Degeneracy: Its Causes, Signs and Results

by Eugene S. Talbot

FIG. 33.

Hannover points out that there often is coincident hydrocephalus and harelip, imperfect genital development, and allied arrest of development. J. R. Folsom, of Cecil, Georgia, has reported a female, born alive to a negro multipara, who died two hours after birth. The eye was centrally located in the forehead, on a line with the nose. The brow was a complete arch, as was the upper eyelid. The lower lid had a mark midway, indicating an attempt at division. The nasal bones were wanting, but the soft part of the nose, destitute of the orifice, hung over the mouth, which was completely covered. The chin was recedent. C. Phisalix described a case in which the nose was wanting. Its place in the median was occupied by a single eye; on the horizontal diameter were two pupils separated by a narrow space. Landolt, discussing a case reported by Valude, points out that in cyclopic eyes all the parts may be double or united in every degree except that there is never a single lens or double vitreous. Bock and others, however, describe cases in which the eye has not been formed by the conglomeration of two separately developed eyes, but it is a single developed eye; the other being wanting entirely. Bruce reports a cyclop in which there was a single socket for the eye of a lozenge-shape, situated in the lower middle of the forehead. The socket was furnished with two pairs of eyelids, upper and lower. The eye was found to consist of two rudimentary eyes, with two rudimentary retinæ, apparently springing from a single optic vesicle. The nose was represented by a short process attached to the forehead, above the median eye.

FIG. 34.

The cyclops illustrated (Figs. [33], [34]) was born to a 17-year old neuropathic primipara, after a protracted labour. The child was living, but was killed by pressure on the funis. The mouth contained an ivory, tusk-like tooth at each corner. There was mane-like hair around the neck.

Cyclopia is very frequently associated with the absence of both the internal and external ear, and with synotia (joined ears).

In triophthalmic cases the three eyes are usually separate, two occupying the usual position, while the third is situated as illustrated in the case cited. Ninety families of degenerates, averaging eleven children each, had five cases of cyclops.

Degeneracy, which affects so deeply the development of the eye, naturally tends to evince itself in other anomalous states in the organ. As excessive asymmetry of the body is one of the most noticeable of the stigmata of degeneracy, it is not astonishing to find that this asymmetry expresses itself both in the position as well as in the size and structure of the eye. As Kiernan[208] pointed out, twenty years ago, asymmetrical irides are exceedingly frequent in the types of insanity due to hereditary defect. This observation has since been confirmed by Féré,[209] not only as to the insane, but as to other classes of the degenerate. The conditions of the eye known as microphthalmia (small eye), macrophthalmia (big eyes) and anophthalmia (absence of eyes), are found quite frequent in degenerate families. Very frequently the pupil of the eye is asymmetrical. This was pointed out by Kiernan in the case of Guiteau. Corectopia (displacement of the pupil so that it is not in the centre of the iris) often exists. Coloboma (eye fissure) is also not infrequent among the degenerate. These vary greatly in situation and general results. The iris is sometimes completely absent on one or both sides. Beside the anomalies, diseased conditions like retinitis pigmentosa, congenital cataract and the macular degeneracy cited by C. P. Pinckard,[210] of Chicago, are far from infrequent expressions of degenerate taint in the eye; the organ in this particular obeying the general law that degeneracy may show itself in the minute change resulting in disturbance of function or in that producing disease, or, finally, in atavism. The defects of the eyes requiring glasses are exceedingly frequent in degenerates, and often aggravate their morbidity. Here, as in the case of the teeth, the chief factor is often ignored.

The external ear is, of all organs, that most affected by degeneracy.[211] It is a cartilaginous organ extending from a bony base, without a bony framework for its support and with very deficient blood supply, on account of its distances from the great blood centres, so that any defect in the nerve centres which control the local blood supply is likely to affect its nutrition. As a cartilaginous organ it has no lymphatics, which of necessity affects its growth. The sensitiveness of the ear to vasomotor changes is evident by the results of the extremes in heat and cold, emotional blushing and fatigue. Galton reports a schoolmistress who judges the fatigue of her pupils by the condition of their ears. If the ears be white, flabby and pendant, she concludes that the children are much fatigued. If they be relaxed, but red, they are suffering, not from overwork, but from a struggle with the nervous system rarely under control in children. These states are very common among degenerates.