ON ANTHROPOMETRIC INVESTIGATION IN THE BRITISH ISLES. 355 
A, Cuest MEASUREMENTS. 
After some consideration it was decided that the dimensions included 
in the list already published should be adhered to, but that further inquiry 
into the level at which chest measurements had been taken at various 
times and in different countries would be advisable. 
As a result of this inquiry it would appear: That observations on 
the shape and the relative if not the actual dimensions of the chest 
have been made since the days of Hippocrates, circa 500 B.c. 
Extensive notes were made by Galen and Aretzeus, circa 150 a.p., but 
after that no further information is available until the end of the 
eighteenth century, when Skoda and Laennec practically introduced to 
the medical world the modern procedure for the physical examination 
of the chest. These observers took tape measurements at the level of 
the xiphoid cartilage. (Laennec, ‘Traité de lAuscultation Médiate,’ 
Paris, 1826, p. 21). The examination of the antero-posterior and trans- 
verse diameters by means of callipers and a flexible metal tube, the 
cyrtometer, fitted accurately to the chest, was introduced by Woillez. 
(‘ Recherches cliniques sur l’emploi d’un nouveau procédé de mensuration,’ 
Paris, 1857.) He made his observations on normal chests apparently at 
the level of the sterno-xiphoid junction, but as his apparatus was designed 
primarily for the study of chests in which one side had been rendered 
asymmetrical by the presence of a pleural effusion, most measurements 
were taken over the point of maximum bulging. The same level was 
adopted by Gee, who studied the relation of the diameters by the use of 
callipers. The extensive series of observations made by Walshe and 
Cotton, and others by Hutchinson on the shape of the chest in relation to 
the vital capacity both in health and disease, were always taken at the 
junction of the sixth costal cartilage with the sternum. Sieveking, on the 
other hand, measured the circumference just above the nipples. 
_ The level adopted for the measurement of recruits in this country is 
to place the tape over the nipples in front and immediately below the 
angles of the scapule behind, the arms being held above the head while 
affixing the tape, but being brought to the side before reading off the 
result. The levels adopted in the Continental armies appear to vary 
from the fourth costo-sternal junction to the fifth interspace. No record 
could be found that calliper measurements were taken as a routine in the 
examination of recruits or conscripts of any army. 
Polanski, of Warsaw, took both transverse and antero-posterior 
diameters at the level of the nipple, and at points 4 centimetres above 
and below this. He later abandoned this, and recorded only the greatest 
diameters in either direction wherever found. (‘ Zeitschrift fiir Tuber- 
culose,’ Heft 5.) 
A greater number of calliper measurements have been made in the 
United States, of which a réswmé appears in an article by Lawrason 
Brown (‘American Journal of the Medical Sciences,’ October, 1904). 
Hutchinson chose the middle of the fourth intercostal space ; Sargent, 
Seaver, Otis, Beyer, and Hrdlicka used the level of the nipples. Sack 
in Russia and Hoesch-Ernst in Zurich took the diameters at the level of 
the mid-sternum. The records of Pagliani, Axel Key, Erissman, Zak, 
and other Continental observers are from tape measurements at the nipple 
line. Topinard and Weisberger measured the diameters at the level of 
the lower end of the sternum. A wide range of variation in the method 
AA2 
