HEREDITY AND DISEASE 



Influence of Heredity Heretofore Largely Overlooked — Both Favorable and 



Unfavorable Characteristics Subject to the Same Laws — 



Lessened Resistance Probably Heritable 



Charles Herrman, M.D. 

 Attending Pediatrist to the Lebanon Hospital, New York 



IT HAS always been a rratter of sur- 

 prise to me, that physicians have 

 given so little attention to heredity 

 as a factor in the causation of dis- 

 ease. Pediatrists especially should be 

 interested, for many inherited qualities 

 and characteristics, show themselves at 

 birth, or in early infancy, and at that 

 time the analysis is still simple. In 

 later life, other factors, such as previ- 

 ous disease, alcoholism, worry and imi- 

 tation are added, and the problem 

 becomes more complicated. 



As a matter of convenience we usu- 

 ally distinguish between the inherit- 

 ance of favorable and unfavorable quali- 

 ties or characteristics; but both are 

 subject to the same laws. The eugenist 

 is primarily interested in the former, 

 the physician chiefly in the latter. We 

 frequently separate the inheritance of 

 anthropological, pathological and psy- 

 chical characteristics; but they, too. 

 should not be separated. It is a curi- 

 ous fact, that although physicians and 

 la\Tnen recognize the inheritance of 

 anthropological peculiarities, the in- 

 heritance of pathological and psychical 

 anomalies is almost completely ignored. 

 One constantly hears, that a child has 

 his mother's eyes or his grandfather's 

 nose; but if a child is born with a hare 

 lip, one is apt to hear, that the mother 

 was frightened by a rabbit during preg- 

 nancy; or if the child is born with a de- 

 fective development of the brain, that 

 the mother had a great deal of worry 

 during pregnancy, or that the attend- 

 ing physician did not conduct the labor 

 skillfully. That the inheritance of 

 anthropological, psychical, and patho- 

 logical characteristics, are closely re- 

 lated is shown by the fact, that all 

 three, may be represented in an anoma- 



lous form in the same patient. Take 

 for example, the mongolian imbecile; 

 the brachy cephalic head, with the 

 flattened occiput, the downward and 

 inward slant of the eyes, and the 

 flattened bridge of the nose, are an- 

 thropological peculiarities; the defective 

 intelligence, the psychical; and the fre- 

 quent presence of such congenital an- 

 omalies, as polydactylism, syndactilism 

 and congenital heart disease, the path- 

 ological peculiarities. 



LESSENED RESISTANCE HERITABLE 



If we believe, that such anthropo- 

 logical, psychical and pathological char- 

 acteristics, may be on a hereditary 

 basis, why may we not go a step further, 

 and admit the possible inheritance of a 

 lessened resistance of certain organs, or 

 parts of the body? I have reported 

 (Archives of Pediatrics, March, 1916) 

 the history of a family in which six 

 children died of pulmonary disease, 

 shortly after birth, or in early infancy, 

 I have also had under observation a 

 famih% in which five children had 

 heart disease of the same type. These 

 of course represent unusual and strik- 

 ing examples, of a vulnerability of a 

 certain organ; but every physician can 

 cite less marked examples of such a 

 family predisposition, from his own 

 practice. 



In the etiology of disease, physicians 

 have always recognized two factors; 

 the character and virulence of the 

 infectious material; and the suscep- 

 tibility or resistance of the individual 

 infected. As a rule, however, the im- 

 portance of the former, has been over- 

 estimated, and that of the latter under- 

 estimated, possibly because it is more 

 difficult to detect and appraise. Still 



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