THE STIGMATA OF DEGENERACY
The attempt made by Morel to limit the doctrine of degeneracy to the
domain of the morbid proved impossible, because of the rapid accumulation
of data by his own school, which demonstrated that atavistic deformity
played a larger part in the production of diseases. Bland Sutton does not
too forcibly put this result when he states[59] that if it be difficult to
define disease when restricted to the human family, it becomes obviously
more difficult when disease is investigated on a broad biological basis.
As the great barrier which exists between man and those members of his
class most closely allied to him consists not in structural characters but
in mental power, it necessarily follows that there should be a similarity
in the structural alterations induced by diseased conditions in all kinds
of animals, allowing of course for the difference in environment. This is
known to be the case, and it is clear that as there has been a gradual
evolution of complex from simple organisms, it necessarily follows that
the principles of evolution ought to apply to diseased conditions if they
hold good for the normal or healthy states or organism; in plain words,
there has been an evolution of disease _pari passu_ with evolution of
animal forms. For a long time it has been customary to talk of physiologic
types of diseased tissues; Sutton's earlier efforts were directed to
searching among animals for the purpose of detecting in them the
occurrence of tissues, which in man are only found under abnormal
conditions. The statement proved to be true in a limited sense. At the
same time the truth of an opinion held by nearly all thoughtful
physicians, that disease may in many instances be regarded as an
exaggerated function, was forcibly illustrated; the manifestations of
disease were found to be regulated by the same law which governs
physiological processes in general, and many conditions regarded as
pathological in one animal were revealed as physiological in another.
The doctrine, therefore, has its scope limited only by biologic data. It
of necessity begins with the cell itself in its relation to other cells of
that practically compound organism which constitutes a single vertebrate.
The cell may, therefore, degenerate as a single member of that organism,
producing danger or benefit to the other cells. Thus the cancer cell
degenerates in its power of reproduction below the tissue to which it
belongs. It is peculiarly true here, as has been said by Herbert Spencer,
that every vertebrate is an aggregate whose internal actions are adapted
to counterbalance its external actions; hence the preservation of its
movable equilibrium depends upon its development and the proper number of
these actions; the movable equilibrium may be ruined when one of these
actions is too great or too small, and through deficiency or need of some
organic or inorganic cause in its surroundings. Every individual can
adapt itself to these changeable influences in two ways, either directly
or by producing new individuals who will take the place of those whom the
equilibrium has destroyed. Therefore there exist forces preservative and
destructive of the race. As it is impossible that these two kinds of force
should counterbalance each other, it is necessary that the equilibrium
should re-establish itself in an orderly way. Since there are two
preservative forces of every animal group--the impulse of every individual
to self-preservation and the impulse to the production of other
individuals--these faculties must vary in an inverse ratio; the former
must diminish when the second augments. Degeneration constitutes a process
of disintegration, the reverse of integration. Hence, if the term
individuation be applied to all the processes which complete and sustain
the life of the individual, and that of generation to those which aid the
formation and development of new individuals, individuation and generation
are necessarily antagonistic.
In the phenomena of unisexual generation we see that the larger organisms
never reproduce themselves in the unisexual way, while the smaller
organisms reproduce themselves with the greatest rapidity by this method.
Between these two extremes unisexual reproduction decreases while the size
increases. In the history of all plants and animals is evident the
physiologic truth, that while the general growth of the individual
proceeds rapidly, the reproductive organs remain imperfectly developed and
inactive. On the contrary, the principle of reproduction indicates
decrease in the intensity of growth and becomes a cause of cessation.
Great fecundity is always attended by great mortality. Each superior
degree of organic evolution is accompanied by an inferior degree of
fecundity. The greater the germs the less is the individuation, and _vice
versa_. The greater and more complex the organisation, the less is the
power of multiplication.
What is true of the cells is also true of organs composed of them. Each
organ can be regarded as a distinct animal (a parasite is preferable for
comparison) which has its own nervous system (the ganglia), but is fed and
controlled by the organism as a whole. Degeneration of this organ may
therefore be an expression of a local state peculiar to it and either
beneficial or maleficent, or both in inverse degree, to the organism as a
whole, or it may be the expression of a general defect in the whole
organism. The sclerotic states of the appendix vermiformis in man and of
the human liver are, as Kiernan has shown, two excellent illustrations of
the degeneracies last described. Man, in common with the four anthropoid
apes, has a little thin tube attached to the caecum known as the appendix
vermiformis. In the early embryo it is equal in calibre to the other
bowels, but ceases to grow proportionately after a certain time. In the
new-born child it is almost as large as in the adult. As this tube proved
disadvantageous to man's precursor (as it does to certain mammals) from
catching foreign bodies which form the nucleus of enteroliths or bowel
stones, it has lost the nutritive supply of the other intestines and is
tending to disappear. It is often absent in man. The defect in its
structure, while predisposing to the attacks of germs and an expression of
its own degeneracy, is an evidence of an advance in evolution in the
organism as a whole by which great danger and waste of nutritive force
are avoided.
Recent researches[60] have shown that "hob-nail" liver, once supposed to
be due entirely to abuse of alcohol, usually occurs in states of
congenital deficiency in persons of defective heredity. The change in the
appendix which is tending to cause its disappearance is essentially a
sclerosis, and hence is morbid, considered from the appendix standpoint
alone. As the same process occurs in "hob-nail" liver, it is obvious that
degeneracy may be an expression of general advance and local defect or may
be a local expression of general defect. The same phenomenon is seen in
the nervous system. The researches of Cunningham[61] have shown that in
man the struggle for existence between the sympathetic and the
cerebro-spinal system has ended in the victory of the latter, while the
first is tending to disappear. Such changes must necessarily result in
local degeneracies which are for the benefit of the organism as a whole.
Degeneracy on this basis may express itself in simple disturbance of the
lower or nutritive functions. The uric acid or gouty states, for example,
are, as Fothergill long ago pointed out, assumptions by mammalian organs
of the functions of those of birds and reptiles. In conditions like
myxoedema the skin, through thyroid gland disturbances, takes on features
which resemble in result those found in certain mollusks and low fish.
These nutritive disturbances may show themselves in disorders of the
pituitary body (acromegaly, giantism, &c.), whereby the bony system of man
reverts to conditions like those of the gorilla. The same conditions also
appear in the diathesis of the "bleeders." All these conditions, however,
may be an expression of a degenerate type assuming a normal equilibrium,
as well as of a normal organism taking the first steps in degeneracy.
In a general way, therefore, as Dohrn has pointed out, this principle
holds good of man not only as an organic unit but as a compound organism.
Degeneracy[62] is a gradual change of structures by which the organism
becomes adapted to less varied and less complex conditions of life. The
opposite progression process of elaboration is a gradual change of
structure in which the organism becomes adapted to more and more varied
and complex conditions of existence. In elaboration there is a new
expression of form corresponding to new perfection of work in the animal
machine. In degeneracy there is suppression of form corresponding to the
cessation of work. Elaboration of some one organ may be a necessary
accompaniment of degeneracy in all the others. This is very generally the
case. Only when the total result of the elaboration of some organs, and
the degeneracy of others, is such as to leave the whole mass in a lower
condition--that is, fitted to less complex action and reaction in regard
to its surroundings than is the type--can the individual be regarded as an
instance of degeneracy. These degeneracies appear at varying periods,
since struggles for existence on the part of the different organs and
systems of the body are most ardent during periods of body evolution and
involution. During foetal life, during the first dentition, during the
second dentition (often as late as the thirteenth year), during puberty
and adolescence (fourteen to twenty-five), during the climacteric (forty
to sixty), when uterine involution occurs in woman and prostatic
involution in man, and finally during senility (sixty and upwards), during
all these periods degeneracy may be shown by mental or physical defect, a
congenital tendency to which has remained latent until the period of
stress. These defects may be such biochemic alterations (undemonstrable by
existing methods) as lead to diminished inhibitory power or other altered
function, or to secondary pathologic or teratologic change of decidedly
demonstrable nature. Organs and structures checked at a certain phase of
development may pursue a course of development differing from that pointed
out in man but outlined in other vertebrates. The human cyclopean
monstrosities, for example, might be regarded as reversions to the
single-eyed sea-squirts, who are possibly the Ascidian precursors of the
vertebrates.
The scope of degeneracy may therefore be limited to certain signs which
are its sole expressions. These signs (stigmata as they were early called)
may be the only expression of degeneracy, and their significance must be
determined by a careful examination of the organism in which these
expressions are found, since they may be merely defects produced by
degeneracy, or may indicate how deep such degeneracy has penetrated. They
may, therefore, indicate either slight or serious defect. In proportion to
the depth of degeneracy in the organism will the stigmata affect the
earlier simpler or later complicated acquisitions through evolution. Of
necessity, when the organism is affected by degeneracy, the morbid element
will take the line of least resistance, determined by the depth of
degeneracy as well as the variability of the structures concerned. The
same influence must equally affect functions of the structures.
Furthermore, expressions of degeneracy will, as already stated, be
influenced by the periods of stress; the first and second dentition,
puberty, the climacteric and the senile period. In a general way these
stigmata are divisible into mental and physical, and are best observable
in their relations to the periods of stress. In certain races, as in
certain animals, conditions appearing before puberty was completed cannot
be considered as settling the position of the animal in evolution. What is
true of individuals is also true of classes. The anthropoid apes and the
negroes are much higher in physical characteristics, with potential mental
results, before puberty than after. The infant ape, as Havelock Ellis[63]
points out, is very much nearer to man than the adult ape. "The infant ape
is higher in the line of evolution than the adult, and the female ape, by
approximating to the infant type, is somewhat higher than the male. Man,
in carrying on the line of evolution, started not from some adult male
simian, but from the infant ape and, in a less degree, from the female
ape. The human infant bears precisely the same relation to his species as
the simian infant bears to his, and we are bound to conclude that his
relation to the future evolution of the race is similar. The human infant
presents, in an exaggerated form, the chief distinctive characteristics of
humanity--the large head and brain, the small face, the hairlessness, the
delicate bony system. By some strange confusion of thought we usually
ignore this fact, and assume that the adult form is more highly developed
than the infantile form. From the point of view of adaptation to the
environment, it is undoubtedly true that the coarse, hairy, large-boned
and small-brained gorilla is better fitted to make his way in the world
than his delicate offspring; but from a zoological point of view we
witness anything but progress. In man, from about the third year onwards,
further growth--though an absolutely necessary adaptation to the
environment--is to some extent growth in degeneration and senility. It is
not carried to so low a degree as in the apes, although by it man is to
some extent brought nearer to the apes, and among the higher human races
the progress towards senility is less marked than among the lower human
races. The child of many African races is scarcely, if at all, less
intelligent than the European child, but while the African as he grows up
becomes stupid and obtuse, and his whole social life falls into a state of
hide-bound routine, the European retains much of his childlike vivacity.
And if we turn to what we are accustomed to regard as the highest human
types, as represented in men of genius, we shall find a striking
approximation to the child type." The face, in its contest for existence
with the brain, has finally caused both the cranium and the jaws to assume
(for defence and food purposes) a lower type, although as regards existing
functions and the higher standpoint of environment the infantile type must
be considered the higher. Still a casual glance at the Ascidian tadpole
shows that deficient as is the development of the ganglia afterward
forming the medulla, the face is still more deficient. The face, as Minot
shows,[64] is a characteristic of the higher vertebrates, and acquires
increased importance with rise in the evolution. The position of the face
in embryonic development is originally determined by the head-bend. If a
median, longitudinal section of the head be imagined to occupy a
rectangular area divided into quarters, then the lower posterior quarter
corresponds to the mouth region, the other three-quarters to the brain. As
development progresses, the mouth quarter so disproportionately enlarges
in relation to the rest of the head as to project forward in front of the
fore-brain. In this stage, which is represented by the adult amphibians,
the bulk of the facial apparatus is very great, proportionately to the
cranium. In the reptiles the mouth region is elongated still further in
front of the brain-case, resulting in the long snout. In mammals a third
stage is established by the great increase in size of the brain,
especially of the cerebral hemispheres. In consequence the brain comes to
extend over the snout, as it were; in man, whose brain has the maximum
enlargement, the facial apparatus is almost entirely covered by the brain.
In the course of evolution the face, while serviceable to the animal for
certain reasons of general constitutional character (food-getting, means
of defence and means of obtaining mates), is less so than brain growth. A
struggle for existence, therefore, inevitably results between the tendency
of the face to appropriate power of growth and the like tendency of the
brain, which, in defective organisms, produces marked reversions of the
one for the benefit of the other. This struggle is further complicated by
the embryonic relations to both of the hypophysis, since this body
admittedly exerts an influence over bone growth, most markedly (but
abnormally) exhibited in acromegaly (excessive bone growth). In this
contest for existence in the degenerate types, degeneracy will, of
necessity, take the direction of least resistance. As the brain is the
last acquirement in vertebrates, considered from the standpoint of
necessity, while the face (also a late acquirement) is much less complex,
the last, obviously, will present the derangements from degeneration in
shape, while the former will show these in shape and function.
Furthermore, during the embryonic period the development of the brain
will, of necessity, be more immediately affected by degeneracy than the
face, which will gain in evolution at its expense. The stigmata of
degeneracy, therefore, most likely to attract attention are in the order
given, those of the face, jaws, and teeth; ear, eye, cranium; body, bodily
functions; brain and spinal cord. Under these last are to be included
their mental and nervous functions.
The following table summarizes in practical form these stigmata[65]:--
{ { Crime.
{ Ethical { Prostitution and Sexual Degeneracy.
{ Degeneracy. { Moral Insanity, Pauperism, and Inebriety.
{
{ { Paranoia.
{ { Adolescent Insanity.
{ { Periodical Insanity.
Cerebral. { Intellectual { Hysteria.
{ Degeneracy. { Epilepsy.
{ { Neuroses.
{ { One-sided Genius.
{ { Idiocy.
{
{ Sensory { Deaf-Mutism.
{ Degeneracy. { Congenital Colour Blindness.
{ { Smell Abnormalities.
Spinal Various congenital and hereditary disorders
{ Exophthalmic Goitre.
{ Lymphoid Degeneracy.
{ Acromegaly.
{ Tissue Instability.
{ Adenoids.
{ Myxoedema.
Nutritive { Plural Births.
Degeneracy { Bleeders.
{ Cancer.
{ Excessive Fecundity.
{ Gout.
{ Early Lipomatosis.
{ Jaws.
{ Cleft Palate.
{ Teeth.
{ Primitive Uteri.
Local { Cloacal conditions (and allied male states)
Reversionary { Horseshoe Kidney and allied states.
Tendencies. { Cyclopian Monstrosities.
{ Amelia and Polymelia, Club feet, &c.
{ Plural mammae.
{ Simian muscular and bony states.
{ Liver and other organ reversions.
The factors producing degeneration act by causing nervous exhaustion in
the first generation. This implies a practical degeneration in function
since tone is lost.
Every nerve cell has two functions, one connected with sensation or
motion, and the other with growth. If the cell be tired by excessive work
along the line of sensation or motion the function as regards growth
becomes later impaired, and it not only ceases to continue in strength,
but becomes self-poisoned. Each of the organs (heart, liver, kidneys, &c.)
has its own system of nerves (the sympathetic ganglia), which while under
control by the spinal cord and brain act independently. If these nerves
become tired the organ fails to perform its function, the general system
becomes both poisoned and ill-fed, and nervous exhaustion results. In most
cases, however, the brain and spinal cord are first exhausted. The nerves
of the organs are thus allowed too free play, and exhaust themselves
later. This systemic exhaustion has local expression in the testicles in
the male, in the womb and ovaries in the female. Through this the body is
imperfectly supplied with natural tonics (antitoxins) formed by the
structures, and the general nervous exhaustion becomes still more
complete. All the organs of the body are weakened in their function.
Practically the neurasthenic in regard to his organs has taken on a
degenerative function albeit not degenerating in structure, since the
restlessness of the organs is a return to the undue expenditure of force
which occurs in the lower animals in proportion as it is unchecked by a
central nervous system. Through the influence of various exhausting
agencies the spinal cord and the brain lose the gains of evolution and the
neurasthenic is no longer adjusted to environment. Since the reproductive
organs suffer particularly, children born after the acquirement of nervous
exhaustion, more or less checked in development as the influence of
atavism is healthy or not, repeat degenerations in the structure of their
organs, which in the parent were represented by neurasthenic disorders in
function. As the ovaries of the neurasthenic women generally exhibit
prominently the effects of the nervous exhaustion, the offspring of these
do not retain enough vigour to pass through the normal process of
development.