new anti-age movement, like its early 20th century precursor, is based on more
than simple hair dyes, hormones, or diet. Rather, their ideas and actions ultimately serve to
marginalize the very process of growing old.

A CCORDING to anti-age advocates, the fountain of

youth has finally been discovered. Rather than
drinking from the mythical well, however, those who search
entirely, anti-age advocates reflect important beliefs about
elderly persons and their role in society. As revealed
through earlier attempts at prolongevity, behind the modern-
for endless youth and vitality are urged to send in their $60 day promise of renewal through hormones, hair dyes, and
and receive the wonder formula of the ‘‘ingestible growth plastic surgery lies a vision of what it means to be old,
hormone.’’ Grow Young with HGH, the Amazing Medical and an understanding of the impact of elderly people on
Plan to Reverse Aging declares the title of Ronald Klatz and American society.
Carol Kahn’s 1998 book (1). The human growth hormone, Before the recent decade, the literature on attaining great
claims the book’s advertisement, is a medically proven plan age generally fell into two major periods: the first ranged
‘‘to lose fat, gain muscle, enhance your sex life, decrease from the 16th century through the 18th century; the second,
wrinkles, prevent disease, and reverse the aging process.’’ from the 19th century through the early 20th century. While
Once the hormone is consumed, the anti-age enthusiasts advocates in both these time periods saw the elimination
declare, age itself will no longer be an inevitable disease of the diseases in old age as an admirable goal, their
accompanied by disability and illness. Instead they promise, characterization of the stage of life, as well as their ultimate
‘‘new’’ and ‘‘revolutionary’’ advances that will ‘‘usher in aims, differed considerably.
a new modern age for humanity: the Ageless Society’’ (2, p. With the Renaissance, the idea of prolongevity developed
3). The future of anti-aging medicine,’’ writes Ronald Klatz out of the belief that individuals could control both the
and Robert Goldman, ‘‘promises the elimination of the length of their time on earth and the quality of their
disability, deformity, pain, disease, suffering and sorrow of existence. One of the most influential of these advocates was
old age. In a few decades, the traditional enfeebled, ailing Luigi Cornaro, an Italian nobleman who in 1550 wrote The
elderly person will be but a grotesque memory of a barbaric Art of Living Long (4). Translated into English, French,
past . . .’’ (3, p. 13). Dutch, and German, the book became the bible of pro-
From the perspective of a historian, however, such claims longevity advocates who asserted that a long and healthy
do not really appear ‘‘new’’ or ‘‘revolutionary.’’ Rather, life was a very real possibility. By the 19th century, the
both in the categorization of old age as a disease, and in the English version of Cornaro’s book had gone through more
hope of eradicating the last stage of life, these declarations than 50 editions (5). In his study, the author argued that
clearly echo well-enunciated ideas of the past. As this article individuals were not destined to die at 60 or 70, but with
will show, such pronouncements are hardly novel; rather, care and a good constitution, could live extremely long
they reflect the medical, social, and economic attitudes lives. The key to this survival, he believed, lay in a simple
of those who search for endless youth and vitality. By life based on the principle of moderation in all things. His
attempting to extend the life cycle, or to eliminate old age own life served as an ideal illustration of his philosophy.

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516 HABER

Suffering at age 35 from a variety of illnesses including understand them in order that the aging individuals remain
gout, fever, and dehydration, he reformed his behavior and productive members of society (6).
lived happily and healthily until his death at 98. Throughout the 19th century, however, this notion of a vital
In formulating his philosophy, Cornaro espoused a widely and meaningful senescence was challenged by scientific
shared idea that old age was caused by a significant decline discoveries that defined old age as a disease to be hated and
in vital energy. The force supposedly supplied the necessary feared. Based on studies first done at the hospitals in Paris,
vitality for growth in childhood and stability in middle age. elite physicians began to link old age to specific physiological
By senescence, however, the reserve was gone; it left most changes in the body. By tracing lesions in the tissues, and later
individuals depleted and debilitated. Those able to maintain changes in the cell, they concluded that old age was not
their vital energy—whether through diet, moderation, or simply a decline in vitality that could easily be controlled

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simple good luck—were apt to experience a healthy and through a regime of diet or exercise. Examining the aging eye,
active old age. With the proper conservation of this vitality, the loss of hearing, or the development of arteriosclerosis,
the diseases that accompanied old age would disappear, they asserted that aging, like many disease entities, appeared
leaving individuals happy and productive until their final to cause numerous pathological transformations that were
days. The secret, then, to a long life was simple: The both progressive and inevitable. As a result, clinicians agreed
fountain of youth was available to all who controlled the that illness and old age were inseparably intertwined, if
means to retain their vital energy. not quite synonymous. ‘‘It is impossible,’’ wrote the ‘father’
Significantly, in advocating the new regimen, Cornaro and of geriatrics, I. L. Nascher: ‘‘to draw a sharp line between
his followers did not see old age itself as an enemy to be health and disease in old age. With every organ and tissue
vanished, but as a stage of life possessing its own riches and undergoing a degenerative change which affects the phy-
rewards. ‘‘I had never known,’’ Cornaro wrote, ‘‘that the siological functions, it is a matter for personal opinion to
world was beautiful until I reached old age. Indeed,’’ he determine at what point the changes in the anatomical features
added, ‘‘old age is the time to be most coveted, as it is then and physiological functions depart from the normal changes
that prudence is best exercised, and the fruits of all the other of senility and to what degree’’ (7, p. 94).
virtues are enjoyed with the least opposition; because by that By the early 20th century, to most authorities, aging was
time, the passions are subdued, and man gives himself a disease that destroyed both the body and the mind. Previous
up wholly to reason’’ (4, p. 43). Cornaro, in fact, gave four beliefs that physical debility or mental decay could be
reasons for approaching a healthy old age with great avoided seemed overly optimistic and completely unscien-
expectations. First, he noted that by reaching an advanced tific. ‘‘The weight of evidence,’’ wrote Dr. W. H. Curtis,
age, an individual might come to understand the worthiness ‘‘seems to establish the fact that old is never physiological,
of a long life; second, he believed that old age could be but pathological, at least its visible and appreciable evidences
a ‘‘happy place of life’’ where individuals could enjoy the are pathological ones’’ (8, p. 401). Early signs of aging, such
results of their youthful endeavors; third, he depicted the final as a loss of short-term memory or a slowing of the step, only
stage of life as characterized by learning and virtue, assets foretold the horrors that were inevitably to come. ‘‘From the
that would have great benefit to the community; and finally, beginning to the end,’’ explained Dr. Charles Mercier, ‘‘the
he believed that, with the elimination of disease, an process is a continuous, gradually progressive loss. Conduct,
individual’s end would come with a peaceful ‘‘natural intelligence, feeling, and self-consciousness gradually di-
death,’’ rather than in pain and suffering (4). In this portrayal, minish, and at last cease to exist . . . The decadence of old age
Cornaro envisioned eliminating the diseases that often is, in fact, a dementia, a deprivation of mind’’ (9, p. 305).
accompanied old age—not old age itself. For him, the stage While many physicians argued that this conception of old
was one that offered both great promise and fulfillment. age called for the establishment of a special study of growing
With the Enlightenment, this philosophy of life exten- old, few devoted themselves to ‘‘senile’’ therapeutics. The
sion was espoused by a number of the philosophes. From theoretical construct that defined aging as a progressive
Condorcet to Benjamin Franklin, leading thinkers believed disease seemed to limit both research and optimism. The
that, in the centuries ahead, science would solve the problem majority agreed that, not only was it as difficult to separate
of debility in old age. Individuals who followed the simple normal old age from its pathological state, but they also
rules of nature could then exist until their deaths with the lacked the knowledge to stop the inevitable decline that led to
vitality of adulthood and the wisdom of their advanced debility and death. Not surprisingly, then, few chose to
years. Most notably, many of these rationalist thinkers did specialize in the diseases of old age (10).
not believe that the decreasing strength of the aging body For a very small number of physicians, however, this
implied an equal weakness of the mind. Benjamin Rush, for conceptual understanding of aging served as a call for action.
example, was convinced that most aged individuals—and If old age was a hated disease, why not simply attack and
especially those who were temperate in their daily habits— destroy it? Could not the same scientific construct that traced
would retain full use of their mental powers until they the decaying cell be used to inhibit its deterioration or return
reached the grave. In 1797, in a study of a group of it to its youthful state? Several scientists answered this
octogenarians, he found that, although some elderly question with a resounding ‘‘yes!’’ They believed, as Eugen
individuals had faulty memories of the recent past, their Steinach would argue, that their research into the aging
intellectual, moral, and religious powers were completely process definitively proved that ‘‘the senile process is
unimpaired. His recommendation for a happy old age, reversible,’’ if doctors were simply willing to intervene (11,
therefore, was not to overcome the laws of nature, but to p. 123). Unlike the philosophes, they no longer believed that
 LIFE EXTENSION AND HISTORY 517

the key lay in working with nature. Rather, they argued, effects observed by Dr. Brown-Sequard.’’ With its use, the
seemingly immutable natural laws could be overcome if they weakness of old age was simply a remnant of the un-
took immediate action. scientific past (16, p. 58). Although patients lined up for
For many in this group, the cause of the ‘‘disease of old injections, the initial popularity of the product and Brown-
age’’ was rooted in the process of cell growth and nutrition. Sequard’s approach failed to produce long-term success.
The cell, they asserted, was immortal; only its development Other companies found themselves charged with fraud for
within the body caused its degeneration and death. One of the swindling a gullible public (13).
first to advocate this position in relationship to old age was Nonetheless, throughout the early 20th century, an
Elie Metchnikoff in the late 1800s. Focusing on cells termed increasing number of physicians argued that their experi-
phagocytes, he contended that they poisoned the body and mental procedures had indeed overcome nature by elimi-

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led to decline. In response, he advocated a diet rich in lactic nating old age and restoring vigor. In 1914, Dr. Frank
acid, which, he declared, would lead to the eradication of Lydston of Chicago performed human testis transplants on
intestinal putrefaction and the destruction of microbes that several patients, including one on himself. Claiming to be
caused the body to decay (12). Following a similar logic, one of the first to experiment with this technique, he argued
Charles A. Stephens argued that the road to longevity and the that the grafting process slowed down the onset of senility.
elimination of death lay in the perfection of cell nutrition. Not only did it improve his sexual performance, but even
Believing that he could retain the youthfulness of tissues turned his gray hair back to its original color. (17).
through proper nutrition and stimulation, he envisioned a time While Lydston believed he never obtained the attention
when cells would never age. There would be, according to or credit he deserved, the work of L. L. Stanley almost
Stephens, no senescence or death, but simply everlasting immediately received widespread scientific notice. In 1919,
youth. ‘‘Immortal life will be achieved by the aid of applied Stanley, a physician at San Quentin prison, removed the
science;’’ he declared, ‘‘it is what the whole scheme of testicles of a recently executed murderer and transplanted
evolution moves forward to’’ (13, p. 178). them into a 60-year-old inmate deemed ‘‘prematurely’’ senile
While these physicians looked to diet and hygiene to (15, p. 26). In the pages of Endocrinology, he later reported
unravel the mysteries of growing old, others took a more that he had performed the operation on 643 inmates as well
experimental and invasive approach. A small—though well as 13 physicians, all with outstanding results. According
publicized—group was convinced that the fountain of youth to Stanley, not only had the gland-grafting operation
lay deep within the endocrine system. Focusing particularly ‘‘rejuvenated’’ the participants, but eliminated a variety of
upon the testicles and ovaries, they were adamant that symptoms, ranging from acne to asthma (18). By 1928, one
natural debility and decline of old age could be overcome. researcher estimated that the Stanley procedure had been
Characterizing their doubters as ‘‘lack[ing] scientific performed effectively with over 50,000 patients (13).
objectivity and sufficient experience’’ or ‘‘unjust, biased, Although later studies revealed that such operations could
and unscientific’’ (14, pp. 8 and 10), they actively pursued not possible have been successful, throughout the 1920s,
operations and experiments that, they were convinced, several physicians became international celebrities by per-
would lead to countless years of youthful activity. forming these grafts. While Stanley’s unique position as a
One of the first to perform such experiments was C. E. prison surgeon provided testicles from human participants,
Brown-Sequard. Linking the aging of the body to a weaken- others experimented—successfully they claimed—with a
ing of the sexual function, he argued in 1889 that science— variety of animal gland grafts. Dr. Serge Voronoff, probably
and radical intervention—could return these key sex glands the most well known for this technique, turned to monkey
to their adolescent state. At age 72, he claimed he had proved gland grafts to rejuvenate his patients. Beginning first with
the validity of his thesis on his own body. Injecting himself operations using the glands of chimpanzees, and then later
with a mixture of animal sex glands, he asserted that he with baboons, he traveled the globe, performing operations,
had restored his own vitality to its youthful state. ‘‘The giving scientific papers, and exhibiting his star patient,
physiological effects of the extract will appear to you,’’ he Edward Liadet, a 76-year-old London businessman who,
wrote ‘‘as they appeared to me, most surprising. It is after receiving his monkey gland transplant, claimed to look
sufficient to state that everything I had not been able to do or and feel as if he were no more than 45. Although Liadet died
had done badly for several years on account of my advanced within 2 years of the operation, Voronoff was convinced that
age I am today able to perform most admirably’’ (15, p. 12). his method was a success (18).
Spread by both scientific and lay journals, the news of The response from more orthodox medical professionals
his work led to great public and commercial interest. In ranged from polite hearings to direct attacks. While the
August 26, 1889, The Medical News announced that a firm journal Endocrinology originally published some of the
of druggists ‘‘claims to have discovered and to furnish for papers, many authorities directly challenged the idea of
use the active principle contained in ‘testicular fluid.’’’ transplanting animal glands onto humans. Immediately
According to the company, the new compound, Spermine, following the announcement of Brown-Sequard’s experi-
was composed of ‘‘semen, calf’s heart, calf’s liver, bull’s ments, Dr. Allen McLane Hamilton argued, ‘‘The theory is
testicles, and also from the surface of anatomical specimens opposed to all the laws of physiology and chemistry. Further
kept under alcohol.’’ The success of the drug could not be than that, I believe it is a very dangerous proceeding, and that
doubted. ‘‘Physiological experiments,’’ the company de- it is time for reputable physicians to express their disapproval
clared, ‘‘have established the fact that in the salts of the of the experiments. There is great danger of introducing
alkaloid Spermine, we have the cause for the stimulant a violent poison into the system’’ (16, p. 102). By 1920,
518 HABER

Dr. Arthur Dean Bevan, the President of the American capacities,’’ he argued, proves that reactivation is not
Medical Association, discussed the issue in his presidential confined to single organs and certainly not merely to sexual
address, ‘‘It is a scientific fact,’’ he stated, ‘‘that any foreign functions, but, as already insisted upon, that it embraces the
gland introduced into the human body must disappear within substance of the whole organism and extends into each
a short time. This is as elementary and incontrovertible as that individual cell structure. In questioning this fact, we have
two and two are four’’ (15, p. 49). Editorials in the Journal of also answered our principal question, which was whether
the American Medical Association called for more studies, the senile process is ‘‘reversible’’ (11 p. 151).
and noted ‘‘the ease at which fragmentary data are woven into Although most doctors generally directed their operations
a story of technical success’’ (15 p. 41), while in France, the to men, physicians such as Voronoff, Steinach, and others
French Surgical Congress and Academy of Medicine refused came to believe that women could be ‘‘rejuvenated’’ as well

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to support Voronoff’s ideas or provide a platform for his through surgical intervention (20). While Steinach preferred
research. Voronoff, however, simply characterized these injections of the ‘‘follicular hormone’’ and radiation of the
associations as ‘‘decaying, rundown organizations who ovaries, others began to transplant ovaries into menopausal
opposed all change and innovation’’ (15, p. 54). Despite patients. The outcome, rejuvenation advocate Norman Haire
increasing doubts about the efficacy of his operation, he declared, was almost always outstanding. In the senile
continued to perform both human and animal operations to female, he wrote, in 1924: ‘‘[T]he implantation of an ovary
popular acclaim. has very striking results. If an ovary is transplanted from
Not surprisingly, many of these gland-transplanting a young into an ageing female it ceases to produce ova, but
physicians portrayed their operations as benevolent acts in continues to secrete hormones which circulate in the blood
which they alone were eliminating the ‘‘grotesque’’ disease of its new host and produce great improvement in mental,
of old age. They were, however, not unaware of the financial physical and sexual health, and stimulate the host’s own
benefit they could gain. Voronoff, for example, charged ovaries to renewed activity of both its functions. The senile
between £500 and £1000 for each operation. Probably no female becomes more vigorous, shows renewed sexual
‘‘doctor’’ profited more from the search for the glandular desire, exerts a renewed attraction over the male, and after
fountain of youth, however, than ‘‘Dr.’’ John R. Brinkley. a longer period of sterility is once more capable of becoming
Having studied 3 months at the Eclectic Medical University pregnant and producing offspring’’ (21, p. 32). Numerous
of Kansas, Brinkley received a medical diploma that he later case studies from these doctors testified to outstanding
used to become licensed in Kansas and Arkansas. Upon results as aged, haggard old women suddenly became
settling in Milford, Kansas, he began grafting goat glands sexually alluring and attractive.
onto individual seeking cures ranging from impotence to Despite the differences in approach and types of
insanity, as well as hoping that they might obtain the secrets operations, all these researchers shared one clear belief:
to eternal youth. Arguing that ‘‘you are only as old as your Aging was an enemy to be attacked at all costs. Without
glands,’’ Brinkley built his own hospital in which he charged question, to grow old was to become impotent and useless.
$750 for a goat gland transplant and $2000 for a human one Old age, according to Stephens, was a period of ‘‘grossness,
(19). By 1923, he had established one of the nation’s largest coarseness, and ugliness’’ (13, p. 177). The body weakened,
radio stations, KFKB, in Kansas. Along with music, religion, the mind grew dim. In this characterization, senescence was
and his attack on traditional medicine, he advertised his hardly linked to wisdom or experience. Rather, nothing in
operations and pharmaceuticals. By the end of the decade, he the last stage of life was worthy of maintaining. ‘‘The
had become a millionaire, complete with several homes, two alleged joys of old age,’’ wrote Voronoff in 1928, ‘‘have
airplanes, a yacht, and numerous cars. Eventually, however, been imagined to console us in our downfall, which is
he found himself attacked by orthodox medicine. In 1930, the considered as inevitable and irremediable’’ (18, p. 73). The
Kansas Board of Medical Registration and Examination only hope was to eradicate it entirely through a direct attack,
revoked his license, while in the pages of the Journal of the in the form of laboratory research, invasive operations, or
American Medical Association, Morris Fishbein labeled a myriad of foods and prescriptions.
Brinkley ‘‘a blatant quack,’’ challenging his educational Embedded in this medical view of old age was the belief
qualifications and procedures (19). After a failed campaign that not only were elderly people nonproductive and
for the governor of Kansas, the ‘‘goat gland doctor’’ moved obsolescent, but they also represented a severe economic
to Mexico, where he once again advertised his beliefs on challenge to modern society. For many commentators, turn-
a powerful radio station. of-the-century western industrial societies were facing
Gland grafting, however, was not the only operation early a crisis of aging. Believing that the old held power and
20th century physicians used to extend middle age. Eugen respect in agricultural societies, they bemoaned what they
Steinach attained international acclaim through the pro- perceived to be the declining status of elderly people in
cedure he termed ‘‘vasoligation’’ that cut the vas deferens the modern world. In their eyes, to be old was to be poor;
and directed the sperm from the testicles back into the body. modernization, for the old, meant dependence rather than
Contending that sperm held great reinvigorating powers, respect. ‘‘The socioeconomic problem of the old man or
he detailed numerous case studies in which the operation woman,’’ wrote aging expert Isaac Rubinow, ‘‘is specifi-
restored youth and vigor to both animals and men. In 80% cally a problem of modern society, a result of the rapid
of his cases, he argued, senility disappeared; both mentally industrialization’’ (22, p. 302). Assuming that the old could
and physically, the patients returned to their ‘‘presenile’’ no longer compete in a world that idolized the young and
state. ‘‘The harmonic restoration of so many failing relied on new technological skills, aging experts asserted
 LIFE EXTENSION AND HISTORY 519

that elderly people had been discarded on the ‘‘industrial of increasing, will diminish progressively’’ (12, p. 134).
scrap heap’’ only to face inevitable impoverishment (23). Although Metchnikoff looked to future research, many of the
‘‘For the great mass of wage-earners,’’ pension-advocate anti-age surgeons argued that the pending crisis had been
Abraham Epstein explained, ‘‘inability to maintain their solved. Touting their operations, they declared that they had
regular employment makes dependency in old age inescap- already discovered how to stop the inevitable poverty of the
able and inevitable’’ (24, p. 60). As old age was an incurable old. With surgical transplants, they contended, the old would
disease, and with no hope of maintaining their health, no longer suffer debility or disease; they would remain
elderly persons would have little choice but to seek refuge in productive and self-sufficient indefinitely. In 1926, in fact,
the poorhouse or depend on their children or the state for Voronoff proclaimed that his procedure would empty old age
support in their inevitable dotage. asylums and allow the inmates ‘‘to resume for a few years an

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The weakness of the old, therefore, was not simply an active mode of life, instead of remaining a burden to the
individual medical problem but seemed to challenge the community.’’ Convinced of the efficacy of the procedure, he
prosperity and progress of the nation. Social as well as recommended that such operations should immediately take
medical experts on aging utilized a wide array of data to place ‘‘on a large scale’’ in all institutions that housed the old
prove the negative impact of the old on modern-day society. (20, p. 110). Two years later, he noted the economic impact
Elie Metchnikoff, for example, noted that France spent huge of his operation on a 64-year-old widow whose ‘‘earnings
sums maintaining 2 million people aged 70 years and older. were diminishing, poverty was facing her, and she came to
‘‘Already it is complained,’’ he wrote, ‘‘that the burden of me with a cry of distress, asking me to restore her strength
supporting old people is too heavy and statesmen are and her energy for work, in order that she might be saved
perturbed by the enormous expense which will be entailed from definitely shrinking and being thenceforth unable to
by State support of the aged’’ (12, p. 134). Even the new film support her son.’’ After he grafted an ovary from a female
industry of the early 20th century delivered this message to its chimpanzee, he reported that the operation ‘‘. . . literally
mass audience. In a short silent film, D. W. Griffith pictured transformed this poor woman . . . Her figure had again
the horrible plight of the aged, and asked, in his title, ‘‘What become erect, her movements alert; her face no longer wore
Shall we do with our Aged?’’ as his elderly protagonist the expression of pain that made it look so old; the wrinkles,
hobbled off to the almshouse. Those who had already further, were much less marked, as a result evidently of the
succumbed to the ravages of old age were clearly pictured as better tone of the muscles which is always to be observed
the marginalized other—they had become little more than after grafting. But what rejoiced the worthy woman more was
a problem for themselves and a useless drain on society. The that she was again able to climb lightly her six flights of steps,
only hope, longevity advocates proclaimed, was to use work twelve hours a day, and feel herself a renewed strength
science and technology to eliminate the stage entirely. which restored her moral courage to face the struggle for life’’
To support this contention, many aging advocates pointed (18, p. 186).
with statistical inaccuracy to the seemingly growing pro- In the 1920s, such pronouncements were taken quite
portion of aged individuals who filled the almshouse. In seriously. Following one of Voronoff’s testis graft oper-
1880, they argued, only 33% of the nation’s residents of the ations, a Hungarian insurance company refused to pay an old
poorhouses had been old; by 1904 the proportion had risen age pension to a patient. With the monkey gland attached to
to 53%, and by 1923, to an astonishing 67% (25). These his body, the man, the company asserted, could no longer
numbers, they asserted, proved that old age was an appalling claim the annuity that had been intended for the debilitated
stage of existence. By the 1930s, the federal government old (15). Other insurance companies hoped that Steinach’s
accepted these statistics as one of the rationales for adopting vasoligation procedure would save them from the increasing
federal pensions. ‘‘The predominance of the aged in the high cost of annuities. ‘‘Recently,’’ reported Steinach-
almshouses,’’ wrote the Committee on Economic Security, enthusiast George F. Corners, in 1923, ‘‘at a meeting of
‘‘is a sign of their increasing dependency’’ (26). What few underwriters in New York, the effect of Steinach’s discovery
advocates acknowledged, however, was that the growing on life insurance, disability clauses, etc., was discussed with
proportion of aged inmates within the asylum was not due to much animation. Provisions for old age, pensions, etc., will
the increasing impoverishment of the old but to the removal be subjected to substantial modifications, if the Steinach
of other, often younger inmates. Nationally, in fact, the operation becomes universal’’ (28, pp. 49–50). Here, it
percentage of all elderly persons who became almshouse seemed was an answer to the growing financial burden of the
residents remained rather constant at 2% (27). Nonetheless, elderly population. Extreme medical actions could ‘‘cure’’
aging advocates repeatedly claimed that the almshouse the disease of old age and impede the seemingly imminent
demonstrated the horror of old age. Unless extreme action economic crisis.
was taken, the government would be overwhelmed with the Beginning in the 1940s, this message was conveyed with
cost of their care. decreasing frequency. The failure of many of these miracle
For physicians such as Elie Metchnikoff, the only hope for treatments to deliver endless youth, along with the
solving this seemingly ever-growing problem was to look to establishment of Social Security and the growing number
the discoveries and procedures of medical science. ‘‘When of private pension plans, all served to diminish the promises
we have reduced or abolished such causes of precocious of prolongevity advocates and the harsh descriptions of
senility as intemperance and disease,’’ he wrote in 1908, ‘‘it aging. Instead of categorizing the entire stage as a disease,
will no longer be necessary to give pensions at the age of newly formed organizations such as the American Geriatrics
sixty or seventy years. The cost of supporting the old, instead Society and The Gerontological Society of America sought
520 HABER

to separate normal old age from treatable, pathological of the A4M now pin their hopes on what they term ‘‘multi-
conditions. Authorities who had once emphasized the hormone optimization’’ and especially note the importance
incapacity of the old now spoke of the last stage of life as of the human growth hormone. ‘‘By replenishing your supply
a time of independence and autonomy. In newspapers and of growth hormone,’’ write Ronald Klatz and Carol Kahn in
magazines, images of decrepit elderly couples in the Grow Young with HGH, ‘‘you can recover your vigor, health,
almshouse were often replaced by happy pictures of newly looks, and sexuality. For the first time in human history, we
retired ‘‘seniors’’ who spent their final years on the golf can intervene in the aging process, restore many aspects of
course in pension-supported leisure. Information on plan- youth, resist disease, substantially improve the quality of life,
ning for retirement, tips on autonomous living, and advice perhaps even extend the life span itself. The ‘Fountain of
on sexuality after menopause filled the pages of literature Youth’ lies within the cells of each of us. All you need to do is

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directed to the aging community and their families (27). release it’’ (1, p. 15).
In the early 1990s, however, beliefs about the uselessness Steinach and Voronoff, of course, would have argued
of old age and the need to eliminate the aging process have vociferously that this was not ‘‘the first time in human
reappeared, espoused by the founders of the American history.’’ They, too, had contended that they had ‘‘in-
Academy of Anti-Age Medicine (A4M). Established in tervened in the aging process.’’ And, like the present-day
1993 by 12 practitioners, the A4M has dedicated itself to testimonies from happy patients, the turn-of-the century
‘‘addressing the phenomenon of aging as a treatable physicians had displayed ‘‘before’’ and ‘‘after’’ photographs
disease.’’ In books, web sites, and television infomercials, and case studies. In words and images, they, like their
leaders of the A4M again picture old age as the ultimate modern-day counterparts, had argued that such indisputable
enemy, a deplorable state that requires eradication. ‘‘Once pictures proved that they had stopped the cell from aging
aging is viewed as a disease,’’ proclaims Dr. Ronald Klatz, and successfully returned their participants to blissful
one of the founders of the anti-age movement, ‘‘then it middle age. For Steinach and Voronoff, as for the members
becomes a treatable condition.’’ According to the anti-age of the A4M, old age was a ‘‘grotesque’’ disease that could
literature, with proper hormone treatment, exercise, plastic be scientifically eradicated through the correct combination
surgery, and nutritional supplements, individuals can then of hormones, diet, and surgery.
look forward to the ‘‘END OF AGING’’ and anticipate Moreover, despite warnings that such treatments may
countless years endowed with the vitality and appearance of have little effect, or in fact, may be dangerous (30, p. 29 and
the middle aged (2, pp. 3–4). 31), both groups eschew the traditional medical establish-
In their approach and their attitudes, this movement ment, finding their methods and approaches to be elitist and
obviously shares little with the first wave of longevity obsolete. In the early 20th century, aging interventionists
advocates. Unlike Cornaro, Condorcet, or Rush, the anti-age criticized the medical establishment that questioned their
advocates see nothing of value in old age itself. Few in the operations and demanded further studies. The traditional
A4M would endorse Cornaro’s notion that ‘‘old age is the academies, they contented, were ‘‘outdated’’ or ‘‘decay-
time to be most coveted’’ (4, p. 43). Hardly a period of ing’’; the time for action was now. A similar attitude is
wisdom, or contemplation, the last stage of life is expressed by the A4M. According to Klatz and Kahn: ‘‘It
characterized only as a time of weakness and disease. took forty years before the medical establishment gave its
According to the founders of the movement, old age is nod for routine replacement of estrogen and progesterone in
simply a ‘‘constellation of degenerative disorders which post-menopausal women and it might take another forty
lead ultimately to disability and death’’ (2, p. 4). As the final years before it gives the nod to growth hormone re-
stage of life is clearly a time of ‘‘prolonged suffering and placement. We believe the consequences of not acting are
decrepitude’’ (29, p. ix), those who have succumbed to its far worse than the consequences of acting’’ (1, p. 28).
ravages are portrayed as the most marginal of individuals. Not surprisingly, like the gland doctors before them, the
But if the new anti-age advocates repeat few of the ideas of leaders of the A4M have had their practices and credentials
their 16th century, 17th century, and 18th century precursors, assailed by the medical and legal communities. In 2000, the
they clearly mirror many of the attitudes and practices of State of Illinois Department of Professional Regulations
a century ago. Although they depict their philosophy and challenged A4M founders Ronald Klatz, DO, and Robert
practices as marking a new and revolutionary approach to the Goldman, DO, who, in numerous books, had identified
eradication of old age, their view of the aging process, as well themselves as MDs. Although both men had acquired an MD
as their methods of ‘‘curing’’ it, vividly echo the approaches, degree from the Central America Health Sciences University
beliefs, and actions of the late 19th and 20th centuries’ School of Medicine in Belize, the state ruled that they were
longevity experts. not licensed to use this credential in Illinois. As a result, on
To the members of A4M, as to the advocates of the early December 6, 2000, Klatz and Goldman agreed to pay $5000
20th century, old age is not simply a life stage, but a disease apiece and ‘‘cease and desist’’ from identifying themselves as
that brings illness, poverty, and decrepitude. The culprit, both MDs (32). Much like Brinkley, the goat gland doctor who
groups would agree, is the cell whose aging transformation had battled with the American Medical Association and the
within the body stands in the way of immortality. And, like Kansas Medical Board, the leaders of the A4M have had to
the interventionist doctors of a century ago, the new anti-age revise their credentials according to professional standards.
experts argue that this process can be ‘‘cured’’ through direct But the similarities to their precursors go well beyond
action. Although doctors such as Steinach and Voronoff had these conflicts with orthodox medicine or even their shared
identified the sex glands as key to the process, the members definition of aging. In justifying their beliefs, both groups
 LIFE EXTENSION AND HISTORY 521

also repeatedly point to statistical ‘‘proof’’ to support their services? The answer, of course, is the younger generations.
contentions. Almost every work of the A4M begins with They will pay. And pay. And pay, even more’’ (2, p. 1).
a discussion of the demographic revolution that has occurred According to Klatz, the only solution to this crisis is to
in the life cycle—seeming indisputable confirmation that we follow the prescriptions of the anti-age movement. ‘‘Those
are now witnessing the exponential growth in the years at of us here today,’’ he writes, ‘‘know a HIGHER truth . . .
the end of the life cycle. In Brain Power, Bob Goldman, And the truth is mankind is poised at the edge of an advance
Ronald Klatz, and Lisa Berger typically note, ‘‘In 1799, the of epic proportions. We the leaders of the Anti-Aging
average life span was 25 years—as it had been for centuries. movement will help to usher in a new modern age for
But today we age very differently. By 1899, just a century humanity: The Ageless Society. There is a remedy for this
ago, the average life span had reached 48 years. Now it is apocalypse of aging, and this remedy comes just in time to

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almost 80 years, and scientists are predicting that average save America. This remedy is the new science of Anti-
life spans will reach 120 to 150 by the year 2049’’ (33, p. 7). Aging Medicine represented by the American Academy of
Relying on graphs and bars that suggest that science had Anti-Aging Medicine’’ (2, p. 3). ‘‘In order to avert the
added more than 30 years to the lives of the old, they argue financially, socially, and medically burdensome task of
that the future implications are clear. As Mary Ann Liebert caring for the swelling aged population,’’ Klatz argues
declares in Advances in Anti-Aging Medicine, ‘‘the A4M elsewhere, his program must be widely adopted. It is, he
maintains a belief and expectation that human longevity can declares, ‘‘a critical imperative to maintain the well-being of
be increased to as much as 250 years, which may be society in the twenty-second century’’ (37, p. 59).
considered ‘‘human immortality.’’ We can, she asserts, ‘‘be The apocalypse of aging, the disease of old age, the hor-
able to live virtually forever’’ (34, p. xvii). ror of wrinkles, and the loss sexuality, as well as the
Like the aging advocates who employed statistic ‘‘proof’’ ‘‘burdensome task’’ of supporting the old, all reflect beliefs
from the almshouse, however, the demographic figures from that go beyond simple hair dye or exercise programs. They
the life cycle hardly demonstrate what the authors contend. reveal the return of disturbing ideas about the nature of elderly
The dramatic change in mortality rates seen in the 20th people and their place in society. As in the campaign of the
century is not primarily due to an expansion in the last years longevity advocates 100 years earlier, and in contrast to the
of the life cycle. Rather, it is largely the result of the sentiments of individuals such as Cornaro, those who have
elimination of childhood morality that once served to depress selfishly succumbed to the ravages of age have once again
average life expectancy. Even in colonial America, 70% of become the enemy ready to challenge and destroy the nation’s
all individuals who reached age 25 survived to 60. And, while economic growth and prosperity. From the perspective of
the 20th century has experienced the first increase in the years history, then, the new fountain of youth may not simply be
at the end of the life cycle, this increase has been far slower offering its supplicants the hope of fewer wrinkles and a more
than implied: In 1900, individuals who attained their 65th active sex life. In both its formula for continued youth and its
birthday could expect an additional 11.9 years of life; by contempt for elderly people, the anti-age movement, like its
1950, it has risen to 13.9 years, and by 1978, 16.1 years (35). late 19th century and early 20th century counterparts, tends to
Several geriatricians argue, in fact, that even if cancer and demean and marginalize the very process of growing old.
heart disease were completely eliminated, life expectancy
would only increase 7 years for women and 8 for men—
hardly the unlimited life span envisioned by some anti-aging ACKNOWLEDGMENTS
experts (36). A much shorter article based on some of the same material appeared in
Generations. Reprinted with permission from Generations (2001-02, 25:4,
Finally, and most troubling perhaps, not only do these pp. 9–15). Copyright 2001-02 American Society on Aging, San Francisco,
promises hark back to hopes of the longevity advocates of the California (www.asaging.org).
19th and early 20th centuries, but the founders of the A4M Address correspondence to Carole Haber, PhD, Department of History,
have once again characterized those who have experienced University of Delaware, Newark, DE 19716. E-mail: chaber@udel.edu
old age or any age-related diseases as the enemy depleting the
country of its wealth and prosperity. ‘‘As we all know,’’
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