: PRESIDENT’S ADDRESS. 731 
the results of other experiments, and all the ideas we thought 
to have been definitely settled are blown into thin air, and 
we forthwith adopt a totally different view. I have no 
doubt that, if a canvass had been made, every nine out of 
ten men would have declared that if one thing was certain 
in Medicine, it was the existence of a predisposition to 
phthisis, and opinions to the contrary would have been 
laughed out of Court. 
I must say that the question of the transmission of 
tubercle, or even’an inclination to the malady, whenever 
I have given a thought to the subject, has seemed to me 
rather doubtful; but now we have the assertion of Dr. 
Koch, and no one can speak with the like authority, that 
hereditary tuberculosis, though not absolutely non-existent, 
is, nevertheless, excessively rare. But to this I have made 
allusion before, and only mention it now to emphasise that 
we are at liberty, in considering practical measures, to leave 
‘this form of origination entirely out of account. 
Well, now, where are our actuaries and those who for so 
many years have been employing their time in constructing 
tables and drawing up statistics for Life Assurance Com- 
panies? It is a question of the utmost importance, for if 
the Professor is right, the elimination of tubercle becomes 
merely a question of sanitation. A few strong municipal 
restrictions, and this disease may almost disappear from our 
midst, to break in again on our reverting to unwholesome 
habits. But, if it can be transmitted, or even if a disposi- 
tion can be handed down from parent to offspring. the pic- 
ture becomes sad, and the outlook is not nearly so hopeful. 
If such should be the case, though few seem to incline ’to- 
wards Dr. Koch, it must be a very subtle peculiarity, and 
so imponderable an influence as to be quite beyond our 
grasp. 
Let us turn to the side of the eminent doctor. How often 
do we see the thinnest, poorest-looking children grow up to 
be fine strong men, and that without having had any special 
care bestowed on them. These, after the age of puberty, 
frequently seem never to contract any malady, and pass 
their lives with scarcely a sickness. So often is this the 
case that I would discard the term “ delicate ’’ altogether, in 
the sense in which it is generally used. Applying it only 
to those who suffer from some neurosis, such as epilepsy, 
prematurely-born infants are “pukey”’ for a time, and are 
generally more or less so for the first three or four years of 
their lives, but if brought up amongst healthy surroundings 
they are no more disposed to tuberculosis affections than 
