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contract pulmonary tuberculosis). Consequently there is a correspondence in type between the head and the thorax. In the measurements taken by me among the women of Latium the results show that the brachycephalics had an average depth of thorax amounting to 188 millimetres and the dolichocephalics only 181 millimetres, while the transverse diameters were very nearly equal: 241 millimetres in the brachycephalics, and 240 millimetres in the dolichocephalics. Hence, the resultant thoracic index of 78 for the brachycephalics and 75 for the dolichocephalics.

Such differences in the index indicate also differences in the formation of the thorax: that it is more or less flattened in the dolichocephalics, and more prominent in the brachycephalics. There is a corresponding diversity of form in the breasts of the women: the dolichocephalic races have more elongated breasts (pear-shaped), the brachycephalics more rounded.

The shape of the thoracic section is at the present time taken into careful consideration, especially in medicine, because it is apt to reveal predispositions to diseases.

It may be obtained by the aid of the cyrtometer (see chapter on Technique). At the present day, however, exceedingly complicated instruments have been constructed, which, by the aid of recording indexes, give a direct representation of the shape of the thoracic perimeter, together with its modifications and respiratory oscillations.

Since these instruments are, for the present, very far removed from widespread practical use, we may adopt as an excellent method for determining the shape and, at the same time, the dimensions of the thorax, that of Maurel, in his research regarding "the square surface of the thoracic section."

Having determined the anthropometric points, Maurel passes strips of metal (stiff enough to retain the shape given them) around the thorax, after the fashion of a tape-measure, first around one half, and then around the other.

Next he places these metal strips (still retaining the shape given them by contact with the thorax), upon a sheet of especially prepared paper, marked in squares, and traces upon it the inner outline of the strips.

The two halves must be made to coincide in such a manner as to reproduce faithfully the thoracic section, both in form and in dimension.

By adding up the squares contained within the outline we obtain the area of the section.

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.

CHAPTER IV
THE PELVIS

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

Fig. 127.—Skeleton of Pelvis, Seen from Above.

The sacrum, formed by the union of the five sacral vertebræ, appears in the adult in the form of a bone that narrows rapidly from above downward in a general curve whose convex side is turned inward. The coccyx has the importance of being a real and actual caudal appendage, reduced in man to its simplest anatomical expression. On each side of the sacrum the two ossa innominata or hip-bones are attached, constituting a sort of massive girdle (cintura pelvica), serving as point of attachment for the lower limbs, while at the same time it sustains the entire weight of the body and the abdominal viscera. These two bones are made up of three separate parts: an upper part, very broad and rather thin (the ilium, which constitutes the flank or hip), one in front (the os pubis), and a third behind, quite massive, and shaped like the letter V (the ischium). The two ossa innominata and the os sacrum form the pelvis or pelvic basin, a broad cavity with bony walls that are by no means complete, within which are a portion of the digestive organs and a considerable part of the organs belonging to the genito-urinary system. The pelvis supports the vertebral column and is in turn supported by the lower limbs, in quite marvellous equilibrium.

The maximum sexual differences of the skeleton are in relation to the pelvis; in woman the iliac bones form a far ampler basin; in man, the pelvis is higher and more confined and formed of more solid bones; but it is not broader. But where the difference is most apparent is in the pelvic aperture (see Fig. 127) which divides the pelvis into two parts, the upper or great pelvis and the lower or small pelvis. This aperture has distinguishing marks that differ widely between the sexes; in woman it is rounder, in man it is more elongated from front to back and is narrowed toward the pubis. One of the most important points of measurement in anthropology and in obstetrics is the extreme anterior apex of the superior border of the ilium or crista iliaca antero-superior. The woman in whom this dimension (the bis-iliac) is less than 250 millimetres cannot give birth naturally; similarly the woman who has a prominent os pubis (due to rachitis) will owe the attainment of maternity to the intervention of surgery, and perhaps even of the Cæsarean operation.

There are also many ethnical differences in the pelvis: brachycephalics (the mongolian race) have a broader and shallower pelvis than the dolichocephalics, who, on the contrary, have a deeper and narrower pelvis (the negroes). The same thing is met with, notwithstanding its intermixture, in our own race: blond, brachycephalic women have a wider pelvis than brunette, dolichocephalic women.

Accordingly, cranium, thorax and pelvis correspond in one and the same ethnic type.

The abdomen extends from the arch of the diaphragm to the lower extremity of the pelvis. It contains all the viscera of alimentation: the digestive system together with the glands belonging to it; the liver and pancreas, besides the renal system and, in women, the

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