These several principles, or propositions, are manifestly true. They may easily be elaborated, but they cannot be refuted. They, if carefully studied, make clear that the cause of the special functions of an individual- normal and abnormal-resides n the special morphology of the organism. In other words, a knowledge of the special morphology enables us to understand the reason for the peculiarities of human physiological processes and reactions, and thus enables us to guide the process of unfoldment of the growing child into normal channels, to prescribe rationally and intelligently for any and every condition.
Now every human being presents a morphological problem. Some degree of physical defect is to be found in everyone. Few come into the world without some hereditary defect, and fewer still find themselves placed in an environment which is uniformly beneficent and makes for perfect development. Adaptation results in functional over-activity in some directions and under-activity in others, which, in turn, results, in over-development in some directions and under-development in others. And here we find the true source of organic predispositions and susceptibilities-the root causes of disease. If this were understood, the matter of preventing disease would be much simpler problem than it is today.
Ontology teaches us that from the moment of conception until death, the organism is continuously passing from one physical state into another, and that normal unfoldment necessitates the completion of each state in regular order. Carrying over structural characteristics of an earlier stage creates defects in structure and inappropriate organs for the newer conditions, and, according to the physiological principle which says that between character of function and character of organization there is a direct and intimate relation, results in inharmonious functions and the creation of certain predispositions and susceptibilities.
The question which now presents itself is: What is normal, what is excessive and what is deficient development? In other words, by what standard are we to judge the conditions of the organism at any particular period.
Many standards of the normal have been given us, but so far as I am able to judge, only one meets the requirements of the physician. The one based on the average of results obtained from many thousands of examinations is wholly inadequate and unscientific. Likewise is the anatomical standard of approximate size of organs, inadequate and misleading.
By that I mean, that when we say, for example, that the liver weighs about four pounds, that the intestines are about thirty feet long, that this or that organ is about so and so, we are dealing in generalities and uncertainties. Approximate knowledge is not scientific knowledge, and cannot be made to satisfy the demands of science. if the proposition be true that vigor of function is in relation to degree of development, then it is necessary that we determine accurately the degree development before we attempt to appraise the vigor of the functions.
Approached from the standpoint of physiology we see that normal development and function stand in relation to each other as do supply and demand. To illustrate: The capacity of the lungs to supply oxygen must be equal to the demand of the whole organism for this particular element. Which means that the size of the lungs must bear a definite relation to that of the whole organism. When these are not proportionate, then the excess or defect, whichever may be the case, is accompanied by a corresponding excess or defect in function and the ceration of certain predispositions and susceptibilities.
A deficient development and lowered function causes respiratory insufficiency, imperfect oxygenation of the blood, impoverished arterial blood, venous excess, imperfect metabolism, deficient trophic process, etc. The morbid states which may grow out of this are many; time will not permit an enumeration of them, nor is it necessary to further emphasize this point.
But how can we determine the size of the organs?.
Among other things our anatomical studies have taught us that the contour of the body is determined by the size of its organs. That is to say, a large thorax contains large lungs, a large right hypochondrium contains a large liver, a large lower abdomen contains a large intestinal tract, etc. Bear in mind that in this discussion we are considering morphological states and not pathological or postural deformities. Proceeding on this basis, Prof. DeGiovanni and his associates, after making literally thousands of examinations and autopsies and comparing the results of these with the histories, arrived at the following conclusions:
The stature and bi-lateral reach are equal; the thoracic circumference, the chest at rest, is equal to one-half the stature; the length of the sternum, i.e., manubrium and gladiolus, and the distance from the gladiolus to the center of the umbilicus and from this point to the crest of the pubis are each equal to one-tenth of the stature; the bi-iliac diameter is equal to four-fifths of the length of the abdomen; the length of the spinal column is equal to two-fifths of the stature. Other measurements are taken in the individual case, but these are the chief ones, relating as they do, to the vital organs. These, let me say, are the proportions for the normal adult.
What the normal proportions are for the infant and growing child at different epochs of life has never accurately determined. However, this can be inferred, namely, that with each year of life of the child there must be a nearer approach to the normal proportions of the adult. Failure in this means, the carrying over of infantile characteristics, both of structure and function and the preparation of soil favorable to the development of disease, indeed, actually growing into disease.
