Pedagogical Anthropology

by Maria Montessori

Physical Conditions—Heat, Light, Electricity

Thermic Conditions.—Among the physical conditions which may have an influence upon the stature, the thermic conditions ought to receive first consideration.

It is a principle demonstrated by nature that organisms in the course of evolution have need of heat. Even the invertebrates, as for example the insects, develop during the heat of summer; and the eggs of the higher vertebrates such as the birds, develop their embryo by means of the maternal warmth. In placental animals the development throughout the whole embryonic period takes place within the maternal womb, in the full tide of animal heat. In order to preserve life in premature babies, that is, in those born before the expiration of the physiological term of nine months, incubators have been constructed, an oven-like arrangement in which the child may be maintained at a temperature considerably higher than would be possible in the outside air; the term is also specifically used of the structures in which fertilised hens' eggs are kept during the required period of time until the chickens are hatched.

Accordingly it is a principle taught us by nature that organisms in the course of evolution have need of heat. The most luxuriant vegetation, the most gigantic animals, the most variegated birds belong to the fauna and flora of the tropics.

How is this physiological law, which nature expresses in such broad, general lines, to be interpreted by us in the environment of the school? It is well known that in this regard there are two conflicting opinions. There are some who would go to excessive lengths in protecting small children from the cold, by dressing them entirely in woolen garments and keeping their apartments well heated; others on the contrary assert that the physiological struggle of adaptation to the cold invigorates the infant organism, and they advise that the child's body should never be completely protected, as for example that the legs should always be left bare, that the child should be lightly clad, that his apartments should not be heated, etc.

Furthermore, it used to be held in the pietistic schools, and still is to some extent, that warmth had a demoralising influence, inasmuch as it tended to enervate both mind and body.

We educators cannot fail to be interested in such a discussion. As often happens in physiological arguments, the two opposite contentions each contain a part of the truth. In order to get at the truth of the matter, it is necessary to distinguish two widely separated facts: on the one hand, physiological exercise in the form of thermal gymnastics, and on the other, the development of organisms in a constantly cold environment.

To live constantly warm, protected either by clothes or by artificial heat, so that the organism remains always at a constant temperature, is not favourable to growth, because it deprives the organism of the physiological exercise of adapting itself to variations in external temperature, an exercise which stimulates useful functions. By perspiring in summer, we cleanse our system of poisonous secretions, and by shivering in winter we give tone to our striped muscles and to our internal organs, as is proved by our gain in appetite. Anyone who wishes to be kept on ice in summer and to transform his apartment into a hot-house in winter, robs himself of these advantages and enfeebles his system.

The apparent comfort is not in this case a real physiological enjoyment but a weakness of habit that is accompanied by a loss of physiological energy. What makes us robust is a rational exercise of all our energies. Thermal gymnastics is consequently useful. It consists in exposing a healthy, resistant organism to changes in temperature, trusting to our physiological resources for the means of defense. Thus, for example, a child who is well fed and well protected from the cold for many hours of the day in the well-heated family apartment, can go out with bare legs into the snow; and doing so will make him more robust. In the same way, the ancient Romans exposed themselves in their hot baths to the steadily increasing temperature of the calidarium, up to the point of 60 degrees (140 Fahrenheit), and then still perspiring flung themselves into a cold plunge. And it is a familiar fact that afterward they held lavish banquets in these same baths. Such exercise which in classic times gave vigour to the race that made itself master of the world may be summed up as follows: "Thermic gymnastics" of organisms "well nourished and strong."

Our own boatmen also throw themselves into the river in midwinter, half nude, and half nude they ply their long poles. They expose themselves to the cold, in the same way that they might raise a weight of many pounds with their robust arms, for gymnastic exercise.

But all this differs radically from living continually in a cold temperature. It is a very different thing from the life of a child of the lower classes, who goes bare-foot in winter, clad in a few scant rags, half frozen in his wretched tenement, and unable to obtain sufficient nourishment to develop the needed heat-units. He is already deficient in bodily heat because of malnutrition, and the effects of cold are cumulative. In this case it is not a question of thermic exercise but of a permanent deprivation of heat, in individuals who are already suffering from an insufficient development of heat-units. Consequently the organism is enfeebled—it grows under unfavorable conditions—and the result is a permanent diminution of development. Whoever grows up, exposed to cold after this fashion, has, in the average case, a lower stature than those who grow up in the midst of warmth, or in the practice of that healthful exercise which constitutes the ideal: thermic gymnastics.

The contradictory ideas that are held as to the efficacy of heat in regard to growth, are due to a large extent to a prejudice which amounts to this: heat is effective in promoting the evolution of life as a whole, and consequently the development of that part of life that is centred in the organs of reproduction; from which comes the wellnigh antiquated theory that artificial heat should be banished from the schools, as one of the factors leading to immorality! It is true that warmth accelerates the development of puberty; but who is there in this twentieth century who can still conceive the idea that it is a moral act to silence the forces of nature? Good nourishment also leads to a more precocious puberty; and the same is true of the repeated psychic stimulus produced by various forms of intellectual enjoyment, by conversation, and by social intercourse with individuals of the opposite sex. Accordingly, if it were a moral act to retard the development of puberty and to produce a general impoverishment of sexual life, the moral measures to be taken in education would be cold, malnutrition, and the isolation of the sexes in the schools, which, as a matter of fact, form the stumbling-block of environment in our colleges. But it is well known that all this leads on the contrary to moral and physical degeneration! As has already been said, the normal physiological development stands in counterdistinction to immoral habits; consequently, whatever is an aid to physiological development is in its very nature moral.

In warm climates the first manifestations of puberty occur precociously in man as well as in woman; and with them come all the transformations that are associated with puberty, among others the rapid increase of stature. In cold climates, on the contrary, such manifestations are more tardy. The women of Lapland are latest of all to develop. With them, menstruation begins only at eighteen, and they are incapable of conceiving under the age of twenty, while the period of the menopause (involution of sexual life) is correspondingly early; in other words, the entire period of sexual life is shortened. Furthermore, the fertility of the women of Lapland is low; they cannot conceive more than three children. But if these same women leave Lapland and make their home in civilised countries, as for example in Sweden, they have a more precocious sexual life, as well as longer and more fertile, and altogether quite similar to that of the Swedish women.[25]

Cabanis[26] notes that even in cold climates, when young girls spend much of their time in the vicinity of stoves, menstruation begins at about the same age as in women who live on the banks of the Ganges—as is the case with the daughters of wealthy Russians, whose development is quite precocious. In Arabia, in Egypt, and in Abyssinia the women are frequently mothers at the age of ten, menstruation having begun at the eighth year. It is even said that Mahomed married Radeejah when she was only five and that he took her to his bed at the age of eight. The religious laws of India permit the marriage of girls when they are eight years old.

Consequently it is true that heat has an influence upon the development of the organism independently of other influences; in fact, heat acts both in the form of climate, that is, in a natural state, and also in an artificially warmed environment. It is also one of the causes of the different degrees of growth in stature through the successive seasons (see below).

In conclusion: it is enjoined upon us, as a hygienic necessity, to heat the schools in winter, especially the schools for the poorer classes; it means more than increased vigour, it may even mean giving life to some who otherwise would pine away from deprivation of heat-units, a condition most unfavourable to organisms in the course of evolution.

Photogenic Conditions.—Light also has a perceptible influence upon growth: it is a great physiological stimulant. At the present day, physical therapy employs light baths for certain forms of neurasthenia and partial enfeeblement of certain organs; and some biological manifestations, such as the pigments—and similarly the chlorophyl in plants and the variegated colouring of birds—receive a creative stimulus from light.

Light contains in its spectrum many different colours, which act quite differently upon living tissues; the ultra-violet rays, for instance, kill the bacilli of tuberculosis and sometimes effect cures in cases of cancer. Psychiatrists and neuropaths have demonstrated that many colours of light have an exciting effect, while others, on the contrary, are sedative.

Hence there has arisen in medicine a vast and most interesting chapter of phototherapy.

In regard to the phenomena of growth, it has been noted that certain coloured lights are favourable to it, while certain others, on the contrary, diminish or arrest it, as the red and the green.

Phototherapy ought to concern us as educators, especially in regard to schools for the benefit of nervous children: a periodic sojourn in a room lit by calming colours might have a beneficent effect upon epileptic, irritable, nervous children, in place of the debilitating hot bath, or, worse yet, the administration of bromides; while light-baths would be efficacious for weak and torpid children.

But for normal children we must consider the light of the sun as the best stimulant for their growth. A sojourn at the sea-shore, so favourable to the development of children, is now believed to owe its beneficial effects to the fact that the child, playing half naked on the sea-shore, bathes more in the sunlight than he does in the salt water. Gymnastics in the sun, while the body is still only half dry, is what the younger generations should practise on a large scale, if they would bring about the triumph of physiological life.

We must not forget this great principle when, by planning home work for the pupils, we practically keep them housed during the entire day, keeping them for the most part employed in writing or reading; in other words, using their sense of sight, which, if it is to be preserved unharmed, demands a moderate light. The eye ought to rest its muscles of accommodation, and the whole body be exposed to the full light of the sun during the greater part of the day. Let us remember that often the children of the poor live in a home so dark that even in full mid-day they are obliged to light a lamp! Let us at least leave them the light of the street, as a recompense for wretchedness that is a disgrace to civilisation!

According to certain experiments conducted in Rome by Professor Gosio, the light of the sun has an intensive effect upon life. Living creatures reared in the solar light grow and mature earlier, but at the same time their life is shortened; that is, the cycle of life is more intense and more precocious; conversely, in the shade the cycle of life is slower, but of longer duration. A plant matures more quickly in the sun, but its stature is lower than that of a plant in the dark, which has grown far more slowly, but has become very tall and slender and lacking in chlorophyl. Similarly, as is well known, the women in tropical countries attain a precocious puberty, while conversely those of the North attain it tardily; and this fact must be considered in relation to the influence of the sun. A life passed wholly in the sunlight would be too intense; an organism that is exposed a few hours each day to the rays of the sun is invigorated; the interchange of matter (metabolism) is augmented; all the tissues are beneficially stimulated. For this reason sun baths are employed for paralytic and idiot children, and consist in exposing the body of the child, reclining upon its bed and with its head well protected, to the direct rays of the sun for several hours a day; this treatment is found to be most efficacious in giving tone to the tissues and improving the general condition of the system.

Variations in the Growth of Stature According to the Seasons.—One proof of the beneficent influence of heat and sunlight upon the growth of the organism, is afforded by the variations in the rate of growth according to the seasons. Every individual grows more in summer than in winter. Daffner gives the following figures relative to the increase in stature according to the seasons:

Number of subjects	Age in years	Stature in centimetres			Increase in centimetres
		October	April	October	Winter	Summer	Entire year
12	11-12	139.4	141.0	143.3	1.6	2.3	3.9
80	12-13	143.0	144.5	147.4	1.5	2.9	4.4
146	13-14	147.5	149.5	152.5	2.0	3.0	5.0
162	14-15	152.5	155.0	158.5	2.5	3.5	6.0
162	15-16	158.5	160.8	163.8	2.3	3.0	5.3
150	16-17	163.5	165.4	167.7	1.9	2.3	4.2
82	17-18	167.7	168.9	170.4	1.2	1.5	2.7
22	18-19	169.8	170.6	171.5	0.8	0.9	1.7
6	19-20	170.7	171.1	171.5	0.4	0.4	0.8

In the "Children's Houses," I require a record of stature to be made month by month in the case of every child, the measurement being taken on the day corresponding to the day on which he was born in the month of his birth; in addition to which I keep a record of the total annual increase.

The ages of these children vary between three and four years, and they all belong to the poorer social classes.

MONTHLY AVERAGE INCREASE IN STATURE
In the "Children's Houses" (In millimetres)

Cold months			Warm months
December	January	February	May	June	July
4	3	4	7	8	8

Another factor of growth is

Electricity.—One of the most interesting discoveries of recent date is that of the influence of terrestrial electricity upon the growth of living organisms.

A series of experiments were made, by isolating cavies (a species of 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 Émile 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 café; 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.

Fig. 30.—Boy, seventeen and one-half years old.

Fig. 31.—Young man, twenty-two years old.

Fig. 32.—Idiotic cretin, age 20 years, stature 1.095 m.

Fig. 33.—An example of myxedematous infantilism.

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 Bicêtre.

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 Vincenzo would be normal
Of the child	Normal measurements at the age of seven
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 chest, 0.507 m.	0.55 m.	Four years, circumference of 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 fœtus which results from a syphilitic conception lacks vitality, and often fails to complete the cycle of intrauterine life. But even granting that the fœtus 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 fœtus 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 resistentiæ (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.

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.