Pedagogical Anthropology by Maria Montessori (new books to read .TXT) 📖

These glands are very small; the largest is the thyroid, which weighs between thirty and forty grams (1 to 1-3/5 oz.); the suprarenal glands weigh four grams each (about 60 grains); the hypophysis hardly attains the weight of one gram.

The importance of these glands began to be revealed when antiseptic methods rendered surgery venturesome, and the attempt was made (in 1882) to remove the thyroid gland. After a few weeks the patient operated on began to feel the effects of the absence of an organ necessary to normal life: effects that may be summed up as, extreme general debility; pains in the bones and in the head; an elastic swelling of the entire skin; enfeebled heart action, and anemia; and on the psychic side, loss of memory, taciturnity, melancholy. After the lapse of some time the patient showed such further symptoms as the shedding of the cuticle of the skin, whitening of the hair and facies cretinica.

But when Sick undertook to operate upon the thyroid of a child of ten, the deleterious effects of interrupting the above-mentioned function of the gland manifested itself in an arrest of development; at the age of twenty-eight the patient operated on by Sick was a cretin (idiotic dwarf) 1.27 metres tall (average stature at age of ten=1.28 m.). Since that time certain diseases have been recognised that call to mind the condition of patients who have undergone an operation for removal of the thyroid glands, and in which the subjects have suffered from hypothyroidea, or insufficient development of the thyroid.

Such individuals were characterised by nanism, solid edema of the skin, arrest of psychic development, and absence of development of puberty; this malady has taken its place in medical treatises under the name of myxedema; and, when serious, is accompanied by nanism and myxedematous idiocy. But in mild cases it may result in a simple myxedematous infantilism.

The other glands of internal secretion are also associated with the phenomena of growth. First in importance is the thymus which is found highly developed in the embryo and in the child at birth, and thereafter diminishes in volume, until it almost disappears after the attainment of puberty. In the psychological laboratories of Luciani, at Rome, the first experiments were conducted upon dogs, for the purpose of determining what alterations in growth would result as a consequence of the removal of the thymus. The dogs thus operated on were weak; furthermore they became atrophied, accompanied by roughness of the skin and changes in pigmentation. After this, experiments were made in the Pediatric Clinic at Padua, under the direction of Professor Cervesato, in the application of thymic organotherapy (that is, the use of animal thymus as medicine) with notable success in the case of atrophic children (infantile atrophy occurs in early infancy; this form is known popularly in Italy as the "monkey sickness." Nursing children become extremely thin, cease to grow in length, the little face becomes elongated and skeleton-like, and is frequently covered with a thick down).

Stoppato also obtained analogous results in infantile atrophy and anemia. Hence it is evident that the very rapid growth in the embryo is associated with the functional action of the thymus. And this is also true of the very rapid growth during the first years of a child's life.

The pituitary gland, or cerebral hypophysis, has also functions associated with the general nervous tone and trophism (or nourishment) of the tissues, and especially of the osseous system. There is a disease known as acromegalia (Marie's disease) which is characterised by an abnormal and inharmonic growth of the skeleton, especially in the limbs and the jaw; the hands and feet become enormously enlarged, while the jaw lengthens and thickens (an unhealthy formation on which the common people of Italy have bestowed the name of "horse sickness," because of the appearance assumed by the face). Such patients complain of general and progressive debility of their psychic activities. In such cases, an autopsy shows an alteration of the pituitary gland, often due to malignant tumors (sarcoma).

The suprarenal capsules also bear a relation to general trophism and particularly to the pigmentation of the skin. It was already noted by Cassan and Meckel that the negro races show a greater volumetric development of the suprarenal capsules; when in 1885 Addison for the first time discovered a form of disease associated with alterations of the suprarenal capsules, characterised by an intensely brown colouration of the skin (bronzed-skin disease), general debility of the nervous and muscular systems, progressive anemia and mental torpor; the malady ends in death. In the case of animals operated on for physiological experiments, not one of them has been able to survive.

Some interesting observations have been made by Zander on the connection between the development of the nervous system and the suprarenal glands. He found that there was an insufficient development of these glands in individuals having teratological (monstrous) mis-shapements of the brain, as in the case of hemicephalus (absence of one-half the brain), cyclops, etc.

There exists between all the ductless glands, or those of internal secretion, an organic sympathy: in other words, if one of them is injured the others react, frequently to the extent of assuming a vicarious (compensating) functional action.

What their functional mechanism is, that is, whether the secretions act as formative stimulants or enzymes, ferments of growth, or whether as antitoxins to the toxins elaborated by various organs in the process of regression, is a question still controverted and in any case cannot enter within the limits of our field.

It is enough for us to know that the general growth of the organism and its morphological harmony, depend not only as regards the skeleton, but equally in relation to the cutaneous system and its pigmentation, the development of the muscles, the heart, the blood, the brain, and the trophic functions of the nervous system, upon some formative and protective action of all these little glands of "internal secretion," with which are associated the psychic activities and even the life itself of each individual, as though within the embryonic crucible there must have been certain substances that acted by stimulating the genetic forces and directing the trophism of the tissues toward a predetermined morphology.

To-day it is held that even the mother's milk contains these formative principles, or enzymes, suited to stimulate the tissues of her own child in the course of their formation; consequently, it produces results which no other milk in all nature can replace.

Alterations in these glands of "internal secretion" may therefore produce an arrest of development—and, in mild cases, forms of infantilism. But the gland which in this connection is of first importance is the thyroid.

Now there is one form of arrest of the trophic rhythm of growth which may be due to hereditary causes effecting the formative glands (myxedematous infantilism), or to exceptional causes occurring in the individual himself in the course of formation, either at the moment of conception, or at some later moment, as may happen even during the period of infancy (dystrophic infantilism of various origin).

In all these cases, however, according to Hertoghe, the exceptional causes, deleterious to growth, would first of all exercise their influence upon the glands of internal secretion and especially upon the thyroid.

In order to make clear, in connection with such complex pathological problems, the cases which are important from the point of view of pedagogy and the school, let us divide them into:

Myxedematous infantilism, due to congenital insufficiency of the thyroid gland from hereditary causes, and

Dystrophic infantilism, associated with various causes deleterious to individual development—and acting secondarily upon the glands of internal secretion (syphilis, tuberculosis, alcoholism, malaria, pellagra, etc.).

Myxedematous infantilism is characterised by short stature, by excessive development of the adipose system, and by arrest of mental development (including speech). Such infantiles very frequently have a special morphology of the face, that suggests the mongol type, and characteristic malformations of the hands (little fingers atrophied). When treated with extracts of the thyroid glands of animals, they improve notably; they become thinner, they gain in stature, their mentality develops to the extent of permitting them to study and to work. Certain mongoloids treated by De Sanctis in the Asylum-School at Rome were improved to the point of being able to attend the high-school and therefore were restored to their family and to society as useful individuals—all of which are facts that are of singular importance to us as educators! Medical care working hand in hand with pedagogy may save from parasitism individual human beings who otherwise would be lost. We ought to be convinced from such evidence of the necessity of special schools for deficients, wholly separated from the elementary schools, and where medical care combined with a specially adapted pedagogic treatment may transform the school into a true "home of health and education." The plan of a "school with a prolonged schedule of hours," including two meals and a medical office, as was conceived and organised by Prof. Sante de Sanctis in Rome, has been proved to answer admirably to this social need; because without wholly removing the children from their families, and therefore without exposing them to the disadvantages of a boarding school, it provides them with all the assistance necessary to their special needs.

Dystrophic Infantilism.—Given a case of infantilism, discoverable by the teacher through the general measurements of the body and psychic examination, it is interesting to investigate the deleterious causes.

It may be the result of poisoning, as for example from alcohol. Alcohol has such a direct influence upon the arrest of development that in England jockeys are produced by making the lads drink a great deal of alcohol. Children who drink alcohol do not grow in stature, and similarly the embryo grows in a less degree when the mother indulges in alcohol during pregnancy; some Swiss women deliberately resort to this means, in order that a smaller child may lessen the pain of childbirth. But alcohol not only diminishes the stature, but destroys the harmony of the different parts; that is, in the development of the body it arrests both the volumetric and the morphological growth. Furthermore, alcohol produces in children an arrest of mental development. An acquaintance with this principle of hygiene should be looked upon by the teacher less as a piece of special knowledge than as a social duty. From the point of view of the educator, the fight against alcoholism should have no assignable limits! It would be vain for him to perfect his didactic methods in order to educate a child that drank wine or other still worse alcoholic liquors. It would be better if the efforts which he meant to dedicate to such educative work could be all turned to a propaganda directed toward the parents of such children, or toward the children themselves, to induce them to abstain from so pernicious a habit!

We may also consider in the category of poisonings certain chronic maladies which act upon the organism with special toxic (poisonous) effects. In the foremost rank of such maladies belongs

Syphilis.—This disease is ranked among the principal causes of abortion; in other words, the fœtus which results from a syphilitic conception lacks vitality, and often fails to complete the cycle of intrauterine life. But even granting that the fœtus survives and attains its complete development, the child after birth grows tardily, and very often remains an infantile. It is well known that syphilis has been transmitted to new-born infants at the time of birth, in consequence of which these infants may in turn transmit syphilis to their wet-nurses. In such cases they are really sick and need medical treatment from the hour of their birth. Just as in the adult patient, syphilis has several successive stages, an acute primary stage, with plain manifestations of hard ulcers, erythema diffused over the skin of the entire body, glandular infiltrations, etc., and then secondary and tertiary manifestations that eventually become chronic