TIIE 
Stigmata of Degeneration. 
-BY- 
Frederick Peterson, M. D., 
Consulting Neurologist to Randall’s Island Hospital for Idiots; Consulting 
Physician to the Manhattan State Hospital for the Insane; Chief 
of Clinic, Nervous Department, Vanderbilt Clinic, College 
of Physicians and Surgeons, New York; Clinical Pro- 
fessor of Insanity, Woman’s Medical College 
of the New York Infirmary. 
Reprint from the State Hospitals Bulletin for July, 1896. 
UTICA, N. Y. 
Utica State Hospital Pbess. 
1896. THE STIGMATA OF DEGENERATION. 
Consulting Neurologist to Randall’s Island Hospital for Idiots ; Consulting 
Physician to the Manhattan State Hospital for the Insane; Chief of 
Clinic, Nervous Department, Vanderbilt Clinic, College of Physi- 
cians and Surgeons, New York; Clinical Professor of 
Insanity, Woman’s Medical College of the New 
York Infirmary. 
Frederick Peterson, M. D., 
The subject of degeneracy in the human race has for 
some years been exciting much interest and discussion 
among scientific men. Unusual facilities have been 
afforded the writer for the study of this condition in con- 
nection with work in reformatories, prisons, asylums and 
institutions for idiots, and he believes that a thorough un- 
derstanding of the various indices of degeneration would 
be of value not only to physicians in institutions of the 
character mentioned, but also to the general practitioner 
who is frequently brought into contact with degenerates 
outside of institutions, and commonly at so early a period 
in life—during childhood or adolescence—that he may often 
do an untold amount of good by calling attention to an 
indication of a degenerative proclivity in some member of 
a family, a discovery occasionally of enormous significance 
as regards prophylaxis, education and care. 
Degeneracy may be defined as a marked deviation from 
the normal original type or standard. We recognize it as 
a rule in its effects upon the intellectual life, in the devia- 
tions from the intellectual habits and social conduct which 
we hold in common with our fellows. To the class of 
degenerates not only belong many criminals, idiots, and 
insane individuals, but also the great majority of persons 
whom we call cranks or eccentrics,—the people who live 
among us a sort of original life, with peculiarities of mental 
habit and conduct, and whom we characterize as feeble- 
minded, odd, quaint, queer or singular. 
A man of talent or of genius often presents eccentricities 
of the kind to which we refer, but such deviation from the 
original normal standard need not be morbid in character; 2 
PETERSON: THE STIGMATA OF DEGENERATION. 
it may be a deviation toward a higher and better standard 
recognized by his contemporaries or posterity to be such, 
and to which we, on our part, try in the end to conform. 
It might be difficult at times to distinguish between the 
eccentricities of genius and the eccentricities of degeneracy. 
There are one or two indications or tests which will aid us 
in this. One of the indications, in fact the chief test of a 
normal state is naturally conformity to the social condition 
in which a man lives. This test applied by itself, how- 
ever, does not exclude talented individuals and geniuses. 
Another criterion must be applied to these cases. Is there 
conjoined with the eccentricity a morbid self-centering of 
his interests? It is in individuals who concern themselves 
little with the affairs of the world, but much with personal 
and selfish matters, that eccentricity of intellectual habit 
or conduct warrants a grave diagnosis. Now one of the 
essential characteristics of degeneracy is its inclusion of 
transmissible elements, so that the degenerate individual 
not only bears in himself the germs which render him more 
and more incapable of fulfilling his own functions in human 
life, but by his hereditary bequests he menaces the in- 
tellectual stability of his descendants. 
So much for the definition of the term degeneracy. We 
will now pass on to a consideration of the indications of 
degeneracy. 
Stigmata of Degeneration. 
The indications of degeneracy are known as stigmata- 
hereditatis or stigmata of degeneration. They may be 
defined as anatomical or functional deviations from the 
normal, which in themselves are usually of little import- 
ance as regards the existence of an organism, but are 
characteristic of a marked or latent neuropathic disposition. 
Much study has of late years been devoted to these indices 
by many investigators, particularly in their relation to 
insanity, idiocy, and criminal anthropology, and it be- 
hooves all who have to do with the development and care 
of the human body in any particular,—and this refers espe- PETERSON: THE STIGMATA OF DEGENERATION. 
3 
cially to men of the medical and allied professions,—to 
familiarize themselves with these signs of degeneration in 
so far as they concern their own special provinces of work. 
These stigmata are vices of functional and organic evolu- 
tion. The deviations from the normal may be in the way 
of excesses or arrest of development. They must be dis- 
tinguished from the deficiencies or deformities produced 
by accidents at birth or by disease. I have said that these 
stigmata are anatomical and functional. But it is more 
convenient to divide the functional group into physiological 
and psychic classes. It is the latter which we are more 
apt to observe in our social relations with degenerate indi- 
viduals. The psychic stigmata are always characterized 
by a want of balance or lack of proportion between certain 
undeveloped or excessively developed faculties and other 
faculties which are normal. Defect of moral sense, of atten- 
tion, of memory, will, judgment, or unbalanced excess of 
musical or mathematical aptitudes may be cited as instances 
of psychic stigmata. Hence the three following divisions 
may be made of all of the degenerative indices: 
(1) Anatomical stigmata. 
(2) Physiological stigmata. 
(3) Psychical stigmata. 
Anatomical Stigmata. 
Cranial anomalies. 
Facial asymmetry. 
Deformities of the palate. 
Dental anomalies. 
Anomalies of the tongue and lips. 
Anomalies of the nose. 
Anomalies of the eye: Flecks on the iris, strabismus, 
chromatic asymmetry of the 
iris, narrow palpebral fissures. 
Albinism. 
Congenital cataracts. 
M icrophthalmos. 
Pigmentary retinitis. 
Muscular insufficiency. 4 
PETERSON: THE STIGMATA OF DEGENERATION. 
Anomalies of the ear. 
Anomalies of the limbs: Polydactyly. 
Syndactyly. 
Ectrodactyly. 
Symelus. 
Ectromelus. 
Phocomelus. 
Excessive length of the arms. 
Anomalies of the body in general: Hernias. 
Malformation of the 
breasts, thorax. 
Dwarfishness. 
Giantism. 
Infantilism. 
Feminism. 
Masculinism. 
Spina bifida. 
Anomalies of the genital organs. 
Anomalies of the skin: Polysarcia. 
Hypertrichosis. 
Absence of hair. 
Premature grayness. 
Physiological Stigmata. 
Anomalies of motor function: Retardation of learning 
to walk. 
Tics. 
Tremors. 
Epilepsy. 
Nystagmus. 
Anomalies of sensory function: Deaf-mutism. 
Neuralgia. 
Migraine. 
Hyperaesthesia. 
Anaesthesia. 
Blindness. 
Myopia. 
Hypermetropia. PETERSON: THE STIGMATA OF DEGENERATION. 
5 
Anomalies of sensory function: Astigmatism. 
Daltonism. 
Hemeralopia. 
Concentric limitation of 
the visual field. 
Anomalies of speech: Mutism. 
Defective speech. 
Stammering. 
Stuttering. 
Anomalies of genito-urinary function: Sexual irritability. 
Impotence. 
Sterility. 
Urinary incontin- 
ence. 
Anomalies of instinct or appetite: Uncontrollable appe- 
tites (food, liquor, 
drugs.) 
Merycism. 
Diminished resistance against external influences and 
diseases. 
Retardation of puberty. 
Psychical Stigmata. 
Insanity. 
Idiocy. 
Imbecility. 
Feeble-mindedness. 
Eccentricity. 
Moral delinquency. 
Sexual perversion. 
Having attempted to classify the various stigmata in 
this manner, we may now proceed to a consideration seri- 
atim of the anatomical and physiological anomalies above 
described: 
Cranial Anomalies.—These I have treated of fully in an- 
other article to which the reader is referred (American 
Journal of Insanity, July, 1895). 
Briefly they consist of asymmetry of the cranium and of 6 
PETERSON.- THE STIGMATA OF DEGENERATION. 
various deformities, such as microcephalus, hydrocephalus, 
leptocephalus, scaphocephalus, trigonocephalus, plagio- 
cephalus, and the like. 
Facial Asymmetry.—Inequality of the two sides of the 
face—when congenital and not due to some such disease as 
hemiatrophy—is to be looked upon as a stigma of degenera- 
tion. In the same category may be grouped various irreg- 
ularities, and such conditions as excessive prognathism or 
retrognathism. Great prominence, or unequal prominence, 
of the malar bones is to be observed, and also asymmetry 
of the orbits. 
Deformities of the Palate.—- In connection with the soft 
palate, bifurcation of the uvula may be mentioned.* As 
regards the hard palate, I have dwelt upon its deformities 
at some length in an article in the International Dental 
Journal (Dec., 1895), the facts there brought forward 
may be recapitulated as follows: 
While the palate occupies but a small place in this great 
category of hereditary stigmata of all kinds, it is one of the 
anatomical group, and this group is for many reasons the 
one of greatest importance. In this group, too, it occupies 
a distinctive place as being among the most striking, fre- 
quent and significant of the anomalies. I will not say of 
the palate what Dr. Amadee Joux said of the ear, “show 
me your ear and I will tell you who you are, whence you 
came, and where you go;” but I will say, “show me your 
palate, and I will probably be able to tell whether you be- 
long to the great class tainted by heredity, comprising 
many insane, imbecile, feeble-minded, criminal, eccentric, 
epileptic, hysterical, or neurasthenic individuals. 
The arch of the hard palate presents considerable varia- 
tion within strictly normal anatomical limits. A large, 
wide, moderately high vault is what may be called a nor- 
mal standard. It means the highest evolution, judging 
from the fact that the mouth cavity increases in capacity 
as we ascend the vertebrate series. Deviations from that 
*Dana on Deformity and Paralysis of the Uvula—Am. Jour, of Insanity, 
April, 1896. Fig. i. 
Palate with Gothic arch. 
Fig. 2. 
Palate with horseshoe arch. Fig. 3. 
The dome-thaped palate. 
Fig. 4. 
1 he flat-roofed palate. Fig. 5. 
The hip-roofed palate. 
Fig. 6. 
The asymmetrical palate. Fig. 7. 
Torus Palatinus. (Broad, wide torus.) PETERSON: THE STIGMATA OF DEGENERATION. 
7 
standard are not at all infrequent, and yet such deviations 
may be normal. Thus the palate may be low and broad, 
or it may be high and narrow; it may be short or long in 
its antero-posterior diameter. It may be ridged unduly 
along the palatine sutures, or it may present marked 
rugosities on its surface, especially in the anterior region; 
yet these variations are normal. Probably we may look 
upon these peculiarities as a species of compensatory de- 
velopment. Just as in a study of heads we find some very 
long and low, and others short and round and high, and 
recognize the fact that the shortness in one dimension is 
compensated for by a corresponding increase in another; 
so we may regard variation in palatine diameters. 
The pathological palate has not been studied as much as 
it deserves to be. Save occasional and casual references 
to the “Gothic” palate in literature, and one or two 
papers upon the torus palatinus, very little has been 
written upon the subject. In my paper referred to above, 
I have attempted to classify such pathological palates as 
could be justly looked upon as indicative of degeneracy. 
The word Gothic having been so long in use, and the hard 
palate being much like an arch or roof,* I have followed 
architectural nomenclature in the classification offered. 
Pathological palates : 
(1) Palate with Gothic arch. 
(2) Palate with horseshoe arch. 
(3) The dome-shaped palate. 
(4) The flat-roofed palate. 
(5) The hip-roofed palate. 
(6) The asymmetrical palate. 
(7) The torus palatinus. 
The seven varieties named are to be looked upon as types 
merely. Each type will be found to present variations 
and combinations with other forms. Thus the Gothic 
arch may have a low or high pitch and be short or long. 
* There is some confusion in literature of the roof of the mouth, or hard 
palate, referred to in this paper, with the dental arch, which is quite another 
thing. 8 
PETERSON: THE STIGMATA OF DEGENERATION. 
The horseshoe arch (a familiar one in Moorish architec- 
ture) is always easily distinguished, but, owing to its con- 
formation, a cast can not well be taken of it to show it in 
perfect outline. The dome-shaped palate may be high or 
low, may be combined with asymmetry or torus. The 
presence of a torus in the Gothic variety is apt to destroy 
the purely Gothic form, and may cause it to resemble 
the flat-roofed palate. Under the heading of flat-roofed 
palate I should include all such palates as are nearly hori- 
zontal in outline (of which I have not a good specimen to 
exhibit), as well as those with inclined roof sides but 
flattened gable. In the hip-roofed palate we have the 
sloping sides as usual, but also a marked pitch of the 
palate roof in front and behind; occasionally one may 
meet with a palate of this kind with so remarkable a pitch 
from before backward, that it is almost like a Gothic roof 
turned about so that the gable runs transversely. Asym- 
metry in the palate is commonly observed in many of the 
previously described forms, but occasionally is the only 
noteworthy peculiarity. It is usual to find asymmetry of 
the face and skull in cases with an asymmetrical palate. 
The torus palatinus (Latin torus, swelling) was first men- 
tioned by Chassaignac as a medio-palatine exostosis. It 
is a projecting ridge or swelling along the palatine suture, 
sometimes in its whole length, sometimes in only a por- 
tion of its course. It is always congenital. It varies con- 
siderably in its shape and size, so that as many as five or 
six different species of torus are recognized. It may be 
wedge-shaped, narrow, broad, very prominent, or irregu- 
lar. I have said nothing about cleft-palate, for I am not 
sure that it may be classed among the well marked stigmata 
of degeneration. I have found but two or three cleft- 
palates among the four hundred and fifty idiots and imbe- 
ciles on Randall’s Island, while a number of cases of this 
kind with which I have come in contact in my professional 
life were very far from degenerates. However it would 
seem that there is great need of a faithful study of a large 
number of cases of cleft-palate, in relation to the question of PETERSON: THE STIGMATA OF DEGENERATION. 
9 
degeneracy. The deformed palate is to my mind one of the 
chief anatomical stigmata of degeneration. It is true that 
from this single indication, it would not be strictly scien- 
tific to adjudge an individual a degenerate. Occasionally 
perhaps a case presents itself where this anatomical 
stigma alone would suffice to ensure a diagnosis of this 
nature, but usually other stigmata co-exist, such as 
cranial anomalies, deformities of the ear, and the like. 
The frequency of the pathological palate among marked 
degenerates, such as the insane, idiots and epileptics, has 
been testified to by many investigators. Thus Talbot re- 
ported 43$ of abnormal palates in 1,605 inmates in institu- 
tions for the feeble-minded. Ireland makes it nearer 50$. 
Charon, a later writer than these, found abnormal palates 
in 10$ of apparently normal people, in 82$ of idiots and 
feeble-minded, in 76$ of epileptics, in 80$ of cases of in- 
sanity in general, in 70$ of the hysterical insane, and in 
35$ of cases of general paralysis. Nacke has studied par- 
ticularly the torus palatinus in 1,449 individuals, normal 
and psychopathic; he found it present in 23.9$ of psycho- 
pathic women (insane, epileptic, idiot, and criminal), 32.9$ 
of epileptic women, 34.4$ of criminal women, 22.7<f0 of 
normal women. 
The percentages were smaller in men than in women. 
A narrow torus is more common than a broad one. 
Stieda examined 1,500 skulls for the torus from an an- 
thropological point of view. The skulls were of Prussians, 
Armenians, Africans, Frenchmen, Russians, and Asiatics. 
He decided that it has no anthropological significance, gives 
no racial distinction. While the torus is undoubtedly of 
value as an index of degeneration, particularly where it is 
well marked, it probably has less importance in this 
respect than some of the other forms of pathological palate. 
Dental Anomalies.—Among anomalies of the teeth are 
macrodontism, microdontism, projecting teeth, badly placed 
or misplaced teeth, double row of teeth, or teeth which are 
striated transversely or longitudinally. Caries of the teeth 
and Hutchinson’s teeth are due to neglect or disease. The PETERSON: THE STIGMATA OF DEGENERATION. 
latter, however, may often be considered as a stigma of 
degeneration. Then there is a retardation of the first and 
second dentition. 
Anomalies of the Tongue and Lips.—A very large tongue 
(macroglossus) is not infrequently observed among the 
lowest classes of degenerates, as in idiocy. Sometimes there 
is microglossus, asymmetry of the two halves, or bifidity 
of the point. Hare-lip is somewhat more common than 
cleft-palate, but, like the latter, its' exact standing as a 
degenerative stigma is not fully determined. Undue 
swelling or puffiness of the lips is noteworthy. 
Anomalies of the Nose.—Marked deviation of the nose to 
one side or the other should be noted. Taken alone it may 
possess little significance, but in conjunction with other 
stigmata, it has value. The nose may be absent, or present 
defect of osseous development (nasus aduncus), or atresia 
of the nasal fossae. 
Anomalies of the Eye.—The pathological conditions of the 
eye have been placed in two groups in the above classifica- 
tion, since some are anatomical and some physiological. 
To enumerate them altogether, they are as follows: 
Anatomical. 
Flecks on the iris. 
Strabismus. 
Chromatic asymmetry of 
the iris. 
Narrow palpebral fissures. 
Albinism. 
Congenital cataracts. 
Pigmentary retinitis. 
Muscular insufficiency. 
Microphthalmos. 
Physiological. 
Blindness. 
Myopia. 
Hypermetropia. 
Astigmatism. 
Daltonism. 
Hemeralopia. 
Concentric limitation of the 
visual field. 
Nystagmus. 
It is true that any one or two or more of these conditions 
present do not certainly indicate degeneracy, but they are 
significant in connection with other abnormal states, and 
all of them are more frequently observed in degenerate 
individuals, especially the lower orders, than in normal F055A OVAL IS 
FOSSA CYttDAE 
FOSSA 5CAP/101PEA 
FOSSA CO/1CHA 
I/iCISVRA 
iriTERTRAGICA' 
nOR/AAL EAR No crus superius; no anthelix; small 
fossa conchas; few details of ear. 
No lobule ; almost no fossa con- 
cha ; shallow fossa scaphoidea ; 
fusion of helix, anthelix and 
antitragus. A type of Stahl 
ear No. 3. 
Darwin ear in an epileptic. 
Prominent anthelix ; mal devel- 
oped helix; absence of lob- 
ule; diminution of the concha. 
Wildennuth ear No. i. Broad band-like helix ; no 
anthelix ; no lobule ; ex- 
cessive size of fossa 
cyrebte. 
Excessive length of 
ear; fusion and dis- 
tortion of helix, an- 
thelix, antitragus 
and lobule. 
Stahl ear No. i. 
Elephant ear. 
Fissure in anthelix ; slight 
Darwin tubercle ; slight 
antitragus. 
Triplication of crura fur- 
cata; mal-formed helix 
and antitragus; absent 
lobule. Excessive length of ears; facial 
asymmetry. 
Blainville ears,' and also excessive 
length of ears. 
Abnormal implantation of ears; too 
marked conchoidal shape. 
The Morel ear. PETERSON: THE STIGMATA OF DEGENERATION. 
11 
persons. In idiots, convergent strabismus, due to defect 
of refraction and in conjunction with hypermetropia, is very 
common. Muscular insufficiency and nystagmus (lateral 
or rotatory) are also often met with in this class of cases. 
In paralytic and other idiots and imbeciles homonymous 
hemianopsia is sometimes met with. 
Anomalies of the Ear.—Deformities of the ear have been 
deservedly well studied, for as stigmata of degeneration 
they take high rank, like anomalies of the hard palate, in 
the anatomical group. Morel, Stahl, Wildermuth, Binder 
and more recently Schwalbe, have given us especially good 
studies of these conditions. From their writings and my 
own studies, the following classification (following Binder) 
into twenty-two varieties may be made : 
I. Abnormally implanted ears; they project too far or 
lie too closely, are placed too high or too low, too far 
forward or too far backward on the head. 
II. Excessively large ears; (x), absolutely too large; (2), 
relatively too large in small or microcephalic individuals. 
III. Ears which are too small. 
IV. Too marked conchoidal shape of the ear. The 
details of the ear (anthelix and crura, etc.) are but slightly 
marked, while the helix outlines the ear like the rim of a 
funnel. 
V. Ears which have a general ugly shape. The breadth 
of the upper part may exceed that of the lower and vice 
versa; excessive length; ears without lobules; unusually 
short ears. 
VI. The ear not uniform in width; usually a long ear 
with one or more constrictions in its breadth. 
VII. The Blainville ear; asymmetry of various kinds 
of the two ears. In most cases the asymmetry is due to 
an anomaly of the left ear. 
VIII. The ear without lobule; there are usually other 
deformities of this ear besides the absence of lobule, such 
as too large a concha, prominence of the anthelix, etc. 
IX. The ear with adherent lobule; the lobule is en- 
larged, adherent and inclines downward towards the cheek. PETERSON: THE STIGMATA OF DEGENERATION. 
X. The Stahl ear No. i (See Zeitschrift fur Psych., Vol. 
xvi). A series of anomalies of the helix. The helix is 
broad like a band and coalesces with the cartilages of the 
crura furcata. The fossa ovalis and fossa scaphoidea are 
scarcely to be seen. The lower half of the helix is ob- 
literated. There are occasionally slight variations from 
this type. 
XI. The Darwin ear; helix interrupted where its trans- 
verse portion passes into the descending, and at this point 
is a projection of the rim above and outward, like the 
pointed ear of lower animals. 
XII. The Wildermuth ear (Wiirt. Corresp. Blatt, 1886, 
No. 40). The anthelix projects so far as to form the most 
prominent part of the auricle. 
XIII. The ear without anthelix or crura furcata. 
XIV. The Stahl ear No. 2. Multiplication of the di- 
visions of the crura furcata, so that there are three instead 
of two crura. 
XV. Wildermuth’s Aztec ear. Lobule wanting; the 
whole ear seems pushed forward and downward; the crus 
superius of the anthelix coalesces with the helix, while its 
crus anterius is scarcely perceptible. 
XVI. The Stahl ear No. 3. Only the crus anterius of 
the crura furcata is present, while the auricle seems divided 
into two halves by a ridge from the antitragus. 
XVII. The ear with double helix. 
XVIII. The ear with too large or too small a concha. 
XIX. The ear with continuous fossa scaphoidea. The 
fossa passes down into the lobe. 
XX. The Morel ear, A form marked by abnormal 
development of the helix, anthelix, fossa scaphoidea and 
crura furcata, so that the folds of the ear seem obliterated, 
and the ear is smooth, larger than usual, often prominent 
and with thin edge. 
XXI. Ears misshapen by abnormal cartilage devel- 
opment. Here belong all irregular cartilaginous growths 
and thickenings except those caused by hsematoma of 
the ear. PETERSON: THE STIGMATA OF DEGENERATION. 
13 
XXII. Various peculiarities, difficult to classify, are 
included here, such as abnormalities of the semilunar in- 
cisure of the tragus and of the meatus, colaboma of the 
lobule, hairiness of the different parts of the auricle, 
accessory ears, clefts, etc. 
The most important malformations of the ear, those that 
may be regarded as belonging to the stigmata of degenera- 
tion, and those too which are striking and plain to the eye, 
are to be summarized as follows: 
The deep position of the crus anterius. 
Marked prominence of the anthelix. 
Excessive broadening of the ear. 
Stunted development of or absence of the helix. 
Trifurcation of the anthelix. 
Widening of the fossa scaphoidea. 
Absence of the crus superius. 
Complete absence of lobule. 
Asymmetry of the two ears. 
Excessive enlargement or diminution of the concha. 
Excessive conchoidal structure of the ear. 
Reference is occasionally made in literature to the Cagot 
ear. The Cagot is a species of cretin in the French and 
Spanish Pyrenees, in which one of the chief physical 
deformities is absence of the lobule of the ear. 
Binder states that the adherent lobule exists in almost 
one-third of normal people, and in the photographs of 
several hundred distinguished people, 15$ had abnormal 
lobules. At the same time more than twice as many 
adherent lobules are found in degenerates as in normal 
people. 
Now with regard to the statistics of mal-formed ears in 
degenerate individuals, Wildermuth noted this condition 
in 41 <f0 of 142 idiots. Binder found 64$ of degenerate ears 
in 354 insane persons. It is to be remarked, however, that 
Binder was more careful in his examinations, and by long 
practice had acquired more expert knowledge than Wilder- 14 
PETERSON: THE STIGMATA OF DEGENERATION. 
muth. Fraenkel observed degenerate ears in 29 cases out 
of 32 with cranium proganseum. 
Knecht found 20$ of degenerate ears among 1,274 crim- 
inals, 27<f0 among 48 epileptics, and 32$ among 84 insane. 
Binder noted degenerate ears in 33 persons outside of 
institutions, supposed to be normal individuals. Inquiring 
closely into their histories he discovered that 7 of them had 
insane parents, brethren or children, in 19 there were de- 
cided psychic abnormalities, and only 7 were apparently 
normal people. As regards heredity, it is very common 
for children to inherit ears with the identical characteristics 
of those of one or the other parent, but on the other hand, 
it is not uncommon for the ears of the children to be quite 
different. 
Anomalies of the Limbs.—Paralysis, atrophy, retarded 
growth, club foot, and athetosis are conditions due to dis- 
ease of the brain, and are observed in many cases of para- 
lytic idiocy. These are not properly stigmata of degener- 
ation, although they may be such under some circumstances, 
as for instance when club foot or club hand has a teratologi- 
cal origin. On the other hand there are anomalies having 
a hereditary character which are essentially degenerative in- 
dices. Among these may be mentioned congenital luxa- 
tions, supernumerary fingers or toes (polydactyly), fusion 
of fingers or toes (syndactyly or aschistodactyly), excessive 
length of the arms as compared with the rest of the body 
and the lower limbs, missing fingers or toes (ectrodactyly), 
missing limb (ectromelus), fusion of the extremities (sym- 
elus or symmeles), or absence of parts of limbs so that 
they are excessively short (phocomelus). There may also 
be anomalous brevity of some digits as compared with the 
relative proportions of normal digits. Excessive volume 
of limbs (megalomelus) or of digits (megalodactyly) or ex- 
cessive gracility of limbs (oligomelus) or of digits (oligo- 
dactyly) also deserves mention. 
Anomalies of the Body in General.—Local malformations 
are naturally of more importance than general anomalies 
of the whole form, but it is necessary to study the relative pro- Phocotnelus of right arm in an epileptic girl. Right humerus several inches shorter 
than left. Movements of arms perfect on both sides. PETERSON: THE STIGMATA OF DEGENERATION. 
15 
portions of the entire figure from an anthropometrical point 
of view and to compare the results with normal standards. 
Excessive diminutiveness of figure as well as excessive or 
giant growth are indications of degeneracy. So too are 
infantile characteristics in an adult, feminine peculiarities 
in males and masculine traits in females. In this regard 
observations of the relative proportions of the shoulders 
and pelvis are particularly useful. The occult form of spina 
bifida with local hypertrichosis is met with. Deviation of 
the vertebral column among neuropaths is mentioned by 
Fer6. They may be lordoses, scolioses, or kyphoses in 
various degrees. The coccyx may present peculiarities, 
such as simulation of a tail. Thoracic asymmetry or 
other deformity is observed at times. Absence of pec- 
toral muscles or of muscles in various parts of the body 
have significance. Hernias are evidence sometimes of 
arrest of development of some part of the abdominal wall. 
Excessive development of mammary glands in males, or 
their absence or reduplication (polymastia) in either sex 
constitutes an evidence of degeneracy. 
Anomalies of the Genital Organs.—Among the genital 
anomalies in males are cryptorchismus; unilateral or bi- 
lateral microrchidia; spurious hemaphroditism; insufficient 
development of the entire genital apparatus; hypospadias; 
epispadias; defect, torsion or great volume of the prepuce; 
median fissure of the scrotum; imperforate meatus. 
In females the labia may be abnormally large, simulating 
a scrotum, sometimes very small. The clitoris may be ex- 
ceedingly large. The labia minora may be hypertrophied. 
Sometimes there are intermediate folds between the labia 
minora and labia majora. The labia minora may be 
pigmented, particularly in brunettes and when they are 
hypertrophic. There may be imperforate vulva, or atresia 
of the vagina, or double vagina; uterus bicomis is some- 
times met with. 
Anomalies of the genito-urinary apparatus should always 
be sought for, for though most frequent among idiots, 
imbeciles, epileptics and the like, they are by no means rare 16 
PETERSON: THE STIGMATA OF DEGENERATION. 
in other classes of degenerates and in degenerate families. 
In males defect of the testicles often coincides with general 
excess of growth in the whole body or in the lower 
extremities, such as is often produced by castration in 
man and lower animals. 
Anomalies of the Skin.—Among the anomalies of the skin 
are to be mentioned adipose thickening; polysarcia; preco- 
cious and often abnormal development of the hairy system; 
hair along the spinal column; rudimentary tail; premature 
grayness; a glabrous chin in grown men; persistent lanu- 
ginous character of the hair; excessive growth of hair on 
the chin and breast in women; complete or partial decolor- 
ation of the hair (albinism, vitiligo); local or general hyper- 
trichosis ; partial or complete absence, or foetal state of the 
nails; melanism of the skin; pigmentary or vascular naevi; 
molluscum; ichythyosis; vitiligo; albinism; pigmented 
spots. 
Anomalies of Motor Function.—Delay in acquiring a 
knowledge of the proper use of muscles for walking, 
eating and the like may often be justly regarded as 
an index of degeneracy. Where ordinary etiological 
factors may be excluded, tremors, tics, epilepsy and nys- 
tagmus have a similar value. Even when not congenital 
they often indicate hereditary instability of the nervous 
system. 
A nomalies of Sensory Function. —The numerous anomalies 
of function in connection with the eye have already been 
mentioned. Congenital deafness has also its significance. 
So too have hereditary forms of migraine and neuralgia. 
Certain defects or excesses in general cutaneous sensibility 
have been noted as frequent among degenerates. A general 
anaesthesia is not uncommon especially among lower 
classes of degenerates. In some instances there is 
hyperaesthesia. 
Anomalies of Speech.—It may be questionable as to how 
far stammering and stuttering are to be looked upon as 
functional degenerative stigmata, but they are certainly 
found more often in children with a neuropathic inheritance Male epileptic, aged 40 years, with glabrous face and chin 
and facial asymmetry. 
Female imbecile, aged 30 years, with hypertrichosis. PETERSON: THE STIGMATA OF DEGENERATION. 
17 
than in children with good heredity. Delay in the acquisi- 
tion of language, or complete or partial defect of speech, 
have more significance. 
Anomalies of Genito-urinary Function.—Sexual irrita- 
bility, impotence, sterility, and urinary incontinence must 
be considered as indices of neuropathic disposition. 
Retardation of puberty in both sexes, but especially in the 
male sex, is a noteworthy indication. 
Anomalies of Instinct or Appetite.—It has been pointed 
out that among all degenerates there is a taste or appetite for 
certain foods or drugs which tends to favor their dissolution 
(alcohol, morphine, cocaine and the like). In many cases of 
inebriety the uncontrollable appetite is to be looked upon as 
a functional stigma of neuropathic inheritance. Gluttony, 
merycism and the like are usually similar indications. 
Miscellaneous. —A diminished resistance against external 
influences (such as strains of various kinds) and diseases is 
significant. Great precocity of intellectual development 
and of certain aptitudes, and morbid emotional conditions 
are among suspicious indications of a neuropathic basis. 
The psychical stigmata of degeneracy need only the 
enumeration given above. 
The Etiology of Hereditary Stigmata. 
A few words should be said concerning the etiology of 
the stigmata of degeneration. When we come to investi- 
gate the causes which lead to their formation we meet with 
much difficulty. Usually we must look to modifications 
occurring during foetal development, during the evolution 
of the child, modifications brought about by arrests or 
errors of development, not so much perhaps in the organs 
themselves (which show the effects) as in the central nerv- 
ous system, in the nervous mechanism which governs 
heredity. As the evolution of our bodies as well as our 
minds depends upon the brain and spinal cord and the 
countless nerve filaments which radiate from them to 
every tissue, so the nervous system plays the most im- 
portant part in the influences which have to do with 18 
peterson: the stigmata of degeneration. 
heredity. The nervous co-ordinations must be re-arranged 
by strong stimuli in order to reproduce the hereditary im- 
pulse. This is why traits acquired by us in our individual 
life-time are not apt to be inherited by our descendants. 
If a person loses an arm, his children are not deprived of 
that useful member, for the nervous mechanism of devel- 
opment which has for ages produced arms in their proper 
places and which is fixed in the powerful hereditary im- 
pulse of the race has not been changed. So in the breed 
of dogs whose tails have been cut off for countless genera- 
tions, not one is born without a tail, because the nervous 
co-ordinations governing the evolution of the tail bear 
down with all the hereditary force of the race since its first 
beginning (when the tail existed though the animal was 
legless) to keep it in existence. If in some way we could 
reach the nervous mechanism which is responsible for the 
evolution of the tail, we might modify or even prevent its 
development. It is therefore some derangement of the 
nervous mechanism governing heredity which brings about 
deviations from the normal type, which gives rise to ana- 
tomical, physiological and psychic anomalies which we 
designate as the stigmata of degeneration. How is the 
nervous mechanism of heredity deranged? It may be 
readily and profoundly deranged in a variety of ways, for 
instance by poisons. Thus alcohol disarranges the nervous 
mechanism of heredity in such away that the descendants 
may suffer from the drink-craving, from idiocy, insanity, 
epilepsy, hysteria, neurasthenia, from shattered nervous 
systems, for at least three generations, and in these un- 
fortunates we find along with marked functional stigmata 
of degeneration, these actual physical deviations from the 
normal type which we call anatomical stigmata. But 
idiocy, insanity, epilepsy and the like are in themselves 
conditions which disarrange the nervous co-ordinations so 
profoundly as to affect the hereditary impulse and give rise 
to anatomical and functional stigmata in the descendants. 
What is bequeathed to the degenerate child is a fragile and 
unstable nervous constitution. The evidence of this in- PETERSON: THE STIGMATA OF DEGENERATION. 
herited fragility of the nerve-mechanism may present itself 
as insanity, or it may be epilepsy, or it may be feeble- 
mindedness, or it may be criminal tendencies, or it may be 
simple nervousness or hysteria or certain kinds of headache 
or possibly only eccentricity. All of these disorders are 
more or less interchangeable and are merely proofs of an 
unstable nervous organization. Where such conditions do 
not develop they may still exist in a latent state and pass as 
a legacy to another generation. Whether the neuropathic 
state be manifest or latent, we are apt to find anatomical 
stigmata of degeneration present on careful examination. 
Bibliography. 
(References not made in the text). 
Altabas: Visual Defects in Idiots (Med. Press and Circ., 1895, p. 234). 
Binder: Arch. f. Psych., Vol. XX, p. 514. 
Calori: Sull' Anat. del palato durA Bologna, 1892. 
Channing: N. Y. Med. Record, Oct. 3, 1891. 
Charon: These de Paris, July 2, 1891. 
Clouston: The Neuroses of Development, 1894. 
Fere: La Famille Neuropathique, Paris, 1894. 
Fraenkel: Allg. Zeit. f. Psych., Vol, XXXVI. 
Knecht: Allg. Zeit. f. Psych., Vol. XL. 
Minot: Embryology. 
Morel: Traite des degen6rescences. 
Nacke: Arch. f. Psych., Vol. XXV, 1893. 
Schwalbe: Arch. f. Psych., Vol. XXXVII, 1895, p. 633. 
Stieda: Internationale Beitriige zur Wissenschaft. Med., Bd. I. 
Talbot: Quoted by Farrar in “Irregularities of the Teeth,” New 
York, 1888 
Voisin: L’ldiotie, Paris, 1893. 
Waldeyer: Ueber den harten Gaurnen, Corr. Blatt der Deutsch. 
Anthrop. Gesellschaft, 1892. 
60 West 50TH Street, 
New York.