FIG. 19.
Among Aryan-speaking races this type would be accepted as the ideal one. Since each nationality, and peoples of the same nationality, living in different countries do not possess exactly the same type of face, the general presumption of evolution as modifying notions of beauty must also be taken into consideration. In the determination of the extent to which the profile exists the facial angle plays a part. This angle was early pointed out by Camper as a means of distinguishing the relative development of the skull and face. “The basis on which a distinction of nationality is founded,” said Camper, “may be displayed by two straight lines (Fig.19), one of which is to be drawn through the meatus auditorius to the base of the nose, and the other touching the prominent centre of the forehead and falling thence on the most advancing portion of the upper jaw, the head being used in profile. In the angle produced in these two lines may be said to consist not only the distinctions between the skullsof different species of animals, but also those which are found to exist between different races. The angle which the facial line or characteristic line of the visage makes varies from 70° to 80° in the race. All who raise it higher disobey the rules of art (from imitation of the antique). All who bring it lower fall into the likeness of the monkeys. If I cause the facial line to fall in front I have the antique head. If I incline it backward I have the head of a negro. If I incline it still further I have the head of a monkey; inclined still more I have the head of a dog; and, lastly, that of a goose.”
This is excellently shown by the following illustrations. Fig.20is the head of Johanna, the female chimpanzee of Central Park, New York City. This head has (by Camper’s method) an angle between 40° and 50°. The brain of this animal occupies one-third of the skull, and the jaws two-thirds. The negro criminal (Fig.21) has an angle of about 70°. Here the brain is encroaching, while the jaws are receding. The Caucasic race (Fig.22) has an angle of 75° to 80°. In many cases the frontal development of the brain and resultant recession of the jaws produce an angle of 90°, with a general result not unlike the Apollo.
Although the general outlines of facial evolution as sighted by Camper are in accord with my own views, yet, as regards accuracy, this angle is not an ideal from whence to study face degeneracy, since the line does not fall low enough to include the chin, and also, as I have elsewhere shown, in the degenerate, the ear varies as much as one to one and one-half inches upon heads of different individuals. Frequently, in the degenerate classes, the ears of the same individual differ as much as one inch in height.
FIG. 22.
An ideal line, from whence to study a degenerate face, should be drawn perpendicularly from the supra-orbital ridge intersecting the upper and lower jaw and chin. While the chin of the Apollo Belvedere falls slightly inside of this line, yet this is hardly perceptible. Having now fixed a standard from which to study the degenerate face, it should be remembered that jaws which protrude beyond this line are atavistic, and those which recede are even more degenerate.
FIG. 23.
FIG. 24.
The angle between 80° and 90° may be accepted as an ideal by which to study degeneracy. This factor alone, however, can not be accepted: the evolution of the face itself must be also taken into consideration. It is obvious that in the struggle for existence and supremacy between the brain and the face (both expressions of vertebrate advance), stress may be concentrated on one particular part. Whence result certain factors which modify the conclusion to be drawn from the facial angle. The hollowed out condition of the face from the supra-orbital ridges down to and including the base of the nose (illustrated in Johanna) merits attention here. The same condition is observable in the negro, only it extends farther down and includes both jaws. One jaw, however, may alone be affected. Most of the Chinese, Japanese, Eskimo, Polynesians, Australians, Aryan Caucasic Africans, and some American Indians, possess this feature. As has been already remarked,the facial regions of man and the ape up to a certain point are similar. Not until the sense organs of man begin to develop are changes noticeable in facial expression. If, through heredity or constitutional defect, that part of the brain which presides over development of the facial bones lose its control, arrest of development of that particular tissue results at any period between birth and the twenty-fifth year, while other parts of the head and face continue to develop. With this understanding Camper’s method can be safely applied to certain cases. If a line be dropped from the supra-orbital ridge to the upper lip in its most prominent part (Fig.23), it will be found here that in place of the face presenting the full appearance illustrated in Fig.19and Fig.22, it has the hollow appearance observable in Johanna and in Fig.25. This is due to arrest of development of the bones of the face and the upper jaw. The extent of depression depends upon the time ofarrest, the frontal development of the skull, and the position of the upper jaw. The nose may present and retain the appearance of that of a child six months old, or any other shape up to normal development, but will not protrude from the face nor present a normal symmetrical appearance. It has the appearance of having been driven into the face. It has been claimed that the bridge of the nose is pushed out by the advancing brain and cranium. This may be true to a certain extent, but one is not necessarily dependent on the other, since an arrested nose is frequently found in a fully developed cranium (Fig.24), which is not unlike Fig.23and a “throw-back” to Fig.20. This is due to the fact that in the struggle for existence the bones of the face and skull base became arrested early in life, while the brain and cranium continued to advance. The lower jaw is usually normal since, while the tendency to arrest may be present in a slight degree, mobility of the jaw often causes such increased nutrition of the part that normal development in many cases thereby results. Overlooking this fact has often led to the assertion that a large lower jaw exists when, in reality, this appearance is due to an arrest of the face and upper jaw, the lower remaining normal. The expression of degeneracy is rather in the arrest of the upper jaw than in the normal lower (see Fig.23).
The criminals of the Elmira Reformatory, and those of the Pontiac Reformatory, present marked instances of this stigma, nearly 50 per cent. being so affected. Arrest of the lower jaw may occur alone, or may be associated with arrest of development of the face (Fig.25). When this is the case a deep, broad groove extends from below the eyesdownward and backward to the lower jaw, also showing a lateral arrest of development, producing a hatchet-shaped face. The upper part of the face may be normal, and the lower jaw arrested antero-posteriorly.
FIG. 25.
FIG. 26.
It has been broadly asserted that this is an atavism, but more probably it is an expression of that phase of evolution whereby both jaws are becoming subservient to the advance in evolution represented by the gains of the brain and cranium. When both jaws are arrested Camper’s disobedience of the rules of art, whereby the facial angle is increased over 90°, occurs. This condition has been found in many degenerates. Almost invariably in connection with the arrest of development of the face occurs arrest of the bones of the nose. The diameter of the nasal cavities is much smaller than normal. Owing to the unstable condition of the nervous system there is also hypertrophy of the turbinate bone and mucous membrane of the nose and throat, tonsil hypertrophy, arrested development of the chest walls and lung tissue, and unstable mucous membranes throughout the lungs. Such a degenerate face, body, and unstable nervous system is a fruitful soil for the germs of tuberculosis. In these cases even a casual glance will show that the two halves of the face and head are not symmetrically developed. It looks as though the two halves were made separately and joined together, one half higher than the other. This condition is excellently illustrated in Fig.26. In this case the left half is higher than the right. (Frequently the right side is the higher.) There is arrest of the upper andlower jaw. The left corner of the mouth is higher than the right. The left half of the lower jaw is higher than the right, the body of the lower jaw is longer, the ramus is shorter. The left eye and ear are higher. The left supra-orbital ridge is higher. The ears stand almost at right angles, while the malar processes are quite prominent. Viewing the face from a three-quarters’ angle (which should always be done in making an examination, or photographing the degenerate face for study) it will be found that there is not only arrest of development of the bones of the face, but also of the lower jaw.
As already stated in the chapter on the cranium, the nasal bones belong to the dermal category, their special function as nose bones being a later acquisition. In their acquirement of this function they have passed through many changes, especially as the human face in its nasal features has assumed an embryonic type. In consequence, like all late embryonic acquisitions, degeneracy is apt to involve the nose.
When arrest of development of the face takes place stigmata of the nasal bones always result. Under such conditions narrowing or arrest of development of the entire nasal cavity ensues.
Deformities of the nasal septum, deflection, hypertrophy and atrophy of the turbinate bones, deformities of the maxillary sinus, hypertrophy of the mucous membrane and polypi are common. Deflection of the external nose is a very common stigma of degeneracy. Not only is the septum involved, but also the outer plates of the nasal cavity. So unstable are the bones of the face in their development that it is not an uncommon thing for the nasal process of the upper jaw on one side to be much more developed than theother. Not only is the nasal septum involved, but also the bones of the face as well, producing a fulness on the long side of the face. This stigma is very common among criminal youth. In such cases the deflected septum is due to the development of the outer plate and notvice versâ. Deflection of the septum to the left may entirely obliterate (as in Fig.27) the left nasal cavity. If one nostril of a rabbit be permanently closed, after the animal has attained its full growth, the nasal cavity of the affected side remains undeveloped and facial asymmetry results.
FIG. 27.
Therefore two factors are common: first, the arrest of development of the bones of the nose, and second, the clogging of the cavity, both active agents in producing a closure, resulting in mouth-breathing.
Coexisting with these is often (as in Fig.27) smallnessof the upper jaw. In the same connection grooved teeth occur, as in the same illustration.
FIG. 28.
The turbinated (Fig.28) bones are often hypertrophied, as is also the nasal septum (vomer or dividing bone) and the mucous membrane. This results from the general instability of the nervous system with its special expression in increased blood supply, whence occur overgrowth in and imperfect work by the mucous membrane, causing mouth-breathing and polypi, which again increase this defect. All these predispose to germ invasion.
In the figure are also shown grooves upon the teeth. Sufficient symptoms are here evident to stamp this as a marked degenerate skull.
Hypertrophy of the turbinate bones, septum, and mucous membrane, as it occurs among degenerates, appears in Fig.29, and is due, first, to an unstable nervous system, and, second, a larger system of bloodvessels which ramify through these parts. Stimulation, together with the stenosis (narrowing), tend to produce a closure. Still further, irritation and an unstable mucous membrane results, with polypi or adenoid vegetation following.
FIG. 29.
Not only do deflection of septum and hypertrophy of the nasal bones occur, but the antrum (cavity behind the nose) may be almost entirely obliterated, while the upper jaw is arrested (Fig.29). The antrum may be entirely wanting, as in Fig.30; so unstable may these tissues develop that the nasal cavities may become almost entirely obliterated, as observed in this figure.
FIG. 30.
These conditions are due to the unstable structure and large nerve and blood supply. Perhaps one of the most interesting points in connection with degeneracy of the nose is the fact that in most cases the structures are either arrested or excessively developed, to the extent of the entire absence of the inferior turbinate bone. This was the case in a girl thirteen years of age who died of tuberculosis. Her skull revealed many other forms of degeneracy as well. The deviation in the development of the two nasal cavities results from the excessive and arrested development of the turbinates, thus preventing inhalation and exhalation of air, the free side developing and the closed side remaining undeveloped. In such case the nose is deflected to theright or left, depending on which side is arrested. When both nostrils are closed the nose becomes thin and pointed and mouth-breathing results. In degenerate nasal cavities polypi (tumours) are apt to occur.
Persons with long, thin noses, arrested nasal cavities, sunken faces (as a result mouth-breathers), and with contracted chest walls are the subjects for tuberculosis. In such cases, especially when the nervous system is unstable, the different forms of catarrh are present. This condition worries the youth under the strain of puberty. To the catarrh which is merely a result is ascribed his constitutional defects. These somatic signs are quite noticeable in most of these cases, and by early recognition proper treatment, with change of climate, frequently prolongs life for years.
The so-called erectile tissue of the nose (containing blood whose flow is checked through spasm to increase sensation), that relic of a time when smell played a greater part among the senses, is apt to be affected by degeneracy either as to its excessive or imperfect development. From this comes the bleeding of the nose, so frequently an expression of nerve strain at puberty, which may take the place of menstruation. It is to be noted that while true hæmophilia (“bleeder” tendency) occurs chiefly in boys, epistaxis shows itself very frequently in their sisters. A remarkable illustration of this was reported by Dr. Delia E. Howe,[199]of the Fort Wayne (Indiana) School for the Feeble-minded. In cases of so-called male menstruation[200]the symptom is apt to be epistaxis.
The irregularity in blood supply predisposes the nose to attacks on its structure from pathogenic germs. Hay fever is an expression of nervous instability of these structures, and is especially apt to occur in neurasthenics, hysterics, and degenerates.
Degeneracy of the Lip, Palate, Eye, and Ear
Eachpart or sense organ may, independently of the face as a whole, exhibit signs of degeneracy. The palate, lip, nose, eye, and ear have their own expressions of degeneracy. The palate, so far as the joining of its two parts is concerned, resists degeneracy to a remarkable degree. The cleft, which results from non-union, is usually an expression of general degeneracy acted on by its nutritive expression, albeit cleft-palate may be associated with the graver degeneracies like idiocy.
As the subjects of the deeper degeneracies associated with cleft-palate usually perish in early infancy, the nutritive degeneracies are most frequently found associated with cleft-palate in adult life. The mouth in the vertebrates does not agree in character with the invertebrate mouth. The mouth has grown in proportion to evolution in the lower vertebrates. It is larger, however, in proportion in the human embryo than in the adult. In this it agrees with the general lower type of the human face. The human chin is at first retreating, and does not become distinctly prominent until the fifth month of fœtal life. The nose separates from the mouth toward the end of thesecond month. It is at first short and broad and resembles at three months the type of some of the lower negro races. When the nose is separated from the mouth a partition forms between the cavities of the nose and the mouth, later supplemented by the true palate, which divides the mouth into an upper respiratory passage and a lower digestive passage. This palate is partly composed of bone and partly of flesh. The fleshy part ends in what is called the uvula. This is very subject to abnormalities, as has been pointed out by C. L. Dana; it is a very frequent mark of degeneracy. Dickens noticed the uvular tone of voice in young thieves, due to deformity of the uvula.
Cleft palates are comparatively rare in proportion to other forms of nutritive degeneracy. Palatal embryology casts light on the causation. At a very early period of fœtal life a series of clefts appear on each side of the cephalic extremity, separated by rods of tissue called branchial arches. The clefts communicate with the alimentary canal. These various clefts have usually coalesced about the ninth and tenth week of fœtal life, but occasionally this coalescence fails or is incomplete. This leads to various deformities, the chief of which are cleft palate and hare-lip. Cleft palate has been known to affect several members of the same family, and to occur in the offspring of the affected members. There are instances of the transmission of this deformity from an affected pug-bitch to her offspring. If it were possible to practise selective breeding in man as in dogs a race of men with hare-lips and cleft palates could probably be produced.[201]
FIG. 31.
Cleft palate may be divided into two classes, congenital and acquired, acquired cleft palate being the result of disease either inherited or acquired, but only affecting the part after birth. Congenital cleft palate is divisible into two kinds, complete and partial; complete when the fissure extends the entire length, from the uvula to and including the anterior alveolar process and even the lips (Fig.31), partial when only a small part of the structure is involved. Thus the cleft may extend through the anterior alveolar process, involving the incisive bone only, which is very rare; when present single or double hare-lip almost invariably coexists. I have observed in practice six cases where a small portion of the interior alveolar process was involved, with the jaw and one or two teeth.The hard palate only may be involved to the extent of a small fissure, or the whole palate may be wanting. The soft palate only may contain the cleft, or simply the uvula. Cases are on record in which the non-development of the intermaxillary bones produces fissures in the lip.A priori, cleft palate is an evident expression of hereditary defect. Langdon Down found a constant relation between brain deformity, cleft palate, and deformed vaults.
In a case cited elsewhere,[202]three members of one family had cleft palate; one 17 years old, the other 30, and the third 35. The first and last are women, the other a married man with a family, who have no trace of the father’s deformity. In these cases no instance of cleft palate could be found either among the ancestors or the collateral branches of the family.
Another family has a remarkable history. G. H. C., born 1853, perfect; L. C., born 1855, single hare-lip and cleft palate; J. F. C., born 1856, perfect; F. W. C., born 1860, double hare-lip and cleft palate; H. E. C., born 1868, perfect. The paternal grandmother also had cleft palate.
Knecht found that 5 per cent. of 1,200 criminals examined had cleft palate. Fourteen per cent. of the prostitutes examined by Pauline Tarnowsky had cleft palates. Langdon Down, among congenital idiots, found only a half per cent. of cleft palates. Grenzer found only nine cases in 14,466 children, or one in 1,607. I examined 1,977 feeble-minded children without finding a single case. In 207 blind only one case was observed. In 1,235 deaf mutes two cases were found. The percentage among thedefective classes, while not large, is, undoubtedly, much larger than among normal individuals.
A keeper of the Zoological Gardens in Philadelphia observed cleft palate in the mouths of lion cubs born in the gardens. Cleft palates were also observed in a number of pups born in Buffalo. Dr. Ogle found that 99 per cent. of the lion cubs born in the London Zoological Gardens had cleft palates. He claims that this is due to the artificial diet, as the result of enforced captivity. Similar results observed in other gardens in Europe are charged to feeding the mothers with meat without bone, as feeding with the whole carcass of small animals greatly diminished these deformities. It would seem that if cleft palate is due to this cause other bony structures should also be involved, and, as a matter of fact, many of the lions born in captivity are rickety. Cleft palate has been observed among dogs, sheep, goats, &c. The question, therefore, whether domesticity here does not play the alleged part of civilisation in man can be solved only by a knowledge of the frequency of the condition among wild animals of the same genus. It is evident that, in dealing with the question of ætiology, the influence of shock on the mother’s nervous system cannot be excluded in the cases charged to feeding.
It should be remembered that cleft palate is a factor which predisposes to death by infectious diseases whose local manifestations are in the mouth and throat; hence the majority of the degenerates in whom cleft palate occurs are liable to die before the completion of their fifth year. Hare-lip (Fig.32) is an exceedingly hereditary disorder, as Murray, Demarquay, Trélat, Hutchinson, Féré, Marsh, Lucas,Ireland, and others have shown. It occurs with great frequency in almost all forms of degeneracy. Kiernan, of Chicago, has found that 5 per cent. of the hereditary lunatics in that city and in New York City have hare-lip.
FIG. 32.
How far degeneracy may turn back the page of evolution is excellently illustrated in the cyclopian descendants of degenerate families elsewhere cited from Kiernan, of Chicago. While there is a seeming conflict as to the primitive eye type of vertebrates between morphologists represented by Howard Ayres[203](who claims that the eyes were derived from the medianeye of the ascidian lancelet) and Semper[204](who is of the opinion that the existing vertebrate eyes represent the paired eyes of a hypothetical annelid precursor); still both opinions are fully reconcilable through the results of study of the ascidian and lancelet eye collated with cyclopian and triophthalmic (three-eyed) degeneracies in man, the human eye and the third eye of reptiles like the hatteria of New Zealand. The eye of the ascidian tadpole agrees fundamentally with the type of eye peculiar to the vertebrates in that the retina is derived from the wall of the brain. On this account it is called a myolonic eye. In the typical invertebrate eye, on the contrary, the retinal cells are differentiated from the external ectoderm.
The ascidian eye, however, differs, as Osborn[205]remarks, essentially from the paired eyes of the craniate (skulled) vertebrates in that the lens as well as the retina is derived from the wall of the brain. The lens of the lateral eye of the vertebrates is derived by an invagination of the ectoderm, which meets and fits in the retinal cup at the end of the optic vesicle. The ascidian eye, however, agrees in respect to the origin of its lens with the parietal or pineal eye of the lizard, in which the lens is likewise derived from cells which form part of the wall of the cerebral outgrowth which gives rise to the pineal body.
The pineal body is another of those remarkable rudimentary structures whose constant presence in all groups of vertebrates forms such an eminently characteristic median outgrowth from the dorsal wall of the brain (thalamencephalon), the distal extremity of which dilates into a vesicle and becomes separatedfrom the proximal portion. The distal vesicle becomes entirely constricted off from the primary epiphysial (pineal) outgrowth of the brain, and the parietal nerve does not represent the primitive connection of the pineal eye with the roof of the brain, but arises quite independently of the proximal portion of the epiphysis.
The remote ancestors of the vertebrates possessed a median, unpaired, myolonic eye, which was subsequently replaced in function by the evolution of the paired eyes. The cyclopic condition occurs very frequently among human monstrosities, much more frequently than among animals, Hannover claims,[206]but this is clearly due to the fact that human monstrosities are much more frequently recorded. Of the 120 cases I have been able to collect from literature, 56 presented other evidences of degeneracy than cyclopic conditions, and 60 had neuropathic or other taint in the ancestry. Dareste[207]has shown that the production of a single eye, the changes in the structure of the mouth, the atrophy and abnormal situation of the olfactory apparatus and of the vesicle of the hemispheres, all result from an arrest of development. The determining influence must be exerted very early in the life history of the embryo.
FIG. 33.
Hannover points out that there often is coincident hydrocephalus and harelip, imperfect genital development, and allied arrest of development. J. R. Folsom, of Cecil, Georgia, has reported a female, born alive to a negro multipara, who died two hours after birth. The eye was centrally located in the forehead, on a line with the nose. The brow was acomplete arch, as was the upper eyelid. The lower lid had a mark midway, indicating an attempt at division. The nasal bones were wanting, but the soft part of the nose, destitute of the orifice, hung over the mouth, which was completely covered. The chin was recedent. C. Phisalix described a case in which the nose was wanting. Its place in the median was occupied by a single eye; on the horizontal diameter were two pupils separated by a narrow space. Landolt, discussing a case reported by Valude, points out that in cyclopic eyes all the parts may be double or united in every degree except that there is never a single lens or double vitreous. Bock and others, however, describe cases in which the eye has not been formed by the conglomeration of two separately developed eyes, but it is a single developed eye; the other being wanting entirely. Bruce reports a cyclopin which there was a single socket for the eye of a lozenge-shape, situated in the lower middle of the forehead. The socket was furnished with two pairs of eyelids, upper and lower. The eye was found to consist of two rudimentary eyes, with two rudimentary retinæ, apparently springing from a single optic vesicle. The nose was represented by a short process attached to the forehead, above the median eye.
FIG. 34.
The cyclops illustrated (Figs.33,34) was born to a 17-year old neuropathic primipara, after a protracted labour. The child was living, but was killed by pressure on the funis. The mouth contained an ivory, tusk-like tooth at each corner. There was mane-like hair around the neck.
Cyclopia is very frequently associated with the absence of both the internal and external ear, and with synotia (joined ears).
In triophthalmic cases the three eyes are usually separate, two occupying the usual position, while the third is situated as illustrated in the case cited. Ninety families of degenerates, averaging eleven children each, had five cases of cyclops.
Degeneracy, which affects so deeply the development of the eye, naturally tends to evince itself in other anomalous states in the organ. As excessive asymmetry of the body is one of the most noticeable of the stigmata of degeneracy, it is not astonishing to find that this asymmetry expresses itself both in the position as well as in the size and structure of the eye. As Kiernan[208]pointed out, twenty years ago, asymmetrical irides are exceedingly frequent in the types of insanity due to hereditary defect. This observation has since been confirmed by Féré,[209]not only as to the insane, but as to other classes of the degenerate. The conditions of the eye known as microphthalmia (small eye), macrophthalmia (big eyes) and anophthalmia (absence of eyes), are found quite frequent in degenerate families. Very frequently the pupil of the eye is asymmetrical. This was pointed out by Kiernan in the case of Guiteau. Corectopia (displacement of the pupil so that it is not in the centre of the iris) often exists. Coloboma (eye fissure) is also not infrequent among the degenerate. These vary greatly in situation and general results. The iris is sometimes completely absent on one or both sides. Beside the anomalies, diseased conditions like retinitis pigmentosa, congenital cataract and the macular degeneracy cited by C. P. Pinckard,[210]of Chicago, are far from infrequent expressions of degenerate taintin the eye; the organ in this particular obeying the general law that degeneracy may show itself in the minute change resulting in disturbance of function or in that producing disease, or, finally, in atavism. The defects of the eyes requiring glasses are exceedingly frequent in degenerates, and often aggravate their morbidity. Here, as in the case of the teeth, the chief factor is often ignored.
The external ear is, of all organs, that most affected by degeneracy.[211]It is a cartilaginous organ extending from a bony base, without a bony framework for its support and with very deficient blood supply, on account of its distances from the great blood centres, so that any defect in the nerve centres which control the local blood supply is likely to affect its nutrition. As a cartilaginous organ it has no lymphatics, which of necessity affects its growth. The sensitiveness of the ear to vasomotor changes is evident by the results of the extremes in heat and cold, emotional blushing and fatigue. Galton reports a schoolmistress who judges the fatigue of her pupils by the condition of their ears. If the ears be white, flabby and pendant, she concludes that the children are much fatigued. If they be relaxed, but red, they are suffering, not from overwork, but from a struggle with the nervous system rarely under control in children. These states are very common among degenerates.
To appreciate the degeneracy observed in the ear its embryology requires study. Before the end of the first month[212]there appears around the externalopening of the first gill-cleft (Fig.35) a series of six tubercles, two in front on the hind edge of the first visceral arch, one above the cleft and three behind it (Fig.36). A little later a vertical furrow appears down the middle of the hyoid arch, in such a way as to mark off a little ridge which joins on to tubercle 3 and descends behind tubercles 4 and 5. The second stage is reached by the growth of all the parts; the fusion of tubercles 2 and 3 and the growth of the ridge down behind tubercle 5 to become continuous with 6. After these changes it is not difficult to identify the parts.
FIG. 35.
FIG. 36.
Tubercle No. 1 is the tragus; 2 and 3, together with the arching ridge, represent the helix; 4, the anti-helix; 5, the anti-tragus; and 6, the lobule; the pit between the tubercles the fossa angularis. During the latter part of the second month the ear changes in its proportion somewhat in the irregular development. The third stage begins at the third month. The upper and posterior part of the concha arises from the surface of the head, and gradually but rapidly bends forward so as to completely cover the anti-helix and the upper portion of the fossa angularis. During this stage in mammals the assumption of the pointed form of the ear commences. The fourth stage begins at the fourth month, when the tubercles, which are now joined together by cartilages, commence to unfold and are completed by the fifth month. Finally, the sixth tubercle develops to form the lobule. This unfolding or development of the tubercles to produce the different portions of the ear and make it complete is not unlike the development of a flower from the bud. By this process may be understood how if,by malnutrition in one tubercle or bud, or should there be a larger supply of nutriment in one than another, malformation of the ear would result. If arrest of development of all the tubercles should take place at any period, from the first to the fifth month of fœtal life, the ear would resemble a semi-developed flower! (Fig.37).
FIG. 37.
FIG. 38.
As in other cases, it is necessary to fix an approximately normal standard for the ear from the standpoint of man’s status in evolution. The ear grows more or less through life, but, like the skeleton,practically reaches its full development about the twenty-sixth year. That this is not always the case, however, is demonstrated by the results of the examination of 546 persons. In an examination of 63 children between 6 and 18 months old the ears measured from 1·60 to 2·12, the average being 1·90 inches; in width from ·75 to 1, with an average of ·96. In 127 children from 8 to 12 years old the ear measured from 1·95 to 2·32 inches, the average being 2·19; width ·81 to 1·50, the average being 1·06. In 356 persons between 12 and 50 years old the shortest ear was 2, the longest 3, the average 2·50; width, smallest 1, largest 1·50, the average being 1·22 inches. The normal ear, or rather the ideal one (for few persons possess it in its entirety), should have a gracefully curved outline, be nowhere pointed or irregular, have a well-defined helix, separated from the anti-helix by a distinct scaphoid fossa extending down nearly to the level of the anti-tragus (Fig.38). Its root should be lost in the concha before reaching the anti-helix. Theanti-helix should not be unduly prominent, and should have a well-marked bifurcation at its superior extremity. The lobule should be shapely, not adherent, not too pendulous and free from grooves extending from the scaphoid fossa. The whole should be well shaped, and its proper proportion and size may be inferred from the table just given; in the adult it should not average over two and a half inches in length and one and a quarter in breadth.
The aural deformities that fall under the head of stigmata, or have been classed as such, affect all portions of the external ear. The helix may be imperfect, it may be angular, from Darwin’s tubercle it may lack its inward roll, it may be interrupted, the root of the helix may extend inward completely across the concha, and in very rare instances it may be bifurcated. The anti-helix may be unduly prominent or be insignificant; the scaphoid fossa may extend through the lobule or be triple.[213]The lobule may be adherent and sometimes almost absent, thus producing the jug-handle-shaped, or so-called Morel ear. It may be exaggerated in size; the whole ear may be misshapen, too large ortoosmall. These deformities may exist in nearly every degree, only when pronounced can they be considered as stigmata. Others have been noted, but their importance as signs of degeneracy is not very significant unless they co-exist with several of those above mentioned.