HEREDITARY DISEASE. 
Kathan Allen, M. D., Lowell, Mass. 
In the history of medicine there is no department in which a 
greater advance has been made than in a better knowledge of 
uie nature and causes of disease; and there is no term employed 
in medicul science, the meaning of which it is so important to 
have clear and definite ideas of, as that of disease. The most 
concise definitions given by different writers are, “deranged 
junction and alteration of structure;” “any deviation from 
health in structure or function causing pain and uneasiness;” 
* any of a living body in which the natural functions of the 
organs are interrupted or disturbed.” 
One of the most popular English writers on medicine gives 
this general definition,—“ disease is but a deviation from the 
state of health, consisting for the most part in a change in the 
properties or structure of any tissue or organ, which renders 
such tissue or organ unfit for the performance of its actions or 
I unctions according to the law of the healthy frame.” It would 
seem by these definitions that in order to have accurate and dis- 
tinct ideas of the nature of disease, we must have some knowl- 
edge of its opposite state, viz., health. This term is variously 
defined. In a general sense it is “ that of a body in which all 
the natural functions are performed with regularity and. liar 
mony. But then, if we are guided by the common use of the 
word health, we find it applied in such a variety of ways that it 
implies a difference in health; and many include only certain 
parts of the body. In fact, the word is used so vaguely, or with 
such latitude, that it is difficult to define it satisfactorily. 
[A paper read at the annual meeting of the Mass. Medical Society, June 3rd, 1373,] Hereditary Disease. 
Thus, while in one sense the terms disease and health aie 
antagonistic, they also have a relative meaning, signifying that 
there are grades or degrees to each, with lines radiating at times 
from each other, and again approximating so near together that 
it becomes difficult to distinguish any border ground between 
them. But in the case of disease, there is this seeming advan- 
tage, that we can the more readily single out the particular tissue 
ov organ affected; when the question naturally arises, what is 
the cause of disturbance or derangement ? Hence, in order to 
understand the nature or character of a disease, it becomes 
necessary to investigate its cause or causes. Thus the meaning 
of the two terms, health and disease, for a full understanding, 
cannot be well separated. 
The results of investigation in this direction constitute an 
important department in pathology, which, in a short period, 
comparatively, has added very valuable knowledge to medical 
science. One of the most popular writers upon this subject 
recently made the following remark Advances in the science 
of medicine in future years will be mainly due to a better knowl- 
edge of the cause of disease; and just in proportion as our 
knowledge of physiology and pathology becomes more exact 
and extended, so will the causes of disease be better appreciated, 
and its occurrence on a large scale be more readily prevented 
A search in the same direction led Dr. John Forbes, perhaps the 
o-reatest modern reformer in medicine, to say, “ here the surest 
and most glorious triumphs of medical science are achieving 
and are to be achieved.” This remark was made twenty years 
a (to and, since that period, the record of improvement and 
discovery in pathological researches has been crowded with 
triumphs. The field is still open, and nature invites all inquirers 
after truth to push their investigations farther and farther. 
With the hope of contributing something to science in 111 a 
direction, we propose to consider in the present paper a distinct 
class of diseases, with reference more particularly to their cause 
than to their nature. We refer to that class called hereditary- 
those that are inherited, or said to be transmitted by the laws oi 
hereditary descent. And for the sake of convenience in the dis- 
cussion, these diseases will be divided into three classes, 
Ist. The class that are well known as congenital and abnoi- 
mal in structure. 3 
2nd class, where the seed or germs of disease are transmitted, 
requiring only time or occasion to be developed. 
Hereditary Disease. 
3rd class, where the organization itself in its development is 
such that, under certain circumstances, or exposed to certain 
influences, diseases of structure or function will inevitably be 
generated. 
The fact that there is a class known as hereditary diseases, is 
admitted, we believe, by all writers on medical science. In the 
early history of Greece and Rome, we find frequent reference by 
different writers to the resemblance between children and parent, 
but only occasionally is any allusion made to the factthat diseases 
also were thus transmitted. The more prominent writers refer- 
ing to this subject were Tacitus, Horace, Lucretius, Aristotle, 
Hippocrates, and Aretseus; and among those of more modern 
times are Boorhaave, Cullen, Prichard, Lucas, Portal, and Merca- 
tus. Near the close of the last century a new era was introduced 
in the study of medicine; that was, to obtain by dissection and 
observation a correct knowledge of the anatomy of the body in 
a diseased state. Bichat took the lead in this great reform, 
and is therefore justly styled the father of pathological anatomy. 
Since that time the study of pathology has been prosecuted 
with very great success. 
While writers have generally admitted hereditary agency as a 
most fruitful source of disease, there has been some difference 
of opinion as to what particular diseases originate from this 
cause, as well as to just what extent this agency exercises an 
influence. One fact is very patent; that is, the individuals who 
have given the most time and attention to this inquiry urge its 
importance most, and assert that this agency in the production 
of disease is far more powerful than is generally supposed. 
Statements expressing this opinion might be cited, or quoted 
from numerous writers, but one must suffice for the present. 
Sir Henry Holland, now president of the Royal Society, says;— 
“We can scarcely name any organ of importance which does 
not afford evidence of diseased actions derived from structure 
and transmissible by descent. The subject is one that meets us in 
practice at every step, and to which our attention is perpetually 
required as an exponent of symptoms; as affording some of the 
most certain rpeans of prognosis; and as directing us in many 
particulars to the right course of treatment. No judicious phys- Hereditary Disease. 
ician will neglect the resources hence derived, which are in truth 
essential to sound and successful practice. It is probable they will 
he largely augmented in future both by more exact and ample observation 
of facts, and by the extension of our knowledge of principles in this 
remarkable branch of physiology This last sentence we italicize, 
inasmuch as it intimates so positively that some new principles 
would be evolved from physiology which might greatly extend 
our knowledge. 
While the causes of disease have been for a long time most 
thoroughly investigated in every possible direction, and our 
knowledge has thus'been much enlarged, very little new light has 
been shed upon hereditary causes, or influences. The difficulty, 
as we apprehend, is that the laws of hereditary descent have not 
been correctly understood or well-defined. Some writers seem 
to have regarded the reproduction of the species, as an agency 
in causing disease, to be enveloped in so much mystery, that but 
little knowledge of pathology could be obtained from this source 
by any amount of study or observation. Others have been more 
hopeful—have closely questioned nature from different points of 
view ; have, in a multitude of instances, traced out the sources of 
or predispositions to disease from children to parents, as well as 
physical weaknesses and defects resulting in disease, and which 
many have extended through several generations. There are 
still others who have undertaken to define or expound the laws 
of inheritance by mapping out distinct portions of the body, 
and establishing a theory upon a too partial or limited view 
of nature. 
■ We believe, however, that there is founded in nature an uni- 
versal law of propagation, upon which the laws of inheritance 
are based, subject to certain conditions; and that when these 
laws are correctly interpreted we shall be able to ascertain the 
real causes or primary sources of many diseases far better than 
we now do. This law applies not only to the human race, but 
extends throughout the whole animal and vegetable kingdoms. 
We will here state our understanding of this law briefly, noticing 
particularly its relations to hereditary diseases, without attempt- 
ing to present any proof or illustration of its truth, which would 
require a volume to do anything like justice to the subject. 
This law of propagation is based upon a perfect standard of 
organization, or consists in the perfectionism of structure and Hereditary Disease. 
function ; or, in other words, that every organ in the body should 
be perfect in structure, and that each should perform its legiti- 
mate functions in harmony with others. Taking this, then” as 
a standard, we have a guide or model by which all changes in 
organization may be tested. But nowhere in nature do we find 
perfect standards—only approximations towards them; the de- 
viations being almost endless in variety. As “ like begets like," 
here comes in the law of heredity, and, as two distinct agents 
are concenied in the union, the hereditary effects become more 
varied and complicated. If the organization of both agents or 
parents was perfect, or was very near alike, we should find the 
law of likeness or resemblance more generally exemplified in 
tiieii offspring. But in this union of the sexes the results de- 
pend very much upon several conditions, such as age, mutual 
adaptation, the health, the physical and mental state, etc. There 
are also some other conditions which modify this law of propa- 
gation, such as food, climate, exercise, etc., though these are 
mostly external, and exert their influence after the birth of the 
progeny. 
It might seem at the first thought, in the blending and mixing 
up of So manjr dissimilar qualities, together with the numerous 
conditions to which they are subject, that weaknesses, defects. 
01 diseases, etc., could not easily be traced from child to parent. 
01 through successive generations. This may be difficult in some 
cases, but then, in proportion as these abnormalities, deviations, 
irregularities, or peculiarities are marked or predominant in the 
organization, they are more or less likely to be transmitted, and, 
il may be, in an intensified form. If anything abnormal in struc - 
ture or morbid in function, predisposing to disease, should exist 
alike in both parents, it becomes generally intensified in the 
offspring. Thus, if either the nervous or sanguineous tempera- 
ment is predominant in both parents, that temperament will be 
very predominant in their children, and will be peculiarly liable 
to the diseases that generally accompany such as organization. 
The question might arise, does this hereditary influence extend 
to every internal organ, and to every tissue in the system, as well 
as to outward forms and appearances ? it is true, we may not 
always be able to trace the marked evidences of it, but all the 
general facts, as well as analogy, look strongly that way, and 
such is the testimony of those who have investigated most 
thoroughly this department of physiology. 6 
Hereditary Disease. 
What relation has this law of propagation and heredity to 
disease? Most intimate and important, we answer. Unless 
there are some fixed and settled principles that govern the pro- 
pagation of the species, and determine just the kind and character 
of organization transmitted, how can we trace far back the pre- 
cise causes of certain diseases, or estimate properly the extent 
of hereditary influences ? This law constitutes a kind of key to 
unlock in nature what would otherwise be obscure and mysteri- 
ous. It is to the inquirer after truth in hereditary pathology 
what the chart and compass are to the mariner at sea, sailing 
along a comparatively unknown coast. In considering this law 
of inheritance, it may be more convenient to notice at first those 
hereditary effects that are the most obvious. These we place in 
the first class. They are termed, sometimes, in books, congenital; 
are abnormalities in structure; some of them would not come 
strictly under the head of disease, while others would ; and most 
of them induce or lead to diseases of the gravest kind. 
We have deformities of the body in size and proportion: giants, 
dwarfs, additional parts, as fingers and toes; we have deformed 
organs and parts, such as club-foot, hare-lip, hernia, spina-bifida, 
hunch-back, strabismus, cateract, hydrocephalus, and other mal- 
formations both external and internal. 
While it may be difficult and perhaps impossible to trace back 
many of these abnormalities to their exact primary cause, still, 
in a large majority of these cases, we think, by careful inquiry 
and investigation, they can be accounted for either directly or 
indirectly by hereditary influences. Such abnormalities cannot 
occur without a cause, though it is impossible for us always to 
fathom or expose all the secrets of nature, especially when her 
agency is concealed from our inspection and may be carried on 
through several generations. Since so large a part of these 
cases—probably a majority—can be explained as arising from 
hereditary causes, and as nature knows no exceptions to her 
laws, the presumption is that all these anomalous cases have an 
origin from similar sources. 
Under this head may also be included what are denominated 
the defective classes, such as the idiotic, the blind, the deaf and 
dumb, and the insane, as far as their defective organization 
arises from an hereditary cause. While it may not be possibly 
to determine just what proportion of each of these classes came Hereditary Disease. 
7 
into the world with a defective organization, or simply with a 
predisposition to these complaints, it is well known in the case 
of large numbers that the cause of their abnormality has an 
hereditary origin. And, reasoning from analogy, is there not a 
strong presumption that the defects or anomalies in many others 
of these same classes, might, if they could be traced step by 
step, be referable to the same sources ? For all these abnormal- 
ities arise from violations of law. If then the great law of pro- 
pagation is based upon a perfect standard in nature, and the 
law of inheritance grows out of the changes or deviations from 
this standard, transmitted from parents to their offspring, how 
important that these principles be correctly understood, and 
the consequences, too, of their violation. 
2nd Class of Hereditary Diseases.—Jn this class may be placed 
those diseases where the seeds or germs are transmitted in a 
dorment state, requiring only time and occasion to be developed. 
This may exist in a change of structure, or morbidness of func- 
tion, or poison in the blood. The class is very large, and we 
can notice only a few of the more prominent diseases. Taking 
the lead in this class, particularly in our cities, is syphilis, which 
primarily is communicated in the blood. The very germ of this 
disease is a most violent poison, and, being transmitted in the 
blood, it penetrates through every organ and fibre of the system, 
and may vitiate every secretion. It combines with other diseases, 
aggravating their form and rendering their treatment more diffi- 
cult as well as the result more doubtful. There is probable no 
one disease at the present day so extensive in its sweep, so 
injurious in its effects, and one which bodes more ill in the 
future to human welfare. Whatever differences of opinion may 
exist as to its medical treatment, or as to employing legal means 
for its suppression, all agree that the germs or the disease are 
hereditary—a poison in the blood—and may be transmitted 
through successive generations. 
The next disease in order property in this class is scrofula. 
This may be transmitted in the blood or in the form of tubercle. 
If we use the term in the widest sense, scrofula would include 
certain diseases of the skin; also glandular swellings and morbid 
growths, as well as tubercular deposits, particularly in the lungs. 
So diversified are the forms in which this disease appears, and 
so obscure are many of its symptoms, that it is very difficult to 8 
Hereditary Disease. 
draw the lines between scrofula and some other diseases. But 
in one thing there is a general agreement of opinion; that is-, 
though the disease is frequently developed and aggravated by 
secondary causes, yet the poison in the blood or the germs of 
the disease have, their origin, in most cases, from hereditary 
influences. In confirmation of this statement, the following fact 
may be cited : In the last report of our State Board of Health, 
t/O the question put to two hundred and ten physicians—“ Is 
consumption caused or promoted by hereditary influences ? 
only one physician answered in the negative. In this question, 
the teim, piomoted, may have influenced some in their deci- 
sion, as there is greater uniformity in the testimony here given 
than is usually found. 
There are several diseases near akin to scrofula that are gener- 
ally considered to have an hereditary origin, viz., richets, cancer, 
and malignant tumours. These may occasionally occur from 
other sources, and are always aggravated by secondary causes. 
Gout, erysipelas, and rheumatism are classed by many writers 
under the head of hereditary diseases, though often produced 
undoubtedly by other causes. The predisposition or diathesis 
leading to these diseases, are strongly marked in particular 
families. Chomel, the distinguished writer on pathology, states 
tnat more than one-half of the cases of rheumatism may be 
traced directly to hereditary causes. There are several diseases 
of the brain that are thought to arise from this source, such as 
epilepsy, apoplexy, and paralysis. It is a well-established fact 
that where there is a great predominance of the brain and nerves 
over the other tissues, a certain class of diseases will uniformly 
be developed. The same fact may be stated of what is called 
the sanguine or bilious temperament; certain diseases accom- 
pany them. So strongly marked or controlling is the influence 
between a certain type of organization and class of diseases, 
that wherever there is found a predominance of one of the tem- 
peraments or a certain class of organs, the particular diseases 
that attack the individual may be predicted-beforehand. 
With reference to chronic diseases, whibh have been super- 
induced upon a healthy structure, there may be difference of 
opinion as to how far they are hereditary in their effects. This 
may depend much upon circumstances. 
There is another question intimately connected with this sub- Hereditary Disease. 
9 
iect, viz.: What are the hereditary effects of habits? If these 
habits are of such a nature as to injure the health and impair 
the constitution, their hereditary influence must be bad; and 
that, too, in proportion to the injury produced upon the system, 
hor illustrations : The frequent or long-continued use of intox- 
icating liquors, of narcotics, of stimulants, etc., must injure the 
health and affect the vital forces, if not taint the blood, so as to 
implant in the offspring a strong predisposition to the same 
habits, and the consequent liabilities to disease. 
The third class of diseases, or predisposing causes, are pecu- 
liar, and require some explanation. All works on pathology 
dwell or lay great stress upon the predisposing causes to disease 
—considering the body, in certain cases, is so organized or con- 
stituted that diseases will inevitably be generated when the 
system is exposed to certain exciting or determining influences. 
This suggests the importance of the great law of propagation, 
and presents new stand-points for the study of disease and its 
causes. As this law is based upon a perfectionism of structure 
and function, it implies that there must be an exact balance in 
all the organs, and perfect harmony in all their functions. In 
their normal state each organ has a specific work to do, and in 
doing that work should not be interfered with or disturbed bv 
airy imperfection in the action of other organs. In this case, 
the “ wear and tear,” or the demands which nature makes to 
support life, and carry on its operations, comes upon all the 
organs alike. In some respects, the body may be compared to 
a perfect machine, made up of many very complicated parts. 
How different is the working or running of such a machine from 
one imperfectly constructed and unequally balanced in its parts ! 
The one seldom needs repairs; the other, constantly. The one 
will last, as it were, for an age ; the other is entirely used up in 
a short time. But in the human body we have something more 
than mere mechanism; we have an organized living being, with 
its most delicate and complicated parts wonderfully exposed: ' 
and when once injured they cannot easily be repaired. 
Taking this perfect or normal standard of organization where- 
upon the law of propagation is based, and applying the laws of 
hereditary descent, we get new and important views of physiol- 
og\ in its relations to disease. We see that wherever there are 
abnonnal developments—where a certain organ, or class of or- 10 
Hereditary Disease. 
gans, is relatively too large or too small, causing a want of 
balance or harmony of action in the system, there must be in 
the very nature of the case far greater liability to disease. And 
when these abnormal developments are carried to extremes, 
nature’s laws are more frequently violated, and hence arise most 
fruitful sources of disease. It is in this imperfect, ill-balanced 
organization where we find not only the greatest amount of sick- 
ness, but that which is the most obstinate and fatal. The reasons 
for such a result are obvious when the true laws of inheritance 
and disease are taker into account. How, in no possible way 
can a thorough or correct knowledge of pathology, in its rela- 
tions to hereditary influences, be obtained until the true laws of 
propagation and inheritance are understood, whether those here 
expounded are the true ones or not. There are three consider- 
ations connected with this subject to which special attention 
should be called ; 
Ist. The great advantages which a knowledge of those 
primary laws afford. In the application of all remedial 
measures, it is of the highest importance to understand, at the 
out-set, the precise nature and cause of the evil to be removed. 
And in making up our diagnosis of disease, we should avail 
ourselves of all the sources or means that can shed any light 
upon the case. By an application of these principles the peculiar 
physiology of every patient is more easily understood. We see, 
readily, the strong and weak points in his organization; what 
parts or organs are most predisposed to disease, as well as to 
what particular diseases. Aided by a knowledge of these laws, 
we can push our inquiries and make our observations in detail 
to far better advantage. If there are any peculiarities or 
idiosyncrasies in the constitution of the patient, they are more 
readily discovered. There is also another feature in organiza- 
tion which it is very necessary to understand in its relations to 
disease—that is fineness of fibre or quality of texture, and which 
pertains to the whole system. This fineness of fibre or delicacy 
of structure has much to do in providing vital forces to resist 
disease, and it is through the laws of inheritance that we find 
such differences in organization. This quality pervades not only 
one organ, but extends to every part of the system, and is trans- 
mitted from generation to generation. This kind or type of or- 
ganization has a far more intimate relation to disease than is 
generally supposed. Hereditary Disease. 
11 
2nd Consideration. In the treatment of disease, a knowledge 
of these laws is of great advantage. Within a few years there 
has been much discussion as to the relative influence of nature 
and art in the cure of disease. Once too much reliance was 
undoubtedly placed in the power of medicine, and it was pre- 
scribed in such variety and quantity as to aggravate, if not pro- 
long, disease. In this respect there has been great improvement 
in medical practice, and, while occasionally too much medicine 
may now be administered, there is danger of going to the other 
extreme of dispensing with medicine entirely. What we want 
is, avoid both extremes; adapt our treatment to the laws of 
nature; and in order to do this correctly, we must understand 
not only the nature and laws of disease generally, but the mate- 
rial, the peculiar organization, of every patient; what his temper- 
ament is; what are the weak points in his system; what aids and 
forces his constitution will afford to withstand disease, and assist 
the means of recovery. The more exact and thorough is our 
knowledge of individual physiology, the more wisely shall we be 
enabled to apply all hygienic agencies, as well as medicine, in the 
treatment of disease. Now by having constantly before the 
mind a physiological standard, which is normal and perfectly 
healthy, and then, by carefully surveying the deviations from 
this standard in the organization of individual patients, we obtain 
clearer and more definite views of the weak and delicate points 
in their constitutions, and can thereby better apply our reme- 
dial measures. Thus by a more correct and exact knowledge of 
hereditary predisposition, or, in other words, of the recuperative 
powers of nature in each individual case, we can make a wiser 
and more skillful use of the resources of art. As a general 
thing the most thorough physiologists make the best practition- 
ers of medicine. 
3rd Consideration. Perhaps the most concise and practical 
definition of the object of medicine anywhere to be found was 
given by a distinguished member of this society, who is now the 
Nestor in the profession in this city; I refer to Dr. Jacob Biglow. 
The practical view of medicine, says Dr. 8., is this, “ it is the art 
of understanding the nature of diseases so as to comprehend 
fully their causes ; and to prevent their occurrence when possible; 
also to promote their cure or to relieve them when they do 
occur.” It is the first clause in this definition that claims more 12 
Hereditary Disease. 
especially our attention. It is such a knowledge of the causes 
of disease that both the cause and the effect, if possible, can be 
removed—it is the prevention of disease as well as cure. This 
should certainly be the aim of the profession as much as the mere 
administration of medicine. And it is a gratifying fact that 
every year we hear more and more of the importance of sanitary 
laws and the principles of hygiene. The public at large are 
beginning to realize more fully than ever the meaning of those 
trite proverbs that, “a stitch in time saves nine,” and “an 
ounce of prevention is worth a pound of cure.” 
How and where can disease be most effectually prevented, and 
that too on the largest possible scale ? It is not so much, per- 
haps, by a general diffusion of a knowledge of physiology, as 
that every individual should understand correctly his own con- 
stitutional weaknesses, defects and liabilities, so that he can 
thereby take better care of himself under all circumstances and 
exposures. Let him learn early what are his hereditary tenden- 
cies, what are constitutionally his weak points, and to what com- 
plaints he is most liable. But to do this properly and success- 
fully, the true laws of propagation and inheritance must be 
better understood. It could not have been intended by the 
Creator that man should always be ignorant of laws so useful and 
Important. 
But there is a wider and more extended view to be taken of 
this subject than its application to individuals; that is, the pre- 
vention of disease upon a large scale. We hear much said of 
this importance to health of the right kind of food, of good air. 
of pure water, of proper drainage, of the situation and construc- 
tion of dwellings, etc. We find almost daily articles discussing 
these several topics both in newspapers and periodical journals, 
showing that there is a growing demand for such information. 
Members of the medical profession and others are pushing their 
inquiries into every department of science for new means or 
knowledge whereby disease be prevented or cured. But 
there is one source or cause of a great deal of sickness and suf- 
fering, more important in many respects and far more reaching 
In its influence than any of those mentioned, to which compara- 
tively very little attention has as yet been given, that is the 
want or value of a sound, healthy and well balanced organization 
at birth. It requires no facts or arguments to show to the Hereditary Disease. 
13 
practising physician what a wonderful difference there is in the 
amount of sickness under almost precisely the same circumstan- 
ces, between some individuals and families and others; and 
then how some patients will recover from the most violent and 
lingering sicknesses, while others die easily from very slight 
attacks of disease. This difference in vitality arises mainly from 
the difference not only in the nature, vigor and strength of con- 
stitution, but that one patient descended from a sound, long lived 
and healthy stock, whereas the other inherited the weaknesses 
and diseases of its parents or ancestors. -In every community 
may be found individuals and families possessing each of these 
characteristics. , 
In no one way, in our opinion, can so much sickness and suf- 
fering be prevented as in obedience to the laws of inheritance, 
but, in order to effect any great change in this direction, it must 
extend through several generations. But how can this improve- 
ment be made without a correct knowledge of the laws of pro- 
pagation and hereditary descent ? Unless we have some definite 
and fixed principles to guide us, how can we here reach any 
certain and satisfactory result ? There must be some fixed laws 
of this character based upon physiology. Interests of such 
magniture, results so important connected with the operations 
of nature, would never be left to mere chance or accident. All 
true science is supported by great laws or principles, though 
they can not all at once be discovered, or be correctly interpreted 
for ages. 
It has been estimated b}' some writers that full one-third of 
all the sickness that now afflict society might be prevented by a 
wise and intelligent application of the principles of hygiene. 
Now if the physiological requisitions for entering the marriage 
relation were heeded as they should be, both by man and woman, 
the predispositions to, or germs of, disease would be diminished 
to a most surprising extent. Let these requisitions be faithfully 
adhered to through several generations, and it would be difficult 
to conceive or 'estimate what an immense difference it would 
make in the amount of sickness and mortality. 
By applying sanitary laws in the matter of ventilation, drain- 
age, pure water, etc., we only cut off some of the branches of 
this upas tree, but by strictly obeying hereditary laws we eradi- 
cate or destroy the roots of disease. It is much easier to dry up 14 
Hereditary Disease 
the springs or cleanse the fountain than to purify large flowing 
streams filled with poisonous feculence. 
It may be said, if the views here expressed of disease should be 
practically carried out, it would most seriously affect the business 
and the interests of the medical profession. We admit the truth 
of such remarks, but, in behalf of humanity, as well as in obedi- 
ence to the laws of the Creator, we would gracefully submit. It 
would afford occasion for the profession to act from purer 
motives and upon a far higher plain of observation. 
As society is now constituted there is one standpoint from 
which a view may be taken of our duties that is not very 
ennobling. It is this: That so much of our time, thought and 
labor are expended upon those constitutionally puny, feeble, 
diseased and sickly for the sake of preserving life, when these 
very individuals, if may be, will transmit to posterity the seeds 
of still more weakness, disease and suffering. Such a view of the 
results of our labors is not at all pleasant or gratifying. While, 
therefore, we attempt to discharge the duties of the passing hour 
in relieving pain and suffering, let us faithfully expound and 
apply, as far as possible, the great laws of life and health, in the 
'prevention as wrell as in the cure of disease. And though we may 
not find our compensation in dollars and cents, it will surely 
come in the consciousness of having done our duty, and in the 
end, that our lives have not been spent in vain. About forty 
years ago a paper was read before this society that startled its 
members. The idea was broached that there were a class of dis- 
eases which medicine could not break up, nor limit their duration, 
and whose leading symptoms were not safely subject to much 
control or interference. Inasmuch as these diseases seemed to 
be governed by certain fixed principles of their own, they were 
denominated “self-limited” a new term in nosology, but most 
appropriately applied. These views of medicine, differing so 
materially from what had been generally entertained, were not 
very kindlj7 received at the time, were thought by some to be ex- 
tremely ultra, and, by others, to be decidedly erroneous. But in 
the process of time they were found to be, after all, remarkably 
correct, that they accorded full}7 with the laws of pathology, and 
the trouble in their reception arose from the fact that they 
happened to be in advance of the state of medical knowledge 
generally. In the history of science such instances have fre- Diarrhea, A Symptom of Pulmonary Tuberculosis. 
15 
quently occurred, but it is seldom where the leader or discoverer 
has been permitted to see so great a change as in the present 
case. Whatever may be thought of the views now presented 
to your consideration, we are confident that time and observation 
will testify to their truth. We live in a day of progress, of dis- 
covery. The course of true science is always advancing, and in 
due time all her great laws will be vindicated and established 
upon a sure and enduring foundation.