VIII THE DESCRIPTION OF OLD AGE IN THE TWELFTH CHAPTER OF ECCLESIASTES

When first approaching the subject of old age every one must recall the famous description in the first six verses of the twelfth chapter of Ecclesiastes beginning “Remember now thy Creator in the days of thy youth while the evil days come not, nor the years draw nigh when thou shalt say I have no pleasure in them.” Formerly ascribed to King Solomon (977 B.C.) the book of Ecclesiastes (in Hebrew Koheleth = the preacher) has been shown by the higher criticism to date only from the end of the third century B.C., and from internal evidence, namely references to the brain, spinal cord, and other anatomical structures, though expressed with poetic imagery, it may fairly be assumed that a medical man was concerned with its construction. In his attractive work, A Gentle Cynic,195 the late Professor Morris Jastrow, jun., of Philadelphia explained that the book of Ecclesiastes as it appears in the authorized version, consists of (i.) the original, cynical, but good-natured obiter dicta of the unknown dilettante who preferred to veil his identity under the name of Koheleth, and (ii.) additions and modifications made by various hands to render it more orthodox and compatible with the tradition that it was written by Solomon; thus the admonition “of making books there is no end and much study is a weariness of the flesh” may very probably have been intended as a hint that Koheleth’s views should not be taken too seriously. Following this conception Jastrow reconstructed the text of the book of Ecclesiastes to what he argued was its original form, and compared it with the more modern writings of Omar Kháyyám and Heinrich Heine. As we all must have speculated over the correct interpretation of the various metaphors in this description of the last stage of life, the explanations offered by others, such as Andreas Laurentius (1599),196 Master Peter Lowe (1612),197 founder of the Faculty of Physicians and Surgeons of Glasgow, Bishop J. Hall (1633),198 John Smith (1665),199 Richard Mead (1775),200 and Jastrow may be very briefly mentioned. The second verse, “While the sun, or the light, or the moon, or the stars, be not darkened, nor the clouds return after the rain,” is regarded by Laurentius, Lowe, and Hall as referring to the ocular disabilities of old age, whereas Smith and Mead consider that mental failure and depression are meant. As regards the third verse, “In the day when the keepers of the house (the hands) shall tremble, and the strong men (the legs) shall bow themselves (become bent), and the grinders (teeth) cease because they are few, and those that look out of the windows (the eyes) be darkened,” there is general agreement, Lowe specially designating cataract as meant in the last sentence. “And the doors shall be shut in the streets,” is regarded as referring to the mouth by Laurentius and Mead, and to the various orifices including the results—constipation and dysuria—by Smith; “when the sound of the grinding is low,” is considered by Jastrow to mean impaired hearing, and by Smith as a lowered rate of metabolic processes, such as assimilation, blood formation, and various secretions. “And he shall rise up at the voice of the bird,” implies, according to Smith and Mead, the early waking of the elderly; “and all the daughters of music shall be brought low” signifies to Laurentius the failure of voice, to Mead deafness, and to Smith all the organs concerned with sounds, namely the lips, tongue, larynx, and the auditory apparatus. “Also when they shall be afraid of that which is high, and fears shall be in the way” is regarded by Smith as describing the general mental attitude of anxiety for things both small and great and a bad head for height, but a more modern commentator suggests that “afraid of that which is high” refers to dyspnoea on climbing a hill. “And the almond tree shall flourish” is by Laurentius, Hall, and Smith thought to refer to the white hair or “churchyard flowers” of the old, but Mead argued that loss of smell is meant. “And the grasshopper shall be a burden” has been very variously interpreted: Hall is content to accept the literal meaning that the least weight is a nuisance; Laurentius and Lowe understand oedema of the legs; John Smith that the aged body undergoes the reverse change of shrivelling, hardening, and angularity; Mead suggests scrotal hernia, and Jastrow, as according to the Talmud the grasshopper is a symbol for the male sexual organ, considers that the sentence refers to the loss of sexual activity. In the sixth verse the words “Or ever the silver cord be loosed,” refers, according to Laurentius, Lowe, Mead, and Jastrow, to kyphosis, but Smith translates them into paralysis of the spinal cord and nerves. “Or the golden bowl be broken,” signifies cardiac failure to Laurentius and Lowe, but cerebral haemorrhage to Smith, who thus explains the next line, “or the pitcher (the veins) be broken at the fountain (the right ventricle), or the wheel (the arterial circulation) broken at the cistern” (the left ventricle), and therefore concludes that King Solomon was perfectly acquainted with the circulation of the blood discovered by William Harvey in 1616. “The pitcher” is regarded as the vena cava by Laurentius, and as the urinary bladder by Mead and Jastrow; “the wheel broken at the cistern” suggests the kidneys and bladder to Laurentius and Lowe, cardiac failure to Mead, and intestinal and hepatic insufficiency to Jastrow.