238 MARRIAGE AND DISEASE. 



asthma, apoplexy, syncope, dropsy, and various 

 affections of the lungs, all of which depend upon and 

 are secondary to disease of the heart. The great 

 danger in all cases of acute rheumatism, and indeed 

 in sub-acute cases too, is the development of heart 

 disease. This occurs in about 50 per cent, of all 

 cases, and is generally the foundation of a condition 

 which ultimately, directly or indirectly, destroys the 

 life of the individual. 



I may here remark that there is a form of heart 

 disease which " runs in families," and which frequently 

 appears without the person ever having suffered from 

 either acute or sub-acute rheumatic attacks. Nearly 

 all such cases I attribute to the action of the rheu- 

 matic poison upon the heart. If the histories of the 

 families in which this form of heart disease occurs be 

 inquired into, it will be found that rheumatism, in- 

 tractable neuralgia, or other sign of family decay, such 

 as consumption or insanity, is common in the stock. 

 Here is the history of such a family, every member 

 of which was personally known to me : Father has 

 suffered for many years from most intractable 

 neuralgia of the head and neck ; no heart disease. 

 Mother became insane at about sixty years of age, as 

 did her father ; no heart disease. There were five 

 children as follows: I. Son, has grave heart disease; 

 never suffered from rheumatism ; is so eccentric that 

 he cannot earn his living. 2. Daughter, has grave 

 disease of the heart, and never suffered from rheu- 

 matism. 3. Son, has been on the verge of insanity. 



