R. Dupuy.Medicine and Eugenics.445
humerus for example). And as, in all states of arrested development, we
meet, as we have said previously, with perversion and deviation, we often
find in these subjects, who are otherwise backward, total or partial gigantism
(especially in the extremities), disproportions, and even types of malforma
tion identical with those of acromegaly.
The common character possessed by all the long bones of those whose
development is arrested—where there is perversion or arrestation—is that of
an arrested ossification which can be verified by the radiograph. On the
contrary, flat bones—those of the cranium for example—sometimes join up
too rapidly without one being able to find lesions of the meninges which
might have pushed on this work of premature ossification.
The muscles behave like the bones. One sees them in a state of
atrophy (Thenar eminence, gluteal region, muscles of the back, muscles of
the limbs), in a state of hypertrophy, or of myxoedema, like those of the
tongue. Considered from the point of view of their tonicity, they are
hypo or hyper-tonic, and if we add to this state the loosening or the con
traction of the ligaments and of the aponeuroses, we can easily understand
why the postures of standing and walking are sometimes difficult for these
subjects. Some are truly “ enfants en caoutchouc ” (with frequent umbilical and
inguinal hernias) who can place themselves in the foetal position by folding
themselves up; others are stiff “ automata ” where the rigidity is marked.
Thus the pathogenesis of certain malformations is explained : flat foot,
club foot, genu valgum, in which, as in most of the osseous dystrophies,
diaphysial or epiphysial, there is disharmony between the ligaments and
the opposing muscles, the one set being relaxed and the others contracted.
As regards articulations, we may note congenital dislocations following on
incompleteness of the articular cavities and relaxation of ligaments. Arti
cular rigidity following on ligamentous and muscular retraction often gives
the impression of ankylosis. We have noted this phenomenon at the level
of the radiocarpal articulation ; this trouble completely prevents movements
of pronation and supination.
It is by this process of hypo and hypertonicitv that the deviations of the
spinal column (scoliosis, lordosis), which are relatively frequent, are pro
duced. In the same connection we may point out unnatural positions of the
head on the trunk, which appear to have the same origin. Often it suffices
to see these children walk or run, the head pushed forward, the arms held
back, going up, and especially coming down, a flight of stairs, in order to
make a diagnosis of errors of development ; so marked is their gait. Their
circulation is always defective. The heart, besides malformations (such
as mitral stenosis), lacks tonicity : low arterial tension is a sign of this.
The beat is irregular (tachycardia, embryocardia, intermittences).
The arteries are small, hard, and inelastic. This state favours a lower
ing of pressure and explains the slight difference—sometimes none at all—
