Pedagogical Anthropology, Maria Montessori [online e book reader TXT] 📗

Fig. 126.

This method is the only really rational method for studying the thorax; and its simplicity, practicality and graphic representation recommend it as a valuable aid to pedagogic anthropology.

There is, for example, an abnormal form of thorax, which I have very often met with in deficient children. It consists in an exaggerated curve of the posterior costal arches, which consequently form a very sharp angle with the vertebral column, which is notably indented, while the sternum is also depressed in a groove, and occupies a plane posterior to that of the ribs. The section of the thorax, in this case, approaches the form of a figure 8; and the thoracic perimeter would not represent the true measurement because it would include the empty spaces left by the front and back depressions. The thoracic index would also give a false idea of the facts, because the antero-posterior diameter would be nowhere so short as at the centres of measurement for this diameter.

The only method for representing the true shape and area of this type of thorax is that employed by Maurel.

Anomalies of Shape.—In addition to the preceding anomaly, very frequent in degenerates, and associated with a deficient development of the lungs and with physical weakness, there are numerous other anomalies. Among others, those that principally deserve attention are the funnel-shaped or consumptive thorax, in which the longitudinal diameter is excessive; the thoracic frame is greatly elongated and the ribs descend to a very low level; this type of thorax is frequent in neuropathic women, and, according to Féré, is associated with degeneration.

The opposite form is the barrel-shaped thorax, in which the prevailing diameter is the antero-posterior; it is very prominent and is frequently met with in persons who are subject to forms of asthma, maladies of the heart, etc.

The bell-shaped thorax is similar to the preceding, but is characterised by an accompanying exceptional brevity of the longitudinal diameter, which causes it to resemble the infantile thorax (arrest of morphological development).

The grooved thorax is the one described above as common among the mentally deficient.

A considerable importance attaches to a form of thorax distinguished by the shortness of the clavicles, in consequence of which the chest remains flat, paralytic or flat thorax (habitus phthisicus). The flattened appearance is due to the fact that the chest cannot rise in front, and the shoulders, being cramped by the shortness of the clavicles, curve forward, while the scapulæ stand out from the plane of the back and spread themselves like wings (scapulæ alatæ). I have met with this form in deficients, accompanied by such laxity of articulations, that it was possible to grasp the points of the shoulders and draw them together until they very nearly met in front.

This form of thorax is characteristically predisposed to pulmonary tuberculosis, and is frequently met with in the macroscelous types.

The commonest deformities of the thorax are those associated with rachitis.

One of the forms regarded as being rachitic in origin is the keel-shaped thorax, in which the sternum is thrust forward and isolated along its median line, like the keel of a boat.

But the thoracic deformities due unquestionably to rickets are of the well-known types that go popularly under the name of hunchback, and are accompanied by curvatures of the vertebral column. The first admonitory symptoms are shown by the so-called rachitic rosary, i.e., by the small swellings due to enlargement of the ends of the ribs at their point of attachment to the sternum. Subsequently, the softened ribs become misshapen in various ways, especially from the fourth rib downward, the upper ribs being fastened and sustained by the thoracic girdle and by the muscles. The curvatures of the vertebral column which accompany rickets are scoliosis or lateral deviation (frequent in school-children) and kyphosis, or deviation in a backward curve; for the most part these two curvatures occur together, so that the vertebral column is thrust outward and at the same time is twisted to one side: kyphoscoliosis.

Pedagogical Considerations.—The following considerations are the natural sequence of what has been said above. Deficiency of the thorax is one of the stigmata left by the school, which in this way tends to make the younger generations feeble and physiologically unbalanced.

The exaggerated importance which is given to the school benches for the purpose of avoiding deformities of the vertebral column deserves to be put aside and forgotten, as an aberration of false hygiene. The bench will not prevent restriction of the thorax; before reaching the critical point which the improved school bench is intended to prevent, many impoverishments of the organism, fatal to robustness and health, and often to life itself (predisposition to tuberculosis!) have been incurred; and there is no other remedy to obviate them than a reform in pedagogic methods. The admonitory fact that neglected, despised, half-starved children have an enormous advantage in the development of the thorax over the more intelligent children who are well-fed and carefully guarded, and solely because the former are free to run the streets, ought to point the direction in which we should look for means of helping the new generations hygienically. They have need of free movement and of air. The recreation rooms which tend to keep the children of the street shut up indoors even during recess are taking from the children of the people the sole advantage that still remained to them. Try to realize that these children are obliged to sleep in dark, crowded environments, and that every night, during the period of sleep, they suffer from such acute poisoning by carbon dioxide that they frequently awaken in the morning with severe pains in the head. The life of the streets is their salvation. We condemn children to death, under the delusion that we are working for their moral good; a perverted human soul may be led back to righteousness; but a consumptive chest can never again become robust. Let those who talk of education and morality and similar themes be sure that they are benefactors and not executioners, and let those who wish to do good seek the light of science.

Curvatures of the vertebral column, such as lordosis and kyphosis, cannot be considered solely in relation to the thorax, but in relation to the pelvis as well, because, especially in lordosis, the lumbar vertebræ are also involved, while the pelvis also suffers a characteristic deformity.

Anatomical Note.—The five lumbar, the five sacral and the four coccygeal vertebræ constitute the lumbar and sacro-coccygeal section of the vertebral column.