One mechanical circ.u.mstance involved in the pituitary personalities may be the determinant of the entire life history. That is the emphasized fact that the pituitary is encased in a small bony box, at the base of the skull. The size of this bony box, and its capacity to yield to the various pressures of a pituitary enlarging to meet the demands of the organism, will often spell happiness or misery, success or failure, genius or idiocy for the man or woman. Certain possibilities are conceivable. All of them occur, for the developments of X-ray technique have rendered available almost a direct view of the sella turcica.

In the first place, the bony box may be definitely too small to start in with. That means a small and so potentially inadequate pituitary, both anterior and posterior, potentially inadequate in that it will become impossible for it to grow and produce extra secretion upon demand. Handicapped thus, the unfortunate so born is doomed to inferiority and very little can be done for him. He will not develop satisfactorily. He possesses small genital organs which will not evolve properly in adolescence, or if they will not stand still, tend to revert to the opposite s.e.x type. Then he tends to be dwarfed, fatigable, adipose. Among these types are included subjects of obsessions and compulsions who are dull and apathetic, cannot learn or maintain inhibitions, and so, without initiative, evolve into moral and intellectual degenerates, liable to epilepsy and the most remarkable s.e.x aberrations. All because a cranny of the skull, about the size of a thimble, is not large enough for their dominating gland.

If the bone of the cavity of the pituitary is softer and yielding, so that some enlargement of the gland is possible, especially of the anterior, there appear rapid growth with a tendency to high blood pressure, great mental activity a.s.sociated with frequent and severe headaches (often of the migraine type), a combination of initiative and irritability and a marked s.e.xuality. X-ray examination of the sella turcica shows what is called erosion of the bone as it yields to the pressure of the growing gland.

The ideal sella turcica for the ideal pituitary type is a large room in which the gland may grow and reach its maximum size and so its maximum function, without needing to exert pressure or destroy and erode bone in front of it, to the side of it or behind it. The distinctive masculine and feminine types, cla.s.sed as the normal, belong to this group. Sometimes, the bone in front of the pituitary will yield, while the one in the rear will not, and sometimes the conditions are reversed. Thus we may have ante-pituitary sufficiency with post-pituitary insufficiency, or ante-pituitary insufficiency with post-pituitary sufficiency, complexes which contribute to create the grosser functional hermaphrodite types of mixed s.e.x.

In the average feminine pituitary type of personality, post-pituitary dominates. In a woman and to a lesser degree in a man, the general build is slight and rather delicate. The skin is soft, moist, and hairless, the face is the doll or Dresden China sort, with a roseate or creamy complexion, flushing easily, eyes large and prominent. The mouth shows a high arched palate and crowded teeth rather long. The voice is high-pitched. One recognizes the traditional womanly woman, pet.i.te and chic, who always marries the hero in stories. She is usually fond of children, easily moved, has a good libido, and the traditional feminine traits. When unstable, the post-pituitary type is restless and hyperactive, craves excitement, and continual change of interest and scene, a new pleasure every moment. A good many of the women of today, who fifty years ago would have been nice sedate girls because of their excellent post-pituitary const.i.tution, have been irritated by the atmosphere of post-1914 into the excess post-pituitary state, the adventurous never-satiated avid pleasure hunter, in whom the craving for stimulation will stop at nothing. F.

Scott Fitzgerald portrayed an exquisite specimen of the kind in his short story "The Jellybean," with a quasi-heroine of a good Southern family, built to be a high standard wife and mother, who drinks, swears, gambles, and finally marries on a dare. Modern post-pituitary woman is excitement mad and thrill chasing. The worst of it is that the resultant personal tragedies cannot be dismissed as transient inevitables. The heredity of the internal secretions determines that the offspring of these women are bound to be pituitary unstable, the least desirable of endocrine instabilities because of the concomitant mental effects. Even from the purely selfish point of view, the standpoint of enlightened selfishness, the post-pituitary type must beware of excesses. For disturbances of menstruation, psychic fears, anxieties, states of suspicion and obsession, various pains are among the penalties.

A period of post-pituitary excess as an effect of disease, pregnancy, or the rapid life, may be followed by post-pituitary deficiency as a result of exhaustion of the gland. The girl or woman then becomes fat and suffers from headaches (the fair, fat and forty type) yet retains a certain capacity for enjoyment which enables her to continue gay, happy and gentle, kind, interested. So she contrasts with the thyroid deficient who gets fat, but also dull, stupid, even morose.

The masculine pituitary personality, the man with a dominant anterior pituitary gland in a roomy sella turcica with plenty of s.p.a.ce to grow in, is the ideal virile type. They are generally tall (unless the growth of the long bones was checked too early by a social precocity of the testes) with a well-developed strong frame, large firm muscles, and proportionately sized hands and feet. The head is of the marked dolichocephalic type, flattened at the sides, face is oval more or less, with thick eyebrows, eyes rather prominent, nose broadish and long, lower jaw prominent and firm. Prominent bony points like the cheek bones, the elbows and the knees, the knuckle joints of the hands and feet. The teeth are large, especially the upper middle incisors, and they are usually s.p.a.ced. The arms and legs are hairy. High grade brains, the ability to learn, and the ability to control, self-mastery in the sense of domination of the lower instincts and the automatic reactions of the vegetative nervous system, the rule by the individual of himself and his environment are at their maximum in him. The ante-pituitary personality is educable for intelligence, and even intellect, provided the proper educational stimulus is supplied. Men of brains, practical and theoretical, philosophers, thinkers, creators of new thoughts and new goods, belong to this group. The distinction between men of theoretical genius, whose minds which could embrace a universe, and yet fail to manage successfully their own personal everyday lives, and the men of practical genius, who can achieve and execute, the great engineers, and industrial men lies in the balance between the ante-pituitary and the adrenal cortex primarily. Men like Abraham Lincoln and George Bernard Shaw belong to this ante-pituitary group.

The feminine pituitary personality, in whom there is predominance of the post-pituitary over the ante-pituitary, occurs in men. The type is short, rounded and stout. They have heads that seem too large for their bodies, the general hair distribution on the trunk and extremities is poor, although that of the scalp and face is plentiful, and they acquire an abdominal paunch early. They exhibit the feminine tendency to periodicity of function, their moods, activities, efficiency are cyclic, reminding one of the menstrual variations of the female. This rhythmicity saturates their personalities, so that poetry and music almost morbidly appeal to them. A number of the great poets and musicians are to be cla.s.sified as of the feminine pituitary species. Last, but not least, they are the hen-pecked lovers and husbands. s.e.x difficulties are frequent in their history.

The determination of endocrine type and tendencies, the prediction of the future personality, during childhood is one of the developments confidently to be looked for, as our knowledge of the internal secretions will grow. The possibilities of control loom as one of the most magnificent promises of science. Yet the high expectations for tomorrow should not depress our respect for the achievements of today.

In the case of the pituitary, for instance, a hint as to the method of approach is furnished by the tabulation of the traits of pituitary dominance and pituitary inferiority in children.

Pituitary sufficient and dominant: Large, spare, bony frame Eyes wide apart Broad face Teeth, broad, large, uns.p.a.ced Square, protruding chin and jaws Large feet and hands Early hair growth on body Thick skin, large s.e.x organs Aggressive, precocious, calculating, self-contained

Pituitary inferior: Small, sometimes delicate skeleton Rather adipose, weak muscles Upper jaw prognathous Dry, flabby skin Small hands and feet Abnormal desire for sweets Subnormal temperature, blood pressure and pulse Poor control of lower vegetative functions Mentally sluggish, dull, apathetic, backward Loses self-control quickly, cries easily, discouraged promptly, psychic stamina insufficient

The pituitary personality in childhood produced by limitation of the size of the gland, because its bony box is completely or partially closed, presents typical hall-marks. He supplies the second and third offenders in the juvenile courts, the delinquents and pathological liars of childhood, the incorrigibles, the precocious hoboes, mental and moral deficients and defectives, the prey of the sentimental complexes of elderly virgins and helpful futility all around. Not utilitarianism or futilitarianism is needed, but pituitarianism.

The feeding of pituitary gland in large enough quant.i.ties to these unfortunates may do more than ten charity organizations, with the most patrician board of directors complete.

THE THYROID PERSONALITIES

The accessibility of the thyroid gland in the neck, the ease of surgical approach, the definite effects following its removal, and then the miraculous marvels of the feeding of thyroid have rendered it the centre of attack by the largest army of endocrine investigators.

As a result we know more about the thyroid in childhood, adolescence, adult life and old age than about the other glands.

In childhood, the subthyroid or thyroid deficient, the cretinoid type, the type resembling the cretin, is fairly common. The peasant's face, with the broad nose and the tough skin, coa.r.s.e straight hair, the undergrowth, physical and mental, a persistent babyishness and a r.e.t.a.r.dation of self-control development, make up the picture. He needs an excess of sleep, sleeps heavily, needs sleep during the day, when awakened in the morning still feels tired, and rather dull and restless, dresses slowly, has to be coaxed or forced to dress, gets to school late nearly every morning, does badly at the school, reaction time, learning time and remembering time being prolonged as compared with the average, and is lazy at home lessons. He perspires little, even after exertion, yet fatigues easily, is subject to frequent colds, adenoids, tonsillitis, and acquires every disease of childhood that happens along.

Adolescence, the coming of menstruation, the first blooming of youth is delayed in the subthyroid. The secondary s.e.x traits as they develop tend to be incomplete and to mimic those of the opposite s.e.x. Yet in adolescence too there may be a sudden change and reversal of the whole process, a jump from the subthyroid to the hyperthyroid state. So a girl who has been dull and lackadaisical, with no complexion and every prospect of evolution into a wall flower, may be transformed into a bright-eyed woman, generally nervous and restless, high colored, and possessed of a craving for continual activity and excitement. Skin, hair and teeth become of the thyroid dominant type. The heart palpitates under the slightest stimulus, she perspires almost annoyingly, heat and emotion are prostrating. If such a transfiguration does not occur, the effect of the reconstructions of p.u.b.erty is to create a person with about the following characteristics.

1. Height below the average 2. Tendency to obesity (toward middle age) 3. Complexion sallow 4. Hair dry--hair line high 5. Eyebrows scanty, either as a whole or in outer half 6. Eyeb.a.l.l.s deep-set, lack l.u.s.tre, in narrowed slits 7. Teeth irregular, become carious early 8. Extremities cold and bluish 9. Circulation poor. Subject to chilblains

Intellectually, these people vary enormously, depending upon which of the other glands will enlarge to compensate for the deficiency of the thyroid. If the growth of the skull has left a roomy sella turcica for the pituitary to grow in, the intellect may be normal or even superior, though energy is below par. If this is not possible and the adrenals have to predominate, a lower, more animal and less self-controlled type of mentality is produced.

In direct contrast to the subthyroid types is he who originally was hyperthyroid. During childhood he is quite healthy, thin, but striking robust, active, energetic, generally fair-complexioned with nose straight and high bridged, eyes rather "poppy," teeth excellent, regular, firm, white with a pearly translucent enamel. These children are always on the go, never get tired, require little sleep. Seldom will one of the cla.s.sical children's diseases strike them, measles perhaps, but no other. Adolescence for them, however, is more apt to be stormy and episodic, adjustment to the new world of people and things is much more difficult, wanderl.u.s.t is acute. All an expression of cells keyed up, charged with energy that must flow somewhere or explode.

The ruddy live-wire, recognized everywhere as bubbling with vitality, the life of any group, the magnetic personality may, however, be shocked by some seismic event like the death of a father or mother, or the ruin of some cherished ambition. A break in the balance of the other glands follows quickly and disablement and invalidism, which may cure itself after some years, remain stationary, or descend to the worst forms of thyroid deficiency.

During maturity, the type are characterized usually by a lean body, or tendency rapidly to become thin under stress. They have clean cut features and thick hair, often wavy or curly, thick long eyebrows, large, frank, brilliant, keen eyes, regular and well developed teeth and mouth. s.e.xually they are well differentiated and susceptible.

Noticeable emotivity, a rapidity of perception and volition, impulsiveness, and a tendency to explosive crises of expression are the distinctive psychic traits. A restless, inexhaustible energy makes them perpetual doers and workers, who get up early in the morning, flit about all day, retire late, and frequently suffer from insomnia, planning in bed what they are to do next day.

Certain types of thyroid excess a.s.sociated with the thymus dominant next to be described are peculiarly susceptible to emotional instability. They are subject to brain storms, outbreaks of furious rage, sometimes a.s.sociated with a state of semi-consciousness. To emphasize the a.n.a.logy to epilepsy, their attacks have been called psycholepsy. Among the Italians especially they were watched and reported during the War, when the explosive fits were seen to take the form of irresponsible acts of insubordination or violence.

THE THYMO-CENTRIC PERSONALITIES

During the first period of childhood, up to five, six or seven, or more accurately, up to the point at which the permanent teeth begin to appear, every child may be said to be a thymus-dominated organism, because the thymus, holding the other endocrines in check, controls its life. That is why up to the third and fourth years at any rate, most children seem alike. Closer observation, however, reveals points of differentiation and signs of the coming potencies of the other hormones. During the second period, up to p.u.b.erty, these marks of the deeper underlying forces of the personality make themselves more and more felt. The thymus, like a brake that is becoming worn out, continues to function in a progressively weaker fashion. Until with the arrival of the gonadal (ovaries' or testes') internal secretion, its influence is wiped out.

There is a definite degree of thymus activity during everyone's childhood, unless by its premature involution, precocity displaces juvenility. Yet even during childhood, there are certain individuals with excessive thymus action, foreshadowing a continued thymus predominance throughout life. The "angel child" is the type: regularly proportioned and perfectly made, like a fine piece of sculpture, with delicately chiselled features, transparent skin changing color easily, long silky hair, with an exceptional grace of movement and an alertness of mind. They seem the embodiment of beauty, but somehow unfit for the coa.r.s.e conflicts of life. In English literature several characters are recognizable as portraits of the type, notably Paul Dombey, whose nurse recognized that he was not for this world. They may look the picture of health, but they are more liable than any other children to be eliminated by tuberculosis, meningitis or even one of the common diseases of childhood.

It is after p.u.b.erty, when the thymus should shrink and pa.s.s out of the endocrine concert as a power, that the more complex reactions of personality emerge when the thymus persists and refuses to or cannot retire. The persistent thymus always then throws its shadow over the entire personality. To what extent that shadow spreads depends upon the strength of the other glands of internal secretion, their ability to compensate or to stay inhibited. Whether or not the pituitary will be able to enlarge in its bony cradle seems to be the most important factor determining these variations. If there is s.p.a.ce for it to grow, at any rate normally, the individual may pa.s.s for normal, although he will have difficulties throughout life he may never understand, particularly in s.e.xual directions. If the pituitary is limited.

partially or completely, the thymus predominance is more prominent and fixed, and the abnormalities become obvious, both of person and conduct.

The anatomic architecture of the latter thymo-centric personality is fairly typical. The reversion in type of the reproductive organs, the slender waist, the gracefully formed body, the rounded limbs, the long chest and the feminine pelvis strike one at the first glance. The texture of the skin is smooth as a baby's, and sometimes velvety to the touch. Its color may be an opaque white, or faintly creamy, or there may be an effect of a filmy sheen over a florid complexion.

Little or no hair on the face contributes to the general feminine aspect in the more extreme types. They are often double jointed somewhere, flat footed, knock-kneed.

In women, the external manifestations of a thymo-centric personality may be limited to thinness and delicacy of the skin, narrow waist, rather poorly developed b.r.e.a.s.t.s, arched thighs and scanty hair, with scanty and delayed menstruation. Or there may be obesity, with juvenility, if there is a repression of the pituitary secretion for one reason or other.

In their reactions to the problems, physical and psychic, of everyday life, the thymo-centrics are distinctly at a disadvantage. In the first place, muscular strain, stress or shock is dangerous to them because they have a small heart, and remarkably fragile blood vessels, which renders their circulation incapable of responding to an emergency, or at least definitely handicapped. In infancy, they may die suddenly because of this, either for no ascertainable cause at all, or because of some slight excitement like that attending some slight operation, a fall, or a mild illness. During the run-about epoch they are unable to cope with the necessities of an active child's existence in playing with other children. p.u.b.erty and adolescence are specially perilous to them for they may endeavour to compensate for an inner feeling of physical inferiority by going in strenuously for athletics and sports, and so risking a sudden hemorrhage in the brain, producible by the tearing of a blood vessel, as if constructed of defective rubber. Reports published in the newspapers from time to time of children or young men instantly killed by a tap on the jaw in a boxing contest, or some other trivial injuries are doubtless samples of such reactions in thymo-centric people.

As an ill.u.s.tration of the conduct aberrations of the thymo-centric personality during adult life, the following extracts from a newspaper report of a suicide are worth quoting.

"An autopsy made yesterday by Dr. Benjamin Schwartz, first a.s.sistant to Dr. Charles Norris, Chief Medical Examiner, removed any mystery that surrounded the death on Sat.u.r.day night by pistol bullets of Dr.

Jose A. Arenas and the wounding of 'Miss Ruth Jackson' and Ignatio Marti.

"Dr. Schwartz said that his post-mortem examination had convinced him beyond doubt that the dead physician-dentist had killed himself after he had tried to take the life of the young woman with whom he had lived and of the youth who was his successful rival.

"'Besides that,' Dr. Schwartz said, 'my report to the police will include a statement from the young woman to me that she always had understood that Dr. Arenas had killed some one in Havana, Cuba, before he came to New York.

"The autopsy left no doubt that Dr. Arenas was a case of status lymphaticus (thymus-centered personality). I made a most complete report because of the scientific value of the autopsy.

"'This confirmed my first deductions after seeing the body on Sat.u.r.day night in the doctor's furnished room with alcove bedroom adjoining.

You will remember that as soon as I had seen him I revealed that he was wearing corsets.

"'These cases of status lymphaticus are intensely interesting. In them the blood vessels are very small, and the lymphatic clement is greatly in excess. They die suddenly, from ruptures of blood vessels. Many of them are degenerate. Most of them are criminals. All of them are liable to commit crimes of pa.s.sion. Among them are found a large percentage of drug addicts.

"'Miss Jackson, in the hospital, confirmed my scientific theory that the dead man was not normal. She was perfectly frank in her statement.

She said she had left her husband, Elmer Schultz, an automobile salesman in Toledo, several months ago and had come to New York. She said she had lived with the doctor for some time.

"'About ten days ago she left him to live with Marti, a healthy, normal lad. Before she went from the doctor's room she destroyed those colored collars that were found beside the body. She cut them with scissors. But that was after, so she states, the doctor had destroyed stockings of hers by cutting them.

"'She told me in the hospital today, and with every appearance of truth, that she had met Arenas in the subway at the station on Seventy-second Street and Broadway on Friday night and that she had asked him when she could come and get her clothes. He said, according to her story:

"'Come to the house tomorrow afternoon--but come with Marti.'

"'She said that she and Marti went there according to this invitation: that first the doctor showed her the cut collars and told her that she would get her clothes back in perfect condition, and that the next thing she knew she had been shot. She couldn't remember much after that.

"'I believe that both she and Marti have told a perfectly straightforward story and the autopsy is proof of it.

"'There were six bullets in the doctor's pistol to be accounted for.

One, in an undischarged cartridge, still was in the weapon. That leaves five. One struck "Miss Jackson" in the right chest squarely in front, and penetrated the flesh about one inch. If there had been any power at all behind the missile it would have gone right through, pierced a lung, caused a hemorrhage, and the chances are that "Miss Jackson" would have died. That leaves four bullets.

"'One more struck Marti in the left upper chest. It pa.s.sed through the pocket there, and the skirt, grazed the skin, and then bounced over to the right hand side in front. It was a most amazing case of a bounding bullet. I was particularly careful about examining its course because at first I was suspicious of the stories that were told by Marti and "Miss Jackson." Now I know they are true.

"'But anyone might have been puzzled by the queer antics of the missiles from the pistol of South American manufacture that the doctor used. If it had had any penetrating power--or rather if the bullets that it sent out, had any real kick behind them--the chances are that both "Miss Jackson" and Marti would be dead now.