Chapter 19

_Face._ We have already remarked on the excessive size of the face compared with the brain-case, owing chiefly to the high cheek-bones, which are one of the most salient characteristics of criminals, and to the enormous development of the jaws, which gives them the appearance of ferocious animals (see Fig. 5). To these peculiarities may be added progeneismus, the projection of the lower jaw beyond the upper, a characteristic found only in 10% of normal persons, receding forehead as in apes, and the lemurian apophysis already mentioned.

_Arms and Hands._ With the exception of the excessive length as compared with the stature, anomalies in the arms are rare, but the hands show some interesting characteristics, which have already been described in the first chapter of Part I, an increase or decrease in the number of fingers and syndactylism or palmate fingers. Also the lines in the palm and those on the palmar surfaces of the finger-tips show deviations from the normal type resembling characteristics of apes.

_Feet._ Degenerates and more especially epileptics, frequently have flat or prehensile feet and an elongated big-toe with which, like the Japanese, they are able to grasp objects.

All these anomalies vary in number and degree according to whether the subject examined is a born criminal or a criminaloid, and according, also, to the special type of crime to which he is addicted. Thieves commonly show great mobility of the face and hands. Their eyes are small, shifty and obliquely placed, and glance rapidly from one object to another. The eyebrows are bushy and close together, the nose twisted or flattened, beard scanty, hair not particularly abundant, forehead small and receding, and the ears standing out from the head. Projecting ears are common also to sexual offenders, who have glittering eyes, delicate physiognomy excepting the jaws, which are strongly developed, thick lips, swollen eyelids, abundant hair, and hoarse voices. They are often slight in build and hump-backed, sometimes half impotent and half insane, with malformation of the nose and reproductive organs. They frequently suffer from hernia and goitre and commit their first offences at an advanced age.

The cinædus is distinguished by his feminine air. He wears his hair long and plaited, and even in prison his clothing seems to retain its feminine aspect. The genitals are frequently atrophied, the skin glabrous, and gynecomastia not uncommon.

The eyes of murderers are cold, glassy, immovable, and bloodshot, the nose aquiline, and always voluminous, the hair curly, abundant, and black. Strong jaws, long ears, broad cheek-bones, scanty beard, strongly developed canines, thin lips, frequent nystagmus and contractions on one side of the face, which bare the canines in a kind of menacing grin, are other characteristics of the assassin.

Forgers and swindlers wear a singular, stereotyped expression of amiability on their pale faces, which appear incapable of blushing and assume only a more pallid hue under the stress of any emotion. They have small eyes, twisted and large noses, become bald and grey-haired at an early age, and often possess faces of a feminine cast.

SENSIBILITY

This external inspection of the criminal should be followed by a minute examination of his senses and sensibility.

=FIG. 34 Esthesiometer=

_General Sensibility and Sensibility to Touch and Pain._ Tactile sensibility should be measured by Weber's esthesiometer, which consists of two pointed legs, one of which is fixed at the end of a scale graduated in millimetres, along which the other slides (see Fig. 34). After separating the two points three or four millimetres, they are placed on the finger-tips of the patient, who closes his eyes and is asked to state whether he feels two points or one. Normal individuals feel the points as two when they are only 2 mm. or 2.5 mm. apart; when, however, tactile sensibility is obtuse (as in most criminals) the points must be separated from 3 to 4.5 mm. or even more, before they are felt as two. Obtuseness varies with the type of crime committed habitually by the subject; in burglars, swindlers, and assaulters, being approximately double, while in violators, murderers, and incendiaries it stands in the ratio of 5 to 1 compared with normal persons.

In the absence of an esthesiometer, a rough calculation may be made by using an ordinary drawing compass or even a hairpin, separating the two points and measuring with the eye the distance at which they are felt to be separate.

_General Sensibility and Sensibility to Pain_ are measured by a common electric apparatus (Du Bois-Reymond), adapted by Lombroso for use as an algometer. (See Fig. 35.) It consists of an induction coil, put into action by a bichromate battery. The poles of the secondary coil are placed in contact with the back of the patient's hand and brought slowly up behind the index finger, when the strength of the induced current is increased until the patient feels a prickling sensation in the skin (general sensibility) and subsequently a sharp pain (sensibility to pain). The general sensibility of normal individuals is 40 and the sensibility to pain, 10-25: the sensibility of the criminal is much less acute and sometimes non-existent.

_Sensibility to Pressure._ Various metal cubes of equal size but different weight, are placed two by two, one on each side, on different parts of the back of the hand. The patient is then asked to state which of any two weights is the lighter or heavier. This sense is fairly acute in criminals.

_Sensibility to Heat._ Experiments are made by placing on the skin of the patient various receptacles filled with water at different temperatures. If great exactitude is desirable, Nothnagel's thermo-esthesiometer should be used. This is an instrument very similar to Weber's esthesiometer, but the points are replaced by receptacles filled with water of varying heat and furnished with thermometers. The patient must state which is the colder, and which the hotter spot. Sensibility to heat is less acute in criminals than in normal individuals.

_Localisation of Sensibility._ After the patient has been requested to close his eyes, various parts of his body are touched with the finger and he is asked to point out the exact spot touched. Should he not be able to reach it with his finger, a statuette should be placed before him on which he should mark with a pencil the part touched. Normal persons are always able to localise the sensation exactly: inability to do so signifies disease of the brain or some kind of anomaly.

_Sensibility to Metals_ is tested by placing discs of different metals, copper, zinc, lead, and gold, or the poles of a magnet, on the frontal and occipital parts of the patient's head. Sometimes he feels pricking or heat, giddiness, somnolence, or a sense of bodily well-being. In general, criminals show great sensibility to metals; in hysterical persons this sensibility reaches an extraordinary degree of acuteness. By applying a magnet to the nape of the neck, the sensations of such individuals become polarised, that is, what appeared white to them before becomes black; bitter, what was formerly sweet, or vice versa. This is an excellent way of distinguishing between bona-fide cases of hysteria and sham ones. My father once detected simulation in a _soi-disant_ hysterical patient by means of a piece of wood shaped and coloured to represent a magnet. On application of either magnet, the real or sham one, the patient's sensations were identical, whereas hysterical persons experience very diverse sensations and are able to distinguish very sharply between the contact, not only of wood and metal, but of the different kinds of metal, and are particularly sensitive to the magnet.

=FIG. 35 ALGOMETER (see page 246)=

=FIG. 36 CAMPIMETER OF LANDOLT (Modified) (see page 249)=

_Sight--Acuteness of Vision--Chromatic Sensibility--Field of Vision._ Visual acuteness is tested by holding letters of a specified size at a certain distance. Sight is generally more acute in criminals than in normal persons; not so, chromatic sensibility, which is tested by giving the patient a number of skeins of different coloured silks, and requesting him to arrange them in series. Persons afflicted with dyschromatopsia confuse the different colours and the different shades of the same colour. Colour-blind people confuse black and red.

Especially important is the examination of the field of vision, as the seat of one of the most serious anomalies discovered by the Modern School, the presence of peripheral scotoma, frequently found in epileptics and born criminals. To test this anomaly, use should be made of Landolt's apparatus (Fig. 36). This consists of a semicircular band, which can revolve around a column. The patient rests his chin on a support placed in front of the semicircle in such a manner that the eye under examination is exactly in the centre, and looks directly at the middle point of the semicircle, corresponding to 0 in the scale: the testing object, a small ball, is passed backwards or forwards along the semicircle. A graduated scale, placed on the semicircle, marks the point limiting the field of vision, and the result is registered on a diagram. The average limit of the normal field of vision is 90 mm. on the temporal side, 55 mm. on the nasal side, 55 mm. above and 60 mm. below (see Fig. 42). If a suitable instrument is not available, a series of concentric circles may be traced on a slate and the patient placed at a certain distance with one eye covered. The examiner then touches the different points of the circles with his hand and asks the patient whether he can see it when his eye is fixed on the central point. In this way the various points limiting the field of vision are noted and furnish, when united, the boundary line.

=FIG. 37 Diagram Showing Normal Vision=

_Hearing_ is generally less acute in the criminal than in the normal individual, but does not show special anomalies. It may be tested by speaking in a low voice at a certain distance from the patient, or by holding an ordinary watch a little way from his ear.

_Smell._ Olfactory acuteness is tested by solutions of essences of varying strength, which the patient should be requested to place in order, indicating the one in which he first detects an odour. Ottolenghi has invented a graduated osmometer which is easy to use. The criminal generally shows olfactory obtuseness.

_Taste_ is tested in the same way as smell, by varying solutions of saccharine or strychnine dropped on to the patient's tongue by means of a special medicine dropper. The mouth should be rinsed out each time. Normal persons taste the bitterness of sulphate of strychnine in a solution 1:600,000; the sweetness of saccharine in a solution 1:100,000. The sense of taste is less acute in criminaloids than in normal persons, and is specially obtuse in born criminals, 33% of whom show complete obtuseness.

_Movements._ Normal individuals in a state of repose remain almost motionless, and their gestures are always appropriate. Lunatics and imbeciles have a habit of speaking and gesticulating even when they are not interrogated. Nervous diseases manifest themselves in facial contortions or slight spasmodic contractions. In melancholia and all forms of depression, the patient does not gesticulate but remains immovable like a statue with his eyes cast down. Degenerates manifest a fairly varied series of involuntary motions,--twitchings of the muscles, as in chorea, tonic and clonic convulsions and tremors. In senility, chorea, and Parkinson's disease, the tremors are incessant and continue even when the body is in a state of repose; in sclerosis, goitre, and chronic inebriety they accompany voluntary movements, and in this case they are easily detected by making the patient lift the tip of his finger to his nose or a filled glass to his lips. The nearer the hand approaches its goal, the more intense the oscillations become. Above all, the examiner should not fail to ask the patient to put out his tongue. If it protrudes on one side, it is a sign of a serious nervous alteration and nearly always denotes the beginning or remains of paralysis, or partial apoplectic strokes.

_Muscular Strength_ is measured by a common dynamometer (Fig. 38), which the patient is requested to grasp with all his might. Compressive strength is tested by compressing the oval. In order to test tractive strength, the dynamometer is fastened to a nail at the point C, and the patient pulls with all his strength at D. The effort is registered on a graduated scale and is of importance for detecting left-handedness and measuring the extraordinary force that is displayed in certain states of excitement.

=Fig. 38 Dynamometer=

_Reflex Action_ consists of movements and contractions produced by an impression exciting the nerves of the cutis (cutaneous reflex) or tendons (tendinous reflex).

_Cutaneous Reflex Movements_ may be tested by placing the patient in a recumbent position and stroking methodically certain parts of the body, the sole of the foot (plantar reflex), the under side of the knee-joint (popliteal reflex), the abdominal wall (abdominal reflex). Certain reflex movements are of special importance: the cremasteric reflex, on the inner side of the thigh (obtuse in old people and individuals addicted to onanism), the reflex action of the mucous membrane covering the cornea (suspended during stupor, coma, and epileptic convulsions), and the pharyngeal reflex along the isthmus of the fauces (absent in hysterical persons).

The dilatation and contraction of the pupil in accommodation to the distance of the object viewed or in response to light stimuli is undoubtedly the most important cutaneous reflex movement. It may be tested by requesting the patient to look at a distant object and immediately afterwards at the examiner's finger, placed close to his eye, or bringing him suddenly from semi-darkness into the light. If the pupil reacts very slightly to the light, it is called torpid: if it does not react at all, it is called rigid. Rigidity of the pupil always denotes some serious nervous disturbance. In certain diseases, especially tabes, the pupils do not respond to light stimuli, but accommodate themselves to objects.

_Tendinous Reflex Action_ may be tested in every part of the body, but the rotular reflex movement is generally sufficient. The patient is asked to sit on the edge of the bed or on a chair with his legs crossed. If he is healthy, the reflex movement is fairly strong, but in some illnesses spastic movements may be provoked and extend to the abdomen (exaggerated reflex action); in others no reflex is forthcoming. This is one of the first symptoms of tabes.

=FIG. 39 HEAD OF AN ITALIAN CRIMINAL=

_Urine_ and _Feces_. As the functions are anomalous, the chemical changes must also be anomalous, owing to the correlation of organs. In born criminals there is a diminished excretion of nitrogen, whereas that of chlorides is normal. The elimination of phosphoric acid is increased, especially when compared with the nitrogen excreted. Pepton is sometimes found in the excretions of paralytic persons in whom there is always an increased elimination of phosphates and calcium carbonate.

The temperature is generally higher than in normal persons, and, more important still, varies less in febrile illnesses.

* * * * *

For the reader's convenience, I have drawn up a list of the different points that should be noted in a careful examination.

_Table showing the Anthropological Examination of Insane and Criminal Patients_ (_drawn up by Tamburini, Strassmann, Benelli, and Mario Carrara_).

A--_Anamnesis._ Name--surname--nationality--domicile--profession-- age--education. Economic and hygienic conditions of native place. Family circumstances--pre-natal conditions--infancy--puberty. Causes to which decease of parents may be attributed. Cases of insanity--neurosis--imbecility--perversity--suicide--crime--or eccentricity in the family. Progressive diseases or trauma in the subject. Offence and causes thereof.

B--_Physique._ Skeletal development--height--span of the arms.

C--_Physical Examination._ Muscular development. Colour of hair and eyes. Quantity and distribution of hair. Tattooing. Craniometry: Antero-posterior diameter--transverse diameter-- antero-posterior curve--transverse curve--cephalic index--type and anomalies of the skull--circumference--probable capacity-- semi-circumference (anterior, posterior)--forehead--face, length, diameter (bizygomatic and bigoniac)--facial type--facial index-- anomalies of conformation and development in the skull, in the face, in the ears, in the teeth, in other parts.

D--_Functions._

E--_Animal Life._ Sensibility: meteoric--tactile--thermal--dolorific and muscular--visual--auditory--of the other senses. Motivity: Sensory left-handedness--motory left-handedness--voluntary and involuntary movements--reflex action (tendinous or muscular, abnormal, chorea).

F--_Vegetative Life._ Muscular strength. Circulation. Respiration. Thermo-genesis. Digestion: Rumination--bulimy--vomiting--dyspepsia--constipation-- diarrhoea. Secretions: Milk--saliva--perspiration--urine--menstruation. Dyscrasia: poisoning.

G--_Psychic Examination._ Language--writing--slang. Attention--perception. Memory (textual)--reason. Dreams--excitability--passions. Sentiments: Affection--morality--religion. Instincts and tendencies. Moral character--industry. Physiognomical expression. Education--aptitudes.

H--_Morbid Phenomena._ Illusions--hallucinations--delusions-- susceptibility to suggestion.

I--_Offences._ Cause of first offence: Environment--occasion--spontaneous or premeditated--drunkenness. Conduct after the offence: Repentance--recidivation.