CLiV BOWMAN LECTURE. 



second has five or six children, in one or two of whom sight is bad both 

 day and night. Ill, 4 died in infancy. Ill, 5 at 14. Ill, 6 is 40 ; has 

 good sight and three normal children. Ill, 10 and 11, and the child, 

 IV, 5, all see well. 



Fig. 38 (p. xcvii), from Mr. Lawford and Mr. E. Collier Green (Paynter 

 family). A single case in a large childship ; possible influence of severe 

 loss of blood. 



Ill, 3,, Mr. Lawford's patient at Moorfields Hospital in the spring of 

 1909 for typical retinitis pigmentosa. He is set. 38 years. From his 

 account, confirmed by personal investigation of his family history and 

 examination of his mother and several siblings by Mr. E. C. Green, of 

 Derby, it may be considered certain that no other cases of bad sight or of 

 degeneracies are known in his generation or the next. He considers 

 his sight to have been failing ten or twelve years, but can give no 

 precise date, and did not himself connect it with the haemorrhages 

 of which he gives a history. When 26, a railway porter, he bled 

 violently from the nose one day from 9 a.m. till noon, and was 

 plugged at St. Bartholomew's Hospital. When 33 (five years ago) was 

 operated at the Great Northern Hospital for " appendicitis/' and says 

 that about two weeks after the operation he vomited a quantity of blood. 

 Again a year ago he was in bed for six weeks, and passed blood both 

 from the bowel and bladder. The history of the epistaxis is clear enough, 

 but his statements as to the internal hemorrhages are, of course, of less 

 value. Has not had typhoid or other infectious illnesses to his know- 

 ledge, and denies venereal disease of any kind, and shows no signs of 

 congenital syphilis. Married ten years; two children, of which IV, 2 

 died at 13 months and would now be 8 ; IV, 2 living, set. 2 r 2 2 - years. 

 Mother (II, 2), set. 60 years, examined by Mr. Green, and found normal ; 

 by first husband (II, 3), who died at 52 from an accident, sixteen concep- 

 tions (III, 1 to 16) , of whom III, 1, get. 40 years, and III, 9 and 10 (the 

 latter the youngest living, eet. 23 years) have been examined by Mr. 

 Green and found normal. Ill, 2, 6 and 11 to 15 miscarriages (seven in 

 all), and III, 16 died of measles at 9 months. IV, 1, 8 children (3 boys, 

 5 girls) of III, 1, set. from 17 to 3 years ; 7 are living, and were examined 

 by Mr. Green and found normal ; the boys are the first, eighth, and fifth ; 

 the latter died of " brain fever " after an accident three years ago ; 

 the girls are Nos. 2, 3, 4, 6, and 7. The other sixteen (IV, 4 and 5) 

 and their parents are scattered, and could not be seen, but all are 

 confidently reported to see well. II, 2 had no issue by her second 

 husband. Her brother (II, 1) married, but had no issue. I, 1 living ; 

 I, 2 dead ; sight good in both. No consanguinity. 



Fig. 39 (p. xcvii), from Mr. Herbert Fisher. The family records have 

 been accurately kept for many generations. The figure shows only 

 the parts of the family tree that bear upon the occurrence of retinitis 

 pigmentosa and deafness. 



V, 5 set. 45 years, well-marked typical retinitis pigmentosa, and is 

 moderately deaf. V, 8 deaf, but good sight ; V, 4 died of phthisis as 

 a young man ; V, 3, 6, 7 and 9 normal. No other cases known of bad 



