236 MARRIAGE AND DISEASE. 



that the rheumatic and neurotic diatheses, which at 

 first sight appear distinct and far removed from each 

 other, are in reality very closely allied that they 

 are, in fact, interchangeable. 



Much further evidence might be advanced in 

 support of this relationship between the rheumatic 

 and neurotic diatheses, but I will only trouble the 

 reader with the following : When rheumatic disease 

 attacks the joints with severity, we call it rheumatic 

 fever or acute rheumatism ; when it attacks the 

 muscles of the back, we call it lumbago ; when it 

 attacks the great nerve of the leg, we call it sciatica ; 

 and when it attacks the other smaller nerves, we call 

 it neuralgia. Now the connection between severe 

 neuralgia and insanity has been pointed out by scores 

 of writers, and neuralgia is looked upon by the whole 

 medical profession as an unmistakable sign of the 

 neurotic temperament, yet it is nothing more nor less 

 than a certain form of rheumatism. Dr. Maudsley 

 comments on the relationship existing between in- 

 sanity, chorea, and neuralgia thus : " Neuralgia in 

 the parent may manifest itself in the offspring in the 

 form of a tendency to insanity, and every experienced 

 physician knows that if he meets in practice with a 

 case of violent neuralgia ... he may predicate the 

 existence of insanity in the family, with almost as 

 great confidence as if the patient were actually insane. 

 How it is we know not, but so it is that a certain 

 form of neuralgia owes its origin mainly to a neurotic 

 inheritance. Chorea, again, which has been described 



