small Indian pig) from terrestrial electricity, and as a result they
were found to be retarded in growth and to develop very imperfectly,
much as though they had been suffering from rickets. In short, they
manifested an arrest of organic development.
If, in electro-therapy, an electric current is applied to the
cartilages of the long bones in children whose limbs have apparently
been arrested in development, the result is a rapid increase in length,
amounting to a luxuriant _osteogenesis_.
Since we know that the electric current can stimulate the nerve
filaments and the fibres of the striped muscles when they have been
rendered inactive from the effects of paresis or even of paralysis,
we realise that _electricity_ can exert an influence over the entire
physiological life of an organism. We live not only upon nutriment,
air, heat, and light, but also upon a mysterious, imperceptible force,
that comes to us from the mother earth.
In addition to the biological potentialities which control the
development of every individual, all living creatures owe something of
themselves to their environment.
_Space._--An empirical contention, without scientific value,
but nevertheless of some interest, is that there is an ultimate
_relationship_ between the dimensions of living bodies and the
_territorial space_, that is, the environment in which they are
destined to live. In view of the innumerable varieties of living
creatures, such an assertion would seem to be utterly unfounded. But
as a matter of fact we see that while inorganic bodies can increase
indefinitely in dimension, living creatures are limited in form
and size. This fact undoubtedly has some primal connection with
properties innate in corporeal life itself; in fact, in order to
attain its appointed end, life requires the services of certain very
small microscopic particles called _cells_. But the aggregations and
combinations of cells in living organisms are also limited in their
turn, and no matter how willingly we would attribute the greatest share
of causation to biological facts, nevertheless, as always happens in
life, we cannot wholly exclude _environment_.
Both animals and men that are bred on vast continents (Chinese,
Russians) have tended to produce races of powerful and giant build: in
islands, on the contrary, the men and the animals are of small size;
it is sufficient merely to cite the men and the little donkeys of
Sardinia, the small Irishmen who furnish jockeys for the race-track,
and the small Irish horses or _ponies_ that serve as saddle-horses for
the children of the aristocracy the world over.
There is a harmony of associations, as between the container and the
contained, between environment and life, notwithstanding that as yet
science has not made serious investigations in regard to it.
Voltaire, in his _Micromega_, avails himself of this intuitive
conception to create the material needed for his satire; he talks
amusingly of the inhabitant of the planet Sirius, who was eight leagues
in height and at four hundred years of age was still in school, while
the inhabitant of Saturn was a mere pigmy in comparison, being scarcely
a thousand rods tall--in fact, the inhabitants of Saturn could not
be otherwise than pigmies in comparison, since Saturn is barely nine
hundred times larger than the earth.
Gulliver makes use of similar standards in his _Travels_, which are
read with so much delight by children.
=Psychic Conditions.=--_Psychic Stimuli._--Accordingly many chemical
and physical factors associated with the environment concur in aiding
_life_ in its development. From the light of the sun to the electricity
of the earth, the whole environment offers its tribute to life, in
order to cooperate in life's triumph. But, in the case of man, in
addition to these widely different factors, there is still another
distinctly human factor that we must take into consideration and that
we may call the _psychic stimulus of life_: We may scientifically
affirm the Bible statement that "man does not live by bread alone."
Without reverting to the basic physiological explanations of the
emotions, as given by Lange and James, we may nevertheless assert that
sensations of pleasure stimulate the renewal of bodily tissues and
consequently promote health, happiness, and strength; while, on the
contrary, painful events produce physiological effects depressing to
the tone of the nervous system and to the metabolic activity of the
tissues.
But it is precisely these metabolic phenomena that hold the key of
life, and an organism in the course of evolution depends directly upon
them. This problem concerns pedagogy in a very special way: when
we have given food to the children in our schools, we have not yet
completed our task of _nourishing_ these children; for the phenomena of
nutrition which take place in the hidden recesses of their tissues are
very different from a simple intestinal transformation of aliments, and
are influenced by the psychic conditions of the individual pupil.
Great workers not only need abundant nutriment, but they require at
the same time a series of stimuli designed to produce "pleasure." The
pleasures of life, necessary to human existence, include more than
_bread_. In the history of social evolution there exist, side by side
with the _productions of labour_, an entire series of _enjoyments_,
more or less elevated, that constitute the _stimului_ to production,
and hence to evolution, and more profoundly still, to life itself.
The further man evolves and the more he produces, the more he ought to
multiply and perfect his means of _enjoyment_.
Without stimuli, nutrition would grow less and less till it ended in
death. Every-day experience in the punishment of criminals gives us
proof of this. Confinement to a solitary cell is nothing else than a
complete deprivation of psychic stimuli. The prisoner does not lack
_bread_, nor air, nor shelter from the elements, nor sleep; his whole
physiological life is provided for, in the strict material sense of the
word. But the bare walls, the silence, the isolation from his fellow
men in utter solitude, deprive the prisoner of every stimulus, visual,
oral and moral.
The consequences are not merely a state of hopelessness, but a real
and actual _malnutrition_ leading to tuberculosis, to anemia, to death
from atrophy. We may affirm that such a prisoner _dies_ _slowly of
hunger due to defective assimilation_; the solitary cell is the modern
donjon, and far more cruel than the one in which Ugolino died within a
few days, so much so that solitary confinement, being incompatible with
life, is only of short duration.
Labour, love, and sensations apt to stimulate ideas, that is, to
nourish the intelligence, are necessities of human life.
This is further proved by observations made regarding the development
of puberty. Psychic stimuli may render such development precocious,
and, on the contrary, their absence may retard it. Jean Jacques
Rousseau relates in _Emile_ that at Friuli he encountered young people
of both sexes who were still undeveloped, although they were past
the usual age and were strong and robust, and this he attributed
to the fact that "owing to the simplicity of their customs, their
imagination remained calm and tranquil for a longer time, causing the
ferment in their blood to occur later, and consequently rendering their
temperament less precocious."[27]
Recent statistical research confirms the intuitive observation of that
great pedagogist; the women in the environs of Paris attain puberty
nearly a year later than those who live in the city; and the same
difference is observed between the country districts around Turin and
those of the city itself.
All this goes to prove the fact of psychic influence upon physiological
life: psychic excitation, experienced with _pleasure_, by developing
healthy activities, aids the development of physical life.[28]
These principles must be taken under deep consideration when it comes
to a question of directing the _physiological growth_ of children.
Fenelon relates a fable about a female bear who, having brought into
the world an exceedingly ugly son, took the advice of a crow and licked
and smoothed her cub so constantly that he finally became attractive
and good-looking. This fable embodies the idea that _maternal love_ may
modify the _body of the child_, aiding its evolution toward a harmony
of form by means of the first psychic stimuli of caresses and counsel.
Nature has implanted in the mother not only her milk, the material
nourishment of her child, but also that absolutely altruistic love
which transforms the soul of a woman, and creates in it moral forces
hitherto unknown and unsuspected by the woman herself--just as the
sweet and nourishing corpuscles of the milk were unknown to the red
corpuscles of her blood. Accordingly, the nature of the human kind
protects the _species_ through the mother in two ways, which together
form the complete nutrition of man: aliment and love. After a child
is weaned, it obtains its aliment from its environment in more varied
forms; and it also obtains from its environment a great variety of
psychic stimuli, calculated not only to mould its psychic personality,
but also to bring its physiological personality to its full development.
I have had most eloquent experience of this in the "Children's
Houses" in the San Lorenzo quarter of Rome. This is the poorest
quarter in the city, and the children are the sons and daughters of
day labourers, who consequently are often out of work; illiteracy
is even yet incredibly frequent among the adults, so much so that
in a very high percentage of cases at least one of the parents is
unable to read. In these "Children's Houses" we receive little
children between the ages of three and seven, on a time schedule
that varies between summer, from nine to five, and winter, from
nine to four.
We have never served food in the school; the little ones, all of
whom live in their own homes, with their parents, have a half
hour's recess in which to go home to luncheon. Consequently we have
not _in any way influenced their diet_.
The pedagogic methods employed, however, are of such sort as to
constitute a gradual series of psychic stimuli perfectly adapted
to the needs of childhood; the environment stimulates each pupil
individually to his rightful psychic development according to his
subjective potentiality. The children are _free_ in all their
manifestations and are treated with much cordial affection.
I believe that this is the _first time_ that this extremely
interesting pedagogic experiment has ever been made: namely, to
_sow the seed_ in the consciousness of the child, leaving free
opportunity, in the most rigorous sense, for the spontaneous
expansion of its personality, in an environment that is _calm_, and
warm with a sentiment of affection and peace.
The results achieved were _surprising_: we were obliged to remodel
our ideas regarding child psychology, because many of the so-called
instincts of childhood did not develop at all, while in place of
them unforeseen sentiments and intellectual passions made their
appearance in the primordial consciousness of these children; true
_revelations_ of the sublime greatness of the human soul! The
intellectual activity of these little children was like a spring
of water gushing from beneath the rocks that had been erroneously
piled upon their budding souls; we saw them accomplishing the
incredible feat of despising _playthings_, through their insatiable
thirst for knowledge; carefully preserving the most fragile objects
of the lesson, the tenderest plants sprouting from the earth--these
children that are reputed to be vandals by instinct! In short, they
seemed to us to represent the childhood of a human race more highly
evolved than our own; and yet they are really the same humanity,
marvelously guided and stimulated through its own natural and free
development!
But what is still more marvelous is the astonishing fact that all
these children are so much improved in their general _nutrition_ as
to present a notably different appearance from their former state,
and from the condition in which their brothers still remain. Many
weakly ones have been organically strengthened; a great many who
were lymphatic have been cured; and in general the children have
gained flesh and become ruddy to such an extent that they look
like the children of wealthy parents living in the country. No one
seeing them would believe that these were the offspring of the
illiterate lower classes!
Well, let us glance over the notes taken upon these children at the
time when they first entered the school; for the great majority,
the same note was made: need of tonics. Yet not one of them took
medicine, not one of them had a change of diet; the renewed vigour
of these children was due solely to the _complete satisfaction_
_of their psychic life_. And yet they remain in school continually
from nine till five through eleven months out of the year! One
would say that this was an excessively long schedule; yet what
is still more surprising is that during all this period the
children are continually _busy_; and even more remarkable is the
report made by many of the mothers to the effect that after their
little ones have returned home they continue to busy themselves
up to the hour of going to bed; and lastly--and this seems almost
incredible--many of the little ones are back again at school by
half past eight in the morning, tranquil, smiling, as though
blissfully anticipating the enjoyment that awaits them during the
long day! We have seen small boys become profoundly observant of
their environment, finding a spontaneous delight in new sensations.
Their stature, which we measure month by month, shows how vigorous
the physiological growth is in every one of them, but particularly
in certain ones, whose blood-supply has become excellent.
Such results of our experiments have amazed us as an unexpected
_revelation_ of nature, or, to phrase it differently, as a
_scientific discovery_. Yet we might have foreseen some part of all
this had we stopped to think how our own physical health depends
far more upon happiness and a peaceful conscience than upon that
material substance, bread!
Let us learn to know _man_, sublime in his true reality! let us
learn to know him in the tenderest little child; we have shown
by experiment that he develops _through work, through liberty,
and through love_; hitherto, in place of these, we have stifled
the splendid possibilities of his nature with irrational toys,
with the slavery of discipline, with contempt for his spontaneous
manifestations. Man lives for the purpose of learning, loving and
producing, from his earliest years upward; it is from this that
even his bones get their growth and from this that his blood draws
its vitality!
Now, all such factors of physiological development are _suffocated_
by our antiquated pedagogic methods. We prevent, more or less
completely, the development of the separate personalities, in
order to keep all the pupils within the selfsame limits. The
perfectionment of each is impeded by the common level which it is
expected that all shall attain and make their limit, while the
pupils are forced to _receive_ from us, instead of producing of
their own accord; and they are obliged to sit motionless with their
minds in bondage to an iron programme, as their bodies are to the
iron benches.
We wish to look upon them as machines, to be driven and guided by
us, when in reality they are the most sensitive and the most superb
creation of nature.
We destroy divine forces by slavery. Rewards and punishments
furnish us with the needed scourge to enforce submission from these
marvelously active minds; we encourage them with rewards! to what
end? to winning the prize! Well, by doing so we make the child
lose sight of his real goal, which is knowledge, liberty and work,
in order to dazzle him with a prize which, considered morally,
is vanity, and considered materially is a few grains of metal.
We inflict punishments in order to conquer nature, which is in
rebellion, not against what is good and beautiful, not against the
purpose of life, but against us, because we are tyrants instead of
guides.
If only we did not also punish sickness, misfortune and poverty!
We are breakers-in of free human beings, not educators of men.
Our faith in rewards and punishments as _a necessary means_ to the
progress of the children and to the maintenance of discipline, is
a fallacy already exploded by experiment. It is not the material
and vain reward, bestowed upon a few individual children, that
constitutes the psychic stimulus which spurs on the multifold
expansions of human life to greater heights; rewards degrade the
grandeur of human consciousness into vanity and confine it within
the limits of egotism, which means perdition. The stimulus worthy
of man is the joy which he feels in the consciousness of his own
growth; and he grows only through the conquest of his own spirit
and the spread of universal brotherhood. It is not true that the
child is incapable of feeling a spiritual stimulus far greater
than the wretched prize that gives him an egotistical and illusory
superiority over his companions; it is rather that we ourselves,
because already degraded by egotism, judge these new forces of
nascent human life after our own low standards.
The small boys and girls in our "Children's Houses" are of their
own accord distrustful of rewards; they despise the little medals,
intended to be pinned upon the breast as marks of distinction, and
instead they actively search for objects of study through which,
without any guidance from the teacher, they may model and judge and
correct themselves, and thus work toward perfection.
As to punishments, they are depressing in effect, and they are
inflicted upon children who are already depressed!
Even in the case of those who are adult and strong, we know that it
is necessary to encourage those who have fallen, to aid the weak,
to comfort those who are discouraged. And if this method serves for
the strong, how much more necessary it is for lives in the course
of evolution!
This is a great reform which the world awaits at our hands: we must
shatter the iron chains with which we have kept the intelligence of
the new generations in bondage![29]
=Pathological Variations.=--Among the factors that may have a notable
influence upon the stature are the pathological causes. Aside from
those very rare occurrences that produce gigantism, it may be affirmed
that pathological variations result in general in an arrest of
development. In such a case it may follow that an individual of a given
age will show the various characteristics of an individual of a younger
age; that is, he will seem younger or more childish.
In such a case the stature has remained on a _lower_ level than that
which is normal for the given age; and this in general is the most
obvious characteristic, because it is the index of the whole inclusive
arrest of the physical personality. But together with the diminution of
stature, various other characteristics may exist that also suggest a
younger age; that is, the entire personality has been arrested in its
development.
It follows, in school for example, that such pathological cases may
_escape_ the master's attention; he sees among his scholars a type that
is apparently not abnormal, because it does not deviate from the common
type, in fact is _quite like_ other children; but when we inquire into
its age, then the anomaly becomes evident, because the actual age of
this small child is greater than his apparent age.
A principle of this sort announced in these terms is perhaps too
schematic; but it will serve to establish a clear general rule that
will guide us in our separate observations of a great variety of
individual cases.
This form of arrested development was for the first time explained by
Lasegue, who introduced into the literature of medicine or rather into
nosographism, the comparative term of _infantilism_.
Infantilism has been extensively studied in Italy by Professor Sante
de Sanctis, who has written notable treatises upon it. I have taken
from his work _Gli Infantilismi_, the following table of _fundamental_
characteristics necessary to constitute the _infantile_ _type_.
1. Stature and physical development in general below that required by
the age of the patient.
2. Retarded development or incomplete development of the sexual organs
and of their functions.
3. Incomplete development of intelligence and character.
In order to recognise infantilism, it is necessary to know the
dimensions and morphology of the body in their relation to the various
ages, and to bear in mind that in young children sexual development
either has not begun or is still incomplete.
_Dimensions and Morphology of the Body at the Various Ages._--What
we have already learned regarding stature will give us one test
in our diagnosis of infantilism: the increase of stature and the
transformations of _type of stature_ concur in establishing the
dimensions and the morphology of the body (See Stature, Types of
Stature, Diagrams).
A sufferer from infantilism will have, for example at the age of
eleven, a stature of 113 centimetres and a statural index of 56, while
the average figures give:
-----------------------------
Age |Stature | Index
----------+---------+--------
7 years | 111 | 56
8 years | 117 | 55
9 years | 122 | 55
10 years | 128 | 54
11 years | 132 | 53
-----------------------------
Consequently, in such a case the eleven-year-old patient would have the
appearance of a child of seven, not only in stature but also in the
relative proportions of his body. (And if we examined him psychically,
we should probably find his speech was not yet perfected, that he
showed a tendency toward childish games, a mental level corresponding
to the age of seven or thereabouts; in school the child would be placed
in the first or second elementary grade.)
Accordingly the anthropological verdict of infantilism must not be
based upon limits of measurement alone, but also upon the _proportions_
of the body. Every age has its own morphology.
Now, such changes are found not only in the reciprocal relations
between the bust and the limbs, but also between the various parts
of the bust, as we shall see when we come to an analytical study of
the morphology of the head, the thorax and the abdomen; the detailed
anthropological examination of the individual patient will furnish us
with further accompanying symptoms helpful in establishing a diagnosis.
Further on we shall give a summarised table of the morphology of the
body from year to year (laws of growth); and of the most notable and
fundamental psychological characteristics of the different years of
childhood; so that a teacher may easily derive from it at a glance
a comprehensive picture that will aid in a diagnosis of the _age_,
and hence of the arrest of development, in subjects suffering from
infantilism.
Before entering upon the important question of pathogenesis in its
relation to infantilism, I will reproduce a few biographic notes of
_infantile types_, taken from various authorities:
Giulio B. was brought to the clinic because of his continued love for
toys, notwithstanding his age. At seventeen and a half he retained
the manners, the games and the language of a child of between ten
and twelve. In appearance, he gave the impression of being between
thirteen and fourteen, and was as well proportioned as a lad of that
age. His stature was 1.45 meters (at thirteen the average stature is
1.40 m. and at fourteen it is 1.48 m.; while at seventeen it ought to
be 1.67 m.) and his weight was 39 kilograms (at fourteen the weight
is 40 k. and at seventeen it is 57 k.). His appearance was lively,
intelligent, but on the whole childish. His genital organs were like
those of a boy of twelve (Fig. 30). The patient understood all that was
said to him, he could read, write and sing, but could not apply himself
to any serious occupation; he did not read the papers, but would
amuse himself by looking at pictures in illustrated books; he could
play draughts, but was equally pleased when playing with children's
toys. During his stay at the clinic he was several times punished for
childish pranks: he filled his neighbour's chamber vessel with stones,
and amused himself by making little paper boats and sailing them in the
urine, etc. He was employed as a page at an all-night cafe; his age
permitted him to perform this work forbidden to children, while his
appearance rendered him fitted for the task. When questioned discreetly
regarding his sexual functions, or rather his sexual incapacity, he
understood at once, and expressed in a childish way his deep regret,
because he had heard it said that "that was why they wouldn't let him
serve in the army."
Vittorio Ch. Is twenty-two years old and looks about eight or ten.
Stature 1.15 metres (average stature for the age of seven being 1.11
m.; for eight, 1.17 m.). Has no beard, nor any signs of virility;
genital organs like those of a child. His intelligence is alert, but
does not surpass that of a boy of ten. He speaks correctly, can read,
write and sing; plays draughts, but does not disdain children's toys,
and prefers looking at pictures in illustrated books to reading the
daily papers. After the death of the patient, it was found, as a result
of the autopsy, that the epiphyses of the long bones had not yet united
with the diaphyses, and that the bones of the skull were still as soft
as those of a child (Fig. 31).
Here is another case, taken from Moige:[30]
It is the case of a young working girl, presenting all the appearance
of a child of twelve or fourteen; she had not yet attained puberty,
although she was thirty years of age. No external sign gave evidence
that she was undergoing the sexual transition that should give her
womanhood. Her breasts were reduced to the mere nipple, as in infancy.
Her voice was weak. This woman was hysterical and subject to frequent
attacks of convulsions. Her mental condition remained infantile. She
was gentle, docile, timid and apprehensive; she was destitute of
coquetry or sense of shame.
[Illustration: FIG. 30.--Boy, seventeen and one-half years old.]
[Illustration: FIG. 31.--Young man, twenty-two years old.]
[Illustration: FIG. 32.--Idiotic cretin, age 20 years, stature 1.095 m.]
[Illustration: FIG. 33.--An example of myxedematous infantilism.]
[Illustration: FIG. 34.--A group of cretins in the valley of Aosta
(Piedmont). The alteration of the thyroid gland is of endemic origin.]
Renato L.,[31] age twenty-nine; stature 1.30 m. (average stature at the
age of ten, 1.28 m.; at eleven, 1.32 m.) weight, 32 kilograms (average
weight, age of twelve, 31 k.). It appears from his history that he
developed normally up to the age of nine, after which period an arrest
of development occurred, both physical and psychic. An arrest of the
genital organs dates back also to early childhood. His intelligence
is that of a backward child; he has never been able to read or write,
but can count up to 1000. He has never been able to learn a trade, but
shows some talent for drawing.
His criminal instincts seem to be especially developed. He spends
whole hours, turning over the leaves of popular illustrated novels,
and whenever he comes across a picture representing a homicide or an
assassination, he utters loud exclamations of delight. He has only one
passion, tobacco, and only one object of adoration, Ravachol. Very
violent, extremely irritable; when he is angry, he would kill someone,
if, as he says, "he had the strength for it." Although, as a rule, he
docilely obeys the orders given him, it is because he is "afraid of
being scolded." His ideal is to be able some time to obtain refuge in
the Hospice de Bicetre.
From De Sanctis's work, _Gli Infantilismi_, I obtain the following
data, that are very suggestive on the anthropological side, regarding a
case of infantilism observed by the professor in his asylum-school for
defective children, in Rome.
Vincenzo P., seven years of age. Father in good health and of good
character. Mother small, thin, weak, underfed; has had nine children,
of which five are living, all feeble. Vincenzo was born in due time,
birth regular; had five wet-nurses; cut his teeth at the normal
intervals; began to walk at the end of the second year and to speak
at the end of the first. According to his mother, all went well until
the fourth year. At this period, Vincenzo became very troublesome
and ceased to "grow taller." Later on he was sent to the communal
school, but the director of the school in the Via Ricasoli, seeing
how undersized and backward he was, sent him to the Asylum-School for
defective children.
In appearance the child is eurhythmic, excepting that the head appears
a little _too big_ in proportion to the rest of his body; but it is not
of the hydrocephalic type (an infantile characteristic). He is slightly
asymmetric, the postero-inferior portion of the right parietal bone
being more depressed than that of the left (infantile plagiocephaly).
---------------------------------------+------------------------------
Measurements | Age at which the
-------------------+-------------------+ measurements of
Of the child |Normal measurements| Vincenzo would
|at the age of seven| be normal
-------------------+-------------------+------------------------------
Stature, 0.870 m. | 1.10 m. |Three years, stature, 0.864 m.
Weight, 12.400 kg. | 20.16 kg. |Two years, weight, 12 kg.
Circumference of | 0.55 m. |Four years, circumference of
chest, 0.507 m. | | chest, 0.505 m.
Vital index, 59 | Vital index, 54 |Two years, vital index, 59.
-------------------+-------------------+------------------------------
The bust is _greatly developed_ in comparison with the lower limbs,
which are unquestionably short. (The sitting stature was not taken,
but this note, recorded from simple observation, reminds us of the
enormous difference between the indices of stature at the age of two or
three and at the age of seven: Index at two years=63; at three=62; at
seven=56.)
But although we lack the index of stature, we may make use of the vital
index, which is given by the proportion between the circumference of
the chest and the stature, and consequently gives us an index of the
morphology of the bust in its relation to the whole personality; thus
we find that the vital index corresponds in the present case to that of
a child of two, as is also true of the weight, so that we may deduce
that the index of stature was probably about 62-63.
He shows no impairment as to external sensations; on the other hand,
internal sensations, such as satiety, illness, etc., are blunted.
His power of attention seems sufficient, both at play and in school
and when questioned. Neither does his memory show anything abnormal.
Emotionally, he is below the normal level; he says that he is afraid
of thunder; occasionally he shows annoyance when disturbed; but it is
equally certain that he never becomes angry, never turns pale and
never blushes, as the result of any excitement. He is of an indifferent
disposition and is passive in manner; he is good natured, or rather, a
certain degree of apathy makes him appear so.
All things considered, his mental development may be described as
that of a three-year-old child; only that he differs from children of
that age in his lack of vivacity and in his complete development of
articulate speech (it should be noted, in regard to the diagnosis of
age made by so distinguished a psychologist as De Sanctis, that he
judged the child to have a psychic development corresponding to the age
of three years); while we, studying the general measurements of the
body, determined that they correspond to three different ages, namely,
two, three and four the average of which is precisely three; while the
stature, which is the index of development of the body as a whole,
corresponds almost exactly to that average of three years (0.870 m.,
0.864 m.).
_Pathogenesis of Infantilism._--At this point it might be asked: Why do
we grow? We hide the mechanism of growth under very vague expressions:
biological final causes, ontogenetic evolution, heredity. But, if we
stop to think, such expressions are not greatly different from those
which they have replaced: the divine purpose, creation.
In other words, a causal explanation is lacking. But positive science
refuses to lose itself in the search after final causes, in which case
it would become metaphysical philosophy. Nevertheless, it may pursue
its investigations into the genesis of phenomena, whenever the results
of experiments permit it to advance.
So it is in the case of growth; certain relatively recent discoveries
in physiology have made it possible to establish relations between
the development of the individual and the functions of certain little
glands of "internal secretion." Now, the discovery of these relations
is certainly not a causal explanation of the phenomenon of growth, but
only a profounder analysis of it.
Hitherto, we have considered the organism in regard to its chief
visceral functions: in speaking of macroscelia and of brachyscelia, we
considered the different _types_ in relation to the development of the
organs of vegetative life and the organs of external relations: the
central nervous system, the lungs, the heart, the digestive system. Our
next step is to enter upon the study of certain little organs, which
were still almost ignored by the anatomy and physiology of yesterday.
These organs are glands which, unlike other glands (the salivary
glands, the pancreas, the sudoriferous glands, etc.), are lacking in
an excretory duct, through which the juices prepared for an immediate
physiological purpose might be given forth; and in the absence of
such excretory tubes, their product must be distributed through the
lymphatic system, and hence imperceptibly conveyed throughout the whole
organism.
One of these glands, the one best known, is the _thyroid_; but there
are others, such, for example, as the _thymus_, situated beneath the
sternum, or breast-bone, and much reduced in size in the adult; the
_pineal gland_ or hypophysis cerebri, situated at the base of the
encephalon; the _suprarenal capsules_, little ear-shaped organs located
above the kidneys. Up to a short time ago, it was not known what the
functions of such glands were; some of them were regarded as atavistic
survivals, because they are more developed in the lower animals than
in man, and consequently were classed with the vermiform appendix
as relics of organs which had served their functions in a bygone
phylogenetic epoch and remain in man without any function, but on the
contrary represent a danger through the local diseases that they may
develop. The cerebral hypophysis was in ancient times regarded as the
_seat of the soul_.
These glands are very small; the largest is the thyroid, which weighs
between thirty and forty grams (1 to 1-3/5 oz.); the suprarenal glands
weigh four grams each (about 60 grains); the hypophysis hardly attains
the weight of one gram.
The importance of these glands began to be revealed when antiseptic
methods rendered surgery venturesome, and the attempt was made (in
1882) to remove the thyroid gland. After a few weeks the patient
operated on began to feel the effects of the absence of an organ
necessary to normal life: effects that may be summed up as, extreme
general debility; pains in the bones and in the head; an elastic
swelling of the entire skin; enfeebled heart action, and anemia; and
on the psychic side, loss of memory, taciturnity, melancholy. After
the lapse of some time the patient showed such further symptoms as the
shedding of the cuticle of the skin, whitening of the hair and _facies
cretinica_.
But when Sick undertook to operate upon the thyroid of a child of ten,
the deleterious effects of interrupting the above-mentioned function
of the gland manifested itself in an _arrest of_ _development_; at
the age of twenty-eight the patient operated on by Sick was a cretin
(idiotic dwarf) 1.27 metres tall (average stature at age of ten=1.28
m.). Since that time certain diseases have been recognised that call
to mind the condition of patients who have undergone an operation for
removal of the thyroid glands, and in which the subjects have suffered
from _hypothyroidea_, or insufficient development of the thyroid.
Such individuals were characterised by _nanism_, solid edema of the
skin, arrest of psychic development, and absence of development of
puberty; this malady has taken its place in medical treatises under the
name of myxedema; and, when serious, is accompanied by _nanism_ and
myxedematous idiocy. But in _mild_ _cases_ it may result in a simple
myxedematous infantilism.
The other glands of internal secretion are also associated with the
phenomena of growth. First in importance is the _thymus_ which is
found highly developed in the embryo and in the child at birth, and
thereafter diminishes in volume, until it almost disappears after the
attainment of puberty. In the psychological laboratories of Luciani, at
Rome, the first experiments were conducted upon dogs, for the purpose
of determining what alterations in growth would result as a consequence
of the removal of the thymus. The dogs thus operated on were weak;
furthermore they became atrophied, accompanied by roughness of the
skin and changes in pigmentation. After this, experiments were made
in the Pediatric Clinic at Padua, under the direction of Professor
Cervesato, in the application of thymic organotherapy (that is, the
use of animal thymus as medicine) with notable success in the case of
atrophic children (infantile atrophy occurs in early infancy; this form
is known popularly in Italy as the "monkey sickness." Nursing children
become extremely thin, cease to grow in length, the little face becomes
elongated and skeleton-like, and is frequently covered with a thick
down).
Stoppato also obtained analogous results in infantile atrophy and
anemia. Hence it is evident that the very rapid growth in the embryo is
associated with the functional action of the thymus. And this is also
true of the very rapid growth during the first years of a child's life.
The pituitary gland, or cerebral hypophysis, has also functions
associated with the general nervous tone and trophism (or nourishment)
of the tissues, and especially of the osseous system. There is a
disease known as acromegalia (Marie's disease) which is characterised
by an abnormal and inharmonic growth of the skeleton, especially in
the limbs and the jaw; the hands and feet become enormously enlarged,
while the jaw lengthens and thickens (an unhealthy formation on which
the common people of Italy have bestowed the name of "horse sickness,"
because of the appearance assumed by the face). Such patients complain
of general and progressive debility of their psychic activities. In
such cases, an autopsy shows an alteration of the pituitary gland,
often due to malignant tumors (sarcoma).
The suprarenal capsules also bear a relation to general trophism and
particularly to the pigmentation of the skin. It was already noted
by Cassan and Meckel that the negro races show a greater volumetric
development of the suprarenal capsules; when in 1885 Addison for the
first time discovered a form of disease associated with alterations
of the suprarenal capsules, characterised by an intensely brown
colouration of the skin (bronzed-skin disease), general debility of the
nervous and muscular systems, progressive anemia and mental torpor;
the malady ends in death. In the case of animals operated on for
physiological experiments, not one of them has been able to survive.
Some interesting observations have been made by Zander on the
connection between the development of the nervous system and the
suprarenal glands. He found that there was an insufficient development
of these glands in individuals having teratological (monstrous)
mis-shapements of the brain, as in the case of hemicephalus (absence of
one-half the brain), cyclops, etc.
There exists between all the ductless glands, or those of internal
secretion, an organic sympathy: in other words, if one of them is
injured the others react, frequently to the extent of assuming a
vicarious (compensating) functional action.
What their functional mechanism is, that is, whether the secretions act
as formative stimulants or enzymes, ferments of growth, or whether as
antitoxins to the toxins elaborated by various organs in the process
of regression, is a question still controverted and in any case cannot
enter within the limits of our field.
It is enough for us to know that the general growth of the organism and
its morphological harmony, depend not only as regards the skeleton,
but equally in relation to the cutaneous system and its pigmentation,
the development of the muscles, the heart, the blood, the brain, and
the trophic functions of the nervous system, upon some formative and
protective action of all these little glands of "internal secretion,"
with which are associated the _psychic activities_ and even the life
itself of each individual, as though within the embryonic crucible
there must have been certain substances that acted by stimulating the
genetic forces and directing the trophism of the tissues toward a
predetermined morphology.
To-day it is held that even the _mother's milk_ contains these
formative principles, or _enzymes_, suited to stimulate the tissues
of her own child in the course of their formation; consequently, it
produces results which no other milk in all nature can replace.
Alterations in these glands of "internal secretion" may therefore
produce an arrest of development--and, in mild cases, forms of
infantilism. But the gland which in this connection is of first
importance is the _thyroid_.
Now there is one form of arrest of the trophic rhythm of growth which
may be due to _hereditary causes_ effecting the formative glands
(myxedematous infantilism), or to exceptional causes occurring in the
individual himself in the course of formation, either at the moment
of conception, or at some later moment, as may happen even during the
period of infancy (dystrophic infantilism of various origin).
In all these cases, however, according to Hertoghe, the exceptional
causes, deleterious to growth, would first of all exercise their
influence upon the glands of internal secretion and especially upon the
thyroid.
In order to make clear, in connection with such complex pathological
problems, the cases which are important from the point of view of
pedagogy and the school, let us divide them into:
_Myxedematous infantilism_, due to congenital insufficiency of the
thyroid gland from hereditary causes, and
_Dystrophic infantilism_, associated with various causes deleterious
to individual development--and acting secondarily upon the glands
of internal secretion (syphilis, tuberculosis, alcoholism, malaria,
pellagra, etc.).
_Myxedematous infantilism_ is characterised by short stature, by
excessive development of the adipose system, and by arrest of mental
development (including speech). Such _infantiles_ very frequently have
a special morphology of the face, that suggests the mongol type, and
characteristic malformations of the hands (little fingers atrophied).
When treated with extracts of the thyroid glands of animals, they
improve notably; they become thinner, they gain in stature, their
mentality develops to the extent of permitting them to study and to
work. Certain mongoloids treated by De Sanctis in the Asylum-School at
Rome were improved to the point of being able to attend the high-school
and therefore were restored to their family and to society as useful
individuals--all of which are facts that are of singular importance to
us as educators! Medical care working hand in hand with pedagogy may
save from parasitism individual human beings who otherwise would be
lost. We ought to be convinced from such evidence of the necessity of
_special schools_ for deficients, wholly separated from the elementary
schools, and where _medical care_ combined with a specially adapted
pedagogic treatment may transform the school into a true "home of
health and education." The plan of a "school with a prolonged schedule
of hours," including two meals and a medical office, as was conceived
and organised by Prof. Sante de Sanctis in Rome, has been proved to
answer admirably to this social need; because without wholly removing
the children from their families, and therefore without exposing them
to the disadvantages of a boarding school, it provides them with all
the assistance necessary to their special needs.
_Dystrophic Infantilism._--Given a case of infantilism, discoverable by
the teacher through the general measurements of the body and psychic
examination, it is interesting to investigate the deleterious _causes_.
It may be the result of _poisoning_, as for example from _alcohol_.
Alcohol has such a direct influence upon the arrest of development that
in England jockeys are produced by making the lads drink a great deal
of alcohol. Children who drink alcohol _do not grow in_ _stature_, and
similarly the embryo grows in a less degree when the mother indulges
in alcohol during pregnancy; some Swiss women deliberately resort
to this means, in order that a smaller child may lessen the pain of
childbirth. But alcohol not only diminishes the stature, but destroys
the harmony of the different parts; that is, in the development
of the body it arrests both the volumetric and the morphological
growth. Furthermore, alcohol produces in children an arrest of mental
development. An acquaintance with this principle of hygiene should be
looked upon by the teacher less as a piece of special knowledge than
as a _social duty_. From the point of view of the educator, the fight
against alcoholism should have no assignable limits! It would be vain
for him to perfect his didactic methods in order to _educate a child
that drank_ _wine or other still worse alcoholic liquors_. It would
be better if the efforts which he meant to dedicate to such educative
work could be all turned to a _propaganda_ directed toward the parents
of such children, or toward the children themselves, to induce them to
abstain from so pernicious a habit!
We may also consider in the category of _poisonings_ certain chronic
maladies which act upon the organism with special toxic (poisonous)
effects. In the foremost rank of such maladies belongs
_Syphilis._--This disease is ranked among the principal causes of
_abortion_; in other words, the foetus which results from a syphilitic
conception lacks _vitality_, and often fails to complete the cycle
of intrauterine life. But even granting that the foetus survives
and attains its complete development, the child after birth _grows_
tardily, and very often remains an _infantile_. It is well known that
syphilis has been transmitted to new-born infants at the time of birth,
in consequence of which these infants may in turn transmit syphilis to
their wet-nurses. In such cases they are really _sick_ and need medical
treatment from the hour of their birth. Just as in the adult patient,
syphilis has several successive stages, an acute primary stage, with
plain manifestations of hard ulcers, erythema diffused over the skin
of the entire body, glandular infiltrations, etc., and then secondary
and tertiary manifestations that eventually become chronic and exhibit
almost imperceptible symptoms; so in the case of children, syphilis may
be transmitted in various degrees of virulence. In the acute stage the
result will be abortion or the child will be still-born, or else the
new-born child will plainly exhibit ulcerations and erythema, but at
other periods of the disease, the child may bear far less evident signs
of its affliction, as for instance a special form of corrosion in the
enamel of its teeth; the _cervical pleiades_ or enlargement of certain
little lymphatic glands like the beads of a rosary, distinguishable
by touch in the posterior region of the neck; certain cranial
malformations (prominent nodules on the parietal bones, Parrot's
nodes); and in the child's whole personality an under-development in
respect to its age. In cases like these the teacher's _observations_
may be of real social value, because the child has shown no symptoms of
such a nature as to cause the parents to have recourse to a physician,
and it is the child's _scholarship_ (using the word in the broad sense
of the _way in which the child reacts in the environment_ _of school_,
the profit he derives from study, etc.) that may reveal an abnormal
development to an intelligent teacher.
The first indication is a _stature below what is normal at a given_
_age_. Such observations ought to be obligatory upon teachers who are
in sympathy with the new ideas, for they alone can be the arbiters of
the rising generations. It is being said on all sides, to be sure, with
optimistic assurance that argues a deficiency of critical insight and
common sense, that an adequate _education of_ _the mothers_ ought to
enlighten all women in regard to the laws of growth in children and
the abnormalities that are remediable. But of what class of mothers
are we supposed to be speaking? Certainly not of the great mass of
working women and illiterates! certainly not of the women who have been
constrained to hard toil from childhood up, and later on condemned to
abortion because of such unjust labor, while their spirit is brutalized
and their memory loses even the last lingering notion of an alphabet!
It will always be easier and more practical, in every way, to enlighten
twenty-five thousand teachers regarding these principles than to
enlighten many millions of mothers; not to mention that if we wished to
enlighten these mothers in a practical way regarding the principles of
the hygiene of generation, we should still have to invoke the services
of that very class whose assigned task in society is precisely that of
educating the masses!
The teacher can and should learn at least how to _suspect_ the presence
of hereditary syphilis in his pupils, in order to be able to invoke the
aid of the physician, leaving to the latter the completion of the task,
namely, the eventual cure. It is well known that iodide of potassium
and its substitutes, especially if used at an early stage, can _cure_
syphilitic children and therefore save innocent boys and girls from
eventual definite arrest of development and from all the resultant
human and social misery.
Another cause that is deleterious to development is
_Tuberculosis._--Although it has now been demonstrated that
tuberculosis is not hereditary, as an active disease--that is, we
cannot inherit in our organism localised colonies of the tuberculosis
bacillus, because the bacilli cannot pass through the placenta into the
foetus during the period of gestation--nevertheless a _predisposition_
to infection from the bacillus can be inherited.
A predisposition which consists in a special form of weakened
resistance of the tissues, rendering them incapable of immunity, and
a skeletal formation which is distinguished by a narrowness of the
chest, and a consequent smallness of lungs, which, being unable to take
in sufficient air, constitute a _locus minoris resistentiae_ (locality
of less resistance) to localisation of the bacilli. Now, since our
environment is highly infected by the bacilli of tuberculosis, we must
all necessarily meet with it, we must all have repeatedly received
into our mouths and air passages Koch's bacilli, alive and virulent;
and yet the strong organism remains immune, while the weak succumbs.
Consequently those who are predisposed by heredity are almost fated
to become tuberculous, and in this sense the malady presents the
appearance of being truly hereditary. But such organic weakness in a
child predisposed to tuberculosis is manifested not only by possible
attacks of various forms of the disease localised in the glands
(scrofula) or the bones, but also by a _delayed development of the
whole personality_.
Now, the environment of school and the educative methods still in
vogue in our schools, not only are not adapted to correct such a
predisposition, but what is more, the school itself _creates_ this
predisposition! In fact, the sitting posture--or rather, that of
stooping over the desk, to write--and the prolonged confinement in
a closed environment, impede the normal development of the thorax
and of all the physical powers in general. Many a work on pedagogic
anthropology has already shown that the _most_ _studious scholars_, the
_prize-winners_, etc., have a wretched chest measure, and a muscular
force so low as to threaten ruin to their constitutions.
Consequently, children who are predisposed to tuberculosis ought
unquestionably to be _removed_ from our schools and cared for and
educated in favourable environments. While we are still impotent in the
face of fatalities due to this deplorable disease, we are not ignorant
of the means needed to save a predisposed child and transform him into
a robust and resistant lad. Such knowledge, to be sure, was applied
to _mankind_ only as a second thought; for the first men to apply and
then to teach such means of defence were the owners of cattle and the
veterinaries. The owners of cattle discovered that if a calf was born
of a tuberculous cow, it could be saved and become an excellent head of
cattle, if only it was subjected to a very simple procedure; the calf
must be removed from its mother and given over to be nursed by another
cow in the open country; and it must remain in the open pastures for
some time after it its weaned.
By taking similar precautions in the case of children, it has been
shown that the son of a tuberculous woman, if entrusted to a wet-nurse
in the _open country_, and brought up on an abundance of nourishing
food until his sixth year in the freedom of the fields, can be made as
robust as any naturally sound child. From this we get the principle of
_schools in the open air_, or of _schools in the woods_, or _on the
sea-shore_, for the benefit of weak, anemic children, predisposed to
tuberculosis. Such a sojourn constitutes the "School-Sanatorium," the
lack of which is so grievously felt by the parents of feeble children,
and that might so easily be instituted in our mild and luxuriant
peninsula, so rich in hillsides and sea-coast!
_Malaria._--One of the chief causes of mortality and of biological
pauperism in many regions of Italy is _malaria_. This scourge rages
even to the very gates of Rome. The country folk of these abandoned
tracts pine away in misery and at the same time in illiteracy, while
their blood is impoverished by disease, and a notable percentage of the
children are _victims of arrested development_.
These unfortunates, forgotten by civilisation, are destined to
roam the fields, bearing with them, till the day of their death, a
deceptive appearance of youth, and an infantile incapacity for work,
an object-lesson of misery and barbarity! Among the means of fighting
malaria, the spread of civilisation and the school ought to find a
place. Even the quinine given freely by the government is distributed
with difficulty among these unhappy people, brutalised by hunger and
fever; and some message from civilisation ought to precede the remedy
for the material ill. A far-sighted institution is that of Sunday
classes founded by Signor Celli and his wife in the abandoned malarial
districts. In these classes, the teachers from elementary schools give
lessons every Sunday, spreading the principles of civic life, at the
same time that they distribute quinine to the children.
If we stop to think that wherever malaria is beaten back, it means
a direct conquest of fertile lands and of robust men, and hence of
wealth, we must realise at once the immense importance of this sort of
school and this sort of struggle, which may be compared to the ancient
wars of conquest, when new territories and strong men constituted the
prize of battles won, and the grandeur of the victorious nations.
_Pellagra._--Pellagra is still another scourge diffused over
many regions of Italy. It is well known that this disease, whose
pathological etiology is still obscure, has some connection with a
diet of mouldy grain. Pellagra runs a slow course, beginning almost
unnoticed in the first year, with a simple cutaneous eruption,
which the peasants sometimes attribute to the sun. The second year
disturbances of the stomach and intestines begin, aggravated by a
diet of spoiled corn; but it is usually not until the third year
that pellagra reveals itself through its symptoms of great nervous
derangements, with depression of muscular, psychic and sexual powers,
together with _melancholia_, amounting to a true and special form of
psychosis (insanity) leading to homicide, even of those nearest and
dearest (mothers murdering their children) and to suicide.
This established cycle of the disease is not invariable. Instead of
representing successive _stages_, these symptoms may often be regarded
merely as representing the _prevailing_ phenomena in various forms of
pellagra; in any case, it constitutes a malady that runs a slow course
during which the same patient is liable to many relapses. While the
malady is running its course, the patients may continue their usual
physiological and social life, and even _reproduce_ themselves. So that
it is not an infrequent case when we find mothers, _suffering from
pellagra_, nursing an offspring generated in sickness and condemned to
manifold forms of _arrested development, both_ _physical and mental_.
Against a disease so terrible that it strikes the individual and the
species, it is now a matter of common knowledge that there is an
exceedingly simple remedy: it consists in a strongly nitrogenous diet
(i.e. meat) and that, too, only temporarily. In fact, in the districts
where the pellagra rages, various charitable organisations have been
established, among others the economic _kitchens_ for mothers, which by
distributing big rations of meat effect a cure, within a few months,
not only of the sick mothers but of their children as well.
The real battle against pellagra must be won through _agrarian_
_reforms_: but in the meantime the local authorities could in no small
degree aid the unhappy population with their counsel, by enlightening
the peasants regarding the risks they run, as well as by informing
them of the various forms of organised aid actually established in
the neighbourhood and often unknown to the public or feared by them,
because of the ignorance and prejudice with which they are profoundly
imbued!
_Pauperism_, _Denutrition_, _Hypertrophy._--We may define all the
causes hitherto considered that are deleterious to growth, as _toxical_
_dystrophies_, since not only alcohol, but the several diseases
above discussed--syphilis, tuberculosis, malaria, pellagra--produce
forms of chronic intoxication. But besides all these various forms
of dystrophies, we may also cite cases of infantilism due purely to
defective nutrition, and family poverty. Physiological misery may
produce an arrest of growth in children.
But just as denutrition associated with pauperism (social misery,
economic poverty, lack of nourishment) may cause an organism in course
of development to arrest its processes of evolution through lack of
material, the same result is equally apt to be produced by any one
of a great variety of causes liable to produce organic denutrition,
physiological poverty.
For example, too frequent pregnancies of the child's mother, which have
resulted in impoverishing the maternal organism, causing deficiency of
milk, etc.
_Infant Illnesses._--In the same way, organic impoverishment is caused
by certain maladies of the digestive system which impede the normal
assimilation of nutritive matter: dysentery, for instance; and the
effects may be still more disastrous if symptoms of this kind are
accompanied by feverish conditions, as in typhus.
There are cases, however, in which the arrest of development is not to
be attributed to some wasting disease, or to the denutrition resulting
from it; but rather to some acute illness occurring in early childhood
(pneumonia, etc.), after which the child ceased to progress in
accordance with his former obviously normal development.
_Anangioplastic Infantilism._--Another form of infantilism is
associated with a malformation of the heart and blood-vessels, that is
to say, the heart and aorta together with the entire circulatory system
are of small dimensions; the calibre of the arteries is less than
normal. In such a case the restriction of the entire vascular system
and the scantiness of circulation of the blood constitute an impediment
to the normal growth of the organism. Although in such cases the
explanation of the cause of the phenomenon is purely mechanical,
nevertheless such abnormality of the heart and veins is to be classed
as a teratological (monstrous) malformation, determined by original
anomalies of the ductless glands, similar to what is found in cases of
cephalic and cerebral monstrosities.
In this form of infantilism the patient shows not only the usual
fundamental characteristics already noted, but also symptoms of
_anemia_ as obstinate to all methods of treatment as _chlorosis_ is;
in addition to which they often show congenital malformations of the
heart, in every way similar in their effects to valvular affections
such as may result from pathological causes (chief of which are mitral
and aortic stenosis, which consist of a stricture of the valves
connected with the left ventricle of the heart).
Accordingly, children who show forms of mitral infantilism are inferior
to their actual age not only in their whole psychosomatic appearance,
but they are noticeably weak, pale and suffering from shortness of
breath and disturbances of the circulation. In such cases, neither
pedagogy nor hygiene can counteract the arrest of development; but it
is well that the attention of teachers should be called to such cases,
in order that cruel errors may be prevented, which would unconsciously
do additional harm to individuals already burdened by nature with
physiological wretchedness.
In conclusion: The normal growth of the organism is _associated_ with
the functional action of certain glands known as glands "of internal
secretion," such as the thymus and thyroid, first of all, as well as
the suprarenal capsules and the cerebral hypophysis.
This group of _formative_ glands presides not only over the entire
growth of the body, but also over the intimate modeling of its
structure; so that a _lesion_ or _deficiency_ in any of them results
not only in nanism and an arrest of mental development, but in various
forms of general dystrophy.
That the organism is associated in the course of its transformations
with the functional action of specific glands is shown by the
_development of puberty_, which consists in a series of transformations
of the _entire organism_, but is associated with the establishment of
functional activity of glands that were hitherto immature: the genital
glands (ovaries, testicles). These glands also are functionally in
close sympathy with the entire group of formative glands: so much so
that, if the glands of internal secretion are injured, the genital
glands usually fail to attain normal development (infantilism). Now,
the transformations which take place in the organism at the period of
puberty might be produced at other periods if the functional action of
the generative glands should show itself at a different epoch. That
is, these transformations are not associated with the _age of the_
_organism_, but with the development of specific glands. There are
cases of the genital glands maturing at abnormal ages; or of local
maladies that have hastened the appearance of the phenomena of puberty
in children of tender years. A notable case is that described by Dr.
Sacchi,[32] of a nine-year old boy, who had grown normally up to the
age of five and a half, both in his physiological organism and in his
psychic personality. At the age of five and a half, the child's father
noticed a physical and moral alteration; the child's voice grew deeper,
his character more serious, and the skeletal and muscular systems grew
rapidly, while on certain portions of the body, as for example on the
face, a fine down appeared. At the age of seven the child had attained
a stature that was gigantic for his age; he was very diligent and
studious and did not care to play with his comrades. At nine, he had a
stature of 1.45 metres (the normal stature being 1.22), a weight of 44
kilograms (normal = 24); his muscles were highly developed, his powers
of traction and compression being equal to those of a man; his chin was
covered with a thick beard five centimetres long. When he was examined
by a physician, the latter discovered a tumor in the left testicle.
After an operation, the child lost his beard and regained his childish
voice; his character became more timid and sensitive; he began once
more to enjoy his comrades and take part in boyish games. His muscular
force underwent a notable diminution.
_Rickets._--It is important not to confound any of the various forms
of infantilism with _rickets_. Rickets is a well-defined malady whose
special point of attack is the osseous system in course of formation;
but it leaves the nervous system and the genital system unimpaired.
The sufferer from rickets may be a person of intelligence, capable of
attaining the highest distinctions in art or in politics; he is normal
in his genital powers, so that he is capable of normal reproduction,
without, in many cases, transmitting any taint of rickets to his
descendants.
Nevertheless this disease, like all constitutional maladies, occurs
only in individuals who are _weakly_.
Among the characteristics of rickets, the one which assumes first
importance is _inferiority of stature_ in comparison with the normal
man. In this connection I quote the following figures from Bonnifay:[33]
--------------------------------------------------
Age | Stature in centimetres
| Rachitic children | Normal children
-------------+-------------------+----------------
11 months | 66.5 | 69.4
2 years | 70.7 | 74.8
2-3 years | 75.8 | 83.0
3-4 years | 76.8 | 91.9
5-6 years | 91-93 | 101.25
6-7 years | 105.0 | 106.8
7-8 years | 110.6 | 115.3
8-9 years | 118.4 | 119.0
9-10 years | 121.6 | 124.4
--------------------------------------------------
But together with diminution of stature there exist in rickets various
_deformities_ of the skeleton, especially in the bones of the cranium,
in the vertebral column and in the frame of the thorax; although even
the pelvis and the limbs have been known to show the characteristic
deformities.
An objective knowledge of the first symptoms of rickets ought to be
regarded as indispensable on the part of mistresses in children's
asylums, and in any case to form an important chapter in pedagogic
anthropology. For it is well known that in the early stages of
_rickets_ the child may be so guided in its growth as to save it from
deformities of the skeleton, even though a definite limitation of the
stature may not be _prevented_.
That is to say, that through the intervention of hygiene and pedagogy
the rachitic child may be saved from becoming a _cripple_ or a
_hunchback_, and will simply remain an individual of _low stature_;
with certain signs and proportions of the skeleton indicative of the
attack through which he has passed. Even in very severe cases it is
at least possible to minimize the deformity of the thorax and the
curvature of the vertebral column.
The precursory signs of rickets in a child are: a characteristic
_muscular weakness_, frequently accompanied by excessive development of
adipose tissue, giving an illusory impression of abundant nutrition;
delay in the development of the teeth and in locomotion, which from the
very beginning may be accompanied by curvature of the long bones of the
legs. The bregmatic fontanelle of the cranium closes later than at the
normal period, and is larger than in normal cases, just as the entire
cerebral cranium is abnormally developed in volume, while the facial
portion remains small, especially in regard to the jaw bones.
One of the most salient characteristics, however, is the peculiar
enlargement of the _articular heads_ of the long bones, easily
recognizable in the size of the _wrists_; the enlargement is also found
in the extremities of the ribs, which at their points of union on each
side of the sternum form a succession of little lumps, like the beads
of a rosary. In conjunction with these characteristics, it is to be
noted, at all ages, as appears from the figures given by Bonnifay, that
there is a notable _diminution of stature_.
The _treatment_ of rickets is _medical_ and _pedagogical_ combined.
Children of this type should be _removed_ from the public school, where
the school routine might have a fatally aggravating effect upon the
pathological condition of such children. In fact, gymnastics based upon
marching and exercising in an erect position, together with a prolonged
sitting posture, are likely to produce weaknesses of the skeleton and
deformities, even where there are no symptoms of rickets!
The establishment of _infant_ asylums for rachitic children is one of
the most enlightened movements of the modern school. We Italians are
certainly not the last to found such institutions, and Padua possesses
one of the oldest and most perfect asylums of this sort of which Europe
can boast. Asylums for rachitic children ought to have a special
school equipment, so far as concerns the _benches_ and the apparatus
for _medical and orthopedic gymnastics_; furthermore they should be
provided with a pharmaceutical stock of remedies suited to building up
the osseous system and the organism in general; and a school refectory
should be provided, adapted to the condition of the children. The
methods of instruction should rigorously avoid any form of _fatigue_,
and instead provide the child with psychic stimuli designed to overcome
a sluggishness due to the mental prostration to which he is for the
most part subject. As regards their situation, these asylums for
rachitic children may be advantageously located upon the _sea-coast_.
_The Stature of Abnormals._--The name of abnormals is applied to the
entire series of individuals who are not normal: hence the categories
already considered (infantilism, gigantism, rachitis) are included by
implication. The group of abnormals, however, includes besides a long
series of other classes, neuropathics, epileptics, and degenerates.
Under the head of abnormals may also be included those who are
abnormal in character, such as criminals, etc. It is not irrational
to group together the different types of abnormals, for the purpose
of anthropological research, in contrast with those who are normal.
In America, for instance, such studies are conducted on a large
scale, precisely for the purpose of showing the _deviation_ of
abnormal dimensions of the body from normal dimensions, not only in
the definitive development of the body, but also during growth. The
abnormals depart from the mean measurements, now rising above and
again falling below, as though they were intermittently impelled by
the biological impulse of their organism, which at one time manifests
a hypergenesis and at another a hypogenesis. A clear illustration of
these facts is afforded by MacDonald's diagram (see page 168): the
solid line which rises regularly represents the growth in stature of
normal individuals; the dotted line which forms a zig-zag, now rising
rapidly above the normal line and then falling very much below it,
represents the growth in stature of the abnormals. Naturally such a
chart must be interpreted by comparison with the standards of mean
measurements gathered at successive ages from a large number of
different children. It shows that normal children are nearly uniform
among themselves, and in relation to the years of their growth: while
abnormal children differ greatly one from another and do not accord
with the mean stature of the age they represent.
Regarding the stature of _criminals_ there can be nothing special
to say: _criminals_ do not represent an anthropological entity.
They belong to a large extent, whenever the criminal act has a
psychophysiological basis, to various categories of _abnormals_. From
the victim of rickets to the infantile, to the submicrocephalic, to
the ultra-macroscele or ultra-brachyscele, all abnormal organisms may
contribute to the number of those predisposed to the social phenomenon
of criminality. And it is for this reason that we may say in general
that the stature of abnormals is sometimes above and sometimes below
the normal, but with a prevailing tendency to fall below.
_Moral and Pedagogic Considerations._--The objection may be raised
that a medico-pedagogic system of treatment, designed to prevent
a threatened arrest of development or to minimise its progressive
symptoms, demands on the part of society an excessive effort, out of
proportion to the end in view. To cure or ameliorate the condition of
the weak may even be regarded as a principle of social ethics that is
contrary to nature, whose laws lead inexorably to the selection of the
strong and to the elimination of all those who are unfitted for the
struggle for life. Sparta has furnished us with a practical example
that is very far from the principles which scientific pedagogy is
to-day seeking to formulate as a new necessity of social progress.
[Illustration: Mac Donald
_Stature of normal persons_
_Stature of abnormal persons_
FIG. 35.]
But we are too far removed from the triumphant civilisation of Greece,
to recur to the authority of her example: the principle sanctioned
to-day by modern civilisation, that of "respect for human life,"
forbids the violent _elimination_ of the weak: Mount Taygetus is no
longer a possible fate for innocent babes in a social environment the
civic spirit of which has abolished the death penalty for criminals.
Consequently, since the weak have a right to live, as many of them as
naturally survive are destined to become a burden, as parasites, upon
the social body of normal citizens; and they furnish a living picture
of physiological wretchedness, a spectacle of admonitory misery,
inasmuch as it represents an _effect_ of social causes constituting
the collective errors of human ethics. Ignorance of the hygiene of
generation, maladies due to the vices and the ignorance of men, such
as syphilis, other maladies such as tuberculosis, malaria and pellagra,
representing so many scourges raging unchecked among the people, are
the actual causes that are undermining the social structure, and
manifesting themselves visibly through their pernicious fruit: the
birth of weaklings. To forget the innocent results of such causes, as
we forget the causes themselves, would be to run the risk of plunging
precipitously into an abyss of perdition. It is precisely these
disastrous effects upon posterity that ought to warn us and shed light
upon the errors through which we are passing lightly and unconsciously.
Accordingly, to gather in all the weaklings is equivalent to erecting a
barrier against the social causes which are enfeebling posterity: since
it is impossible to conceive that if the existence of such a danger
were once demonstrated, society would rest until every effort had been
made to guard against the possibility of its recurrence.
In addition to such motives for human prophylaxis, a more immediate
interest should lead us to the pedagogic protection of weak children.
The establishment of special schools for defective children,
sanatarium-schools for tuberculous children, rural schools for
those afflicted with malaria and pellagra, infant asylums for
rachitic children, is a work of many-sided utility. They constitute
a fundamental and radical purification of the schools for normal
children: in fact, so long as intellectual and moral defectives and
children suffering from infantilism and rachitis intermingle with
healthy pupils, we cannot say that there really exist any _schools_
_for normal children_, in which pedagogy may be allowed a free progress
in the art of developing the best forces in the human race.
Still another useful side to the question is that of putting a stop to
the physiological ruin of individual weaklings. Very small would be
the cost of schools for defective children, asylums for the rachitic,
tonics, quinine, the iodide treatment, school refectories for little
children afflicted with hereditary taints and organic disease: very
small indeed, in comparison to the disastrous losses that society must
one day suffer at the hands of these future criminals and parasites
gathered into prisons, insane asylums and hospitals, in comparison
to the harm that may be done by one single victim of tuberculosis
by spreading the homicidal bacilli around him. It is a principal of
humanity as well as of economy to _utilise_ all human forces, even
when they are represented by beings who are apparently negligible.
To every man, no matter how physiologically wretched, society should
stretch a helping hand, to raise him. In North America the following
principle has the sanction of social custom: that the task of improving
physiological conditions and at the same time of instilling hope
and developing inferior mentalities to the highest possible limit
constitutes an inevitable human duty.
Accordingly it remains for the science of pedagogy to accomplish the
high task of human redemption, which must take its start from those
miracles that the twentieth century has already initiated in almost
every civilised country: straightening the crippled, giving health
to the sick, awakening the intelligence in the weak-minded--much as
hearing is restored to the deaf and speech to the mutes--such is
the work which modern progress demands of the teacher. Because such
straightening of mind and body naturally lies within the province
of those who have the opportunity to give succor to the human being
still in the course of development; while after a defect has reached
its complete development in an individual, no manner of help can ever
modify the harm that has resulted from lack of intelligent treatment.
The prevention of the irremediable constitutes a large part of the work
which is incumbent upon us as educators.
SUMMARY OF STATURE
We have been considering _stature_ as the linear index of the whole
complex development of the body, taking it in relation to two other
factors, the one internal or biological, and the other external or
social. These two factors, indeed, unite in forming the character of
the individual in his final development; and in each of them education
may exert its influence, both in connection with the hygiene of
generation and through reforms instituted in the school.
In the following table are summed up the different points of view from
which we have studied stature in its biological characteristics and in
its variations:
Varieties {Ethnic varieties {Stature in different races; extreme limits.
of stature { and limits of {Stature of the Italian people; and its
{ oscillation { geographical distribution.
{ {Limits of stature: medium, tall, low.
{Biological {Difference of stature in the sexes.
{ varieties {Stature at different ages (growth).
{Mechanical {Transitory or physiological.
{ {Permanent, often caused by
Variations {Variations { {deformities (Causes: the
in stature { due to { {attitudes required by the work.)
{ adaptation {
{ {Physiological {Nutrition.
{ {Physical {Heat.
{ { {Light.
{ { {Electricity.
{ {Psychic {Psychic stimuli.
{Myxedematous.
{Pathological {Infantilism {
{ variations { {Dystrophic {from alcohol.
{ { { {from syphilis.
{ { { {from tuberculosis.
{ { { {from malaria.
{ { { {from pellagra.
{ { {Hypotrophic {Denutrition.
{ { {Anangioplastic
{ {Rachitis
SUMMARY OF THE SCIENTIFIC PRINCIPLES ILLUSTRATED IN THE COURSE OF THE
EXPOSITION OF OUR SUBJECT
When an anthropological datum is of such fundamental importance as
the _stature_, its limits of oscillation must be established, and its
terminology must be founded upon such limits expressed in figures that
have been measured and established by scientists (medium, tall, low).
The stature is the most important datum in pedagogic anthropology,
because it represents the linear index of the development of the body,
and for us educators is also the _index_ of the child's normal growth.
_Biopathological Laws._--In cases of total arrest of development
of the personality (infantilism) the first characteristic symptom
usually consists in a diminution of stature in relation to age; the
morphological evolution, as well as the psychic, fails to progress in
proportion to the _age of the subject_; but it corresponds to the mean
bodily proportions belonging to the age which would be normal for the
actual stature of the subject.
=WEIGHT=
The _weight_ is a measure which should be taken in conjunction with
the stature; because, while the stature is a linear index of the
development of the body, the weight represents a _total measure_ _of
its mass_; and the two taken together give the most complete expression
of the bio-physiological development of the organism.
Furthermore the weight permits us to follow the _oscillations_
of development; it provides educators with an index, a level of
excellence, or the reverse, of their methods as educators, and of the
hygienic conditions of the school or of the pedagogic methods in use.
The fact is, that if a child is ill, or languid, etc., his stature
remains unchanged; it may _grow more slowly_, or be arrested in growth;
but it can never diminish. The weight, on the contrary, can be lost and
regained in a short time, in response to the most varied conditions of
_fatigue_, of _malnutrition_, of _illness_, of _mental_ _anxiety_. We
might even call it the _experimental datum_ of the excellence of the
child's development.
Another advantage which the measure of weight has over that of stature
is that it may serve as an _exponent of health_ from the very hour
of the child's birth; while _stature_ does not exist in the new-born
child, and begins to be formed (according to the definition given) only
after the first year of its life, that is, when the child has acquired
an erect position and the ability to walk steadily.
_Variations._--Weight is one of the measures that have been most
thoroughly studied, because it is not a fruit of the recently founded
science of pedagogic anthropology; but it enters into the _practice_ of
pediatricians (specialists in children's diseases) and of obstetricians
(specialists in childbirth), while even the general practitioner can
offer precious contributions from his experience.
According to Winckel, and practically all pediatricians agree with him,
"the weight of a child, if taken regularly, is the best thermometer of
its health; it easily expresses in terms of figures what the nursing
child cannot express in words."[34]
The new-born child weighs from three to four kilograms; but
oscillations in weight from 2,500 to 5,000 grams are considered normal.
Some obstetricians have noted weights in new-born children that
are enormous, true gigantism, which, however, while possible, are
altogether exceptional; nine and even eleven kilograms.
The oscillations in weight of the child at birth, within normal limits,
may have been determined by general biological factors, as for example
the sex (the female child weighing less than the male), and the race
(especially in regard to the stature of the parents): but the factors
which influence the weight of the new-born child in a decisive manner
are those regarding the _hygiene of generation_.
1. "The children which have the greater weight are those born of
mothers between the ages of twenty-five and thirty." (Mathews Duncan.)
Let us recall what we have said regarding stature; at the end of the
twenty-fifth year, that is, at the end of the period of growth, man is
admirably ripe for the function of reproduction; and we ought further
to recall the views cited regarding the mortality of children conceived
at this age which is so favourable to parenthood; and finally the note
in regard to celebrated men, almost always begotten at this age.
2. "First-born children have in general a weight inferior to that of
those born later (1,729 first-born children gave an average of 3,254
grams: while 1,727 born of the second or subsequent conceptions gave an
average of 3,412 gr.)" (Ingerslevs). Let us remember that celebrated
men are scarcely ever the _first-born_.
3. "Very short intervals between successive pregnancies interfere with
this _progression_ in weight; long intervals on the contrary do not
interfere with it" (Wernicke). In other words, too frequent pregnancy
is unfavourable to the result of the conception.
4. "Mothers who, at the birth of their first child weigh less than
fifty-five kilograms and are under twenty years of age, have children
of inferior weight, who are less predisposed to normal growth"
(Schafer).
Let us recall what we have said regarding the _form_ and the scanty
weight in the case of macrosceles; and also in regard to the age of
procreation in its relation to stature.
5. "Women who toil at wearisome work up to the final hour give birth
to children inferior in weight to those born of mothers who have given
themselves up to rest and quiet for some time before the expected
birth" (Pinard).
All these considerations which refer to _normal individuals_, represent
a series of hygienic laws regarding _maternity_, which may be summed
up as follows: excellence in procreation belongs to those mothers
who have already attained the age at which the individual organism
has completed its development, and before it has entered upon its
involutive period; the mother must herself have a normal weight; the
pregnancies must be separated by long intervals; and during the last
weeks of pregnancy it is necessary that the mother should have the
opportunity of complete rest.
The increase in weight of the new-born child during the first days of
its life, may constitute a valuable prognostic of the child's life.
That is to say, through its successive gains it reveals the vitality,
the state of health of this new human being.
Here also the pediatrists can furnish us with valuable experimental
data, which serve to formulate the "laws of growth." These are:
1. From the moment of a child's birth, throughout the first two days,
it suffers a loss in weight of about 200 grams, due to various causes,
such as the emission of substances accumulated in the intestines during
the intrauterine life (meconium), and the difficulties of adaptation to
a new environment and to nutrition. But by the end of the first week a
normal child should have regained its original weight; so that after
the seventh day the normal child weighs the same as at the moment of
birth.
On the contrary, children born prematurely, or those having at the time
of birth a weight below the average, or those that are affected with
latent syphilis, or are weak from any other cause whatever, regain
their original weight only by the end of the second week.
Accordingly, in one or two weeks the family may form a prognosis
regarding future life of the new-born child: a matter of fundamental
and evident importance.
Furthermore, an antecedent detail of this sort may be valuable in
the progressive history of subjects who, having attained the age for
attendance at school, come to be passed upon by the teachers.
To this end, in the more progressive countries, the _carnet_
_maternel_, or mother's note-book, has begun to come into fashion,
for the use of mothers belonging to the upper social classes (as, for
instance, in England): it consists of a book of suitable design, in
the form of an album, and more or less _de luxe_ in quality, in which
the most minute notes are to be registered regarding the lives of the
children from the moment of their birth onward. Various authors,
especially in France, now give models for the _maternal_ _registration_
of the child's physiological progress; true _biographic_ _volumes_
that would form a precious supplement to the _biographic_ _charts_
of the schools: and the efforts of the family would round out and
complete those of the school for the protection of the lives of the
new generations. Such assistance, however, is only an _ideal_, because
nothing short of a great and far distant social progress could place
_all_ mothers (the working women, and the illiterate of Italy) in a
position to compile their _carnet maternel_. Auvard advocates, for
registering the weight of the child during the first days of its life,
a table in which the successive days from the first to the forty-fifth
are marked along a horizontal line, while a vertical column gives a
series of weights, with 25-gram intervals, covering a range of 700
grams, the multiples of a hundred being left blank, to be determined by
the actual weight of the child and filled in by the mother or whoever
takes her place.
[Illustration: FIG. 36.]
In such a table, the graphic sign indicating the changes in weight
ought to fall rapidly and rise again to the point of departure by the
seventh day, _if the child is robust_.
Another law of growth which may serve as a prognostic document in the
child's physiological history is the following:
2. "Children nourished at their mother's breast double their weight at
the fifth month and triple it at the twelfth." In other words, before
the middle of its first year a healthy child, normally nourished, will
have doubled its weight.
On the contrary, "Artificial feeding retards this doubling of weight in
children, which is attained only by the end of the first year; so that
the weight is not tripled until some time in the course of the second
year."
And this gives us pretty safe principles on which to judge of the
personality in the course of formation, at an epoch when stature does
not yet exist.
Undoubtedly a great moral and social progress would be accomplished
through a wide dissemination of very simple and economical _carnets
maternels_; which should contain not only tables designed to facilitate
the keeping of the required records, but also a statement of the laws
of _infant hygiene_; or at least, simple and clear explanations of the
significance of such phenomena, in relation to the life and health of
the child; and also as to the causes which produce weakness in new-born
children; or in other words, advice regarding the fundamental laws of
the hygiene of generation. All that would be needed, in such case,
would be a progressive exposition by means of the _carnets_, through
lessons made as simple and as objective as possible, such as the
weighing of small babies, to make the much desired "education of the
mothers" both possible and practical.
But without this practical means; without this new sort of syllabarium
on hand, to serve as a constant and luminous guide for married women,
I do not believe that we shall have much success with the scattered
lectures, obscure and soon forgotten, that at present are being
multiplied in an attempt to reach the mothers of the lower classes.
In conclusion, I note this last contribution that comes to us from the
pediatrists:
3. "There are certain maladies that cause a daily and very notable loss
in weight"; they are the intestinal maladies; there may be an average
loss of from 180 to 200 grams a day; but even in cases of simple loss
of appetite (dyspepsia) the weight may decrease by about 35 grams a
day. But when a child suffering from acute febrile intestinal trouble
(cholera infantum), loses a tenth of his weight in twenty-four hours,
the illness is mortal.
Now from the point of view of the educator this fact ought to be of
serious interest, because we very frequently find among the recorded
details of sickly children, or those suffering from arrested or
retarded development, a mention of some _intestinal_ malady incurred in
early infancy.
Still one further observation: Meunier has noted a fact of extreme
importance: that while children are passing through the period of
incubation of an infectious disease, and before they show _any
symptoms_ likely to cause a suspicion of the latent illness, they
sustain a _daily loss in weight_, from the fourth or fifth day after
exposure to contagion until the appearance of decisive symptoms. In
children between one and four years old, the daily loss is about fifty
grams, and the total about 300; but such a loss may rise as high as 700
gr. The most numerous observations were taken in cases of _measles_.
Now, there is no need of explaining the prophylactic importance of
observations such as these! A child who for a period of twenty days
is in a state of incubation, is called upon to struggle, with all the
forces of immunity that his organism possesses, against a cause of
disease which has already invaded him; yet no external sign betrays
this state of physical conflict. Consequently, the child's organism
_continues_ to sustain the customary loss of energy due to the
activities of its daily life, and by doing so lessens its own powers
of immunity. To prescribe rest, if nothing more, for a child suspected
of passing through the period of incubation would in many cases mean
the saving of a life, and at the same time would protect his companions
from infection, which is communicable even during the period of
incubation.
In our biographic records of defective children, which include
the great majority of the weakly ones, we find in many cases a
_characteristic tendency to relapses_ in all kinds of infective
diseases, from which they regularly recovered. Such organisms, feeble
by predisposition, yet sufficiently strong to recover from a long
series of illnesses, were _exhausted in respect to those biological
forces_ on which the normal growth of the individual depends, by this
sort of internal struggle between the organic tissues and the invading
microbes. No scheme of special hygiene for children of this type can
help us, either in the home or at school; the _daily variations_ _in
weight_, on the contrary, might constitute a valuable guide for the
protection of such feeble organisms; at the first signs of a diminution
in weight, such children ought to be subjected to absolute repose.
The use of the weighing-machine, both at home and in school cannot be
too strongly recommended. In America the pedagogic custom has already
been established of recording the weight of the pupils regularly once
a month; but instead of once a month, the weight ought to be taken
_every day_. The children might be taught to take their own weight by
means of self-registering scales, and to compare it with that of the
preceding day, thus learning to keep watch of themselves: and this
would constitute both a physical exercise and an exercise in _practical
living_.
The weight may be considered by itself, as a measurement of the
body; and it may be considered in its relation to comparative mean
measurements given by the authorities; just as it may also be
considered, in the case of the individual, in its relation to the
stature.
_a._ The weight, taken by itself, is not a homogeneous or rigorously
scientific measurement. In the same manner as the stature, it
represents a sum of parts differing from one another, the difference in
this instance being that of specific gravity. As a matter of fact, it
makes a great difference whether a large proportion of the weight of an
individual is adipose tissue, or brain, or striped muscles. Each of the
various organs has its own special specific gravity, as appears from
the following table:
-------------------------
Specific Gravity
----------------+--------
Tubular bones | 1.93
Spongy bones | 1.24
Cartilage | 1.10
Muscles {from | 1.10
{to | 1.30
Tendons | 1.16
Epidermis {from | 1.10
{to | 1.19
Hair {from | 1.28
{to | 1.34
Liver | 1.07
Kidneys | 1.04
Brain | 1.039
Cerebrum | 1.036
Cerebellum | 1.032
Adipose tissue | 0.97
-------------------------
All these specific gravities are low; we weigh but little more than
water; and for that reason it is easy for us to swim. But because of
the difference in their composition, the _total weight of_ _the body_
gives us no idea of its constituent parts.
Take for example the question of increase in weight. We can compare
the mean figures given by the authorities with the ascertained weight
of some particular child of a given age, so as to keep an empirical
check upon the normality of its growth. But since we know that an
individual in the course of evolution undergoes profound alterations
in the volumetric proportions of the different organs in respect to
one another, we cannot obtain from the total weight any light upon
this extremely important alteration in proportions. Thus, for example,
Quetelet gives the following figures of increase in weight for the two
sexes:
------------------------------------------
Weight | Weight
--------------------+---------------------
Age | Males |Females| Age | Males |Females
0 | 3.20 | 2.91 | 15 | 46.41 | 41.30
1 | 10.0 | 9.30 | 16 | 53.39 | 44.44
2 | 12.0 | 11.40 | 17 | 57.40 | 49.08
3 | 13.21 | 12.45 | 18 | 61.26 | 53.10
4 | 15.07 | 14.18 | 19 | 63.32 | --
5 | 16.70 | 15.50 | 20 | 65.0 | 54.46
6 | 18.04 | 16.74 | -- | -- | --
7 | 20.16 | 18.45 | 25 | 68.29 | 55.08
8 | 22.26 | 19.82 | 30 | 68.90 | 55.14
9 | 24.09 | 22.44 | 40 | 68.81 | 56.65
10 | 26.12 | 24.24 | 50 | 67.45 | 58.45
11 | 27.85 | 26.25 | 60 | 65.50 | 56.73
12 | 31.0 | 30.54 | 70 | 63.03 | 53.72
13 | 35.32 | 34.65 | 80 | 61.22 | 51.52
14 | 40.50 | 38.10 | -- | -- | --
------------------------------------------
INCREASE IN WEIGHT OF BODY
ACCORDING TO SUTILS
------------------------------------
Age |Weight of body | Increase
| in grams |
----------+---------------+---------
At birth | 3000 | --
1 month | 3750 | 750
2 months | 4450 | 700
3 months | 5100 | 650
4 months | 5700 | 600
5 months | 6250 | 550
6 months | 6750 | 500
7 months | 7200 | 450
8 months | 7600 | 400
9 months | 8000 | 400
10 months | 8350 | 350
11 months | 8700 | 350
12 months | 9000 | 300
------------------------------------
But these figures give no idea of the laws of growth that govern each
separate organ, and that have been studied by Vierordt. According to
this authority, the total weight of the body increases nineteen-fold
from birth to complete development. Certain ductless glands, on the
contrary, _diminish_ in weight in the course of growth; the thymus, for
instance, is reduced to half what it weighed originally.
Furthermore, the various organs all differ in such varying degrees, as
compared with their respective weights at birth, that it facilitates
comparison to reduce the weight of each separate organ to a scale of 1.
On this basis we find that when complete development is attained, the
eyes weigh 1.7; the brain 3.7; the medulla oblongata (spinal marrow) 7;
the liver 13; the heart 15; the spleen 18; the intestines, stomach and
lungs 20; the skeleton 26; the system of striped muscles 48.
And these widely different augmentations are not uniform in their
progress, nor is the complete development of each organ attained at the
same epoch. As a matter of fact, the brain acquires one-half its final
weight at the end of the first year of age; the organs of vegetative
life attain half their weight at the beginning of the period preceding
puberty (eleventh year). To offset the lack of indications regarding
such increases in weight, we have a guide in the _morphology_ of
growth, which reveals how differently the various parts of the body
develop.
However empirical it may be from an analytical point of view, the datum
of weight is a valuable index, and represents, _taken by_ _itself_, a
synthetic anthropological measure of prime importance.
It obeys certain laws of growth which are themselves of great interest;
namely, there exist two periods of rapid growth: at birth and during
puberty; while at various periods in childhood, between the ages of
three and nine, there are alternations of greater and lesser growth
analogous to those already noted in relation to stature.
Accordingly, the weight confirms the fact that the organism does not
proceed uniformly in its evolution, but passes through _crises_ _of
development_ during which the forces of the organism are all devoted to
its rapid transformation; such periods represent epochs at which the
organism is more predisposed to maladies, more subject to mortality and
less capable of performing work (compare the observations already made
in relation to stature).
_Index of Weight._--Accordingly, weight and stature stand in a
certain mutual relationship, but the correspondence between them is
not perfect. In the study of individual physiological development it
is necessary to know the anthropological relation between weight and
stature; in other words, the ponderal index. Without this, we cannot
get a true idea of the weight of an individual. For instance, if two
persons have the same weight, 65 kilograms for example, and one of them
has a stature of 1.85 metres and the other of 1.55 m.; it is evident
that the first of these two will be very thin, because his _weight
is insufficient_, while the second, on the contrary, will have an
_excessive weight_.
A stout, robust child will weigh less, in an absolute sense, than an
adult man who is extremely thin and emaciated; but relatively to the
mass of his body, he will weigh more. Now this relative weight or
index of weight, the _ponderal index_, gives us precisely this idea
of relative _embonpoint_, of the more or less flourishing state of
nutrition that any given individual is enjoying. Hence it is a relation
of great physiological importance, especially when we are dealing with
children.
The calculation of the ponderal index ought to be analogous to that
of other indexes; what has to be found is its relation to the stature
reduced to a scale of 100. In this case, however, we find ourselves
facing a mathematical difficulty, because _volumetric_ measurements are
not comparable to linear measurements. Consequently it is necessary to
reduce the measurement of weight by extracting its cube root, and to
establish the following equation:
_St_:[*cube root](_W_) = 100:_X_
whence
_Pi_ = 100([*cube root](_W_))/_S_
The application of this formula necessitates a troublesomely
complicated calculation, which it would be impracticable to work out in
the case of a large number of subjects. But as it happens, tables of
calculations in relation to the ponderal index already exist, thanks
to the labours of Livi[35] and it remains only to consult them, as one
would a table of logarithms, by finding the figure corresponding to the
required stature, as indicated above in the horizontal line, and the
weight as indicated in the vertical column.
Some authors have thought that they were greatly simplifying the
relation between weight and stature by calculating the proportional
weight of a single centimetre of stature and assuming that they had
thus reduced the relation itself to a ratio based upon a single linear
measurement (one centimetre), analogous to the ratio established by the
reduction of the total stature to a scale of 100. But evidently such
a calculation is based upon two fundamental errors, namely: first, no
comparison is ever possible between a linear measure and a measure of
volume; and secondly, the relation which we are trying to determine is
that between synthetic measurements, _i.e._, measurements of the whole,
and not of parts.
[Illustration: FIG. 37.]
In the aforesaid method of computing (which is accepted by such weighty
authorities as Godin and Niceforo), the number expressing the weight
in grams is divided by the stature expressed in centimetres, and
the quotient gives the average weight of one centimetre of stature
expressed in grams. This method, which sounds plausible, may easily be
proved to be fallacious, by the following illustration, given by Livi
in his treatise already cited (Fig. 37). The two rectangles _A_ and _B_
represent longitudinal sections of two cylinders, which are supposed
to represent respectively (in _A_) the body of a child so fat that he
is as broad as he is long (the rectangle _A_ is very nearly square),
and (in _B_) that of a man of tall stature and so extremely thin that
he very slightly surpasses the child in the dimensions of width and
thickness (note the length and narrowness of rectangle _B_). Evidently
the ponderal index of _A_ is very high and that of _B_ is very low.
But if we calculate the _proportional weight_ of one centimetre of
stature, it will always be greater in the man than in the child, and
consequently we obtain a relation contrary to that of the ponderal
index.
Let us make still another counterproof by means of figures; let us take
an adult with a stature of 1.70 metres and a weight of 19 kilograms;
and a three-year-old child 0.90 m. tall and weighing 55 kg. (the normal
weight of a child of four). In the case of the adult one centimetre of
stature will weigh 65000/170 grams = 382 grams; while one centimetre of
the child's height will weigh 15000/90 = 166 grams. In other words,
one average centimetre of the child's stature weighs less than one
centimetre of the adult, as it naturally should, while the ponderal
index on the contrary is 23.6 in the case of the adult, and 27.4 in
that of the child.
The reciprocal relations between stature and weight vary from year
to year. In babyhood, the child is so plump that the fat forms the
familiar dimpled "chubbiness," and Bichat's adipose "fat-pads" give
the characteristic rotundity to the childish face; while the adult is
much more slender. A new-born syphilitic child which, with a normal
length of 50 centimetres, weighed only two kg.--and consequently would
be extremely thin--would have the same identical ponderal index as an
adult who, with a stature of 1.65 m., weighed 100 kg.
The _evolution_ of the ponderal index forms a very essential part
in the _transformations_ of growth; and it shows interesting
characteristics in relation to the different epochs in the life of the
individual.
In this connection, Livi gives the following figures, for males and
for females; from which it appears that at some periods of life we are
_stouter_, and at others more _slender_; and that men and women do not
have the same proportional relation between mass and stature.
---------------------------------------------------
Indices | Indices
-------+-------+---------+--------+-------+--------
Age in | Males | Females | Age in | Males | Females
years | | | years | |
-------+-------+---------+--------+-------+--------
0 | 29.7 | 29.6 | 15 | 23.1 | 23.4
1 | 30.9 | 30.5 | 16 | 23.4 | 23.6
2 | 28.7 | 28.9 | 17 | 23.1 | 23.7
3 | 27.5 | 27.3 | 18 | 23.2 | 24.1
4 | 26.5 | 26.6 | 19 | 23.4 | 24.1
5 | 25.8 | 25.6 | 20 | 23.5 | 24.1
6 | 25.1 | 24.8 | -- | -- | --
7 | 24.4 | 24.1 | 25 | 23.7 | 24.1
8 | 24.0 | 23.8 | 30 | 23.8 | 24.1
9 | 23.5 | 23.5 | 40 | 23.9 | 24.7
10 | 23.1 | 23.2 | 50 | 24.3 | 25.3
11 | 22.8 | 23.3 | 60 | 24.6 | 25.3
12 | 23.1 | 23.6 | 70 | 24.5 | 24.9
13 | 23.4 | 23.5 | 80 | 24.4 | 24.7
14 | 23.1 | 23.3 | -- | -- | --
---------------------------------------------------
It may be said in general, so far as regards the age, that the
following is the established law of individual evolution: during the
first year the ponderal index increases, after which it diminishes
up to the period immediately preceding puberty (eleventh year for
males, tenth year for females), the period at which boys and girls
are exceedingly slender. After this, throughout the entire period
of puberty, the ponderal index seems to remain remarkably constant,
oscillating around a fixed figure. At the close of this period
(seventeenth year for males, fourteenth for females), the ponderal
index resumes its upward course (corresponding to the period in which
the transverse dimensions of the skeleton increase, and in which the
individual, as the phrase goes, _fills out_), and it continues to rise
well into mature life (the individual _takes on flesh_); until in old
age, the ponderal index begins to fall again (the soft tissues shrink,
the cartilages ossify, the whole person is shrunken and wasted.)
[Illustration: FIG. 38.]
Women, during their younger years are on a par with men in respect to
the ponderal index, but in later life surpass them, because of woman's
greater tendency toward _embonpoint_, since she is naturally stouter
and plumper than man, who is correspondingly leaner and more _wiry_.
The following diagram indicates the progressive evolution and
involution of the ponderal index throughout the successive stages of
life:
The ponderal index has revealed certain physiological conditions
in pupils that are extremely interesting. Some authors had already
noted that the ponderal index was higher in _well-nourished_ children
(Binet, Niceforo, Montessori); but last year one of my own students,
Signorina Massa, in a noteworthy study of children, all taken from
the same social class and quite poor, and who did not attend the
school refectory or have the advantage of any other physiological
assistance, established the fact that the more _studious_ children,
the _prize winners_, have a lower _ponderal index_ and a _muscular_
_force_ inferior to that of the non-studious (negligent) pupils. That
the development of the ponderal index stands in some relation to the
muscular force, might already have been deduced from the fact that the
greatest increase of weight is due, in the evolution of the individual,
to the system of striped muscles. Studious children, accordingly,
are sufferers from _denutrition through_ _cerebral consumption_;
furthermore, they are weakened throughout their whole organism; in
fact, I discovered, in the course of researches made among the pupils
in the elementary schools of Rome, that the _studious_ children, those
who _received prizes_, had a _scantier_ chest measurement than the
non-studious. This goes to prove that school prizes are given at the
cost of a useless holocaust of the physiological forces of the younger
generations!
That the ponderal index has an eminently physiological significance, is
further shown by the following comparative figures between normal and
weak-minded children. The stature, which is biologically significant,
is lower in the weak-minded; but their ponderal index is greater when
they are well fed, as in the asylums in Paris.
Accordingly, the sole cause of the physical inferiority of studious
children is _study_, _cerebral fatigue_.
BIO-PHYSIOLOGICAL DIFFERENCES BETWEEN NORMAL AND
WEAK-MINDED CHILDREN
(SIMON AND MONTESSORI: BASED ON CHILDREN FROM 9 TO 11)
----------------------------------------------------------------------
| Weight in kilograms| Average stature | Ponderal index
|--------------------+--------------------+-------------------
Age |Weak-minded |Normal |Weak-minded |Normal |Weak-minded |Normal
----+------------+-------+------------+-------+------------+------
9 | 21.0 | 25.5 | 1.15 | 1.24 | 24 | 23.9
10 | 26.5 | 28.5 | 1.25 | 1.30 | 24 | 23.6
11 | 27.0 | 30.5 | 1.25 | 1.33 | 24 | 23.6
------------------------------------------------------------------
It should be noted that in the foregoing table the normal children
include both the studious and the non-studious.
FOOTNOTES:
[4] See further, as to these fundamental ideas: Laloy, _L'Evolution de
la Vie. Petite Encyclopedie_ _du XX Siecle_; CLAUDE BERNARD, _Lecons
sur les Phenomenes de la Vie_; LE DENTU, in _La Matiere Vivante, et
Theorie nouvelle de la Vie_; Luciani, _Fisiologia Umana_, in the first
chapter: "Material Substratum of Vital Phenomena."
[5] Consult: HAECKEL, _Anthropogenie_; E. PERRIER, _Les Colonies
animales et la Formation_ _des Organismes_; RICHET, _L'Effort vers la
Vie, et la Theorie des Causes finales_.
[6] CORRENS: _Concerning the Laws of Heredity_.
[7] Translator's note.
[8] Translator's note.
[9] De Giovanni, _Op. cit._, p. 236. Cases referring to the first
morphologic combination.
[10] DE GIOVANNI, _Op. cit._
[11] DE GIOVANNI, _Op. cit._
[12] Boxich, _Contribution to the Morphological, Clinical and
Anthropological Study of_ _delinquents_.
[13] DENIKER, _Races et peuples de la terre_.
[14] TOPINARD, _Elementi di Antropologia_.
[15] QUETELET, _Proporzioni medie (mean Proportions)_.
[16] LIVI, _Antropometria Militare (Military Anthropometry)_.
[17] MONTESSORI, _Caratteri fisici delle giovani donne del Lazio._
[18] Translator's note.
[19] Fig. 25 and those following it, dealing with deformities resulting
from labour, are taken from Pieraccini's great work, _The Pathology of
Labour_.
[20] PIERACCINI, _Op. cit._
[21] ALFREDO NICEFORO, _Les classes pauvres_ (the poorer classes).
[22] Taken from Livi: _On the Development of the Body in relation to
the profession and the_ _social condition._ Rome, Voghera, 1897.
[23] MARRO, _Puberty_.
[24] Cited by PAGLIANI, _Human Development, according to age, sex, etc._
[25] RACIBORSKI, cited by MARRO, _Puberty_.
[26] _Idem._
[27] Rousseau, _Emile_, cited by MARRO.
[28] It should be noted that sexual precocity or vice retards the
development of puberty, while healthful psychic stimuli are favourable
to it. Hence it was a right instinct that led us to give the name of
sin and vice to what retards the normal development of life, and virtue
and honour to what is favourable to it.--Author's note.
[29] Compare _The method of Scientific Pedagogy applied to infantile
education_ _in the "Children's Houses,"_ MONTESSORI: Casa Editr. Lapi,
1909.
[30] MOIGE, _Nouvelle Iconographie de la Salpetriere_, 1894.
[31] APERT, _Op. cit._
[32] Cited by Marro.
[33] Cited by Figueira, _Semejotica Infantile_, p. 121.
[34] Cited by FIGUEIRA (Rio Janeiro) in his volume, _Elementi di
Semejotica infantile_, 1906. From this volume, which contains the
result of the most modern investigations in pediatry, I have taken a
number of data regarding the weight of children.
[35] LIVI: _Antropometria_.