TUBERCULAR DISEASE. 201 



the laws of health the necessarily fatal type is soon 

 reached, and to this must be attributed the extinction 

 of hundreds of families every year. In some families, 

 even in the highest ranks of society, the susceptibility 

 to the tubercle bacillus becomes so great, that, despite 

 all modern science backed by wealth can do, the 

 children die one after another in infancy, or succumb 

 on the approach of adolescence. In other cases the 

 degeneration from intermarriage or some other cause 

 becomes more or less mixed in character, and while 

 some of the children succumb to tubercular disease 

 in infancy or later in life, idiocy, suicide, epilepsy, 

 insanity, or the true scrofulous cachexia will appear 

 in others. 



This phthisical diathesis might be described as a 

 general degeneration, very closely related to the 

 neurotic, which occurs in families once decidedly 

 above the lower stages of development, but now on 

 the down grade of general decay. Such family decay 

 being the result of the repeated exposure of ancestors 

 to the devitalising attack of the tubercle bacillus, 

 or some other exhausting disease, or to some of the 

 thousand and one evil influences which are constantly 

 at work producing progressive deterioration among all 

 civilised peoples. 



Let us now look at the true scrofulous type, which 

 in many, indeed in most points, is the extreme opposite 

 of that we have just been considering. Here the 

 skin is usually thick and sallow or pale and spongy ; 

 the features are coarse and ill cut; the eyes dull, 



14 



