RHEUMATISM. 235 



is a neuropathic state which antedates and pre- 

 disposes to chorea. This state is often manifested 

 in the family history by proneness to affections of 

 the nervous system, and in the individual by a 

 highly excitable state of the emotions, so that he 

 evinces joy, grief, or anger from slight causes. All 

 writers admit that there is often an inherited pre- 

 disposition to chorea." * In fact, chorea may be said 

 to stand midway between the rheumatic and the 

 neurotic diatheses. We have seen how closely related 

 it is with the former, and if we inquire, we shall 

 discover that it is equally nearly allied on the other 

 side with the later. 



Dr. Radcliffe made careful inquiry into the re- 

 lationship existing between chorea and nervous dis- 

 ease generally, and found that in 56.2 per cent, of 

 all his cases of chorea, " the father, mother, brother, 

 or sister had been, or was the subject of one or other 

 of the following disorders : paralysis, epilepsy, apo- 

 plexy, hysteria, or insanity." This is how the case 

 stands, then : We first discover that in about 60 per 

 cent, of all cases of chorea, the patients themselves, 

 or their parents, are rheumatic. Next we discover 

 that about the same percentage of all patients 

 suffering from chorea have had a father, mother, 

 brother or sister who has shown unmistakable signs 

 of the neurotic diathesis in other words, has actually 

 suffered from paralysis, epilepsy, apoplexy, hysteria, 

 or insanity. And what does all this prove ? Simply 

 * J. Lewis Smith's " Diseases of Infancy and Childhood." 



