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''Congenital Anomalies of the I^ye" but in the 244 pages entitled '"Pupil 

 in Healih and Disease" in WjI. X Dr. D. T. Vail gives 13 lines about the 

 matter, page 10673 ''-'^- 5'- '■'^ -^^y^ '■'1^*^ '^^^'-' condition must be a deve- 

 lopment fault, and states that it may appear in consanguinal marriage of 

 the parents, but there are also cases without this fact; it may be combined 

 with microcornea or other signs of microphthalmus; there is no treatment 

 to be suggested. In Dr. V'ail's article, as well as in Collins and Mayou's 

 "Pathology and Bacteriology in Ophthalmic Practice", Philadelphia 191 1 

 (Lit. 4), where the condition is twice mentioned, the probability of a feeble 

 development of the iris musculature is stated; they do not i-efer to any 

 microscopical examination. In congenital cataract Collins and Mayou have 

 often seen that the pupil will not dilate well on the application of atropine; 

 I have made the same observation myself, but I have never seen the pupils 

 so small here as in miosis congenita. Dr. Mayou has pointed out to me 

 that Dr. W. R. Wilde's essay of 1862 on "Malformations and Congenital 

 Diseases of the Organ of Sight" (Lit. i) is the work on which the references 

 in English writings on the subject, are based. Wilde clearly differentiates 

 between "myosis" or "Microcoria" and "Sinizesis congenita" due to closure 

 of the iridial aperture produced by persistence of the pupillary membrane; 

 he saw "Myosis congenita" in both the eyes of one patient, unilateral 

 myosis in two patients, one of whom had been treated elsewhere for 

 "syphilitic iritis"^; a third unilateral case is called "microcoria" but he adds: 

 "It was almost similar in appearance to the preceding cases." None of 

 these patients could tell of any similar cases in their families. There was 

 no microscopical examination. Neither does Wilde speak of the effect of 

 mydriatics nor of treatment in these cases. 



Since the autumn of 1897 I have had under observation two sisters 

 and a brother whose pupils have all their lives had a diameter of about 

 0.5 mm.; after several days of instillation of mydriatics the pupils are 

 dilated to 2.5 mm. at the utmost, but generally less. 



a) Miss Ingeborg B. (the youngest of them, born in 1876) came to consult 

 me on September 4th 1897. On my inquiries she informed me that as long she 

 could remember her eyesight, like that of her sister Anna, born in 1867, and 

 of Axel the twin brother of the latter, had been very bad in twilight. The 

 parents had observed in all of them irinhoJe pupils dnce tJieir birth. A 

 younger brother, born in 1881. has normal pupils, and his eyesight is al- 

 ways good even in twilight. The parents were cousins; the father was 

 stated not to see quite well, and his pupils were rather small (I estimated 



1 In Saupe's case Lit 7) had the previously consulted oculist considered the pinhole 

 pupils as Argyll Robertson's spinal miosis and wrongly diagnosticated tabes. 



