Inspired by Ashley Montagu’s Touching: The Human Significance of the Skin (1971)
At the turn of the twentieth century, an unsettling mystery haunted European and American orphanages. Infants, well-fed, clean, and medically cared for, were dying at alarming rates. Many wasted away slowly, their bodies thin and their eyes lifeless, despite the absence of clear disease. Physicians called it marasmus, a term that would later come to signify not only malnutrition but also the fatal consequences of emotional starvation.
Ashley Montagu, in his groundbreaking 1971 work Touching: The Human Significance of the Skin, explored this tragedy to demonstrate that touch is as vital to survival as food or air. He argued that the human skin, our largest sensory organ, is also our first and most essential bridge to life, an organ through which we feel connection, security, and identity.
What Is Marasmus Syndrome? In medical terms, marasmus is a severe form of protein-energy malnutrition in which the body, deprived of calories, draws energy from its own tissues. Muscles and fat are consumed, the immune system collapses, and the infant eventually dies. Yet Montagu highlighted a psychosomatic dimension, a condition he called “psychogenic marasmus.” He proposed that infants in institutions were not dying from lack of nourishment but from lack of affection and physical contact. Their environment starved them emotionally and neurologically; deprived of touch, they lost the will to live.
Historical accounts support Montagu’s insight. Early twentieth-century reports from foundling homes and hospitals across Europe revealed that infant mortality among those under one year of age sometimes reached 70–90 percent. Caregivers provided milk, cleanliness, and medical attention, yet babies continued to perish. Physicians were initially baffled, attributing deaths to “infection,” “failure to thrive,” or vague constitutional weakness. Only later did researchers such as René Spitz (1945) and John Bowlby (1951) identify the real cause: emotional and sensory deprivation. Spitz’s pioneering studies on “hospitalism” showed that infants separated from their mothers exhibited withdrawal, loss of appetite, delayed development, and ultimately marasmus-like wasting.
Montagu linked these observations to the biology of touch. He argued that human infants are neurologically programmed for tactile stimulation. Gentle skin-to-skin contact regulates heart rate, body temperature, and hormonal balance. When that sensory input is absent, the infant’s autonomic systems falter, immunity weakens, and growth halts. Touch, in other words, is not a luxury: it is a biological necessity.
To illustrate this truth, Montagu recounted the story of “Old Anna,” a nurse in a Düsseldorf hospital who became known for saving infants others had deemed hopeless. Her method was simple: she held them, stroked them, and spoke to them lovingly. Those babies, previously wasting away, began to gain weight and recover. Though anecdotal, this story embodied Montagu’s central thesis: that touch sustains life at its deepest level. For him, marasmus was not merely a metabolic failure but an existential one. Humans deprived of touch lose their physiological drive to survive.
Fact-checking Montagu’s narrative reveals both historical accuracy and rhetorical flourish. It is true that institutionalized infants at the turn of the century experienced extremely high mortality despite adequate feeding and medical care. However, the often-quoted “100 percent mortality rate for infants under six months” in European orphanages lacks consistent documentation in primary medical sources and appears to be an exaggeration for emphasis. The phenomenon Montagu described corresponds to what modern pediatrics recognizes as “failure to thrive,” a condition in which psychosocial neglect leads to severe physical deterioration. Later developmental research, particularly in attachment theory and neuroendocrine studies, has validated Montagu’s conclusion that affectionate physical contact is biologically indispensable.
Contemporary science further explains why. Touch deprivation disrupts the hypothalamic–pituitary–adrenal (HPA) axis, increasing stress hormones such as cortisol while suppressing growth hormones. This biochemical imbalance mimics the symptoms of malnutrition. In neonatology, the practice of “kangaroo care,” continuous skin-to-skin contact between mother and infant, has dramatically reduced mortality and improved weight gain, affirming Montagu’s insights decades later. What he termed emotional marasmus aligns closely with today’s diagnoses of psychosocial dwarfism and non-organic failure to thrive, conditions caused not by disease but by emotional neglect and the absence of nurturing touch.
Ashley Montagu’s message was not purely scientific; it was profoundly moral and, in retrospect, psycholinguistic. He reminded humanity that to touch is to affirm existence, but also to inaugurate communication. The earliest dialogues between caregiver and infant are not linguistic in sound, but tactile in nature: a rhythm of holding, caressing, and responding that forms the first grammar of human connection. Touch, gaze, and vocal tone operate as a multimodal system through which the infant learns reciprocity, turn-taking, and anticipation, the foundational structures upon which all later language rests. In this sense, the deprivation Montagu described was not only emotional but communicative: infants denied touch were also denied the first lessons in interaction, contingency, and symbolic meaning.
Neuroscience and developmental psycholinguistics now affirm this continuum between affectional contact and language acquisition. The same oxytocin and dopaminergic systems that are activated through gentle physical contact regulate social attention, affective attunement, and the motivation to engage in proto-conversations. Studies on early attachment and “motherese” reveal that infants who experience consistent tactile and emotional responsiveness develop stronger joint attention and faster lexical mapping, both predictors of later linguistic competence. Thus, Montagu’s marasmus is not only a biological tragedy but a linguistic one: the silencing of the body’s first language.
More than fifty years later, the enduring lesson of marasmus remains timeless and urgent. No human being can live on sustenance alone; we must be touched to live, and we must be touched to speak.
References
- Apple, R. D. (1987). Mothers and medicine: A social history of infant feeding, 1890–1950 (Vol. 7). Univ of Wisconsin Press.
- Bowlby, J. (1951). Maternal care and mental health (Vol. 2). Geneva: World Health Organization.
- Field, T. (2010). Touch for socioemotional and physical well-being: A review. Developmental review, 30(4), 367-383.
- Montagu, A. (1971). Touching: The human significance of the skin.
- Spitz, R. A. (1945). Hospitalism: Psychoanalytic study of the child.
- SPITZ R. A. (1945). Hospitalism; an inquiry into the genesis of psychiatric conditions in early childhood. The Psychoanalytic study of the child, 1, 53–74.
