Typos p. 250: peoples' [= people's]; p. 261: villanous [= villainous]; p. 266: feminity [= femininity]; p. 267: hypochondriachal [= hypochondriacal]; p. 270: In paragraphs d and e the figures 12.36 per cent, 50.94 per cent, and 36.70 per cent are identical; p. 271: pancreatis [= pancreatitis]; p. 271, n. 2: p.p [= pp.]; p. 283: pharasaical [= pharisaical]; p. 290, n. 2: PERSONALTY [= PERSONALITY]
The Approaches from the Visible to the Invisible. Human Types
Before I consider more closely the various approaches from the visible to the invisible, I propose to offer certain conclusions of my own which, in view of the fact that I have been studying the problem of mating almost all my adult life, may appear not unworthy of consideration. 1
In a previous chapter I have drawn the following conclusions concerning the desirable mate:
(a) Except for sex differentiation, he or she should be like oneself.
(b) According to the highest racial norm of health and good spirits, he or she should be beautiful.
(c) He or she should be savoury.
(d) He or she should have lustre.
(e) He or she should have youth.
I now suggest various further desiderata.
The first is Positiveness. This is a term I employed, I believe to some useful purpose, in my book on Woman. 2 As I defined it, it was much appreciated by many readers, 3 as providing the basis for a useful classification, and I propose to employ it here. By it I mean the general character of a human constitution that says "Yea" to life, and accepts it eagerly, interestedly, lovingly, with all its light and shade.
1 I must protest against the tendency of modern medicine to appropriate all the sciences relating to Man. There is nothing in a medical degree, however exalted, which makes its holder better able than an observant layman to distinguish human types and their psycho-physical correlations. I therefore heartily endorse Professor G. Ewald's remarks on the classification of human types. His words are all the more welcome coming from a doctor: "Is it not after all more and more a matter of having an intuitive and artistic eye, which we drape in a more or less suitable anthropometric cloak? And is it even absolutely necessary that we should be medical men or natural scientists in order to be able to work in this field? Is it not sufficient to possess a good artistic eye and some knowledge of humanity in order to deal with these things?" (K.U.C. . op. cit., p. 53).
2 W.V., Chap. I, particularly; but the term is used throughout the book.
3 Among them, no less a psychologist than May Sinclair.
In a sentence, the positive person wishes for more and more life, while, in his heart of hearts, the negative person wishes for less life.
All people, as they age, tend to grow negative to some extent. But the positive septuagenarian never attains to the degree of negativism reached by his naturally negative contemporary.
Nor is positiveness to be confused with a licentious or debauched nature, as Puritans would like to confuse it.
The principal characteristic of positiveness is that it is a feature of exuberant health in a certain kind of body, which I shall describe, and consequently he who displays positiveness possesses an intuitive measure of satisfaction and gratification beyond which his appetites refuse to go. He has an instinct regarding sufficiency which is lacking in the unbalanced libertine of both sexes.
Puritans, ascetics, people below parity in general health, and those who, by nature and endowment, feel resentful towards life and their fellows, tend to be negative. Negative, too, are very old people, in whom the memory of the years of their healthiest functioning, has died away. Plato, for instance, became negative in old age. "Le diable se fait hermite" is the popular French proverb relating to this well-known phenomenon.
Positive people, even in comparative youth, may also become negative as the result of an affront directed by circumstances at their deepest impulses. Thus, as I show in WOMAN: A VINDICATION, owing to the revolt of her organism against life's chief disappointment, a very positive spinster may acquire a bitterly negative attitude to life and her fellows. Hence the number of "impossible" spinsters in countries like France and Italy, where positiveness is more common than in the north. In the north, the negative spinster, who has always had a tincture of negativeness in her constitution, is less venomous and seems, and is, more content with her lot. The reason being that her disappointment has been infinitely less severe.
Thus the contented spinster is really a monstrous phenomenon,
In the matter of mating, however, it is important to choose the positive person, because, owing to the fact that he or she is in love with life, such a person is more likely to be an inspiring, courageous, helpful and cheerful mate throughout all life's ups and downs, than the person who starts out with a rather bitter taste on his or her tongue in regard to the whole of life's drama.
I think this is a vitally important and useful distinction. The question is, how can this invisible quality of positiveness be inferred from the visible exterior of a prospective mate?
If we consider the equations:
Positiveness = Yea to life = More life, and
Negativeness = Nay to life = Less life = Death,
I think we obtain a reliable clue to the visible aspects of the positive person. For what is death? Is it not rigidity, immobility, stiffness? And is not life flexibility, mobility and suppleness?
I have said that even positive people tend to grow more or less negative as they grow old. But is not immobility the characteristic of old peoples' faces? Is not economy of movement characteristic of their life's technique? I am convinced that the basic constitutional quality of the positive person is to be sought in this antithesis. I have always found positive people 1 possess the following visible and noticeable characters:
Their features are very mobile. They cannot smile without something moving as high up in the face as the temples. In conversation, almost every feature moves. Their expressions are eager. They easily grow grave and intent, however, when any life matter is being discussed. They are usually grave when eating, because this is an important vital activity. They are intensely earnest when the equally important instinct of sex is roused in them. There is a display of generosity in the mould
1 The reader should bear in mind that I naturally include among people displaying the outward or visible signs of positiveness, the men and women who have acquired negativism early in life through a violent affront directed at their deepest impulses by circumstances. Because in them the negativism is not native, but a weapon of revenge, an exceptional adaptation, like defensive armour.
As to their invisible characters, they easily forget incidents or facts which tend to impair or depress their lively interest in humanity and their love of their fellows. Like their digestive tracts, their minds easily digest an experience and get rid of its non-essentials, particularly if the latter are life-poisoning. In childhood their positiveness, or yea-saying, makes them accessible and friendly to too many things, and therefore has to be curbed and disciplined. But it is difficult to inculcate upon them the Christian notion of "Sin".
Negative people, on the other hand, have the following visible and noticeable characters:
Their features are rigid. If they smile the expression causes no general commotion in their features, but tends to be limited to the mouth. In conversation their lips alone seem to be working without the participation of any other features. Their expressions are calm and reminiscent of observers, watchers, rather than of interested collaborators. They listen as if they disapproved, although they may not disapprove. They do not become animated when questions of life are discussed. Their faces, generally impassible, show flickerings of approval when any indictment of life is made, of which the positive person does not understand the first syllable. Their mouths are usually small and their lips thin and never everted. They never have thin lips
As to their invisible characters, their interest is aroused chiefly by subjects remote from human life abstract speculations, metaphysical problems, rigid legislative and sometimes mathematical questions. They treat neither food nor sex very seriously, and would like to do without both. They do not easily forget an incident, particularly if they can distil from it some argument against life. They tend to treasure up the morbid, non-essential by-products of their mental digestion, just as their bowel often fails to rid them of the non-essential by-products of their food. They easily absorb the Christian doctrine of "Sin".
These are the visible and invisible manifestations of the two types. 1
Owing to their position at the opposite end of life to old age, all children tend to be more or less positive. A child who shows immobility of the facial muscles early and at puberty, may be classed at once as undesirable for mating, because, as such a child ages, its already apparent negativeness will tend only to increase.
It is important to bear this in mind. It is also important to learn to distinguish genuine or native, from spurious or affected positiveness. Young people, particularly the negative ones, are envious. As, therefore, positiveness is very lovable, and positive young people, owing to their warmth, score great successes with their seniors, young people who tend to negativeness will often deliberately imitate the eager manner and gestures of their positive friends and associates, particularly when dealing with their elders.
If, however, their features are closely watched, it will be found that there is one thing they have neither observed nor are able easily to render, and that is the extreme mobility of the facial muscles, which is the leading feature of their positive fellows.
Another important requisite in the mate is, in my opinion, the inward cast of the eyes. It happens to be associated with eagerness and positiveness, so that it is often selected unintentionally
1 For more details, see W.V.
I mean by the inward cast (see Fig. II), not that form of strabismus known as a convergent squint, but that angle of the eyes which causes the inside triangle of white in each eye to be noticeably the smaller triangle.
Again, I argue from long experience. This is the type of eyes associated with:
(a) Young life.
(b) Reserves of energy.
(c) Normal vision, or long sight.
(d) Beauty, and robust health associated with ardent sensibilities.
(e) And the mental qualities of concentration, steadfastness, eagerness, determination, and intelligence which are usually associated with ardent sensibilities.
It is found in all vigorous and energetic people, in healthy babies, children and adolescents, in adults in their prime, and it is seen in the portraits of the great and those distinguished by a positive outlook. It is also seen in the portraits of the gods in Chinese and Japanese prints. In fact, if racial beauty is due to sexual selection, it may be suspected that, ages ago, the Chinese and Japanese deliberately cultivated this type; because, with them, it has become a national ideal, intensified by the characteristic Mongolian skinfold over the inner canthus of each eye, which shortens the palpebral fissure and therefore blunts the apex of each inner triangle of white. When two whole races of highly tasteful people deliberately cultivate an exaggeration of a characteristic peculiar to a feature as conspicuous and as revelatory of the mind as the eye, it is not too much to suppose that a good deal probably depends upon it.
Its beauty and the desirable qualities correlated with it are best we appreciated from a description of the opposite type, the type with the outward cast (Fig. III).
This is the type in which the inner white triangles of the eye appear large, so that the eyes have an equine, unconcentrated look. This outward cast of the eyes became a high favourite with
and liberalism. It is the type popularized by Greuze, and is still regarded by many as very beautiful. When it reveals anything more than a faint inferiority of size on the part of the outer white triangles of the eyes i.e. when these outer white triangles are minute compared with the inner white triangles, the expression is fish-like and, of course, disease (strabismus) is present.
From the standpoint of our equations Positiveness = Life, and Negativeness = Death it is important to bear in mind that people who naturally have inward casts tend to develop outward casts as they grow seriously ill, or approach death, and that people who naturally have outward casts tend to develop an acute form of this character in similar circumstances.
The mental qualities of people with outward casts are vagueness, an incapacity for concentration and the listlessness accompanying a loosely braced personality. They display a lack of sympathy towards the tragic conception of life, i.e. they refuse to see that the tragic side of life is only a necessary aspect of its deeper manifestations. Consequently, they are always trying to suppress the tragic side of life, and tragic people, and fail to see that some of life's greatest poetry and charm must vanish with them. It is typical of them that they would like to retain deep love, deep passion, deep sensibilities as picturesque, and yet rid the world of the inconveniences, the inevitable clashes and conflicts which such qualities bring with them. 1 In fact they wish for the charm of fireworks at midday. Thus they are essentially people who ruin the world by constantly making laws to meet hard cases, forgetting that even in the best-regulated communities, exceptional, hard cases must occur, and rules making them
1 Larochefoucauld, like a true realist, saw this conflict, and decided that, despite all their inconveniences, fine passions were desirable. "J'approuve extrêmement les belles passions," he said, "elles marquent la grandeur de l'âme: et quoique dans les inquiétudes qu'elles donnent il y ait quelque chose de contraire à la sevère sagesse" (MAXIMES )
One last contribution:
I have always found it important to study hands, particularly their inside surfaces. And, among the principal features I look for, in both men and women, are:
(a) A long thumb.
(b) A noticeable prominence of the bulbs at the finger tips.
(a) The long thumb, being an essential human feature, and generically distinct from the thumb of the pre-human anthropoids and lower primates, it might be said that a human thumb cannot be too long. Everything that we associate with super-bestiality in humanity must surely involve morphological differentiations from the beast. And it seems to me important to light precisely on those bodily parts in which differentiation has been most marked. Now although the thumb is not the only one of these parts, it is one of the most conspicuous; for it is a single member in an organ which otherwise has remained very much the same for probably millions of years. To insist on a long thumb, therefore, is to insist on a marked human differentiation. And, according to my creed of the inseparableness of soma and psyche, it must be of the utmost significance. I believe the palmists know enough to associate a long thumb with desirable features; but this does not concern me. What does concern me is that I have never yet found a man or woman with a long thumb anything but conspicuous for his or her essentially human seniority over the beast, and I have never yet seen either with a short thumb, without having soon detected the caudal appendage in his or her mind. 1
(b) These bulbs are very important. Behind them are plexuses of nerves concerned with touch and with the reading of surface impressions. In people whose finger-tips are congenitally devoid of bulbs, or are smooth and hard, I have always encountered an obtuseness of understanding for certain important matters, an exasperating lack of sensitiveness, which although not necessarily
1 See p. 222 ante.
I now turn to the various approaches from the visible to the invisible. One or two of these will appear somewhat dubious. For instance, the sections on the approach from psycho-analysis and the approach from common repute will hardly seem examples of proceeding from the visible to the invisible. They are included here, however, for the sake of convenience, and must be taken as a means of getting at least from the known to the unknown.
1. There is the historical and biographical approach. We can closely examine a gallery of historical portraits and try to find laws relating the known exploits, habits, character and tastes of the subjects and the physical characters exhibited in their effigies. We can pass kings, soldiers, sailors, politicians, poets, philosophers, authors, engineers, scientists, and even our own relatives, in review, and try to discover general principles in the relation of their peculiar gifts to their peculiar physical traits. This method of correlating the visible and the invisible man has been used to some extent by the morphologists, MacAuliffe, Kretschmer, Weidenreich, etc., but not nearly enough. It is a wide and fruitful field of investigation. Its chief difficulty is the unreliability of portraiture before the days of photography.
2. The statistical and anthropometrical approach. There are innumerable anthropometric works and papers dealing with the morphology of ancient races, and contemporary civilized and uncivilized races. Many of these I have already used in Chapters II and III, and others, such as the investigations of Dr. Franz Daffner, Dr. Oskar Schultze, Havelock Ellis, etc., dealing with
As a rule, however, it is only indirectly that such studies as these afford any help regarding the approach from the visible to the invisible. Galton was one of the first in this field, and the Americans are now energetically prosecuting this line of inquiry.
Dr. Arthur Macdonald, for instance, made a statistical investigation into the problem of the relation of the birthday and the order of birth, to the quality of a person, and found that, among girls, "the first-born are slightly superior to the second-born", and, among boys, the "first-born are slightly superior mentally to both the second and later-born." 2 This added an important feature to the results of Boas, who had found that "the first-born excel the later-born in both stature and weight." 3 Macdonald's findings may give an explanation of the legion of great men who have been first children, 4 and some confirmation of the ancient Jewish regard for the first-born.
Macdonald's results also confirmed those of other investigators regarding the superiority of body in those who have superior minds. 5 He also found that "a superior physical development usually seems to be accompanied with greater acuteness of the sensibilities." 6
As the result of a comparative examination of children in private and State-supported schools, Macdonald also found that the former were more sensitive than the latter, and that children (both boys and girls) were more sensitive to pain before than after puberty. 7
1 In M.A.I., Chap. II, I have given a good deal of data on this point.
2 P.S.M., p. 34. Dr. M. Tramer of the Rosegg Institute, Solothurn, found that, in a material of 3,100 patients (between 1896 and 1927), mental disease was commonest in persons born in December, and rarest in persons born in May (J.A.M.A., 28.9.29).
3 P.S.M., p. 34.
4 See my NIGHT HOERS, Chap. X, for a statistical inquiry into this problem. Napoleon, Nelson, Richelieu, Shakespeare, Descartes, etc., were not first-born, but my lists make it clear that great men are very often first-born.
5 P.S.M., p. 35.
6 Ibid., p. 38.
7 Ibid., pp. 3638.
Among the conclusions of others quoted by Macdonald, which give hints regarding the relation between the visible and the invisible, I give the following:
"Dull children are lighter and precocious children heavier than the average child.
"High percentile rank in height, weight and chest circumference in growing children, is nearly always associated with a superior grade of mental work, as that is determined in our schools.
"Children with abnormalities are inferior in height, sitting height, and weight and circumference of head to children in general." 3 The more important of these findings are confirmed by Dr. Dayton. 4
Professor Karl Pearson, whose tables give data for 2000 boys and 2000 girls, though for some characters he dealt with only 2300, and for a few with only 1700 individuals, records these interesting results:
"It is the intelligent rather than the slow or dull children who exhibit athletic powers", and "athletic power goes not only with good handwriting, but also with good draughtsmanship." And he adds: "Health, as one might naturally anticipate, is certainly highly correlated with athletic power." 5
1 Ibid., p. 40.
3 Ibid., pp. 7176.
4 Dr. Dayton, in a physical examination of 14,379 retarded elementary school children, found the mean intelligence quotient of the males, 0.71, and of the females 0.69. "Below average weight is more characteristic of children with an intelligence quotient of 0.69 or lower. It is not as characteristic of children with an intelligence quotient of 0.70 or higher." Again: "Physical defects appear to be more characteristic of the groups with intelligence quotients of 0.60 or lower, than they are of groups with intelligence quotients of 0.70 or higher." The report concludes: "This investigation demonstrates a positive association between the factors of physical defect or underweight and the lower levels of intelligence" (J.A.M.A., 4.9.29).
5 O.R.H.P., pp. 2025. The second conclusion conflicts with Crépieux-Jamin's to the effect that "physical conditions have no effect on handwriting. See note 3, p. 342 infra. See also O.R.H.P., p. 55, where Pearson associates handwriting with health.
The correlation of intelligence with each category of health shown in a table where the figures relate to "children in schools for the professional classes from the Kindergarten upwards" places the association of very robust, robust and normal health, with higher intelligence, beyond doubt, and Pearson concludes that the mental machine, as a rule, runs less smoothly "although by no means in complete accord" where "the physical machine is not of the highest order." 2
Another very interesting conclusion, bearing, as we shall see, on Adler's findings, is that "delicate children are slightly more self-conscious." 3
Other conclusions, full of interest for us, are:
"The healthier have . . . rather larger heads," and, although temper is not highly correlated with health, the healthy children are very slightly more quick-tempered. 4
Miss R. M. Fleming, in a study of 2210 boys and 2073 girls, chiefly between 4 and 17 years old, during which 6670 observations were made on boys, and 6749 on girls, came to many interesting conclusions, a few of which are germane here, particularly her correlations between femininity and masculinity, respectively, and certain morphological characters.
For instance, she found that "boys are more variable in head length than girls", that "growth in girls is more rapidly completed than in boys", and paralleled Dr. Pryor's observations "as to the union of the epiphysis 5 of the lower extremity of the ulna with the shaft in girls at 16 or 17 and in boys at 17 to 20", by her own observations on changes in colour, shape and head form, which are very slight or altogether absent after the age of 15 or 16 in girls, but continue in most boys." 6 She also found "that in head sizes . . . the boys are larger than the girls" 7
1 O.R.H.P., p. 43.
2 Ibid., pp. 4448. The relevant table is on p. 44.
3 Ibid., p. 48.
4 Ibid., pp. 58 and 60.
5 The epiphysis is that part of the extremity in the long bones where growth takes place prior to complete synostosis.
6 S.G.D., pp. 40 and 46. See also p. 49 and relevant table No. 24, p. 50.
7 Ibid., pp. 52 and 75.
Miss Fleming's extreme caution only makes these conclusions the more valuable.
Miss Katherine B. Davis investigated the sexual life of 2200 women, and some of her correlations are germane here. For instance, she says:
"Rich and poor, married or single, lady of leisure or working woman, there can be no disputing that in any walk of life, for any business in life, good health is the single greatest asset. We are not surprised, therefore, to find that good health before marriage is found to be greater among those happily married than among those of the same age and education who are not so fortunate." 4
Miss Davis also found that "stability of health is greater m the happy group." 5 R. L. Dickinson and L. Bean, in their examination of a Thousand Marriages, found that the first child came at an average age of 26 1/2 years "and the typical woman wanted more." 6
They also found that "there is some tendency for coldness in the love relation to show on the side of the less fertile, and for the satisfactory or at least the non-complaining marriage to show more children." 7
The authors found complete unity in marriage depends on sexual unity even where there are no children. Thus of 367 wives who claimed happy marriages, 100 were actually sterile. 8
1 Ibid., p. 52. Also p. 76: "Most women have smooth erect foreheads, most men receding foreheads."
2 Ibid., p. 75. Stockard (P.B.P., p. 210) also says: "The sisters in a family . . . have a higher cephalic index or rounder heads than their brothers." See also R.U.K., p. 160: "Woman's head is not only smaller but also rounder than man's."
3 S.G.D., p. 76.
4 F.I.L.T., pp. 44, 45. The relevant table is on p. 45.
5 Ibid., p. 46.
6 T.M., p. 436.
7 T.M., p. 437. Assuming that daily intercourse denotes warm love relations, this confirms Miss Davis who found that "pregnancies are higher in couples with daily intercourse" (F.I.L.T., p. 25).
8 T.M., pp. 440446.
3. The common man's approach. This method tells from a glance, from a curl in a lip, from a profile, from a note in the voice, what a person is worth, or what he means to the observer, and according to it people are straightway classed as German, English, French, Oriental, artistic, stupid, rural, urban, humorous, untrustworthy, etc. The failure and unreliability of this approach, which was tentatively codified by Lavater, is due to its partially subjective basis, its lack of systematized records, and its consequent omission to keep account: of the percentage of "bad shots" to which it is fatally liable. As it is based on much accumulated human experience, however, and is reinforced by what is popularly termed "intuition", it is by no means valueless, and is likely to remain the principal approach for ordinary people and even for the expert, 1 for all time. But as intuition varies considerably in individuals and even in those who possess it may be temporarily knocked out of gear by strong disturbing reactions, caused by a harsh word, an insult or even a bad smell, coming from the person observed, it does not do, even after giving full weight both to it and the accumulated experience of humanity, to regard the common man's approach as a very reliable method of inquiry. It is this approach which provided Aristotle with the principal data for his PHYSIOGNOMY, which is responsible for coining the many popular physiognomical proverbs and saws of all languages, and which has established in the minds of all unsophisticated people a rooted suspicion of ugliness, and a similarly rooted love of beauty, an instinctive association of extreme thinness with irascibility and nervous lability, and of fatness with equanimity and good humour.
That the brain is the organ of the mind has been known to man since classical antiquity, and throughout the period from Plato to Gall there has been an increasing tendency to localize faculties. But while Gall popularized the notion that a high brow is, or is alleged to be, associated with great intellectual qualities, mankind long before his time must have looked at a man's forehead for indications of mental power, for we find Shakespeare speaking of "foreheads villanous low." 2
1 Dr. Arthur Kronfeld (K.U.C. FRAGESTELLUNGEN UND METHODEN DER CHARAKTEROLOGIE, p. 47) declares that even "psychiatrists of great experience are constantly emphasizing the fact that they obtain far greater knowledge of all their cases by means merely of intuition than through all the intelligence and efficiency tests in the world, no matter how subtle."
2 TEMPEST, IV, i.
Speaking of a well-known portrait of Beethoven with an unusually high brow. Dr. Piderit says: "The cast of Beethoven's skull is astoundingly different from the mental picture one would be led to form from this portrait." It has a retreating brow, and Professor Schaffhausen, on first seeing it, had a very severe shock. 3
Balzac, who lived after Gall's time, evidently knew that Frederick the Great had a low brow, and, through the influence of phrenology, associated this feature with undesirable qualities, for he speaks of Barbé-Marbois, Boissy d'Anglas, Helvetius and Frederick the Great as having had retreating brows which "betray a tendency to materialism." 4
Of Shakespeare, Dr. Piderit says that, if we take the bust in the church at Stratford-on-Avon as our guide, and "it seems to be pretty generally regarded as the truest image of him, we see that the brow is only moderately developed and retreats at the top", while "the eyes are very prominent". He also refers to Nathaniel Hawthorne's testimony that this bust was quite unlike what he had been led to suppose Shakespeare looked like. 5
Dr. Piderit thus warns us against taking Gall too seriously, and declares that, just as we find highly gifted men with low brows, so we find mediocrities with dome-like foreheads. He instances the Austrian Imperial family as an example of the latter. 6 In the library of the Royal Society of Medicine I have myself
1 See his BRAIN, MIND AND THE EXTERNAL SIGNS OF INTELLIGENCE (London, 1931) with its portraits of Shakespeare and other great poets with very high brows.
2 M.P., pp. 192195. Against this, at least as regards Goethe, we should remember Eckermann's remarks. Eckermann speaks of the dead poet's "mighty brow," and he saw Goethe's corpse and knew Goethe alive. (See last paragraph of E.G.G., II.)
3 M.P., p. 196. See also K.U.R., pp. 136138 for similar facts and arguments.
4 URSULE MIROUET.
5 M.P., p. 193.
6 M.P., p. 196.
A recent study by the anthropologist, Hrdlicka, confirms these findings. To determine the correlation between the height of forehead and intellectuality in males, he made measurements of 685 people; of these 653 were Old Americans (of whom 118 came from the Highlands of Tennessee, an extremely backward group, and 25 were members of the National Academy of Sciences) and 32 members of the same Academy but not necessarily Americans. He found the maximum difference between the heights of forehead in these four groups only 0.02 cm., the average height being 6.58 cm. Four groups of males of different races were taken, with the result that the average height of forehead was, in Old Americans, 6.59; in American Indians, 6.62 cm.; in full-blooded young American Negroes, 6.98 cm.; and in Alaskan Eskimos, 7.16 cm. This suffices to show the fallacy of regarding a high forehead either as a sign of high intellectuality or even of superior race. Hrdlicka found, in fact, that the height of the forehead bears little relationship either to race, sex or degree of intellectual attainments. The whole question of height of forehead seems to be simply one of the downward extension of the hair line. 3
Here, then, we have an example of the common man's approach going astray; though perhaps it would be more fair to say that, m this particular instance, the common man may have been to some extent misled by pseudo-science.
Shakespeare was, of course, not a common man, neither was Balzac; but there is surely some justification for supposing that when either made physiognomical comments, he was expressing
1 Op cit., Plate X.
2 D.C.S.R., p. 168. Also P.C., p. 39, where Kretschmer says the cranium is not reliable as an index to personality, because it is "very obscure as to the laws of its growth, and extremely liable to secondary formations" (trauma, over-lying in childhood). Kretschmer adds that "the face, on the contrary, undergoes the richest morphological development of all parts of the body, and the final form to which this development leads, is far less obliterated or modified through secondary influences."
3 J.A.M.A., 13.1.34.
When, for instance, the former makes Cleopatra say that excessively round faces usually denote foolishness, and makes Cæsar prefer as associates men who are fat, sleek-headed and who sleep at night, before men like Cassius with his lean, hungry look, whose type is dangerous, 1 he is probably expressing the wisdom of centuries; and the fact that, as we shall see, science has confirmed him, at least as regards Cæsar's choice, shows that these common man's judgments must not be dismissed too lightly.
Moreover, it should be remembered that the common man is not always wrong, even when he judges the low-browed adversely; because, as Spencer points out, it is "the protrusion of the upper part of the cranium", and the recession of the lower part of the face that has increased the so-called facial angle characteristic of the human being. 2 Popular opinion may, therefore, be nearly right after all, except that it sees a gross intellectual distinction where there is probably little more than a slight one, and that the rule is by no means constant.
It is this approach to soundness in the common man's view that makes some of the physiognomical rules of Aristotle and even of Lavater true for all time.
For instance, Aristotle said: "Men and women that are fat are more unprolific than those that are not fat", and later on in the same work he says, "fat animals have less seed than those that are lean." 3 Here again, although Aristotle was, of course, no common man, these views were surely based on the general experience of mankind up to his time, and have to some extent been confirmed by modern science.
We now know that there is such a thing as gonadal obesity i.e. associated with a congenital deficiency of the sexual glands or else with their declining vigour. For, although this gonadal obesity is said to occur only after the age of 30, "it probably occurs before that age". 4 Also it is true that the obesity of adolescents is usually hypopituitary or hypo-thyro-pituitary in origin; but, when we recall the intimate relation between the pituitary and sexual glands, as shown by Tandler and Gross, we
1 ANTONY AND CLEOPATRA, III, 3, and JULIUS CÆSAR, I, 2.
2 P.B., pp. 389390.
3 ON THE GENERATION OF ANIMALS (Trans. as before. Book I, Chaps. 18 and 19).
4 Dr. W. F. Christie (op. cit., pp. 894896).
Nor does Lavater seem to have been always wrong, although he too (probably only when he was right) voiced the general experience of mankind.
When, for instance, he says: "Eyebrows regularly arched are characteristic of feminine youth. Rectilinear and horizontal are masculine. Arched and the horizontal combined denote masculine understanding and feminine kindness". . . and "I never yet saw a profound thinker, or even a man of fortitude and prudence, with weak, high eyebrows, which in some measure equally divide the forehead. . . . Weak eyebrows denote phlegm (apathy), and debility [flabbiness]" 2 when Lavater writes in this way, most men of observation and human understanding cannot help agreeing with him.
Commenting on this passage. Dr. Paolo Mantegazza, the cautious modern authority on physiognomy, says, I think, rightly: "In spite of profound scepticism towards all physiognomical statements, which are based on anatomical characters and not expression, I confess that I have always found the guesses of Lavater relative to the eyebrows exact in the circle of my own experience." 3
Mantegazza speaks of "guesses"; but surely they are, in this instance, the conclusion of mankind in general. And that is why Lavater is right. Shakespeare certainly supports him up to a point.
In A WINTER'S TALE, Mamillius, addressing Second Lady, says he does not love her because:
"Your brows are blacker; yet black brows, they say,
Become some women best, so that there be not
Too much hair there, but in a semicircle
Or half-moon made with a pin." 4
Shakespeare evidently knew the facts relating to the eyebrows of a woman: (a) that too strong a growth of hair is suspicious as demonstrating unfeminine elements in the organism, and (b) that horizontal and rectilinear eyebrows are objectionable for
1 These conclusions are drawn chiefly from Christie, and two articles on obesity already referred to. See note 3, p. 225 supra.
2 Op. cit., p. 389.
3 P.E., p. 43.
4 Act III. 1.
Again, when he said: "A woman impudent and mannish grown, is not more loathed than an effeminate man in time of action" 1, he voiced the common judgment of mankind which, while it remains healthy, has a taste for the normal. The Italian proverb, "A bearded woman greet with stones", reveals but another aspect of the same feeling. And modern science is showing it to be sound by demonstrating that marked masculine traits in a woman, like the converse in a man, indicate some disturbance of the normal endocrine balance, through either disease, or a congenital abnormality of the gonads, etc. 2
The fact that long and luxurious hair in a woman is as a rule indicative of feminity, and not merely the outcome of a fashion, is so well known even among the uneducated, that when Balzac described a typically feminine heroine as having very long hair, and then proceeded to enumerate many of the feminine characters that might be expected to accompany this secondary sexual character, he too, genius though he was, was merely expressing the accumulated knowledge of mankind. 3 And here again we have a common man's approach from the visible to the invisible, which has been confirmed by modern science. 4
The French proverb, Jamais grand nez ne gâta beau visage, has already been discussed. I may add, however, that the human nose, like the human thumb, is a feature peculiar to the species; it differentiates man very conspicuously from the lower primates, whose flat, almost rudimentary noses are familiar. In selecting this feature as one that can hardly be too large, the French proverb
1 TROILUS AND CRESSIDA. III, 3.
2 Authorities for these statements are given abundantly elsewhere in this book. The ancients knew the bare facts. Aristotle himself (ON THE GENERATION OF ANIMALS, Chap. VII) says: "There are masculine women and feminine men."
3 LA FEMME DE TRENTE ANS. III.
4 Authorities abound. See, for instance, M.W., pp. 256257, for evidence that normal women have a more vigorous growth of pate hair than men. Also B.D.M., p. 20. "After the more vigorous growth of the pubic and axillary hair has set in with the seventeenth year of age, a shortening of the pate hair occurs in male Europeans, whereas in woman, in spite of the growth of hair in the armpits and on the pubes, the childhood's growth of pate hair becomes more vigorous than ever. In woman the number of hairs per square inch on the scalp increases rather than decreases after puberty, and the length of the hair also increases. In races with marked pubic and axillary hair, the more feeble growth of pate hair in man after puberty is actually a secondary sexual male characteristic, as is also the formation of bald patches on the head."
Thus, much traditional wisdom is contained in the common man's approach, and even if science does not always confirm it, its occasional usefulness cannot be denied.
Where the common man seems unfortunately to be the least reliable is in discerning health, particularly in people of middle age. Despite what Mantegazza says, 2 I regard modern mankind as deplorably ignorant precisely in this respect. To the average man, health too often means simply bigness, fulness and a florid face. Can one wonder, therefore, at the frequency with which people who were the object of their circle's admiration for alleged "fitness" are reported to have dropped suddenly dead?
During the Great War, I noticed that it was much more often the kind of man, whom an audience of his fellows would have condemned as nervous and "unfit", who survived the strain of constant enemy shelling, than the so-called strong, beefy type. And, if we had to send somebody back to the Base with shell-shock, he was usually of the type whom a hall full of English people would have acclaimed as "fit" and healthy. 3
In this respect, much re-education is required. For the infallible guide of beauty is not always applicable in middle age, and if, as Mantegazza says, "The healthy look means that the face expresses general nutrition, an excellent chemical composition of the blood, and a harmonious and powerful innervation 4", I do not see how the average man can, as Mantegazza claims, judge this aright, unless he confines himself to beauty and youth.
4. The medico-surgical approach. This is a very old approach and dates from Hippocrates. Certain words in our language which relate to states of mind and body bear the stamp of this expert approach, e.g., the words, sanguine, melancholic, hypochondriachal, splenetic, atrabilious, and jaundiced (applied to moods or points of view). The approach seeks to establish broad
1 B.F.L., p. 603: "A. Woods has found that the majority of great men have a large or long nose, whereas short noses are hardly ever found in them. Highly gifted groups of persons have, on the average, longer noses than less gifted persons."
2 See p. 202 supra.
3 Stockard (P.B.P., p. 288) disagrees with me. But was he at the war? He says: "Shell-shock was probably most common in the armies having most linear type persons" (whom he describes as "nervous" in the popular sense). Strangely enough he has already described the linear type as that most constantly under nervous control. Does not this argue powerful development of nervous energy and the exercise of it? It does, in fact, explain what I saw at the Front.
4 P.E, p. 267.
He found that "underweight" has long been regarded as of serious importance at the younger ages 2039"; 2 and the relevant tables he supplies prove it. But he also shows that "even a considerable underweight is of itself no disadvantage in persons of 40 years old and upwards." 3
Again, he shows that overweight between 20 and 59 is not nearly as serious as it is from 40 to 62; though overweight even between 20 and 39 is serious if over 28 to 80 lbs. 4
He also leaves us in no doubt that "at ages 2029 at entry, in five of the weight groups, the insured from 5 ft. 3 ins. to 5 ft. 6 ins. were better risks than those from 5 ft. 7 ins. to 5 ft. 10 ins., while the latter height group shows lower mortality throughout than the tall group." 5
His tables relating to the incidence of disease confirm those supplied by Dr. Weber below, so I need not reproduce them. But when we come to examine Dr. Weber's it will be well to remember that Dr. Austen, dealing with that vast material, confirms them on the whole.
Now these are important findings, in view of the extent of the material used, and the last finding seems to indicate that people over 5 ft. 10 ins. are less good lives than the lower heights. This is remarkable, seeing that Dr. Austen excluded everybody above 6 ft. 2 ins."
1 MORTALITY IN RELATION TO HEIGHT AND WEIGHT (London, 1916). The figure 744, 692 does not include men under 5 ft. 3 in. and above 6 ft. 2 in. in height, or over sixty-two years of age.
2 Ibid., p. 19.
4 Ibid., p. 20.
5 Ibid., p. 23.
(a) A low incidence of pulmonary tuberculosis 5.4 per cent against 15.5 per cent.
(b) A high incidence of heart diseases: 18.9 per cent against 13.5 per cent.
(c) A high incidence of kidney disease: 13.8 per cent against 9 per cent.
(d) A high incidence of apoplexy: 11.3 per cent against 7 per cent.
(e) A high incidence of liver disease: 4.4 per cent against 2.1 per cent, and,
(f) A slightly higher incidence of malignant growths: 9.8 per cent against 8.3 per cent. 2
In a material of 26, 222 policy holders in the Connecticut Mutual Life Insurance Co. who were classed as 20 per cent above or below the normal in weighty there died of:
(a) Tuberculosis, 1.9 per cent of those over, against 22.0 per cent of those under weight.
(b) Diabetes, 3.5 per cent of those over, against 0.0 per cent of those under weight.
(c) Nervous Disease, 23 per cent of those over, against 14 per cent of those under weight.
(d) Heart Disease, 15 per cent of those over, against 6.0 per cent of those under weight, and
(e) Kidney Disease, 9.7 per cent of those over, against 5.2 per cent of those under weight. 3
The high incidence of heart disease among the corpulent in both tables is interesting, as is also the comparatively higher incidence of nervous diseases among the corpulent in the second table, which seems to confirm my conclusion as against Professor Stockard's. Thus the "nervous man", according to the popular view would, in my opinion, be unlikely to suffer from a nervous breakdown. 4
1 DISEASES IN RELATION TO OBESITY (London, 1916).
2 Ibid. Relevant table, p. 12. The higher incidence of malignant growths in the corpulent is confirmed by Meckle and Wunderlich, but denied by E. H. Kisch.
3 Ibid., p. 13.
4 Dr. Robert Hutchinson (op. cit.) supports me here; for he says of Prognosis: "Healthy-seeming robust individuals, indeed, often offer much less 'resistance' than those of a more fragile type, except perhaps to infection by T.B." By "healthy-seeming" he obviously means the type which the average man unhesitatingly and often ignorantly calls "very fit."
(a) Cancer, 16.56 per cent were lean, 61.10 per cent medium, and 22. 34 per cent corpulent.
(b) Tuberculosis, 23.61 per cent were lean, 65.35 per cent were medium, and 11.04 per cent were corpulent.
(c) Diabetes, 9.09 per cent were lean, 36.36 per cent were medium, and 54. 55 per cent were corpulent.
(d) Kidney disease, 12.36 per cent were lean, 50.94 per cent were medium, and 36.70 per cent were corpulent.
(e) Nervous disease, 12.36 per cent were lean, 50.94 per cent were medium and 36.70 per cent were corpulent.
(f) Disease of the Circulatory Organs, 11.79 per cent were lean, 55.05 per cent were medium, and 33.16 per cent were corpulent. 1
The table contained nine other diseases and three lots of suicides, but its value is to some extent vitiated by the fact that we are not told the ultimate state of the policy-holders when they died. Nevertheless, it is interesting to see again the comparatively low incidence of nervous disease and cancer among the lean. On the other hand the high incidence of tuberculosis among the medium suggests that a considerable change must have occurred in the condition of the material before death; because, in the other tables, it is the lean who head the list for this disease, while the fact that some of the lean are reported to have died of obesity proves that the state on acceptance was in many cases impermanent.
These tables, however, indicate that, except for diseases of the respiratory organs, the corpulent are at a disadvantage in life, particularly in regard to the functions of the heart, the kidneys 2 and certain organs along the digestive tract (the pancreas, for instance).
Another kind of result is that obtained by Dr. George Draper, of America, whose hospital work led him to note the surprising frequency with which people suffering from the same disease revealed similarities in their appearance. As he says, this, of course, did not mean "that possession of a certain set of morpho-
1 Dr. Weber, p. 14.
2 Tests carried out by Dr. Teresa Malamud indicate that the renal function is disturbed in obese persons. (J.A.M.A., 29.6.33, p. 413).
He found, for instance, a tendency for certain diseases to occur especially in either males or females, and was thus able, in some cases, to infer from the occurrence in a male of a disease not generally male, the presence of female elements in the sufferer, and vice versâ.
Among the diseases which showed, in his material, a preference for one sex were:
For males: Pneumonia, 5 to 1; ambic dysentery, 15 to 1; gout, 4 to 1; gastric ulcer, 4 or 5 to 1; acute pancreatis, large majority; pernicious anæmia, 2 to 1; hæmophilia, 100 per cent plus; angina pectoris, 6 to 1; cerebral hæmorrhage, greatly plus; sciatica, ditto; paralysis agitans, ditto; pseudo-hermaphroditism (2000 cases), 10 to 1; pulmonary tuberculosis and nephritis, much more often.
For females: Influenza, 2 to 1; rheumatic fever, considerably plus; obesity, ditto; gall-stones, 3 or 5 to 1; movable kidney, 7 to 1; chlorosis, 100 per cent plus; goitre (ex-ophthalmic), 6 or 8 to 1; myxdæma, 6 to 1; hyperthyroidism, 12.5 to 1; chorea, 2 to 4 to 1; hysteria, 7 to 1; Graves' disease, 6 or 8 to 1. 2
Regarding the greater frequency of gall-stones in women, Dr. Draper says that while it might be due to "their habits of over-eating and insufficient exercise", there are grounds for suspecting other factors, seeing that the males who develop the disease (especially cholelithiasis) show "definite feminised trends". Their pelvic width and pelvic-shoulder ratio is greater than that of males in all other disease groups, and "they also reveal feministic traits of gesture and psyche." 3
1 D.M., p. x.
2 D.M., p.p 62, 135, 140 As it may interest the reader to know if Draper's findings are confirmed by other authorities, I referred to E.M., all the contributors to which are specialists in their subjects. Now I found all Draper's conclusions confirmed there, except in regard to ambic dysentery (in which I believe war conditions play a part, and women are therefore naturally protected), gastric ulcer, of which Dr. Hugh Morton says, "women are more frequently attacked . . . than men" (E.M., XII, p. 269), and pernicious anæmia, of which Dr. G. Lovell says "males and females are affected with about equal frequency" (R.M., I, p. 325). As regards the higher incidence of influenza in females, I found in B.M.J. of 10.8.29, Dr. E. Apert's confirmation of this. I could find in E.M. no statement either confirmatory or contradictory of Draper's conclusions regarding sciatica or pulmonary T.B.
3 D.M., p. 138.
On the other hand, women who develop gout, nephritis, and hypertension have pronounced male elements. 2
He found that in both pernicious anæmia and gall-bladder disease the face tends to be shortened the upper facial segment in pernicious anæmia, and the lower in gall-bladder disease 3 and that "gall-bladder and pernicious anæmia people have wide faces and wide upper faces". But the distance between the angles of the mandible in the anæmic is greater, this giving them wide lower faces. 4
His description of the face in likely sufferers from five to six diseases may be summarized as follows:
Nephritis-hypertension: long, thin, with wide-set eyes.
Tuberculosis: long, thin, with narrow-set eyes.
Gall-bladder disease: wide, rounded, with narrow-set eyes, and strong, thick-set, square-angled jaw.
Pernicious anæmia: wide features with wide interpupillary space.
Gastric and duodenal ulcer: intermediate in every respect, with gracile, slim, wide-angled jaw (as much as 127 deg.). 5
Further, "gastric ulcer people are essentially of masculine design". They have shorter necks and larger interpupillary spaces than the tubercular." 6
As regards the gall-bladder people, it may be said that generally their silhouette is more massive than slender . . . is likewise marked by curving contours, increased fat and other trends towards feminism. In regard to their deep chests, they may be compared with the pernicious anæmia people." 7
In the acute rheumatic fever people, on the other hand, Dr. Draper found a tendency to physical asymmetry, especially in the face, with dental irregularity, childishness of countenance and bearing, and the shortest necks of all groups. 8
Before concluding this all too brief survey of Dr. Draper's work (some of which still awaits confirmation), 9 I must refer to the question of diabetes.
1 D.M. p. 140.
3 D.M., pp. 6575.
4 D.M. p. 73.
5 D.M., pp. 7378.
6 D.M., pp. 8384.
7 D.M. p. 86. Many of Draper's findings have already been quoted. Part I, Chap. V, supra, but particularly in notes to that chapter.
8 D.M. p. 93.
9 Crew speaking of the kind of work performed by Draper, evidently believes in the validity of some of the conclusions, for he says (M.L., p. 387): "There are
Now it seems to be generally agreed that, at present, diabetes is increasing almost everywhere. In New York deaths from this disease have risen from 17.3 per 100,000 in 1901, to 27.9 per 100,000 in 1931, 2 and "it has not been checked by the introduction of insulin." 3 Commenting on the statistical analysis published by the Metropolitan Life Insurance Co., of New York, the LANCET says: "The general conclusion . . . is that the incidence of diabetes, especially in women, is definitely on the increase." And it adds: "The economic prosperity of America tends to produce more diabetes." 4
According to a recent study by Dr. O. Scheel (Sept. 9th, 1933), the mortality from diabetes in England and Wales, Norway and Sweden, has risen greatly during the last few years, in spite of the introduction of insulin. He assumes that the insulin era began in England in 1923 and in Norway and Sweden in the following year. Since then the diabetes mortality has risen instead of fallen in all three countries, and is now higher than it has ever been. In Norway, Dr. Scheel finds the rise particularly marked among women, and he is inclined to think "that women who have passed the menopause are less capable than men of keeping to a strict diet." 5
Regarding the much greater frequency of diabetes among women than men in New York (in 1931, 1288 female deaths occurred as compared with only 633 males), Godias J. Dolet, the statistician, after remarking that this same reversal of the pro-
individuals who, in virtue of their genetic constitutions, are predisposed to the development of such conditions as peptic ulcer, duodenal ulcer, chronic nephritis, pernicious anæmia, asthma, gout, gall-bladder affections, high blood pressure, urinary calculi, migraine, tuberculosis and so forth. . . . Doubtless any of these conditions can present themselves in individuals who are not hereditarily predisposed to them as a result of physiological extravagance or mishap, but such causes cannot account for all."
1 D.M., p. 137.
2 J.A.M.A., 1.7.3, p. 9.
3 Ibid., p. 14. See also Ibid., 11.3.33, for an article confirming these facts and figures.
4 Issue of 9.2.29.
5 LANCET (20.1.34, p. 141).
Much the same increase is noted in Austria, where the mortality figures of diabetes for 1930 are over 2000 higher than for 1925. 3 On the other hand, we have it on the authority of Sir Humphrey Rolleston that during the war, when everyone was on shorter, or at least limited rations, diabetes showed a decided fall in both Russia and Germany. 4
Now though, as we have seen, diabetes is supposed to be often due to heredity, do not the above facts and comments all point to the conclusion that the disease, which frequently runs in families, may also be and often is determined, particularly when it occurs in later life, by sitomania?
When, in addition, we bear in mind the frequent association of diabetes with obesity, 5 and Dr. Bright Bannister's remarks about excessive eating in later life, 6 can there be much doubt about it? 7
Thus, there would appear to be some grounds for supposing that many diabetics who develop the disease in middle age, are people inclined to both indolence and sitomania, and the fact that recent developments in the conditions of life have made it possible for women rather than men to indulge both of these failings, possibly accounts for the present greater frequency of the disease in the female sex.
I have said that many of Dr. Draper's generalizations await confirmation. The tendency seems to be increasing, however,
1 J.A.M.A., 11.3.33, p. 734.
3 Ibid., 10.9.32, p. 932.
4 B.M.J., 25.3.33, pp. 499500.
5 Dr. Ethel Browning (op. cit., p. 427).
6 LANCET, 11.10.30, on DISORDERS OF THE MENOPAUSE: "As a result of metabolic changes many women are much distressed with obesity; nine out of ten persons in later life ate too much."
7 See also a remarkable article in J.A.M.A. (6.6.31). where it is said over-feeding and lack of physical exercise is increasing and producing more and more overweight in America.
Many such results have been obtained. There seems to be no doubt whatsoever, for instance, that a relation exists between the "allergic" constitution (which gives rise to such ailments as asthma, hay fever, migraine, eczema, and urticaria) and a certain lability of the vegetative nervous system. Such patients "have a psychical complex that is quite distinctive . . . their vegetative nervous system, which controls their digestive and metabolic functions, is very easily disturbed, not only by bacterial infection, foreign proteins or protein derivatives and chemical poisons, but by fatigue or emotion as well." 5
Strange to say. Dr. R. M. Balyeat has discovered from observations on "several hundred allergic children", that "the patients were above the average in general health" and that their "intelligence quotient . . . is considerably above the average normal of their nonallergic fellow students". They "cope with
1 See, for instance, p. 281 supra for Kretschmer's correlations of type and disease.
2 LANCET, 18.2.33, p. 349.
3 A morbid impulse (especially morbid in males) to display their persons.
4 LANCET, 18.2.33. p. 273.
5 LANCET: Drs. H. W. Barber and G. H. Oriel on ALLERGY (Part I, 17.11.28, pp. 10091013, Part II. A week later).
There seems to be some indication that the supersensitiveness of allergic people is, therefore, not as morbid as it seems, but possibly due to a very high organization and the acute "awareness" of the whole system. There is little doubt to take an example from the lives of the famous that Goethe's sister suffered from allergy, because she exhibited a tendency quite common among allergic people, to develop an attack (probably urticaria) when excited. 2
5. The approach from psychiatry. Although based on pathology, this has led to fruitful results in regard to the healthy, and, in the hands of a man like Kretschmer, has become sufficiently important and been sufficiently confirmed, both in Europe 3 and America, to justify very special attention.
Kretschmer briefly sums up his position as follows: "The physical characters which, with varying regularity, indicate such and such psychological traits, do not consist of those individual features, each of which alone reveal but little, but of typical groups of such individual features." 4
Drawing upon his experience with the insane, and differentiating his patients as described, he found "three ever-recurring principal types of physique", which he called "asthenic", "athletic", and "pyknic", correlated with two kinds of pathological mental states schizophrenia and the manic-depressive reaction respectively the schizophrenes being recruited from the first two, and the manic-depressives from the third type.
He found healthy counterparts of these types in the so-called "normal" in the outside world, and also discovered that these healthy counterparts showed psychological affinities to their pathological fellows inside asylums. 5
He used the words Circular and Schizophrene to denote the pathological cases, Cycloid and Schizoid to denote the border-line
1 J.A.M.A., 21.9.29. Studies on this subject abound and have multiplied enormously recently. I have by me a number of them.
2 See Goethe's AUS MEINEM LEBEN (Loeper's ed., 1876, IV, Book 18, p. 59). After describing her lack of feminine charm, Goethe says: "Her skin was seldom free from blemish a trouble which, thanks to infernal bad luck, was wont from her youth onwards to visit her on feast days and holidays, and when she was going out to a concert, a dance, or some other social function."
3 For confirmation recently received from Russian investigators, based on an extensive material consisting of Moscow children, see T.M.B., pp. 9899.
4 G.M., p. 59. Also pp. 243245 supra.
5 P.C., p. 19.
From the figures given by Kretschmer, we are forced to concede that there is slightly less regularity in the correlation between the leptosome and his standard psyche than between the pyknic and his.
I shall now explain a few of the terms. 3
The asthenic (schizoid, schizophrenic or schizothymic) is "of average height but . . . thin, with a long, narrow, shallow chest. His shoulders are relatively broad contrasted with the diameter of his chest. His muscles are thin and poorly developed, his skeletal structure is slight. The skin is thin and loosely attached to the underlying tissues. The face is characteristically long and narrow, with a prominent nose and clear-cut features." 4 He also has "a skin poor in secretion and blood . . . delicately boned hands". . . while his weight tends to be below normal for his height (7 st. 13 lbs. 5 ozs.: 5 ft. 6 ins.) and his chest measurement below his hip measurements (33.11 ins.: 33.14 ins.). 5
Kretschmer says asthenic women are essentially like asthenic men in being thin and of very small growth. 6
The mask of the asthenic schizophrene has an angular profile, 7 and the face and head a shortened-egg form. (See Fig. IV.)
1 Ibid., p. 208.
2 G.M., p. 61. Also T.M.B., p. 88: "Delma has observed in his own clinical experience . . . that of 203 dementia precox [schizophrenia] cases, 56.6 per cent had the astheno-athletic physique and 1.5 per cent were or the pyknic physique with no dysplastic forms amongst them."
3 The general reader does not require to know the pathological states associated with the three types; but useful definitions of manic depressive (pathological pyknic) and schizophrenic (pathological asthenic or athletic) are given in Dr. E. Miller's Glossary (MODERN PSYCHOTHERAPY, London, 1930, pp. 125217). Briefly, manic depression is a periodic mental disorder characterized by alternating fits of depression and mania; and schizophrenia is a form of insanity arising in adolescence in people inclined to be introspective, detached and emotionally erotic, and characterized by bizarre delusions and hallucinations.
4 This description and those of Kretschmer's athletic, pyknic and dysplastic types which follow have been taken for brevity's sake from Drs. Mohr and Gundlach (J.E.P., April, 1917, p. 118).
5 P.C., p. 21.
6 Ibid., p. 23.
7 This Kretschmer calls one of "the commonest stigmata of the schizophrenic class" (P.C, p. 44).
Kretschmer says we do not know for certain whether the physical characters of the schizophrene are found in the latter in a more marked form than in the healthy schizothyme. 1
The athletic type "is similar to the asthenic in general bodily proportions, but all the structures are thicker, firmer, and of more robust development. The shoulders are heavy, the chest is broad and of medium depth. The skeleton is heavily built. The muscles are thick, of good tone, and are well contoured. The skin is thick and closely adherent. The face is relatively long and narrow, with proportions similar to the asthenic, but with thick well-defined features. The facial angle is less marked than in the asthenic, and the lower jaw more heavily developed.
The athletic build is considered a variant of the asthenic." 2
Kretschmer describes the face of the athletic schizophrene as "steep-egg-shape" (Fig. V), with "substantial, high head". His complexion, usually pale, is not always clear. He tends to pimples, and often to a pasty puffy look. 3 . . . His face is often very long, with an astounding long mid-facial length (up to 3.5 ins.). 4
The pyknic type reveals "an increase in the volume of all the body cavities". The large, round, broad head is not very high, the chest is large and unusually broad and deep. The shoulders,
1 P.C., pp. 4041.
2 J.E.P., as before, p. 118.
3 P.C., p. 47
4 Ibid, p. 48.
The profile is gently curved, clear, and well-defined about the nose and lips, without being sharp or projecting. The proportions of the forehead, the mid-face, and chin are usually very harmonious. As regards the general æsthetic impression, "schizophrene faces are on the whole more interesting, circulars more balanced." 3 This does not refer to what Kretschmer calls the "dysplastics" of all three types.
1 J.E.P., as before, pp. 118119.
1 P.C., pp. 4950. When schizothymes and schizophrenes are ruddy or rosy they reveal cyclothymic characteristics, such as good humour and temper (P.C., pp. 6263).
3 Ibid., p. 50.
The dysplastic members of all three types are "deviants from the normal", and reveal disturbances of the various ductless glands. The long eunuchoid form, under-developed forms, and those with localized developmental disturbances are included. 3 Kretschmer regards hair as a revelatory feature and finds it different in his three types.
A defective development of pubic or armpit hair (rarely found) is "always to be considered a dysplastic abnormality". 4 The pyknic tend more to baldness than the schizophrene groups. In the former it develops regularly, in the latter in indefinite patches, and the bare scalp is not as polished as in the former. 5
Young schizophrenes, especially of the asthenic group, often reveal up to the age of 20 "an excessive formation of primary hair". On the head it is not only "very thick, but seems to spread itself over its usual boundaries "down the neck and invading the forehead and temples. The eyebrows are often "very wide and thick and join over the root of the nose." 6
The beard, on the other hand, remains weak in schizophrenes, and often locally restricted, "with preference for the chin and upper lip". Weak growth of beard is also seen in many dysplastics. Even among athletic schizophrenes Kretschmer found a tendency to weak rather than strong beards, while the hairiness of extremities in the whole class showed "weak to medium profusion, and [was] seldom remarkably plentiful". 7
Male eunuchoid schizophrenes reveal, besides extreme length of extremities, feminine characters in hips, scanty "terminal" hair
1 Ibid., p. 51.
3 J.E.P., as before, p. 119. See P.C., pp. 6566, where Kretschmer says dysplastics are rare among pyknics though they form a striking proportion of the schizophrenes.
4 P.C., p. 55.
5 Ibid., p. 57.
6 Ibid., pp. 5859. Kretschmer says that this, with "hairy bridge at temples," is often found in elderly schizophrenes, "hence the old theory of the brows growing together as a sign of degeneration." These features are rare in circulars. Dr. Louis Berman connects ubiquitous hair with the hypo-adrenal type. G.R.P., p. 237.
7 P.C., pp. 6061. Most of these characteristics, except beards, are the same in women (Ibid., pp. 6162).
Female eunuchoid schizophrenes are masculine, especially in length of extremities and hip-shoulder ratio. They also have hypoplasia (underdevelopment) of genitalia, small malish breast, and scanty terminal hair. 2
Schizophrenes are rarely fat, 3 tend to have undeveloped calves, and often reveal an elective hypoplasia of limbs hands and feet. 4
Diseases. Tuberculosis is frequently met with in schizophrenes. 5 But while the pyknics and circulars are prone to obesity, diabetes, arterio-sclerosis, rheumatism and enlarged thyroids and goitre, the asthenic schizophrenes much more rarely have enlarged thyroids, though the athletic type tend frequently to both enlarged thyroids and goitre. 6
Sex. In pyknics and people with circular madness, impulses are usually simple, natural and lively. The behaviour of schizophrenes is far more complicated, with frequency of homosexuality, sexual sub-parity, gynandromorphism and androgyny, with occasional sadism as the outcome of typical coldness of the emotional life and hunger for stimulation. 7
Temperament. Among the pyknics there are three sub-types:
(1) The hypomanics: sociable, good-natured, friendly, bright and cheerful.
(2) The syntonics: cheerful, humorous, hasty, realistic and practical.
(3) The wistful and lethargic: quiet, calm, easily depressed, soft-hearted.
Generally, all three subtypes tend to be open-hearted, sociable and genial towards environment. The pyknic harbours no malice; intrigue and sensibility are foreign to him; depression vanishes after a heavy outburst. In a difficulty he is sad or hot-headed, never nervous, and he has no tendency to cool acrimony or cutting malignity. He is warm-hearted and philanthropic, capable of being moved to joy or sorrow and expresses either readily. He is not hindered by any inhibition. He inclines to positiveness (as described above), realism and optimism, and does
1 Ibid., p. 67.
2 Ibid., p. 70.
3 Ibid., p. 73.
4 Ibid., pp. 7981.
5 See T.M.B., p. 25, for confirmation of this. Here is independent support for conclusions given under section 4 supra, concerning incidence of T.B. and chest diseases in thin and lean people.
6 P.C., p. 83.
7 Ibid., pp. 8889.
Among the schizoid and the schizothyme group, the chief characteristic is Autism 2 the capacity for reserve, to consume one's own smoke, and to live isolated and inside oneself. Usually grave and humourless, they may be brutally cutting, or timidly retiring. Their feelings are inscrutable, sometimes even to themselves. It is more difficult in this group to separate the healthy from the diseased. They offer their superficial side only. The three subtypes are:
(1) The hyperæsthetics, or nervously irritable and supersensitive, with complicated and tender souls, who may be unsociable, quiet, reserved, humourless and eccentric. (Most common.)
(2) Intermediates with cool energy and systematic consistency, who may be timid, sensitive, nervous, excitable, fond of nature and books.
(3) The anæsthetic, who are cold, eccentric, odd creatures, sometimes wasters; they may also be pliable, kindly, honest, dull-witted, silent, callous and indolent to boot.
Their emotional average lies between extremes of excitability and obtuseness or dullness, just as that of the cyclothymes lies between extremes of cheerfulness and sadness. They tend to be over-sensitive and cold at the same time. "They close the shutters of their house" and seek loneliness, trying to protect their hyperæsthesia. The anæsthetics are either unsociable or eclectically sociable, and vary from anxiety and shyness to hostile coldness and even misanthropy. New personalities give them an abnormal stimulus, generating rigidity of mind and body with hopeless timidity. Their love of books and nature is part of their flight from humanity and the unfamiliar.
1 Ibid., pp. 124146 and G.M., p. 61.
2 For an excellent description of the schizothymic temperament, see T.M.B., pp. 8894.
"If the cycloid vary between fast and slow . . . the schizoids vary between tenacious and jerky."
The schizoids incline to seeing other people all white or all black. 1
In remembering the list of characteristics associated with each group, we must not imagine them as always inclining to disease, or actually diseased. On the contrary, as Kretschmer says: "the notions 'schizothyme' and 'cyclothyme' have nothing to do with the question: pathological or healthy . . . they are inclusive terms for large general biotypes, which include the great mass of healthy individuals with the few corresponding psychotics scattered among them." 2
As examples of schizothymes and cyclothymes, Kretschmer gives the following:
The former are plentiful among philosophers, the latter very rare. 4 Kretschmer gives a table of their respective disposition as follows:
1 P.C., pp. 146207 and G.M., p. 61.
2 P.C., p. 206.
3 Ibid., p. 240. Also G.M., pp. 99100 for interesting discussion of types as distributed among geniuses in various walks of life.
4 P.C., p. 239. In G.M., p. 196, Kretschmer says pyknics among great names of philosophy are extremely rare after the sixteenth century.
5 P.C., p. 261.
Many other investigators have obtained more or less similar results, 4 though not necessarily starting out from psychiatry. But Kretschmer's work has the outstanding merit of having placed a number of pure-type psycho-physical correlations broadly before us, and of having made a substantial contribution to scientific physiognomy.
Minor investigations by psychiatrists abound. There are, for instance, the investigations of Drs. D. Wiersma, Heyman and E. D. Wiersma into pathological lying. The former obtained his cases among the patients of the Dutch state asylum for mental defective criminals; the two latter carried out a statistical investigation on a material of 2523 persons. Among 176 who were reported as nervous, 11.4 per cent were liars, and Dr. Wiersma concludes: "The nervous temperament is by far the most frequent group among the liars and it is found more than three times as often among them as in the whole statistical material. So it is clear that untruthfulness is promoted by the nervous temperament." 5
The investigators also found vanity and partial infantilism prominent features of habitual liars: "The extreme vanity of our patients," says Dr. Wiersma, "and their marked inclination to speak not about business or about other people, but only about themselves, leads to the opinion that their attention will be attracted exclusively by the contents of their own fictions, the more because almost without exception the patients themselves play such an important and noble part in the stories they produce." As Dr. Wiersma points out, "a similar interest, only in the contents, but not the correctness of the stories they tell is seen in young children." 6
1 Ibid., p. 22.
2 D.P.C., p. 511.
3 J.E.P., as before, pp. 156157.
4 Others will be referred to in due course. See, for instance, T.M.B., where Dr. R. Miller accepts Kretschmer's classification and relates it to endocrinology and Jung's psychology.
5 CHARACTER AND PERSONALITY, II, No. 1, pp. 5960.
6 Ibid., p. 61.
Another example of the statistical work being done by psychiatrists is the investigation carried out by Dr. C. B. Farrer of the Toronto Psychopathic Hospital, based on a material of 739 women and 632 men.
Among his conclusions we find the following:
"Abnormal mental reactions during the climacteric are more common in single than in married women."
"The maximum incidence [of the disorders] comes well before the normal climacteric period [in women.] In males the peak is reached at a slightly later age."
He found pyknic and asthenic types in the minority, implying that the athletic, or intermediate type, was more often affected. 1
I would but caution the reader, when studying such results, always to remember that, at the present day, both the married and the unmarried must be regarded as to a great extent abnormal, and that the statistical material cannot be regarded as standard, more particularly when it consists of married women who, owing to the extensive use of birth control methods and to the errors now prevailing in the treatment of gestation and parturition, are grossly mishandled. These are facts usually overlooked by the medical investigators responsible for such inquiries, and the results arrived at particularly when they seem to tell against married life are especially prone to be misinterpreted by spinster medical women who have a feminist Cause to defend.
6. The approach from endocrinology. In spite of the intensive study of this subject during the last few decades, and the contributions that continue to be made almost daily to our knowledge of it, it is still shrouded in mystery. Here, too, undue haste has been shown in reaching generalizations, some of which have, and many of which may still be, proved untenable. But the main findings of the investigators are incontestable, and have all been developed out of the original and ancient observations of the changes following the loss of the sexual glands in men and women. It is important constantly to bear in mind that the human body is not a test-tube in which standardized substances act in a standardized manner. Not only are the nature and
1 LANCET, 20.9.30. The Investigation of the Menopause in 1,000 women by the Medical Women's Federation, although revealing prejudice, slightly confirms above finding; for it records that nervous disorders during the menopause were a little higher in single than married women (LANCET, 14.1.33, p. 106).
This does not mean that much has not already been established. The fact that we already possess a well-tried endocrine therapy, and that even the layman has heard of the alleged dramatic effects of insulin on diabetics, and of thyroxin on cretins and thyroid defectives, shows that much headway has been made. And, indeed, when we contemplate the profound and far-reaching influence of the ductless glands on growth, development, metabolism, the normal rhythm of bodily functions, and the adjustment of the individual to his environment, we are forced to admit that enough is already known to warrant our ascribing a great part of the so-called "soul" and character to the body's endocrine balance or imbalance. 1
Much work has already been done on the relation of the ductless glands to sex characters, sex function, and secondary sexual characteristics, as also upon endocrine therapy in sexual disorders, particularly disturbances of growth and development and of the rhythm of the sexual cycle in females. It is impossible to take even a cursory glance at the vast literature that has accumulated. But a few examples will suffice.
There is the work by Tandler and Gross on the BIOLOGICAL BASES OF THE SECONDARY SEXUAL CHARACTERISTICS, 2 to which I shall often have occasion to refer, with its searching inquiry into the influence of the ductless glands on such phenomena as eunuchoidism, infantilism, growth and development at puberty, changes due to pregnancy and so on. Tandler and Gross, starting out with an analysis of the phenomenon resulting from castration, show the relationship of the growth factors of the pituitary to the gonads. Where the latter are removed in early life, there appears to be not only a persistence of the thymus (which they feel justified in regarding as a symptom of immaturity), and an enlargement of the supra-renal medulla and the pituitary gland, but also a long-delayed synostosis of the epiphyses (i.e. a long delayed closing up of the growing ends of the long bones), with the result that abnormal length of arms and legs becomes a typical feature of castrates. They then show that in eunuchoidism, which has similar symptoms to those exhibited by castrates, there
1 See, for instance, H.I.M., pp. 307308 for influence of thyroid gland alone.
2 DIE BlOLOGISCHEN GRUNDLAGEN DER SEKUNDÄREN GESCHLECHTS-CHARAKTERE (Berlin, 1913).
There is the work of Dr. Oskar Riddle and his associates of the Carnegie Institute, New York, who have attempted to show that the fundamental difference between the sexes lies in two different rates of metabolism. Referring to the changes of sex accomplished in experiment. Dr. Riddle says: "Specifically, it is a sustained increase in metabolic rate that probably has accompanied and accomplished the change of females into males, and it is found that the higher rate is characteristic of the normal male. Conversely it is a sustained decrease in metabolic rate that has probably accomplished the transformation of males into females, and it is found that a lower rate characterizes the normal female. 2
Thus, "the basic relation borne to sex by metabolism places those endocrine organs which are primarily concerned in regulating the metabolism, notably the thyroid-supra-renal medulla, in a new and close relationship with sexuality." 3
I cannot reproduce the cogent arguments and convincing data advanced, but the consequences of Dr. Riddle's theory are momentous enough.
"Since sex," he says, "in favourable early stages and under prolonged metabolic changes, may be completely reversed, can it be that the wide and often nearly continuous fluctuations in the metabolism produced in these ways are of no effect on those sex characteristics which develop only at and after adolescence? Is the increased metabolism of the female professional athlete favourable to her sex development and reproductive functions?"
1 Ibid., pp. 5971.
2 J.A.M.A. (23.3.29, p. 943).
3 J.A.M.A. (23.3.29, p. 944).
Dr. Riddle then considers the relation which a much larger number of internal secretions bear to the processes of reproduction the influence of the anterior pituitary on sexual development and function, the probable retarding effect upon the former by the thymus secretion, and of some other thymic tissue besides the known thymus gland; the possible share even of the pancreas in the processes of vertebrate reproduction, etc. 2 And he concludes: "Nearly all the true hormones are those found intimately concerned in the processes of reproduction as of sex, 3 and probably the only true hormones not thus concerned, secretin and the doubtful gastrin are engaged in the regulation of other irregular rhythms." 4
"Just as other hormones than those secreted by the sex-glands influenced reproduction," says Dr. Wiesner, "so the effects of the hormones of the sex-glands were not restricted to the genital functions. They had a marked influence on the metabolism and spontaneous activities of animals, 5 and thus the control of reproductive hormones implied much more than the control of reproduction."
When we bear in mind how profoundly the adult organism is influenced in its emotions, intellectual life, and general adjustments by the sex glands, it is impossible to overrate the importance of a normal endocrine equipment, and when Zondek speaks of the pituitary as "the motor" of the ovary, 6 when Professor Harvey Cushing, confirming much that we find in Tandler and Gross, declares that there are "experimental indications that in the anterior lobe of the pituitary two hormones are formed one growth-promoting and the other sex-maturing, and that their actions are in some way opposed," 7 and when we gather from a paper by Dr. Samuel R. Meaker, that a merely temporary disturbance of a ductless gland, such as the pituitary, may, if it occur
2 Ibid., p. 947.
3 Dr. E. Miller confirms this (T.M.B., Chap. II).
4 Op. cit., p. 950.
5 HORMONES CONTROLLING REPRODUCTION (B.M.J., 8.3.30). Also Dr. Emil Novak (THE PRESENT STATE OF OVARIAN THERAPY. J.A.M.A., 1.9.28, pp. 607613).
6 See a report by the American Council on Pharmacy and Chemistry, on the whole literature dealing with the female sex "hormones" (J.A.M.A., 23.3.29, pp. 13311332).
7 B.M.J., 20.8.32, p. 358.
But while it would be unscientific to underestimate the importance of this factor in human life, more particularly as no lesser authorities than Dr. Franz Weidenreich, Dr. E. Miller and Professor Stockard can, as we shall see, speak of hypothyroid and hyperthyroid types, meaning thereby not cretins or sufferers from exophthalmic goitre, but healthy, differentiated types, we must bear in mind that, in the human body we are not concerned with an uncontrolled experimental vessel, in which standardized chemicals can be mixed and balanced. The human body possesses a central nervous system, and subordinate sympathetic and parasympathetic systems, which exert influence by stimulation on the endocrine glands, and, in their turn, are influenced by the latter. The chemico-mechanical work of the ductless glands, therefore, cannot be estimated apart from the nervous equipment, and ultimately, of course, cannot be estimated, or reckoned with, apart from the state of the central nervous system and its adjustments to environment. Endowment, therefore, is as important on the side of the nervous system as on the side of the endocrine equipment; for their influence is reciprocal; and it follows from this that the importance of the ductless glands has its limits, and may be exaggerated.
Thus Dr. A. Lipschütz says, "a changed capacity on the part of the central nervous system to respond to sex hormones, interferes with erotization, without the hormone being disturbed"; and he adds: "if minimal quantities of sexual hormone are sufficient for a normal erotization, it follows that the differences which occur in regard to the erotization of the individual cannot be really caused by dysfunction of the sex gland. . . . So, besides cases of eunuchoidism with a primary or secondary suppression of the hormonic activity of the sex-gland, there may be recognized a second group in which response by the soma to several hormones is changed." 2 And he proceeds to lay stress on the condition of the nervous system.
Dr. Oskar Riddle's investigations appear to cast doubt on this
1 See STUDIES OF FEMALE GENITAL HYPOPLASIA (J.A.M.A., 16.5.30, pp. 468470).
2 THE INTERNAL SECRETIONS OF THE SEX-GLANDS (London, 1924, pp. 429430).
If this were true of the endocrines related directly to processes so important as those of reproduction, it would probably be true of all the ductless glands. But is it and can it be valid? In view of what we know about the oneness and indivisibility of the body and mind, it sounds, on a priori grounds alone, most unlikely. When, however, we read Dr. E. Miller and Dr. E. Laudan, and appreciate with what authority they emphasize the importance of the nervous controls of the endocrines, while fully admitting the reciprocal action prevailing between the nerves and the ductless glands, 2 we feel inclined to accept the warning implicit in Dr. Lipschütz's words quoted above, and to give it its full value.
For this reason, it is with caution that I approach Dr. Louis Berman's work on personality and the glands, though I deny neither its enormous interest nor the intrinsic probability of many of its conclusions. Wherever I have been able to find confirmation of anything he says that is striking I have produced it, although to the alert and attentive reader much confirmation of this nature will be found dispersed over most of the chapters of this second part of my book.
Dealing with the adrenals. Dr. Berman associates freckles with the hypo-adrenal i.e. the person in whom there is adrenal inadequacy of some kind. He thinks that tuberculosis is more prevalent among freckled people than among others, and adds: "Diphtheria, influenza and T.B. . . . have a greater power to kill, cripple or hurt those with defective adrenal constitutions than others."
The hair of this type, he says, "is ubiquitous, thick, coarse, and dry; to it belong red-haired people, who have well-marked canine teeth . . . and a low hair line." 3
The hypo-adrenal supplies the most frequent variety of neurasthenic. Such a person is easily fatigued, suffers from cold
1 Op. cit., p. 950.
2 See T.M.B., Chap. II, and CHARACTER AND PERSONALTY, I, No. 3, p. 241.
3 G.R.P., p. 237.
According to MacAuliffe, following Dr. Pende, the hypo-adrenal has a short trunk and long limbs, with long slender bones, and is usually thin. Muscular atrophy, a tendency to visceroptosis, lymphatism and hyperplasia of thymus are common. 2 Psychically there is a tendency to repression, pessimism, with hypersensitivism to pain. Intelligence is normal or sub-normal, if the individual is also hyperthyroid. 3
Hyper-adrenal people, on the other hand, are, according to Dr. Berman, always efficient, and, if women, masculoid. "They are the good workers . . . the kinetic successes of the driven world." 4
In the pituitary sufficient and dominant. Dr. Berman finds: Large, square, bony frame; square, protruding chin and jaws; eyes wide apart; large feet and hands, broad face, early hair-growth on body; teeth broad, large and unspaced; thick skin, and large sex organs.
In character he is aggressive, calculating and self-contained. 5
MacAuliffe says the hyper-pituitary type is usually tall. His limbs are larger, proportionately, than his trunk; but his peculiar characteristic is the excessive development and frequent grossness of the face, hands and feet. The external genitalia are larger than the average, and, in the female, Pende finds generally masculoid characters. The musculature is well developed, there is usually little adiposity.
Temperamentally, the type tends to anxiety, easy excitability, super-emotionalism, and it is usually intelligent. 6
In the hypo-pituitary. Dr. Berman finds a small delicate skeleton, muscles weak, inclination to adiposity, upper jaw prognathous, skin dry and flabby, hands and feet small, an abnormal desire for sweets, and subnormal temperature, blood-pressure and pulse.
1 Ibid., p. 239. Dr. Leonard Williams says of adrenal inadequacy: "Here there is never adiposity; the change in bulk, if any, is always in the direction of emaciation. . . . The tone of the blood-vessels is below par, as evidenced by the instability of the pulse and the absence of reserve power in the heart itself" (MINOR MALADIES, 4th ed., London, 1918, pp. 244246).
2 Dr. W. N. Kemp of Vancouver has recently confirmed this. He found adrenal insufficiency secondary to dysfunction of the thymus in the condition of "status lymphaticus." B.M.J., 30.12.33, p. 1223.
3 T., p. 210.
4 G.R.P., pp. 238239. Confirmed by MacAuliffe. T., p. 211.
5 Ibid., p. 247.
6 T., p. 201.
According to MacAuliffe, he shows, in adolescence and adulthood, persistence of infantile forms with feminine contours and lines. He also has delicate features with smooth or rounded bony sub-structure, small mandible with pointed chin, large upper incisors and small canines, small pointed nose, sparse eyebrows, silky hair, large mouth and abdomen, feminine pubic hair, much adiposity, large breasts, lack of hair on trunk, armpits and arms, small conical hands, delicate nails with lunulæ, external and internal genitalia feebly developed and impotent.
In the female, MacAuliffe finds: undeveloped breasts, masculoid secondary sex-characters, proneness to amenorrhea and dysmenorrhea, 2 sterility or low fertility and frigidity.
Both sexes have weak musculature and constipation. Physically there is a tendency to torpidity, apathy, puerility, inattention, occasionally impulsiveness and low moral sense. 3
According to Dr. Berman, the hypothyroid has a peasant face, broad nose, tough skin, coarse straight hair, physical and mental undergrowth, persistent infancy and low self-control. He needs excess of sleep, is drowsy, slow in movements and in dressing, late at school and lazy. He perspires little, even after exercise, tires easily, and is subject to frequent colds and every disease of childhood. His puberty (menstruation in girls) is delayed, and in both sexes the secondary sex-characters may resemble those of the other sex.
There may, however, be a sudden reversal to the hyperthyroid type. Should this not occur, height remains below average, obesity appears towards middle age, complexion is sallow, hair is dry with hair-line high, eyebrows are scanty, especially in outer half, eyeballs deep-set and lack lustre in narrow slits. Teeth are irregular and decay early, extremities are cyanized, circulation is poor and chilblains common. 4
According to MacAuliffe, who confirms most of the above, there is a general tendency to adiposity. The head is massive, the neck thick and short, the hands stumpy and unrefined. The thick skin seems inflamed and gets wrinkled precociously. Sex is about
1 G.R.P., p. 247.
2 Amenorrhea = absence of menstrual function in one who should be menstruating. Dysmenorrhea = painful menstruation.
3 T., pp. 202203.
4 G.R.P., p. 248.
The hyperthyroid, according to Berman, is, as a child, healthy, thin, but very robust, energetic, usually fair-complexioned, with straight high-bridged nose, eyes slightly prominent and teeth excellent, and is not prone to diseases of childhood. As an adult he or she is usually lean and tends to reduce under stress. He or she has thick hair and eyebrows; large, frank, keen and bright eyes; regular, well-developed teeth and mouth; is noticeably emotional, quick in perception and volition, impulsive and explosive. He or she is always active, an early riser, late to bed, and frequently suffers from insomnia. 2
MacAuliffe confirms all this, and adds: The skin of the hyperthyroid is warm, often perspiring, and the peripheral vessels dilate easily (emotional blushes). Breath is shallow and rapid. Temper is uneven, irritable and super-sensitive, and character is irresolute and unstable. The type has a short bust, long legs and arms, and the body remains for a long while juvenile and graceful. It is usually thin and little changed, no matter what food is eaten. There is often lordosis. The features are well-defined, but long. The stomach is small, and, owing to the feeble musculature, prone to dilation. The intestine is excessively peristaltic and diarrha may be frequent with easily congested liver. Intellect is quick, sometimes remarkable, and often precocious. 3
Dr. Leonard Williams, speaking of the similarity of symptoms in glandular deficiency, says, "confusion is most likely to arise between insufficiency of the thyroid and pituitary glands." 4
I have tabulated the more striking of his findings as follows 5:
1 T., pp. 195197.
2 G.R.P., p. 249.
3 T., pp. 197199.
4 Op. cit., p. 244.
5 Ibid., pp. 247251.
In the male there are feminine, seraphic contours and proportions. The skin is velvety and smooth, and little or no face-hair enhances this effect. The reproductive organs reveal reversion of type, and there is sometimes double-jointedness, flat feet, and knock knees. In the female, the effect is limited to thinness and delicacy of skin, slender waist, poorly developed breasts, arched thighs, scanty hair, and delayed menstruation, or there may be juvenile obesity.
Such people are at a disadvantage in life. Muscular strain, stress, or shock is dangerous to them, because their small heart and fragile vascular system handicaps circulation. Thus they may die suddenly in infancy, as the result either of slight excitement, such as attends a minor operation, a fall, or illness.
They try to compensate the feeling of inferiority by indulging in athletics and sports, and so risk cerebral hæmorrhage. The so-called "status lymphaticus" in coroners' findings refers to this condition. "Many are degenerate, most are criminals, all are inclined to crimes of passion, and they produce a large percentage of drug addicts." 2 "The persistence of the thymus after adolescence makes for an arrest of masculinization and feminization", and most sex-intermediates have some degree of this persistence. Suicides are commonly of this type. 3
The hypo-gonadal type (eunuchoid) is, according to Berman, tall and slender or generally undersized. In the male, the muscles and lines of the body are soft as a woman's. The hands and feet are small and gracile, and the breasts may be almost feminine. Axillary and pubic hair is scanty, and approximates to that of the opposite sex in quality and distribution, as do the reproductive organs. The face is round with thick cheeks, the eyes are puffy, the head is small and nose undeveloped. Eyebrows and lashes are sparse, limbs thick and plump, and the whole body is adipose, The genital organs are infantile, as are also the mental states. The hypo-gonad is naïf, timid, cheerful, easily made to laugh,
1 G.R.P., p. 250.
2 Ibid., pp. 251252. Confirmed by Pende and MacAuliffe. T., pp. 212213.
3 G.R.P., pp. 254256.
The eunuchoids tend to pursue occupations away from crowds and to become ship-cooks, stewards and so on, and their physiological tendency is transmitted. 2
MacAuliffe finds hypo-genitalism (or hypo-gonadism) in the asthenic and excessively leptosome types, i.e. in people who have for the most part remained morphologically fixed at the pre-puberal stage. He says it is a disease rather than the characteristic of a type. 3
Berman also describes what he cans a parathyroid-centred personality. This type tends to suffer from super-excitability of the heart, stomach, intestines or sexual organs, and is known clinically as the visceral neurotic. Puberty may change the emotional instability and general sensitivity of the parathyro-centric who, if he is uncompensated (sexually), will have a slender physique which looks weaker even than it is, a peculiarly pale, long-featured face, with a narrow stiffened upper-lip, and rather fixed expression. 4
1 Ibid., pp. 257258.
2 Ibid., p. 261.
3 T., pp. 205208.
4 G.R.P., pp. 261267.