ARE ACQUIRED DISEASES TRANSMISSIBLE? 261 



be, which cause the disease, or that they caught the contagion, if 

 the disease is contagious, as many believe. " It is quite certain," 

 Mr. Jonathan Hutchinson says, " that the children of lepers, 

 born out of leper districts — in England or the United States, 

 for example — never inherit it." 



Gout. — Because gout sometimes sets in after a particular 

 course of diet, some have attempted to regard it as an acquired 

 character, just as Herbert Spencer regarded short-sightedness 

 and a liability to consumption as acquired characters. But 

 there is no warrant for such interpretations. In all three cases 

 we have to do with innate germinal qualities which find various 

 degrees of expression according to the conditions of nurture. 

 There is no reason to believe that the expressions of goutiness in 

 a father can specifically affect the germ-cells in such a fashion 

 that the son thereby becomes gouty. Moreover, in many cases the 

 son who becomes gouty was born before his father became gouty. 

 What, then, is meant by the " heritability of gout" ? The cases 

 of gout " running in a family " are too numerous to allow us 

 to take refuge in the suggestion that a germinal variation which 

 was expressed as goutiness in the father occurs de novo in the 

 offspring. All that can be said at present is that the predis- 

 position to gout is an inborn character, which, like any other, 

 may be transmitted. Even if gout turns out to be definitely 

 microbic, the general argument will not be seriously affected. 



Albuminuria. — There seems to be such a thing as constitutional 

 albuminuria, and a predisposition to it seems to be heritable. This 

 means that a defect or peculiarity in the filtering apparatus of the 

 kidney arises as a germinal variation, and is handed on from genera- 

 tion to generation. Under conditions which may mean nothing 

 to normal subjects, the inborn peculiarity may find expression in 

 the active disease of albuminuria. As in the case of gout, a con- 

 stitutional tendency to albuminuria is very transmissible, but the 

 disease must not be called " acquired " simply because particular 

 external conditions of life seem to supply the liberating stimuli 

 which lead to its expression. Where the albuminuria is transitory 



