THE DEGENERATE FACE AND NOSE
The development of the face depends, as I have already shown, upon the
enlargement and fusion of the mouth and nose cavities, and upon the later
partial separation of the nose and mouth and the nose cavities, leaving
the posterior nose open. It depends further upon the growth and
specialisation of the face region, of which the elongation is the most
prominent indication, and finally upon the development of a prominent
external nose. The relations of face to cranium in embryology have already
been described. When the medullary tube of the notochord enlarges to form
the brain the end of the head bends over to make room for that
enlargement. The bending of the head carries the mouth plate, which is to
be the mouth, over to the front of the head. The changes which develop the
mouth cavity are the growth of the brain and the increase in size of the
heart cavity, which expand to the front, leaving the mouth cavity between
them. The mouth cavity represents two gill-slits united in the front line.
The nose is formed from two olfactory plates situated just in front of the
mouth and in contact with the fore-brain. These olfactory plates grow in
size by the increase of tissue, and the resulting pits pass away from the
brain. At first these pits, although widely separated by what is called
the nasal process, communicate freely with the mouth. The nasal process
includes the origin of the future nose and of the future intermaxillary
region of the upper lip.
The human face is modified backward from the vertebrate type. It is an
additional illustration of the degeneracy of a series of related
structures for the benefit of the organism as a whole. The progress of
development of the face in the vertebrates is checked in man. First, as
Minot remarks,[196] because the upright position renders it unnecessary to
bend the head as in quadrupeds. Second, because the enormous cerebral
development has rendered an enlargement of the brain cavity necessary.
This has taken place by extending the cavity over the nose region as well
as by enlarging the whole skull. Third, because the development of the
face is arrested at an embryonic stage; the production of a long snout
being really an advance of development which does not take place in man.
From what has been said of the relations of the dermal bones to the nose
and face in the chapter on the skull, it will be obvious that these must
follow the same laws as to degeneracy as the skull itself. These checks
from degeneracy in arrest of development are apt to affect most obviously
the unilateral development of the face. From this results the exaggerated
asymmetry so frequently observed.
Jacob Baumler, the founder of the Zoar community of the United States, a
religious fanatic, had a very marked asymmetry of the face and the mind
of a degenerate. His orbits were unequal, one being exceedingly large and
the other correspondingly small.
The human face at birth is so near that of the monkeys that if only the
heads of both were exposed to view at birth it would be difficult for a
casual observer to distinguish one from the other. Cope[197] has made the
following classification of the head and face for comparative study: The
relative size of the cerebral to the facial regions, the prominence of the
forehead, the prominence of the superciliary regions, the prominence of
the alveolar borders of the jaws, the prominence and width of the chin,
the relation of length to width of the skull, the prominence of the
cheek-bones, the form of the nose, the relative size of the orbits and
eyes, the size of the mouth and lips.
At birth in the infant ape the facial region of the skull is smaller than
in the adult, the forehead is more prominent, the superciliary ridges are
more prominent, the edges of the jaws are more prominent, the chin is
less, while the cheek-bones are more prominent, the nose is without a
bridge and has short and flat cartilages, the face is flattened, the
orbits and eyes are smaller and closer together, the mouth is small and
the lips thin.
In the typical infant child as he begins to develop the cerebral part of
the skull predominates over the facial more than in the adult, the
superciliary ridges are not developed, the alveolar borders are not
prominent, the cheek-bones are not prominent, the nose is without a bridge
and the cartilages are flat and generally short, the eyes are larger. In
this last particular the human infant resembles the lemurs and thus
retains an embryonic tendency. In some degenerates this tendency remains
unchecked, and the result is unusually large orbits as in Fig. 18. In
other instances the human foetus passes through this lemurian stage to
reach and even exceed the anthropoid in smallness and closeness together.
[Illustration: FIG. 18.]
In determining a standard by which to measure the face two principles come
into play: the general principle of evolution, and also that aesthetic
principle governing profile, which has practically obtained supremacy,
after long struggles for existence, from the Egyptian period of the first
dynasty until its final acceptance by the Greeks, as shown, for instance,
in the Apollo Belvedere. Indeed, so nearly does the modern standard
approximate to the Greek, that Kingsley,[198] speaking of modern profiles,
remarks that if he were to describe the American type he should be as much
inclined to give that name to the form of features of the Apollo Belvedere
as any other, since it is quite universal, distinctive, and possesses the
same elements of beauty.
[Illustration: FIG. 19.]
Among Aryan-speaking races this type would be accepted as the ideal one.
Since each nationality, and peoples of the same nationality, living in
different countries do not possess exactly the same type of face, the
general presumption of evolution as modifying notions of beauty must also
be taken into consideration. In the determination of the extent to which
the profile exists the facial angle plays a part. This angle was early
pointed out by Camper as a means of distinguishing the relative
development of the skull and face. "The basis on which a distinction of
nationality is founded," said Camper, "may be displayed by two straight
lines (Fig. 19), one of which is to be drawn through the meatus auditorius
to the base of the nose, and the other touching the prominent centre of
the forehead and falling thence on the most advancing portion of the upper
jaw, the head being used in profile. In the angle produced in these two
lines may be said to consist not only the distinctions between the skulls
of different species of animals, but also those which are found to exist
between different races. The angle which the facial line or characteristic
line of the visage makes varies from 70 deg. to 80 deg. in the race. All who raise
it higher disobey the rules of art (from imitation of the antique). All
who bring it lower fall into the likeness of the monkeys. If I cause the
facial line to fall in front I have the antique head. If I incline it
backward I have the head of a negro. If I incline it still further I have
the head of a monkey; inclined still more I have the head of a dog; and,
lastly, that of a goose."
[Illustration: FIG. 20.]
[Illustration: FIG. 21. COLOURED CRIMINAL YOUTH.]
This is excellently shown by the following illustrations. Fig. 20 is the
head of Johanna, the female chimpanzee of Central Park, New York City.
This head has (by Camper's method) an angle between 40 deg. and 50 deg. The brain
of this animal occupies one-third of the skull, and the jaws two-thirds.
The negro criminal (Fig. 21) has an angle of about 70 deg. Here the brain is
encroaching, while the jaws are receding. The Caucasic race (Fig. 22) has
an angle of 75 deg. to 80 deg. In many cases the frontal development of the
brain and resultant recession of the jaws produce an angle of 90 deg., with a
general result not unlike the Apollo.
Although the general outlines of facial evolution as sighted by Camper are
in accord with my own views, yet, as regards accuracy, this angle is not
an ideal from whence to study face degeneracy, since the line does not
fall low enough to include the chin, and also, as I have elsewhere shown,
in the degenerate, the ear varies as much as one to one and one-half
inches upon heads of different individuals. Frequently, in the degenerate
classes, the ears of the same individual differ as much as one inch in
height.
[Illustration: FIG. 22.]
An ideal line, from whence to study a degenerate face, should be drawn
perpendicularly from the supra-orbital ridge intersecting the upper and
lower jaw and chin. While the chin of the Apollo Belvedere falls slightly
inside of this line, yet this is hardly perceptible. Having now fixed a
standard from which to study the degenerate face, it should be remembered
that jaws which protrude beyond this line are atavistic, and those which
recede are even more degenerate.
[Illustration: FIG. 23.]
[Illustration: FIG. 24.]
The angle between 80 deg. and 90 deg. may be accepted as an ideal by which to
study degeneracy. This factor alone, however, can not be accepted: the
evolution of the face itself must be also taken into consideration. It is
obvious that in the struggle for existence and supremacy between the brain
and the face (both expressions of vertebrate advance), stress may be
concentrated on one particular part. Whence result certain factors which
modify the conclusion to be drawn from the facial angle. The hollowed out
condition of the face from the supra-orbital ridges down to and including
the base of the nose (illustrated in Johanna) merits attention here. The
same condition is observable in the negro, only it extends farther down
and includes both jaws. One jaw, however, may alone be affected. Most of
the Chinese, Japanese, Eskimo, Polynesians, Australians, Aryan Caucasic
Africans, and some American Indians, possess this feature. As has been
already remarked, the facial regions of man and the ape up to a certain
point are similar. Not until the sense organs of man begin to develop are
changes noticeable in facial expression. If, through heredity or
constitutional defect, that part of the brain which presides over
development of the facial bones lose its control, arrest of development of
that particular tissue results at any period between birth and the
twenty-fifth year, while other parts of the head and face continue to
develop. With this understanding Camper's method can be safely applied to
certain cases. If a line be dropped from the supra-orbital ridge to the
upper lip in its most prominent part (Fig. 23), it will be found here that
in place of the face presenting the full appearance illustrated in Fig. 19
and Fig. 22, it has the hollow appearance observable in Johanna and in
Fig. 25. This is due to arrest of development of the bones of the face and
the upper jaw. The extent of depression depends upon the time of arrest,
the frontal development of the skull, and the position of the upper jaw.
The nose may present and retain the appearance of that of a child six
months old, or any other shape up to normal development, but will not
protrude from the face nor present a normal symmetrical appearance. It has
the appearance of having been driven into the face. It has been claimed
that the bridge of the nose is pushed out by the advancing brain and
cranium. This may be true to a certain extent, but one is not necessarily
dependent on the other, since an arrested nose is frequently found in a
fully developed cranium (Fig. 24), which is not unlike Fig. 23 and a
"throw-back" to Fig. 20. This is due to the fact that in the struggle for
existence the bones of the face and skull base became arrested early in
life, while the brain and cranium continued to advance. The lower jaw is
usually normal since, while the tendency to arrest may be present in a
slight degree, mobility of the jaw often causes such increased nutrition
of the part that normal development in many cases thereby results.
Overlooking this fact has often led to the assertion that a large lower
jaw exists when, in reality, this appearance is due to an arrest of the
face and upper jaw, the lower remaining normal. The expression of
degeneracy is rather in the arrest of the upper jaw than in the normal
lower (see Fig. 23).
The criminals of the Elmira Reformatory, and those of the Pontiac
Reformatory, present marked instances of this stigma, nearly 50 per cent.
being so affected. Arrest of the lower jaw may occur alone, or may be
associated with arrest of development of the face (Fig. 25). When this is
the case a deep, broad groove extends from below the eyes downward and
backward to the lower jaw, also showing a lateral arrest of development,
producing a hatchet-shaped face. The upper part of the face may be normal,
and the lower jaw arrested antero-posteriorly.
[Illustration: FIG. 25.]
[Illustration: FIG. 26.]
It has been broadly asserted that this is an atavism, but more probably it
is an expression of that phase of evolution whereby both jaws are becoming
subservient to the advance in evolution represented by the gains of the
brain and cranium. When both jaws are arrested Camper's disobedience of
the rules of art, whereby the facial angle is increased over 90 deg., occurs.
This condition has been found in many degenerates. Almost invariably in
connection with the arrest of development of the face occurs arrest of the
bones of the nose. The diameter of the nasal cavities is much smaller
than normal. Owing to the unstable condition of the nervous system there
is also hypertrophy of the turbinate bone and mucous membrane of the nose
and throat, tonsil hypertrophy, arrested development of the chest walls
and lung tissue, and unstable mucous membranes throughout the lungs. Such
a degenerate face, body, and unstable nervous system is a fruitful soil
for the germs of tuberculosis. In these cases even a casual glance will
show that the two halves of the face and head are not symmetrically
developed. It looks as though the two halves were made separately and
joined together, one half higher than the other. This condition is
excellently illustrated in Fig. 26. In this case the left half is higher
than the right. (Frequently the right side is the higher.) There is arrest
of the upper and lower jaw. The left corner of the mouth is higher than
the right. The left half of the lower jaw is higher than the right, the
body of the lower jaw is longer, the ramus is shorter. The left eye and
ear are higher. The left supra-orbital ridge is higher. The ears stand
almost at right angles, while the malar processes are quite prominent.
Viewing the face from a three-quarters' angle (which should always be done
in making an examination, or photographing the degenerate face for study)
it will be found that there is not only arrest of development of the bones
of the face, but also of the lower jaw.
As already stated in the chapter on the cranium, the nasal bones belong to
the dermal category, their special function as nose bones being a later
acquisition. In their acquirement of this function they have passed
through many changes, especially as the human face in its nasal features
has assumed an embryonic type. In consequence, like all late embryonic
acquisitions, degeneracy is apt to involve the nose.
When arrest of development of the face takes place stigmata of the nasal
bones always result. Under such conditions narrowing or arrest of
development of the entire nasal cavity ensues.
Deformities of the nasal septum, deflection, hypertrophy and atrophy of
the turbinate bones, deformities of the maxillary sinus, hypertrophy of
the mucous membrane and polypi are common. Deflection of the external nose
is a very common stigma of degeneracy. Not only is the septum involved,
but also the outer plates of the nasal cavity. So unstable are the bones
of the face in their development that it is not an uncommon thing for the
nasal process of the upper jaw on one side to be much more developed than
the other. Not only is the nasal septum involved, but also the bones of
the face as well, producing a fulness on the long side of the face. This
stigma is very common among criminal youth. In such cases the deflected
septum is due to the development of the outer plate and not _vice versa_.
Deflection of the septum to the left may entirely obliterate (as in Fig.
27) the left nasal cavity. If one nostril of a rabbit be permanently
closed, after the animal has attained its full growth, the nasal cavity of
the affected side remains undeveloped and facial asymmetry results.
[Illustration: FIG. 27.]
Therefore two factors are common: first, the arrest of development of the
bones of the nose, and second, the clogging of the cavity, both active
agents in producing a closure, resulting in mouth-breathing.
Coexisting with these is often (as in Fig. 27) smallness of the upper
jaw. In the same connection grooved teeth occur, as in the same
illustration.
[Illustration: FIG. 28.]
The turbinated (Fig. 28) bones are often hypertrophied, as is also the
nasal septum (vomer or dividing bone) and the mucous membrane. This
results from the general instability of the nervous system with its
special expression in increased blood supply, whence occur overgrowth in
and imperfect work by the mucous membrane, causing mouth-breathing and
polypi, which again increase this defect. All these predispose to germ
invasion.
In the figure are also shown grooves upon the teeth. Sufficient symptoms
are here evident to stamp this as a marked degenerate skull.
Hypertrophy of the turbinate bones, septum, and mucous membrane, as it
occurs among degenerates, appears in Fig. 29, and is due, first, to an
unstable nervous system, and, second, a larger system of blood vessels
which ramify through these parts. Stimulation, together with the stenosis
(narrowing), tend to produce a closure. Still further, irritation and an
unstable mucous membrane results, with polypi or adenoid vegetation
following.
[Illustration: FIG. 29.]
Not only do deflection of septum and hypertrophy of the nasal bones occur,
but the antrum (cavity behind the nose) may be almost entirely
obliterated, while the upper jaw is arrested (Fig. 29). The antrum may be
entirely wanting, as in Fig. 30; so unstable may these tissues develop
that the nasal cavities may become almost entirely obliterated, as
observed in this figure.
[Illustration: FIG. 30.]
These conditions are due to the unstable structure and large nerve and
blood supply. Perhaps one of the most interesting points in connection
with degeneracy of the nose is the fact that in most cases the structures
are either arrested or excessively developed, to the extent of the entire
absence of the inferior turbinate bone. This was the case in a girl
thirteen years of age who died of tuberculosis. Her skull revealed many
other forms of degeneracy as well. The deviation in the development of the
two nasal cavities results from the excessive and arrested development of
the turbinates, thus preventing inhalation and exhalation of air, the free
side developing and the closed side remaining undeveloped. In such case
the nose is deflected to the right or left, depending on which side is
arrested. When both nostrils are closed the nose becomes thin and pointed
and mouth-breathing results. In degenerate nasal cavities polypi (tumours)
are apt to occur.
Persons with long, thin noses, arrested nasal cavities, sunken faces (as a
result mouth-breathers), and with contracted chest walls are the subjects
for tuberculosis. In such cases, especially when the nervous system is
unstable, the different forms of catarrh are present. This condition
worries the youth under the strain of puberty. To the catarrh which is
merely a result is ascribed his constitutional defects. These somatic
signs are quite noticeable in most of these cases, and by early
recognition proper treatment, with change of climate, frequently prolongs
life for years.
The so-called erectile tissue of the nose (containing blood whose flow is
checked through spasm to increase sensation), that relic of a time when
smell played a greater part among the senses, is apt to be affected by
degeneracy either as to its excessive or imperfect development. From this
comes the bleeding of the nose, so frequently an expression of nerve
strain at puberty, which may take the place of menstruation. It is to be
noted that while true haemophilia ("bleeder" tendency) occurs chiefly in
boys, epistaxis shows itself very frequently in their sisters. A
remarkable illustration of this was reported by Dr. Delia E. Howe,[199] of
the Fort Wayne (Indiana) School for the Feeble-minded. In cases of
so-called male menstruation[200] the symptom is apt to be epistaxis.
The irregularity in blood supply predisposes the nose to attacks on its
structure from pathogenic germs. Hay fever is an expression of nervous
instability of these structures, and is especially apt to occur in
neurasthenics, hysterics, and degenerates.