Chapter I: Certain Principles of General Biology (6)

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.

_Stature of normal persons_

_Stature of abnormal persons_

FIG. 35.]

But we are too far removed from the triumphant civilisation of Greece, to recur to the authority of her example: the principle sanctioned to-day by modern civilisation, that of "respect for human life," forbids the violent _elimination_ of the weak: Mount Taygetus is no longer a possible fate for innocent babes in a social environment the civic spirit of which has abolished the death penalty for criminals. Consequently, since the weak have a right to live, as many of them as naturally survive are destined to become a burden, as parasites, upon the social body of normal citizens; and they furnish a living picture of physiological wretchedness, a spectacle of admonitory misery, inasmuch as it represents an _effect_ of social causes constituting the collective errors of human ethics. Ignorance of the hygiene of generation, maladies due to the vices and the ignorance of men, such as syphilis, other maladies such as tuberculosis, malaria and pellagra, representing so many scourges raging unchecked among the people, are the actual causes that are undermining the social structure, and manifesting themselves visibly through their pernicious fruit: the birth of weaklings. To forget the innocent results of such causes, as we forget the causes themselves, would be to run the risk of plunging precipitously into an abyss of perdition. It is precisely these disastrous effects upon posterity that ought to warn us and shed light upon the errors through which we are passing lightly and unconsciously. Accordingly, to gather in all the weaklings is equivalent to erecting a barrier against the social causes which are enfeebling posterity: since it is impossible to conceive that if the existence of such a danger were once demonstrated, society would rest until every effort had been made to guard against the possibility of its recurrence.

In addition to such motives for human prophylaxis, a more immediate interest should lead us to the pedagogic protection of weak children. The establishment of special schools for defective children, sanatarium-schools for tuberculous children, rural schools for those afflicted with malaria and pellagra, infant asylums for rachitic children, is a work of many-sided utility. They constitute a fundamental and radical purification of the schools for normal children: in fact, so long as intellectual and moral defectives and children suffering from infantilism and rachitis intermingle with healthy pupils, we cannot say that there really exist any _schools_ _for normal children_, in which pedagogy may be allowed a free progress in the art of developing the best forces in the human race.

Still another useful side to the question is that of putting a stop to the physiological ruin of individual weaklings. Very small would be the cost of schools for defective children, asylums for the rachitic, tonics, quinine, the iodide treatment, school refectories for little children afflicted with hereditary taints and organic disease: very small indeed, in comparison to the disastrous losses that society must one day suffer at the hands of these future criminals and parasites gathered into prisons, insane asylums and hospitals, in comparison to the harm that may be done by one single victim of tuberculosis by spreading the homicidal bacilli around him. It is a principal of humanity as well as of economy to _utilise_ all human forces, even when they are represented by beings who are apparently negligible. To every man, no matter how physiologically wretched, society should stretch a helping hand, to raise him. In North America the following principle has the sanction of social custom: that the task of improving physiological conditions and at the same time of instilling hope and developing inferior mentalities to the highest possible limit constitutes an inevitable human duty.

Accordingly it remains for the science of pedagogy to accomplish the high task of human redemption, which must take its start from those miracles that the twentieth century has already initiated in almost every civilised country: straightening the crippled, giving health to the sick, awakening the intelligence in the weak-minded--much as hearing is restored to the deaf and speech to the mutes--such is the work which modern progress demands of the teacher. Because such straightening of mind and body naturally lies within the province of those who have the opportunity to give succor to the human being still in the course of development; while after a defect has reached its complete development in an individual, no manner of help can ever modify the harm that has resulted from lack of intelligent treatment.

The prevention of the irremediable constitutes a large part of the work which is incumbent upon us as educators.

SUMMARY OF STATURE

We have been considering _stature_ as the linear index of the whole complex development of the body, taking it in relation to two other factors, the one internal or biological, and the other external or social. These two factors, indeed, unite in forming the character of the individual in his final development; and in each of them education may exert its influence, both in connection with the hygiene of generation and through reforms instituted in the school.

In the following table are summed up the different points of view from which we have studied stature in its biological characteristics and in its variations:

Varieties {Ethnic varieties {Stature in different races; extreme limits.
of stature { and limits of {Stature of the Italian people; and its
{ oscillation { geographical distribution.
{ {Limits of stature: medium, tall, low.
{Biological {Difference of stature in the sexes.
{ varieties {Stature at different ages (growth).
{Mechanical {Transitory or physiological.
{ {Permanent, often caused by
Variations {Variations { {deformities (Causes: the
in stature { due to { {attitudes required by the work.)
{ adaptation {
{ {Physiological {Nutrition.
{ {Physical {Heat.
{ { {Light.
{ { {Electricity.
{ {Psychic {Psychic stimuli.
{Myxedematous.
{Pathological {Infantilism {
{ variations { {Dystrophic {from alcohol.
{ { { {from syphilis.
{ { { {from tuberculosis.
{ { { {from malaria.
{ { { {from pellagra.
{ { {Hypotrophic {Denutrition.
{ { {Anangioplastic
{ {Rachitis

SUMMARY OF THE SCIENTIFIC PRINCIPLES ILLUSTRATED IN THE COURSE OF THE EXPOSITION OF OUR SUBJECT

When an anthropological datum is of such fundamental importance as the _stature_, its limits of oscillation must be established, and its terminology must be founded upon such limits expressed in figures that have been measured and established by scientists (medium, tall, low).

The stature is the most important datum in pedagogic anthropology, because it represents the linear index of the development of the body, and for us educators is also the _index_ of the child's normal growth.

_Biopathological Laws._--In cases of total arrest of development of the personality (infantilism) the first characteristic symptom usually consists in a diminution of stature in relation to age; the morphological evolution, as well as the psychic, fails to progress in proportion to the _age of the subject_; but it corresponds to the mean bodily proportions belonging to the age which would be normal for the actual stature of the subject.

=WEIGHT=

The _weight_ is a measure which should be taken in conjunction with the stature; because, while the stature is a linear index of the development of the body, the weight represents a _total measure_ _of its mass_; and the two taken together give the most complete expression of the bio-physiological development of the organism.

Furthermore the weight permits us to follow the _oscillations_ of development; it provides educators with an index, a level of excellence, or the reverse, of their methods as educators, and of the hygienic conditions of the school or of the pedagogic methods in use.

The fact is, that if a child is ill, or languid, etc., his stature remains unchanged; it may _grow more slowly_, or be arrested in growth; but it can never diminish. The weight, on the contrary, can be lost and regained in a short time, in response to the most varied conditions of _fatigue_, of _malnutrition_, of _illness_, of _mental_ _anxiety_. We might even call it the _experimental datum_ of the excellence of the child's development.

Another advantage which the measure of weight has over that of stature is that it may serve as an _exponent of health_ from the very hour of the child's birth; while _stature_ does not exist in the new-born child, and begins to be formed (according to the definition given) only after the first year of its life, that is, when the child has acquired an erect position and the ability to walk steadily.

_Variations._--Weight is one of the measures that have been most thoroughly studied, because it is not a fruit of the recently founded science of pedagogic anthropology; but it enters into the _practice_ of pediatricians (specialists in children's diseases) and of obstetricians (specialists in childbirth), while even the general practitioner can offer precious contributions from his experience.

According to Winckel, and practically all pediatricians agree with him, "the weight of a child, if taken regularly, is the best thermometer of its health; it easily expresses in terms of figures what the nursing child cannot express in words."[34]

The new-born child weighs from three to four kilograms; but oscillations in weight from 2,500 to 5,000 grams are considered normal. Some obstetricians have noted weights in new-born children that are enormous, true gigantism, which, however, while possible, are altogether exceptional; nine and even eleven kilograms.

The oscillations in weight of the child at birth, within normal limits, may have been determined by general biological factors, as for example the sex (the female child weighing less than the male), and the race (especially in regard to the stature of the parents): but the factors which influence the weight of the new-born child in a decisive manner are those regarding the _hygiene of generation_.

1. "The children which have the greater weight are those born of mothers between the ages of twenty-five and thirty." (Mathews Duncan.) Let us recall what we have said regarding stature; at the end of the twenty-fifth year, that is, at the end of the period of growth, man is admirably ripe for the function of reproduction; and we ought further to recall the views cited regarding the mortality of children conceived at this age which is so favourable to parenthood; and finally the note in regard to celebrated men, almost always begotten at this age.

2. "First-born children have in general a weight inferior to that of those born later (1,729 first-born children gave an average of 3,254 grams: while 1,727 born of the second or subsequent conceptions gave an average of 3,412 gr.)" (Ingerslevs). Let us remember that celebrated men are scarcely ever the _first-born_.

3. "Very short intervals between successive pregnancies interfere with this _progression_ in weight; long intervals on the contrary do not interfere with it" (Wernicke). In other words, too frequent pregnancy is unfavourable to the result of the conception.

4. "Mothers who, at the birth of their first child weigh less than fifty-five kilograms and are under twenty years of age, have children of inferior weight, who are less predisposed to normal growth" (Schafer).

Let us recall what we have said regarding the _form_ and the scanty weight in the case of macrosceles; and also in regard to the age of procreation in its relation to stature.

5. "Women who toil at wearisome work up to the final hour give birth to children inferior in weight to those born of mothers who have given themselves up to rest and quiet for some time before the expected birth" (Pinard).

All these considerations which refer to _normal individuals_, represent a series of hygienic laws regarding _maternity_, which may be summed up as follows: excellence in procreation belongs to those mothers who have already attained the age at which the individual organism has completed its development, and before it has entered upon its involutive period; the mother must herself have a normal weight; the pregnancies must be separated by long intervals; and during the last weeks of pregnancy it is necessary that the mother should have the opportunity of complete rest.

The increase in weight of the new-born child during the first days of its life, may constitute a valuable prognostic of the child's life. That is to say, through its successive gains it reveals the vitality, the state of health of this new human being.

Here also the pediatrists can furnish us with valuable experimental data, which serve to formulate the "laws of growth." These are:

1. From the moment of a child's birth, throughout the first two days, it suffers a loss in weight of about 200 grams, due to various causes, such as the emission of substances accumulated in the intestines during the intrauterine life (meconium), and the difficulties of adaptation to a new environment and to nutrition. But by the end of the first week a normal child should have regained its original weight; so that after the seventh day the normal child weighs the same as at the moment of birth.

On the contrary, children born prematurely, or those having at the time of birth a weight below the average, or those that are affected with latent syphilis, or are weak from any other cause whatever, regain their original weight only by the end of the second week.

Accordingly, in one or two weeks the family may form a prognosis regarding future life of the new-born child: a matter of fundamental and evident importance.

Furthermore, an antecedent detail of this sort may be valuable in the progressive history of subjects who, having attained the age for attendance at school, come to be passed upon by the teachers.

To this end, in the more progressive countries, the _carnet_ _maternel_, or mother's note-book, has begun to come into fashion, for the use of mothers belonging to the upper social classes (as, for instance, in England): it consists of a book of suitable design, in the form of an album, and more or less _de luxe_ in quality, in which the most minute notes are to be registered regarding the lives of the children from the moment of their birth onward. Various authors, especially in France, now give models for the _maternal_ _registration_ of the child's physiological progress; true _biographic_ _volumes_ that would form a precious supplement to the _biographic_ _charts_ of the schools: and the efforts of the family would round out and complete those of the school for the protection of the lives of the new generations. Such assistance, however, is only an _ideal_, because nothing short of a great and far distant social progress could place _all_ mothers (the working women, and the illiterate of Italy) in a position to compile their _carnet maternel_. Auvard advocates, for registering the weight of the child during the first days of its life, a table in which the successive days from the first to the forty-fifth are marked along a horizontal line, while a vertical column gives a series of weights, with 25-gram intervals, covering a range of 700 grams, the multiples of a hundred being left blank, to be determined by the actual weight of the child and filled in by the mother or whoever takes her place.

In such a table, the graphic sign indicating the changes in weight ought to fall rapidly and rise again to the point of departure by the seventh day, _if the child is robust_.

Another law of growth which may serve as a prognostic document in the child's physiological history is the following:

2. "Children nourished at their mother's breast double their weight at the fifth month and triple it at the twelfth." In other words, before the middle of its first year a healthy child, normally nourished, will have doubled its weight.

On the contrary, "Artificial feeding retards this doubling of weight in children, which is attained only by the end of the first year; so that the weight is not tripled until some time in the course of the second year."

And this gives us pretty safe principles on which to judge of the personality in the course of formation, at an epoch when stature does not yet exist.

Undoubtedly a great moral and social progress would be accomplished through a wide dissemination of very simple and economical _carnets maternels_; which should contain not only tables designed to facilitate the keeping of the required records, but also a statement of the laws of _infant hygiene_; or at least, simple and clear explanations of the significance of such phenomena, in relation to the life and health of the child; and also as to the causes which produce weakness in new-born children; or in other words, advice regarding the fundamental laws of the hygiene of generation. All that would be needed, in such case, would be a progressive exposition by means of the _carnets_, through lessons made as simple and as objective as possible, such as the weighing of small babies, to make the much desired "education of the mothers" both possible and practical.

But without this practical means; without this new sort of syllabarium on hand, to serve as a constant and luminous guide for married women, I do not believe that we shall have much success with the scattered lectures, obscure and soon forgotten, that at present are being multiplied in an attempt to reach the mothers of the lower classes.

In conclusion, I note this last contribution that comes to us from the pediatrists:

3. "There are certain maladies that cause a daily and very notable loss in weight"; they are the intestinal maladies; there may be an average loss of from 180 to 200 grams a day; but even in cases of simple loss of appetite (dyspepsia) the weight may decrease by about 35 grams a day. But when a child suffering from acute febrile intestinal trouble (cholera infantum), loses a tenth of his weight in twenty-four hours, the illness is mortal.

Now from the point of view of the educator this fact ought to be of serious interest, because we very frequently find among the recorded details of sickly children, or those suffering from arrested or retarded development, a mention of some _intestinal_ malady incurred in early infancy.

Still one further observation: Meunier has noted a fact of extreme importance: that while children are passing through the period of incubation of an infectious disease, and before they show _any symptoms_ likely to cause a suspicion of the latent illness, they sustain a _daily loss in weight_, from the fourth or fifth day after exposure to contagion until the appearance of decisive symptoms. In children between one and four years old, the daily loss is about fifty grams, and the total about 300; but such a loss may rise as high as 700 gr. The most numerous observations were taken in cases of _measles_.

Now, there is no need of explaining the prophylactic importance of observations such as these! A child who for a period of twenty days is in a state of incubation, is called upon to struggle, with all the forces of immunity that his organism possesses, against a cause of disease which has already invaded him; yet no external sign betrays this state of physical conflict. Consequently, the child's organism _continues_ to sustain the customary loss of energy due to the activities of its daily life, and by doing so lessens its own powers of immunity. To prescribe rest, if nothing more, for a child suspected of passing through the period of incubation would in many cases mean the saving of a life, and at the same time would protect his companions from infection, which is communicable even during the period of incubation.

In our biographic records of defective children, which include the great majority of the weakly ones, we find in many cases a _characteristic tendency to relapses_ in all kinds of infective diseases, from which they regularly recovered. Such organisms, feeble by predisposition, yet sufficiently strong to recover from a long series of illnesses, were _exhausted in respect to those biological forces_ on which the normal growth of the individual depends, by this sort of internal struggle between the organic tissues and the invading microbes. No scheme of special hygiene for children of this type can help us, either in the home or at school; the _daily variations_ _in weight_, on the contrary, might constitute a valuable guide for the protection of such feeble organisms; at the first signs of a diminution in weight, such children ought to be subjected to absolute repose.

The use of the weighing-machine, both at home and in school cannot be too strongly recommended. In America the pedagogic custom has already been established of recording the weight of the pupils regularly once a month; but instead of once a month, the weight ought to be taken _every day_. The children might be taught to take their own weight by means of self-registering scales, and to compare it with that of the preceding day, thus learning to keep watch of themselves: and this would constitute both a physical exercise and an exercise in _practical living_.

The weight may be considered by itself, as a measurement of the body; and it may be considered in its relation to comparative mean measurements given by the authorities; just as it may also be considered, in the case of the individual, in its relation to the stature.

_a._ The weight, taken by itself, is not a homogeneous or rigorously scientific measurement. In the same manner as the stature, it represents a sum of parts differing from one another, the difference in this instance being that of specific gravity. As a matter of fact, it makes a great difference whether a large proportion of the weight of an individual is adipose tissue, or brain, or striped muscles. Each of the various organs has its own special specific gravity, as appears from the following table:

-------------------------
Specific Gravity
----------------+--------
Tubular bones | 1.93
Spongy bones | 1.24
Cartilage | 1.10
Muscles {from | 1.10
{to | 1.30
Tendons | 1.16
Epidermis {from | 1.10
{to | 1.19
Hair {from | 1.28
{to | 1.34
Liver | 1.07
Kidneys | 1.04
Brain | 1.039
Cerebrum | 1.036
Cerebellum | 1.032
Adipose tissue | 0.97
-------------------------

All these specific gravities are low; we weigh but little more than water; and for that reason it is easy for us to swim. But because of the difference in their composition, the _total weight of_ _the body_ gives us no idea of its constituent parts.

Take for example the question of increase in weight. We can compare the mean figures given by the authorities with the ascertained weight of some particular child of a given age, so as to keep an empirical check upon the normality of its growth. But since we know that an individual in the course of evolution undergoes profound alterations in the volumetric proportions of the different organs in respect to one another, we cannot obtain from the total weight any light upon this extremely important alteration in proportions. Thus, for example, Quétélet gives the following figures of increase in weight for the two sexes:

------------------------------------------
Weight | Weight
--------------------+---------------------
Age | Males |Females| Age | Males |Females
0 | 3.20 | 2.91 | 15 | 46.41 | 41.30
1 | 10.0 | 9.30 | 16 | 53.39 | 44.44
2 | 12.0 | 11.40 | 17 | 57.40 | 49.08
3 | 13.21 | 12.45 | 18 | 61.26 | 53.10
4 | 15.07 | 14.18 | 19 | 63.32 | --
5 | 16.70 | 15.50 | 20 | 65.0 | 54.46
6 | 18.04 | 16.74 | -- | -- | --
7 | 20.16 | 18.45 | 25 | 68.29 | 55.08
8 | 22.26 | 19.82 | 30 | 68.90 | 55.14
9 | 24.09 | 22.44 | 40 | 68.81 | 56.65
10 | 26.12 | 24.24 | 50 | 67.45 | 58.45
11 | 27.85 | 26.25 | 60 | 65.50 | 56.73
12 | 31.0 | 30.54 | 70 | 63.03 | 53.72
13 | 35.32 | 34.65 | 80 | 61.22 | 51.52
14 | 40.50 | 38.10 | -- | -- | --
------------------------------------------

INCREASE IN WEIGHT OF BODY
ACCORDING TO SUTILS

------------------------------------
Age |Weight of body | Increase
| in grams |
----------+---------------+---------
At birth | 3000 | --
1 month | 3750 | 750
2 months | 4450 | 700
3 months | 5100 | 650
4 months | 5700 | 600
5 months | 6250 | 550
6 months | 6750 | 500
7 months | 7200 | 450
8 months | 7600 | 400
9 months | 8000 | 400
10 months | 8350 | 350
11 months | 8700 | 350
12 months | 9000 | 300
------------------------------------

But these figures give no idea of the laws of growth that govern each separate organ, and that have been studied by Vierordt. According to this authority, the total weight of the body increases nineteen-fold from birth to complete development. Certain ductless glands, on the contrary, _diminish_ in weight in the course of growth; the thymus, for instance, is reduced to half what it weighed originally.

Furthermore, the various organs all differ in such varying degrees, as compared with their respective weights at birth, that it facilitates comparison to reduce the weight of each separate organ to a scale of 1. On this basis we find that when complete development is attained, the eyes weigh 1.7; the brain 3.7; the medulla oblongata (spinal marrow) 7; the liver 13; the heart 15; the spleen 18; the intestines, stomach and lungs 20; the skeleton 26; the system of striped muscles 48.

And these widely different augmentations are not uniform in their progress, nor is the complete development of each organ attained at the same epoch. As a matter of fact, the brain acquires one-half its final weight at the end of the first year of age; the organs of vegetative life attain half their weight at the beginning of the period preceding puberty (eleventh year). To offset the lack of indications regarding such increases in weight, we have a guide in the _morphology_ of growth, which reveals how differently the various parts of the body develop.

However empirical it may be from an analytical point of view, the datum of weight is a valuable index, and represents, _taken by_ _itself_, a synthetic anthropological measure of prime importance.

It obeys certain laws of growth which are themselves of great interest; namely, there exist two periods of rapid growth: at birth and during puberty; while at various periods in childhood, between the ages of three and nine, there are alternations of greater and lesser growth analogous to those already noted in relation to stature.

Accordingly, the weight confirms the fact that the organism does not proceed uniformly in its evolution, but passes through _crises_ _of development_ during which the forces of the organism are all devoted to its rapid transformation; such periods represent epochs at which the organism is more predisposed to maladies, more subject to mortality and less capable of performing work (compare the observations already made in relation to stature).

_Index of Weight._--Accordingly, weight and stature stand in a certain mutual relationship, but the correspondence between them is not perfect. In the study of individual physiological development it is necessary to know the anthropological relation between weight and stature; in other words, the ponderal index. Without this, we cannot get a true idea of the weight of an individual. For instance, if two persons have the same weight, 65 kilograms for example, and one of them has a stature of 1.85 metres and the other of 1.55 m.; it is evident that the first of these two will be very thin, because his _weight is insufficient_, while the second, on the contrary, will have an _excessive weight_.

A stout, robust child will weigh less, in an absolute sense, than an adult man who is extremely thin and emaciated; but relatively to the mass of his body, he will weigh more. Now this relative weight or index of weight, the _ponderal index_, gives us precisely this idea of relative _embonpoint_, of the more or less flourishing state of nutrition that any given individual is enjoying. Hence it is a relation of great physiological importance, especially when we are dealing with children.

The calculation of the ponderal index ought to be analogous to that of other indexes; what has to be found is its relation to the stature reduced to a scale of 100. In this case, however, we find ourselves facing a mathematical difficulty, because _volumetric_ measurements are not comparable to linear measurements. Consequently it is necessary to reduce the measurement of weight by extracting its cube root, and to establish the following equation:

_St_:[*cube root](_W_) = 100:_X_

whence

_Pi_ = 100([*cube root](_W_))/_S_

The application of this formula necessitates a troublesomely complicated calculation, which it would be impracticable to work out in the case of a large number of subjects. But as it happens, tables of calculations in relation to the ponderal index already exist, thanks to the labours of Livi[35] and it remains only to consult them, as one would a table of logarithms, by finding the figure corresponding to the required stature, as indicated above in the horizontal line, and the weight as indicated in the vertical column.

Some authors have thought that they were greatly simplifying the relation between weight and stature by calculating the proportional weight of a single centimetre of stature and assuming that they had thus reduced the relation itself to a ratio based upon a single linear measurement (one centimetre), analogous to the ratio established by the reduction of the total stature to a scale of 100. But evidently such a calculation is based upon two fundamental errors, namely: first, no comparison is ever possible between a linear measure and a measure of volume; and secondly, the relation which we are trying to determine is that between synthetic measurements, _i.e._, measurements of the whole, and not of parts.

In the aforesaid method of computing (which is accepted by such weighty authorities as Godin and Niceforo), the number expressing the weight in grams is divided by the stature expressed in centimetres, and the quotient gives the average weight of one centimetre of stature expressed in grams. This method, which sounds plausible, may easily be proved to be fallacious, by the following illustration, given by Livi in his treatise already cited (Fig. 37). The two rectangles _A_ and _B_ represent longitudinal sections of two cylinders, which are supposed to represent respectively (in _A_) the body of a child so fat that he is as broad as he is long (the rectangle _A_ is very nearly square), and (in _B_) that of a man of tall stature and so extremely thin that he very slightly surpasses the child in the dimensions of width and thickness (note the length and narrowness of rectangle _B_). Evidently the ponderal index of _A_ is very high and that of _B_ is very low. But if we calculate the _proportional weight_ of one centimetre of stature, it will always be greater in the man than in the child, and consequently we obtain a relation contrary to that of the ponderal index.