Source:
A case not wholly hypothetical, article written by Dr. Henry Putnam Stearns for The American Journal of Insanity, volume 46, pages 152 to 165, published by Utica State Hospital Press, 1888-89
The article:
A CASE NOT WHOLLY HYPOTHETICAL.
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BY H. P. STEARNS, M. D.,
Superintendent of the Retreat for the Insane, Hartford, Conn.
—
When Christina was twenty-two years of age she was at the zenith of splendor and power, as Queen of one of the most important countries of Europe, at the period in which she lived. She had inherited the throne from a long line of ancestry on one side eminent in character and ability, and was surrounded by such favorable conditions and faithful subjects as few other sovereigns of her time. She was a person endowed by nature with a very brilliant mind, delighted in books and music, languages, social life and the fine arts; was surrounded by some of the most learned scholars of her time, and with every facility of gratifying her natural and acquired tastes. She had been far more successful in bringing about beneficent charges and results among the governments of Europe than any other sovereign, and is said to have been chiefly instrumental in putting an end to the thirty years' war.
She had an exceedingly attractive countenance, and brilliant conversational powers, and delighted in filling her court with learned men. Her hand had been repeatedly sought in marriage by persons who occupied the highest positions of trust and influence in Europe. Her every wish was almost anticipated, and most certainly fulfilled by a loyal ministry and a devoted people.
Such a one was Christina, Queen of Sweden, at about twenty-two years of age. A few years before, or at some time not now definitely known, there began to appear a change in her character, and to some extent in her tastes and pursuits. From one who had been a laborious student, an abstemious liver, rarely sleeping, according to her own statement, more than four of the twenty-four hours, delighting in physical exercise and out-door enjoyments, governing her kingdom with such dignity as to inspire the highest respect of all with whom she surrounded herself, and such as only one born to rule can, she began to exhibit opposite characteristics, which gradually became more and more conspicuous. She lost her interest and largely her confidence in the men of strong and incorruptible integrity with whom she had lived for years, and invited to her court quacks and mountebanks from all over Europe. She lavished large amounts of money on these persons, and on such bric-a-brac as they brought to her notice from time to time and advised her to buy.
She became more fond of private theatricals than of the affairs of her kingdom, and neglected the latter for the former. An atheistic physician, who she supposed had saved her life, was admitted to her closest intimacy, and exercises more influence with her than chancellors of state, or others of her ministers, and she squandered large sums of the public money on old manuscripts, books, and other articles of questionable value, and neglected the care of the finances of the kingdom to such an extent that they became so embarrassed that it was quite impossible to fully understand or arrange them; and when her old and trusty advisers ventured to remonstrate or even to make suggestions as to the importance of other courses of conduct, or to invite her attention to the most pressing affairs of state, they were treated with indifference and coolness.
After a few years of living with such changed habits of life and character she announced her determination to resign her crown to another person, leave her native land, and spend her remaining days in another country; and she actually persevered in this determination, notwithstanding the very urgent appeals and entreaties of her ministers and her people that she should abandon this intention and remain with them as their queen. Finally in an august assembly called for the purpose, after having made an eloquent and affecting speech to the States General, reviewing what she had been able to accomplish for the kingdom by her exertions, she removed the crown from her head with her own hands and publicly resigned it to another, having stipulated in negotiations which extended over many months, that she should receive a yearly income of $240,000 from the crown lands, and be permitted to live in whatever European country she might choose. Shortly afterward she gathered together her possessions, arranged her household, and suddenly left for Italy. As soon as she had passed the frontiers and was finally free from those restraints with which she had been surrounded while queen, she adopted what might be termed a free and easy mode of life; she became hilarious, profane and coarse in language, undignified, donned male attire, and otherwise manifested feelings and conduct quite at variance with her former position in life. She had been educated in the Protestant faith — her father had died while warring in its support — yet when she arrived in a city, the great majority of whose inhabitants were of the Catholic faith, she at once openly renounced the faith of her ancestry, and adopted that of the Catholic Church. The manner in which this was done, however, and her conversation in reference to it, all indicated that this step was taken as a matter of policy, and that in her own words, she regarded it in the light of a kind of "farce". She not only renounced the faith of her fathers, but became at times negligent in dress and personal appearance, and so continued, notwithstanding she was received with public demonstrations and with attentions of the highest respect by the authorities and people of the different countries through which she passed. The Pope himself welcomed her to Rome, and offered her every facility of becoming acquainted with the distinguished and learned men of Italy, and even granted her a pension; and yet within a short time she openly quarreled with him, and defied him to enforce obedience to his requisitions. In the course of a few months, however, she began to tire of this kind of society and routine of life, became ill, and passed through a severe and protracted physical illness. After recovering she visited Paris, and while there received attentions from some of the most distinguished men and women of the country; she conversed with great fluency and ease upon all subjects pertaining to the government and politics of not only her own country, but those of every other country of Europe, about science, art and the languages, and yet on occasion she did not hesitate to use profane, and even vulgar language, became at times irascible, and on one occasion while in France ordered the steward of her household to be put to death, because, as she said, he had betrayed some of her secrets. After some years, when the throne of Sweden became vacant by the death of her cousin, she at once repaired to Stockholm, and used every effort to induce her former subjects to again install her as queen.
On another occasion, when the throne of Poland was vacant, she entered upon the project of being elected to occupy it, and exerted all the energies of her genius in her endeavor to secure this great boon, which was less than a like one which she had wilfully cast aside a few years before. She employed the most talented ministers to work for her, and drew up full instructions and letters for their guidance. She lavished large sums of money and indulged in dreams of power and future conquest, when she should be once again on a throne and in control of an army; but all her hopes and expectations ended as they began, in dreams only. She again returned to Rome, and for years lived a highly sensual mode of life, and occupied herself with petty intrigues and quarrels, at times with the Pope, at others with persons of less consequence, and finally wrote a short time before death, as follows: "I resign myself to live on with as much pleasure as I can. Death, which I see approaching step by step[,] does not alarm me; I await it without a wish and without a fear."
Query: What would such a course of life and conduct indicate as to sanity or insanity?
In answer to this question we have first to observe that there certainly occurred a great and in some respects a radical change in the character of Christina; and further, that change of character, as indicated in habits, quality of thought, taste, pursuits, feelings, and will, is generally regarded as one of the most important tests of insanity. But all such changes do not indicate such a lesion of the mind as to render the subject irresponsible.
It may be noted, first, that there are some persons who are so constituted by nature that they always look upon, and judge of events which relate to themselves and others in an unusual manner. They are registered in the community as singular, and are accustomed to do things in an odd and out-of-the-way manner, as naturally as other persons would do them in such a manner as to attract no attention. They are generally unconscious of being different from others, or if conscious, more directly on in their own pathway sublimely indifferent. Having determined upon their course, the opinions, or entreaties even of others, have no influence in changing them. Such persons often triumph over obstacles which would abash and overcome others of more sensitive nerves, and if disastrous issues appear they seem never to be aware of them. When certain mental and moral characteristics are united with nervous systems run in such moulds, and of such tough fibre, they often develop into heroes, conquerors, reformers, and if need be, the leaders of revolutions, and in other cases into cranks.
Again; there occur in many persons revolutions of character, as evinced in tastes, feelings, and general conduct. This is true during the great epochs of life, and especially so from seventeen to twenty-four years of age, and while the brain is passing into its more permanent character of activity. There is doubtless a grain, and probably many grains of truth in the old adage, "train up a child in the way he should go, and when he is old he will not depart from it." I am confident, however, that many a parent and guardian has longed to know something more definite as to what is meant by the way in which the child should go. Some children will grow up into grand characters of men and women, whether they have had a training up, or a training down, or have been left with no training at all. There are others who will go to the bad notwithstanding, and in spite of, apparently, the most careful and judicious training. There are others still, who may go on well, or ill, for years and then turn in the other direction, and eventuate in what was least expected of them before they were twenty years of age. It is doubtless within the memory of every one present that young men who have exhibited the most unpromising mental and moral characteristics and of whose future every neighbor's tongue has wagged an ominous prophecy, have nevertheless at some period before twenty-five years of age turned a corner, or a new leaf in their calendar, and have finally eventuated in very respectable characters. The opposite is equally true. Many persons who have given large promise up to twenty years of age, have in the face of every inducement to the contrary, thrown away the brightest prospects and hopes of life, given the lie to all their early antecedents and become bankrupt in character, moral and intellectual. I have no doubt that in these changes of character in whichever direction they are pursued there actually occurs in some measure a change in the physical tendencies of the brain. The change is not all mental, nor is the physical change the cause of the mental in all cases, but rather the change proceeds, pari passu in both, and more often, especially when the character becomes altered for the better, the physical results from the mental.
But once more, there are changes in the character of mental activities resulting from conditions of the brain which may be termed functional, anæmic or neurasthenic. There are periods during which persons so affected, hear, touch, taste and smell with much greater delicacy than at other times; harsh and discordant sounds are more harsh and discordant; certain articles of food produce a keener sense of relish, and colors a greater sense of pleasure. The same is true even to a larger extent of the emotional nature; persons are delighted at times with objects which would afford no pleasure at other times; they may be displeased and pained in consequence of conduct and occurrences, which, when its health would produce no such effects. At times they regard the world and its possessions and pleasures so great that they cannot endure the thought of leaving them, and in a short time perhaps, in consequence of the occurrences of some trivial matter, all is changed in the mental horizon, and these pleasures and possessions seem utterly valueless, and the thought of leaving them seems almost pleasureable. At other times they are irritable, restless and easily excited; unimportant incidents, which in other conditions of the nervous system they would think little or nothing of, turn them into a passion of excitement which can with difficulty be controlled for the time being; sudden impulses at times come over them and they are tempted to throw themselves into the water, or the fire, or to push others in. At times the most powerful instincts of the system, such as the love of offspring and near relatives, which in a healthy condition of the nervous system lead to a readiness to suffer and even, if need be, to die for them, seem to fade away and opposite ones of dislike and hatred, take their place, eventuating in diverse emotions and conduct. Similar changes occur in the whole range of mental endowment when the brain is in certain abnormal conditions, and there can be no doubt that they come because of such abnormal conditions. They may possibly be reproduced by those alterations which are constantly taking place in the blood from the process of reception and elimination, or from those delicate chemical operations which must be forever going on in the nerve elements of the hemispheres of the brain, affecting their receptive and sensitive capacities, or from some other cause of an imperfect functioning of the brain. Here then, we have a disordered nervous system, and in consequence, a changed quality of mental and physical activity, both of which conditions not unfrequently continue for months, and both of which are beyond the control of the will, which itself may be impaired, and yet we do not classify such cases as those of insanity. The disorder of mentality has not proceeded so far as to cloud the vision of consciousness as to its character or to destroy the capacity of appreciating the change which has occurred in sensation and mental activities, and reasoning about it correctly, and at least, a limited self control. The morbid state has not yet extended into the centre of the intellect. The mental state indicated stands in relation to that of insanity, as the condition of congestion does to that of inflammation; that is, in a readiness to pass over into it. These changes of character are in the line of actual insanity and if they were to proceed far enough and become profound enough would, in like manner as congestion passes into inflammation, actually become evidences of it. If, for instance, the will power should become so far paralyzed that the emotional system should rise above it and control the systematic activity of the individual; or if those states of the nervous system which render persons irascible, unreasonable, excited or depressed, should become fixed; if the love of offspring should become continuous hatred, and beyond the power of the will to modify, such changes in the thought process would doubtless indicate insanity.
I am, however, inclined to the view that the great changes which occurred in the Queen's conduct and subsequent character should be classed under some one, or perhaps all three of those above enumerated, and that they did not pass over into the realm of actual insanity. Her history would indicate that her conduct was largely within her power of control and the outcome of conscious intelligent purpose.
From a studious and overworked person, she became indifferent, careless, and turned her mind into other channels of thought and purpose. From the severe and the hard theology of her father, under the facile and insidious influences and teachings of an atheistic friend, she turned to the freer and easier way of no belief at all. From the long and severe restraints of a monarchical court formality and etiquette, her tired soul turned with longing for freedom, as the eagle, released from the cage, turns once more to sweep the azure sky. The bound from Sweden and a throne, to Italy without a throne, was a long one, but it left her free, and her spirit had long chafed under the restrictions with which she was surrounded, and languished for more genial skies, a larger freedom of conduct, and a more luxurious ease. "Gracious heaven", she cried, or might have cried, in the later words of Sterne, "grant me but health, thou great bestower of it, and give me the fair Goddess of Liberty as my companion, and shower down thy mitres, if it seems good under thy Divine Providence, upon those heads which are aching for them." The use of profane language was not of much significance if we remember that her companionship had been mostly of men, and that her faith in all religion had been undermined and lost. The adoption of male attire by one who had been educated as a boy and accustomed to wear when it engaged in hunting expeditions indicated vastly less than it would have done in a lady of like position to-day, specially when it is borne in mind that this was resorted to only while traveling which was generally done on horseback. The causing of her steward's death would have signified more if she had not regarded herself as still a sovereign of her own household, and with full power to rule and punish all offenders even with death. Her coarse manners and language, and her preference for the society of men would have signified a larger change in her mental character if she had not been educated as a man and become immoral. She cared very little what the world might say, but she cared very greatly that it should say something. The more strange and outrageous she could appear, the more pleased she was that all Europe should be astonished. "Having found that a drama brought satiety in a single night she determined to enact one that would be marveled at not only in her own day but for all time." The efforts that she afterwards made to recover her throne, or to secure that of Poland, were indications of a return to the old paths of thought and purpose, and her queenly impulses so long in abeyance were struggling once more to assert themselves. A reaction had occurred in her mental inclinations. This could have been prophesied in her case. How many a student after months or years of mental effort has longed to throw his books into the river or the fire, and declared that he never wished to see them again. Many an overworked business man or physician, in whose brain channel, thoughts of only a limited range of character have been coursing for years, has longed for a rest or a change; many a tired and exhausted housekeeper has prayed for mansions where the endless weariness of detail and incompetent servants would be no more. And yet in these cases, the student, the business man and the housekeeper has prayed for mansions where the endless weariness of detail and incompetent servants would be no more. And yet in these cases, the student, the business man and the housekeeper see things in an altogether different light after a run to Europe or California, or even to the seaside for a few weeks — a change, rest and recuperation for the worn nerves and brain. A permanent realization of those conditions that they have so longed for would be the last to be desired, and they would strive to return to their homes, studies and labors, as earnestly as Christina did to return to her throne.
But there are other elements which enter into an explanation of this change in the character of Christina, and it becomes necessary to go back and study a little more in detail some of the history of her early life. She was the daughter of Gustavus Adolphus, King of Sweden, a great warrior, a man of inflexible will, great courage, and the most renowned general in Europe. He was also a very religious person — a firm Protestant, who spent his life and died in battling for his faith. Her mother, the daughter of Elector John Sigismund, is said to have been a beautiful lady with fair complexion, a handsome face and figure, graceful, kindhearted, and affectionate even to weakness; she was also a person of shallow mind, deficient judgment, and delighted in petty court intrigues, and getting the better of others by dissimulation and deceit. In short, she had a high appreciation for those qualities of character and kinds of conduct, which were regarded with little favor by her husband or her subjects. It will be observed that two persons with more diverse character could hardly have been united as husband and wife, and it was a most grievous disappointment to these most diverse parents, as it has been to many since, that their first child was a daughter. She however early asserted herself and soon won her way into the tender affection of her large hearted father. On one occasion when she became ill, he rode night and day, passing several hundred miles until he reached home, and on the occasion of her recovery had the event celebrated by a grand national festival. After this she frequently accompanied her father on journeys to the distant parts of his kingdom and shared the hardships incidental to such travel with cheerfulness and heroism. This led him to conceive the project of having her educated as a boy, and she was instructed in such exercises and feats of horsemanship as the young of the other sex were accustomed to follow; when a mere child she went into the forests with the huntsmen to follow game, and became an excellent marksman. When [she was] six years of age her father died, and the future Queen was consigned to the care of her weak-minded mother and an aunt, who at times indulged her every wish and at others punished her for the most trivial faults. They filled her court with fools, jesters and persons of most ordinary minds, with whom they expected the child to consort more or less. Before ten years of age, however, Christina became disgusted with such frivolities as she daily saw about her, and insisted upon being permitted to devote herself to studies and books. This she did with great assiduity[,] spending as many as twelve hours a day in the study of the languages and the mathematics. After this she was placed under the tuition of five learned professors whose duty it was to conduct her education, and so far as appears from history she had very little to do at any time with persons of her own sex. It is said that she early conceived a strong dislike for them and avoided female society altogether. Her proficiency as a student was such that before sixteen years of age she could read fluently in no less than six different languages — delighting especially in Thucydides and also in Latin authors. When seven years of age she could conduct herself with utmost propriety at court and converse intelligently with learned scholars. At sixteen she had discovered such maturity of intellect and judgment that the regency urged her to assume the full duties pertaining to the sovereignty. When eighteen she could harangue her Senate — issue commands to her ministers — direct the affairs of state — was as self-willed, presumptuous, domineering and arrogant as kings and queens usually were. She was impatient of suggestions when they ran counter to her desire or caprice — would brook control from no one and devoted her entire energies to administering the affairs of her kingdom and in acquiring a knowledge of the diplomatic relations it sustained to other governments.
Here then we have two facts of transcendent importance towards enabling us to form a just conception of the great change in the Queen's character. First, her heredity; and second, her education. According to the laws of heredity, the off-spring inherits traits of character existing in both parents, these traits shading and blending into each other, thus form a third, which differs from each of the others. There exists, however, no known rule or law, which regulates the degree or intensity of hereditary influence, and it appears in very diverse ways and degrees in different cases. In some persons it is easy to recognize distinct and well marked traits of physical constitution and personal character which have been known to exist in one or other parent, or in both, and these characteristics have continued side by side, so to speak, during life. In other cases what is termed the law of atavism exercises a special influence, and the peculiarities of grand-parents make their appearance after one or more generations. In other cases still the physical and mental tendencies of one parent hold sway and largely dominate the course of the individual during childhood and youth, and those of the other parent during a later period. This is perhaps more often the case when, as in the present instance, the parents were eminently unlike in their mental make-up. Indeed this is very much what actually occurred in the case of Christina. During her child and adolescent life, she displayed largely those characteristics of mind which made her father so marked a man. She delighted in the sound of cannon, in the exposures and fatigues of campaigns, and in the pomp and circumstance that attends the conduct of great armies and affairs of state. She delighted in the converse of heroes and ministers, and in moving the lever which moved the subjects of her country to its farthest bounds. When in the counsel chamber of the regency an inspiration lifted her to a level with its wisest members and enabled her to speak and act with a breadth of intelligence and capacity which surprised them all. She displayed a mental grasp and firmness united with an ability to forecast the future, and what it might bring of good to her country, which easily placed her above all her subjects and won their admiration and devotion.
Now at certain periods of life there occur physiological changes in the system which are not unfrequently attended by marked alterations of physical health and the fuller development of mental tendencies. One of the most important of these epochs lies within the decade from seventeen to twenty-seven years of age. The period of adolescence is now past and the individual comes into the maturity of physical growth and strength. With the consummation of this physical growth it is not uncommon to have a change in mental tendencies and characters. The hereditary influence which comes from the other parent or ancestor, and which has apparently lain dormant during these early years of life, appears to gradually come into forceful activity and assert its presence. This is what occurred to some extent in the case of the Queen; and from the age of twenty-one or twenty-two forward, she exhibited in a marked degree some of the traits of character which had been so conspicuous in her mother. She became capricious, changeful and frivolous, fond of petty intrigues and alliances with court favorites, upon whom she bestowed princely sums and precious stones. She delighted in such pursuits and tastes as much more resembled those of her mother than those of her father. It does not appear that she altogether lost those opposite traits of character which had formerly existed, but that they were in partial abeyance, and overshadowed by those inherited from her mother, and which did not assert themselves until that period of life to which I have referred. I am, therefore, inclined to think that hereditary influences should be taken largely into account in attempting an explanation of the change in the Queen's character.
But this is not sufficient to account for all. No one influence ever is. Every human being is vastly changed and molded by his or her environment for good or bad. While there may be now and then one who may be able in consequence of a grand inheritance from a long line of superior ancestors, or from some iron-headed-old-grandfather, or large-hearted grandmother, to rise above and triumph over the hard circumstances of ignorance and poverty, yet the ói polloi never do. They bend and go down like the rootless tree before the blast, and generally remain down. Education then, and by this I mean all those influences which are brought to bear upon an individual more especially in the early formative period of life, must come in for our share of attention in the study of this subject.
From infancy the Queen was taught to believe herself the most important child, if not individual, in Sweden. From the time she could understand, she was instructed to regard herself as the sovereign of a great nation, and every event of her child-life pointed toward the time when this should be consummated. Her fancies were indulged, and her mind roamed abroad into whatsoever pastures of knowledge she might choose. She was largely separated from her own sex, or rather she separated herself from it. Because she displayed mental ability of an uncommon order, she was allowed to do as she pleased, and indulged in such studies and pursuits as she chose for herself, and while they might have been eminently good for her tough old regents and conditions of state, they were certainly eminently unfit for a little girl who had not yet come into her teens. All those elements of character, which so adorn and beautify women in all ages and conditions, were left to slumber and rust unquestioned, and uncared for, as if there were none such. Alone she stumbled on almost in darkness as to one great side of her nature, and yet in the full blaze and splendor of a court.
The impulses of her brilliant intellect were ever impelling her on in the paths of such knowledge as old men might properly feed on, while the wealth, which was buried in her child-heart, was permitted to remain shriveled and shrouded. No angel of light appeared to lead her into the green pastures of affection and beside the still waters where children most love to dwell. On the contrary[,] the pomp and the majesty of state and court were ever in heart and thought; toward these she looked, and for these she aspired to fit herself with all the ardor of an inspiration. We read of no child-life, no companions who loved her or whom she loved. All the bounteous wealth which comes to childhood in love and laughter, in play and sport, in favoring and being favored, never found its way to her heart. From the death of her father she was regarded and treated as if the throne was in sight, and the crown was ready to drop upon her brow. The story told in these few sad words, "she studied twelve hours a day before she was ten years of age", is extremely pathetic in the light of to-day. How unwise the admiration that was poured upon her successes and great achievements, which served only to stimulate her to still greater efforts in the same weary way.
After she had assumed the full duties pertaining to her throne, and had succeeded in bringing peace to her distracted country and to impoverished Europe, she became hopelessly tangled and crippled in her endeavors to restore prosperity. During long months she labored by day and night to solve the difficult problem which had baffled the great abilities of Oxenstiern and the other members of the Council. No form of mental application more thoroughly tests the strength and staying qualities of brain tissue than that pertaining to such a subject. Failing to accomplish her task, and perceiving no brighter future, she determined to abandon the position and duties which had become so painfully unwelcome to her. There certainly need be little surprise that in after years she became one-sided, cross-grained, peculiar, half-ill, and despoiled of much that might have made her so potent in the affairs of life.
While then, Christina, in one of the most interesting periods of her life, in consequence of unfortunate inheritances, ill-health, and an environment which ever lured her on to shipwreck of life's largest promise, appears to me at this distance, to have moved on to the very borderland of insanity, yet she did not actually pass over it, and become irresponsible. The ability to fully understand and appreciate the character of her conduct in its relation to herself and others, and so to modify it as to suit an intelligent purpose was never lost. And this conclusion in her case becomes confirmed by a survey of the later years of her life. She lived in all about twenty years [sic] in Rome, and though she quarreled with the Pope, and defied his authority, and had her favourites, yet she was occupied very largely in the culture of literature, and was constantly in correspondence with the most learned men of the age[,] among whom were Leibnitz and Descartes. While she had been frivolous and dissolute, yet she maintained her intellect and her courage to the last. She made large collections of rare books and works of art, and founded the A[r]cadian Academy. Nine hundred of her most precious manuscripts are in the Vatican, and her most costly paintings are scattered throughout the galleries of Europe, some of the finest having been purchased by the Regent of France. She died at the age of sixty-three, and bequeathed her large fortune to Cardinal Azzolina [sic]. Her own writings were voluminous, and after her death were published in four volumes. Strangely, and we may say, delightfully at variance with the stormy extravagance of her life, she desired that there should be only the simple inscription: "Vixit Christina annos sexaginta tres" on her monument. She was buried in the church of St. Peter, and her biographer says "exhibited a soul ardent and untamed by years of striving in all things after the extreme and the Supreme, but submitting at last."
Above: Kristina.
Above: Dr. Henry Putnam Stearns.
Notes: "Read at the forty-third annual meeting of the Association of Medical Superintendents of American Institutions for the Insane, held at Newport, R. I., June 18-20, 1889."
Kristina died at age 62, not 63. It seems that even as late as at the 17th century, at least when writing in Latin, that some people used the ancient Roman age reckoning system that one was already one year old at birth, similar to traditional Chinese age reckoning both in the past and still today.
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