CONSUMPTION OF THE LUNGS. 219 



The tendency to consumption is, in many cases, congenital. When 

 the congenital tendency is due to the fact that the parents were con- 

 sumptive at the time of begetting the offspring, it may properly be 

 spoken of as inherited. But it is not (as is often asserted) the malady 

 which causes the inheritance, but the weakness and vulnerability of 

 constitution which had already laid the foundation of the consumption 

 in the parents, or which had arisen in them in consequence of that 

 disease. The hereditary constitutional feebleness of the offspring may 

 proceed from other disease of the parent instead of consumption 

 Parents afflicted by other exhausting maladies, or who are ruined by 

 debauchery, or who are far advanced in years, are quite as liable as 

 consumptive parents to beget children who come into the world with 

 a predisposition to consumption. 



Among the influences by which a liability to consumption is ac- 

 quired, or by which a congenital predisposition to it is aggravated, 

 that of an insufficient or improper diet stands first. Feeding a suck- 

 ling-babe with bread, pap, etc., instead of the mother's milk, may sow 

 the seeds of the malady. An erroneous regimen is often kept up 

 throughout the entire period of childhood. The child is ill-fed (" ver- 

 futtert ") as the laity say, and consequently acquires a feebleness and 

 susceptibility to disease identical with a scrofulous predisposition. 

 The comparatively greater prevalence of consumption among the poor 

 than among the more well-to-do classes is in great measure dependent 

 upon the wretched diet of the former, which consists chiefly of vege- 

 tables. [Germany.] This also accounts for the increased frequence 

 of consumption, according to the size of towns, or, what amounts to 

 the same thing, the number of its pauper population. Hunger and 

 want, as is well known, are less common in the country than in great 

 cities. The influence of a want of fresh air is quite as baneful as is 

 that of an insufficient or improper supply of nourishment. We have 

 no satisfactory explanation of the mode in which continuous sedentary 

 life, and especially an abode in a close atmosphere charged with effluvia, 

 produces its pernicious effect upon the organism ; but the fact has long 

 been established that both scrofula and consumption are far more com- 

 mon in asylums for foundlings and for orphans, in houses of correction, 

 prisons, and among factory operatives who spend the entire day at 

 work in a close room, than among persons who take much exercise in 

 the open air. The objection, that the prevalence of scrofula and con- 

 sumption in such institutions proceeds from other causes than lack of 

 fresh air, is untenable. The average diet of the populations of many 

 poor villages is much worse, and the number of prejudicial influences 

 far greater, than is the case among the occupants of prisons and houses 

 of correction, and yet they are not equally subject to these diseases. 



