A Short Note Upon So-called " Hereditary Optic 
Nerve Atrophy"-as a Contribution to 
the Question of Transmission 
of Structural Peculiarity. 
CHARLES A. OLIVER, A.M., M.D. 
A Paper Read before the American Philosophical Society, Philadelphia, 
On the Occasion of the Celebration of the 150th Anniversary 
of its Foundation, May 22 to 26, 1893. 
Reprinted, January 25, 1894, fronrProc. Amer. Philos. Soc., Vol. xxxii. A Short Note upon So-called " Hereditary Optic-Nerve Atrophy"- 
as a Contribution to the Question of Transmission of Structural 
Peculiarity. 
By Charles A. Oliver, A.M., M. D. 
Deeming it possible that the question of " The Transmission of 
Structural Peculiarity" may be judiciously studied from a patho- 
logical standpoint, as shown in the peculiar disease of man generally 
known as Hereditary Optic-Nerve Atrophy, where certain morbid 
changes of optic-nerve structures of a sufficient amount for ready 
recognition take place during the years just previous to adolescence 
in subjects who frequently have consanguineous ties, extending in 
some instances through several generations, the writer has ventured 
the following terse notes of one such family that he has had the op- 
portunity to submit several of its members to careful and prolonged 
clinical research extending over several years. 
In 1892, he saw for the first time a man, aged twenty-seven years, 
who stated that for the past year the sight of both eyes had been 
gradually failing, this being accompanied by frontal headaches and 
dizziness. No history of any general sickness was given and no 
clinical evidences of the introduction of any toxic agents into the 
system could be obtained. He asserted that his mother's three 
brothers were similarly affected. 
Examination showed that central vision for both form and color 
was highly defective. The ophthalmoscopic appearances were 
those of a semiatrophic condition of the optic-nerve head. 
At irregular intervals, though especially later in the disease, vari- 
ously colored phosphenes appeared in the centre of the visual fields 
and attacks of "fogging of vision" during perspiration without 
watering of the eyes came on. Ocular pain upon exposure to 
light, with gradual decreasing color perception, passing through 
the failure of recognizing green, red, blue and yellow ensued, until 
at last nothing but equal intensities of " color " were laid side by 
side without reference to tint. 
REPRINTED JAN. 25, 1894, FROM PROC. AMER. PHILOS. SOC., VOL. XXXII. 2 
This peculiar history and the patient's assertion that his three 
maternal uncles had suffered in the same manner induced a careful 
ocular examination to be made of as many of the family as possible. 
This resulted in the finding of more or less similar ocular symp- 
toms and conditions in all that could be seen. It also elicited the 
fact that the disease with one exception had passed from unaffected 
mothers to affected sons through six generations on the maternal 
side; a family that the writer had the privilege to study in a num 
ber of its members ten years ago and had careful clinical notes of 
several in the earlier generations. 
This brief history of a gross pathological condition first appear- 
ing about or a short time before adolescence, and eventuating in 
permanent partial blindness at about twenty-seven years of age, is 
here given as one among many facts based upon pathological 
changes that may be placed side by side with those so-called normal 
physiological acts and physical peculiarities of structure which are 
so often seen passing through several generations especially by ties 
of consanguinity. 
In other words, this fault of optic-nerve structure, which doesnot 
show itself for several years after the birth of the individual, indi- 
cates to the writer's mind at least that here there is an inheritance 
of a physical material which is not only shorter lived than that 
which is found in the same organ in other organisms, but that it has 
a briefer existence than the other organs in the same general organ- 
ism ; a fault which shows that an imperfect material has been born, 
and dies prematurely because it is subjected to an amount of wear 
and tear that would not seriously disturb or injure a properly formed 
substance. Further, it serves as a living evidence that a substance 
has been improperly made most probably on account of physical 
imperfection and repetition of faulty cell combination of similar 
kind extending through several generations; an evidence which in 
measure says that primarily acquired pathological characteristics of 
structural form may be transmitted through forthcoming generations 
as imperfect formation of similar structure in due proportion to 
both the want of hygiene and care given to the afflicted subjects 
and the reassociation of similarly degraded developmental cells ; an 
evidence which gives answer in part to the transmission of ordinary 
structural characteristics, which, if acted upon in the same way as 
those which are not made, as it were, in the same peculiar manner, 3 
will produce far different and even what may be termed idiocratic 
results. 
In other words, this disease, for example, which manifests itself 
as faulty transmission, teaches us conversely that a peculiar physical 
condition which has been obtained from frequently repeated physio- 
logical acts during the life existence of some antecedent containing 
animal form, may be transmitted to the offspring (more particularly 
by consanguineous ties of the parents) and thus render the new or- 
ganism more capable of evolving certain definite acts that are the 
physiological representatives of heredity of physical structure; the 
partial answer at least for so-termed hereditary genius.