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e。
The varieties of strabismus are so common that they will be passed without mention。 Kuhn presents an exhaustive analysis of 73 cases of congenital defects of the movements of the eyes； considered clinically and didactically。 Some or all of the muscles may be absent or two or more may be amalgamated； with anomalies of insertion； false； double； or degenerated； etc。
The influence of heredity in the causation of congenital defects of the eye is strikingly illustrated by De Beck。 In three generations twelve members of one family had either coloboma iridis or irideremia。 He performed two operations for the cure of cataract in two brothers。 The operations were attended with difficulty in all four eyes and followed by cyclitis。 The result was good in one eye of each patient； the eye most recently blind。 Posey had a case of coloboma in the macular region in a patient who had a supernumerary tooth。 He believes the defects were inherited； as the patient's mother also had a supernumerary tooth。
Nunnely reports cases of congenital malformation in three children of one family。 The globes of two of them （a boy and a girl） were smaller than natural； and in the boy in addition were flattened by the action of the recti muscles and were soft； the sclera were very vascular and the cornea； conical； the irides dull； thin； and tremulous； the pupils were not in the axis of vision； but were to the nasal side。 The elder sister had the same congenital condition； but to a lesser degree。 The other boy in the family had a total absence of irides； but he could see fairly well with the left eye。
Anomalies of the Ears。Bilateral absence of the external ears is quite rare； although there is a species of sheep； native of China； called the 〃Yungti；〃 in which this anomaly is constant。 Bartholinus； Lycosthenes； Pare； Schenck； and Oberteuffer have remarked on deficient external ears。 Guys； the celebrated Marseilles litterateur of the eighteenth century； was born with only one ear。 Chantreuil mentions obliteration of the external auditory canal in the new…born。 Bannofont reports a case of congenital imperforation of the left auditory canal existing near the tympanic membrane with total deafness in that ear。 Lloyd described a fetus showing absence of the external auditory meatus on both sides。 Munro reports a case of congenital absence of the external auditory meatus of the right ear； and Richardson speaks of congenital malformation of the external auditory apparatus of the right side。 There is an instance of absence of the auditory canal with but partial loss of hearing。 Mussey reports several cases of congenitally deficient or absent aural appendages。 One case was that in which there was congenital absence of the external auditory meatus of both ears without much impairment of hearing。 In neither ear of N。 W。 Goddard； aged twenty…seven； of Vermont； reported in 1834； was there a vestige of an opening or passage in the external ear； and not even an indentation。 The Eustachian tube was closed。 The integuments of the face and scalp were capable of receiving acoustic impressions and of transmitting them to the organs of hearing。 The authors know of a student of a prominent New York University who is congenitally deficient in external ears； yet his hearing is acute。 He hides his deformity by wearing his hair long and combed over his ears。
The knowledge of anomalous auricles is lost in antiquity。 Figure 103 represents the head of an aegipan in the British Museum showing a supernumerary auricle。 As a rule； supernumerary auricles are preauricular appendages。 Warner； in a report of the examination of 50；000 children； quoted by Ballantyne； describes 33 with supernumerary auricles； represented by sessile or pedunculated outgrowths in front of the tragus。 They are more commonly unilateral； always congenital； and can be easily removed； giving rise to no unpleasant symptoms。 They have a soft and elastic consistency； and are usually composed of a hyaline or reticular cartilaginous axis covered with connective or adipose tissue and skin bearing fine hairs； sometimes both cartilage and fat are absent。 They are often associated with some form of defective auditionharelip； ocular disturbance； club…feet； congenital hernia； etc。 These supernumerary members vary from one to five in number and are sometimes hereditary。 Reverdin describes a man having a supernumerary nipple on the right side of his chest； of whose five children three had preauricular appendages。 Figure 104 represents a girl with a supernumerary auricle in the neck； described in the Lancet； 1888。 A little girl under Birkett's care in Guy's Hospital more than answered to Macbeth's requisition； 〃Had I three ears I'd hear thee！〃 since she possessed two superfluous ones at the sides of the neck； somewhat lower than the angle of the jaw； which were well developed as to their external contour and made up of fibrocartilage。 There is mentioned the case of a boy of six months on the left side of whose neck； over the middle anterior border of the sternocleidomastoid muscle； was a nipple…like projection 1/2 inch in length； a rod of cartilage was prolonged into it from a thin plate； which was freely movable in the subcutaneous tissue； forming a striking analogue to an auricle。 Moxhay cites the instance of a mother who was frightened by the sight of a boy with hideous contractions in the neck； and who gave birth to a child with two perfect ears and three rudimentary auricles on the right side； and on the left side two rudimentary auricles。
In some people there is an excessive development of the auricular muscles； enabling them to move their ears in a manner similar to that of the lower animals。 Of the celebrated instances the Abbe de Marolles； says Vigneul…Marville； bears witness in his 〃Memoires〃 that the Regent Crassot could easily move his ears。 Saint Augustine mentions this anomaly。
Double tympanitic membrane is spoken of by Loeseke。 There is sometimes natural perforation of the tympanum in an otherwise perfect ear； which explains how some people can blow tobacco…smoke from the ear。 Fournier has seen several Spaniards and Germans who could perform this feat； and knew one man who could smoke a whole cigar without losing any smoke； since he made it leave either by his mouth； his ears； or in both ways。 Fournier in the same article mentions that he has seen a woman with ears over four inches long。
Strange to say； there have been reports of cases in which the ossicles were deficient without causing any imperfection of hearing。 Caldani mentions a case with the incus and malleus deficient； and Scarpa and Torreau quote instances of deficient ossicles。 Thomka in 1895 reported a case of supernumerary tympanic ossicle； the nature of which was unknown； although it was neither an inflammatory product nor a remnant of Meckel's cartilage。
Absence of the Limbs。Those persons born without limbs are either the subjects of intrauterine amputation or of embryonic malformation。 Probably the most celebrated of this class was Marc Cazotte； otherwise known as 〃Pepin；〃 who died in Paris in the last century at the age of sixty…two of a chronic intestinal disorder。 He had no arms； legs； or scrotum； but from very jutting shoulders on ea