RHEUMATISM. 229 



of the disease, but beyond the supposition we can 

 hardly at present go. Why a chill, which to one 

 person is harmless, should in another be followed by 

 high fever, swelling of the joints, excruciating pain, 

 and later by disease of the heart, we cannot explain. 

 All we can say is, that a special temperament pre- 

 disposes the one to this suffering and sickness, and 

 the other escapes because he is not possessed of that 

 peculiar temperament. 



The peculiar temperament here referred to is 

 called the rheumatic diathesis, and it is hereditary. 

 Authorities agree that in about a third (30 per cent.) 

 of all cases of rheumatism, hereditary predisposition 

 can be traced, but that these figures represent any- 

 thing like the real amount of hereditary taint existing 

 among such cases, I do not for a moment believe. 

 Of course the rheumatic diathesis, like every other 

 pathological character, has been and is being acquired 

 by certain individuals, and some of the cases of rheuma- 

 tism which turn up to-day may be of those in which 

 the necessary abnormal temperament has been acquired 

 within the lifetime of the individual. Still I cannot 

 believe that the acquisition of so grave and far-reaching 

 a diathesis as the rheumatic within one lifetime is 

 common, and that it occurs in anything like 70 per 

 cent, of all the cases of rheumatism at present met 

 with, I deny, and shall prove to be untrue. 



When observers tell us they can trace heredity in 

 30 per cent, of all the cases of rheumatism they meet 

 with, what do they mean ? Simply this, that in that 



