JULY 28, I&92J 



NATURE 



303 



he word, it is not precisely what was acquired that is trans- 

 mitted, but something broader and more general. 



(3) The cases which are really in point : morbid characters 

 which were really acquired by the somatic tissues alone. We 

 shall see, later, whether or no these are transmitted. 



(i) This group embraces all those cases in which a morbid 

 character is acquired by the entire organism, somatic and repro- 

 ductive cells alike. Behind the distinction between somatic and 

 reproductive cells lies the fact of a common relation to the cir- 

 culatory and nervous systems. Any change, therefore, in the 

 circulation for example, will affect both. A pregnant woman 

 takes a fever, and transmits it there and then to her offspring. 

 There is no more mystery in this than in the fact that certain 

 poisons produce abortion — indeed, the materies morbi is a poison 

 in either case. But this explanation has, in all probability, a 

 much wider range than the zymotic diseases. Consider, for 

 example, gout. In a sense it is no doubt true to say that gout 

 was an acquired disease. We can point to periods in the world's 

 history in which gout was conspicuous by its absence. We can 

 trace with some degree of accuracy its rise and progress at dif- 

 ferent epochs, and point to the conditions under which it rose, 

 as, for example, in the early days of the Roman Empire.^ 



But even if we allow that gout was, in a general sense, an 

 acquisition of civilized society, we have only to reflect on its 

 pathology to see that it could never have been acquired in Weis- 

 mann's sense. For what is gout ? People usually think of gout 

 by one of its manifestations — inflammation. This, however, is 

 in reality no more than a symptom— perhaps than an incident — of 

 a condition. The gouty attack is due to the existence of certain 

 sites in the system conveniently cool and dry for the deposition 

 of what are popularly known as chalk stones, if, indeed, it be 

 correct to think of the morbid process as a deposition. The 

 general morbid condition lies deeper, and still eludes us. But 

 if we are in the dark as to the precise nature of the pathology 

 of gout, it would be affectation to say that we are unable to 

 prescribe its general outlines. Is it a degeneration, in which 

 the entire organism shares ? Then it will be a morbid acquisi- 

 tion of both somatic and reproductive cells alike. Or is it a 

 failure in metabolism generally ? The same will be the case. 

 Or is it due to a failure in some particular gland to elaborate the 

 materials brought to it, or to do its share of excretion ? If so, 

 the mischief will immediately make itself felt in the circulation, 

 and the conditions of the sufferer will become practically those 

 of slow self-poisoning. So that on no hypothesis can we re- 

 present gout as an acquisition of the somatic cells exclusively. 



It is I he element of progressive heredity which makes the 

 hypothesis of transmission of acquired characters an attractive 

 one in a disease like gout. This element is, in the case of 

 ■certain families, strongly marked. We even see children suffer- 

 ing from the disease. And bearing in mind what we know of its 

 etiology, we naturally say to ourselves, " It was not this child's 

 fault that he was born gouty. ' The fathers must have eaten 

 the sour grapes,' or in this case, perhaps, have drunk the sweet 

 ones." Hut it needs but a moment's reflection to convince us 

 that the element of progressive heredity, so far from being an 

 anomaly, is deducible from the facts of the case. It is true that 

 here we cannot directly apply the theory of natural selection. 

 We are not now concerned with conditions of progress, but 

 with those of regress. Nature selects the fittest. There is no 

 reason why she should select the goutiest. The question we 

 have to ask in disease is not whether Nature selects, but whether 

 she summarily rejects. If she stepped in and exterminated the 

 gouty, she would stop gout altogether, and with it the feature of 

 progressive heredity. But there is no reason to suppose that, 

 as a fact, she does anything of the kind. In the first place, 

 gout is not a disease which seriously shortens life ; in an ad- 

 vanced stage of civilization its existence is quite consistent, not 

 merely with life, but with the active discharge of elaborate 

 duties. 



But there is another more important consideration. Strange 

 as it may sound, there may be good reasons for supposing that 

 Nature, so far from rejecting, might even select, the goutiest. 

 For gout, like other diseases, is only one corner of a much 

 wider question. Diseases have coincidents and relations 

 which stretch beyond the bounds of pathology, and trespass 

 upon biology. This, indeed, is a side of clinical study which 

 has only comparatively recently received its proper recognition. 



' Pliny, " Hist. Nat.," lib. xxvi. cap. Ixiv., ed. Fran/ius. Senecae Opera, 

 F. Haase (Lips., 1886), Epistul. Mor., lib. xv.. Ep. 3(95). Galen, "Com- 

 ment, in Hipp. Aphorism," cap. xxviii.,ed. Kiihn, xviii. A. 42. 



NO, II 87, VOL. 46] 



In former days men contented themselves with observing the 

 morbid symptoms of a gouty patient ; they paid no regard to 

 his other " points"— his nails, his teeth, his intellectual endow- 

 ments. But it may often happen that morbid characters have 

 their good affinities. This is probably the case in gout. We 

 have heard it said, for example, by one of wide experience in 

 this disease, " No gouty person is a fool " — a statement which de- 

 rives some support from the number of eminent men who have 

 been the subjects of this disease. It is often implied that in what 

 is termed an "artificial" civilization natural selection ceases. 

 Might we not, perhaps, say that it still proceeds, only upon a 

 modified plan. The conditions of the competition for existence 

 have altered. The fittest in one generation need not be the 

 fittest of another. Thus, in a rude state of society, in which 

 sustained physical strength is the one thing needful, the gouty 

 man would have no chance. His enemies, however inferior they 

 might be, would have nothing to do but to lay by for the next 

 attack of gout, when they would easily kill him. In a more 

 advanced state of society all this is changed. If the gouty man 

 has talents, he probably has friends and money. There is no 

 demand for sustained physical strength. If he has the gout he 

 can be nursed. His gout may be even of advantage to him — 

 he gets into the papers. So that, paradoxical as it may seem. 

 Nature may even select the gouty, not for their gout, but for 

 their biological equivalents. 



We have shown then that Nature, so far from interfering to 



exterminate the gouty, might even select them. But a more 



plain and obvious reason exists for the progressiveness which we 



sometimes observe in gout. If gout be a modification of the 



system generally, if its progressive increase in the tissues of a 



gouty patient with increasing years is in some cases a matter of 



observation, it would only be reasonable to infer that the same 



is true of the reproductive cells. For, if they share in the de- 



. generacy, why should they not share in the progressive tendency ? 



I In the light of this consideration we can explain a fact widely 



I received among medical men — that the incidence of a gouty 



inheritance falls mainly upon the younger children. Since the 



I reproductive cells as well as the somatic grow goutier and 



I goutier as age advances, the later their separation occurs the 



more likely will they be to manifest gout. 



(2) The second group includes cases in which there is an un- 

 doubted transmission of morbid characters, but where it is by 

 no means certain that they were "acquired" in the sense under 

 discussion. But even if they were, it dies not seem that what 

 was acquired is transmitted, but something broader, and more 

 general. We shall take as examples two important diseases — 

 phthisis and "new growths" — alluding briefly to the pheno- 

 mena of " short sight." 



Phthisis may be said to be in one sense, like gout, a disease 

 acquired by civilized humanity. " Tlie naked savage," writes 

 Dr. Andrew in 1884,- " whatever ills he may have to bear, rarely 

 reckons phthisis among them ; with every addition to his clothing 

 and the comfort of his tree or cave, proclivity to it increases," — 

 a statement which is fully borne out by what we know of the 

 spread of phthisis in the Rocky Mountains and the islands of 

 the Pacific. If we know less of the history of the rise and 

 spread of phthisis than we do of gout, we have more definite 

 conceptions regarding its pathology. At the present day that 

 pathology may be said to have two sides. There is the side 

 originated and elaborated by Koch— the demonstration of the 

 constant presence of a vegetable parasite in the tissues in this 

 disease. There is the chemico-physiological side. Before 

 Pasteur's time, such terms as "medium," "soil," as applied to 

 the human organism, were little more than inetaphors, while 

 such words as "constitution," "predisposition," had little 

 more than a metaphysical value. At present, scores of workers 

 are busily engaged in translating these terms from the language 

 of metaphysics into their chemical and biological equivalents. 



If, then, phthisis was originally acquired, what was it that was 

 acquired ? It would seem that we can take our choice between 

 saying that the microbe was acquired, or a habit of body favour- 

 ing its growth. Supposing, then, the acquisition to have been 

 no more than the lodgment of a parasite in the tissues, can we 

 suppose that it is the parasite which is transmitted? Our facts 

 will hardly warrant such an assumption. How, for example, 

 could we interpret such familiar incidents as the following? A 

 mother, after giving birth to several children, who successively 

 fall victims to phthisis in young adult life, is ultimately attacked 

 herself by the same disease, at a date removed by an interval of 



' lirit. Med. Jonrn., 1884, 707 



