THE CAUSATION OF DISEASE. 26 J 



are rarely destroyed by disease. I have no hesitation in saying 

 that, practically, all cases of bronchitis, "consumption of the 

 bowels," and so-called "struma" (all of which cause an enor- 

 mous number of deaths) are due to neglect — neglect as to 

 feeding, ventilation, the simplest common-sense precautions. 

 I say this deliberately. Can any one point to a single case of 

 "struma" — say, hip-joint disease — in which the motions have 

 not been for a long time unhealthy, in which that vast mucous 

 tract whose business it is to convert the crude food-stuffs into 

 suitable, soluble nutriment for the whole body, is not diseased? 

 And what is the cause of this unhealthy state of the ali- 

 mentary mucous tract, which of necessity leads to miserable 

 and puny growth ? It is due to errors in diet alone, or to 

 this in conjunction with other forms of mal-E. In such a case 

 the mother will probably tell us that the child has always been 

 delicate, that for a long time, perhaps from earliest infancy, 

 the motions have been unhealthy, and she will attribute all the 

 trouble to an inborn weakness in the child; but on close inquiry 

 we shall find in the majority of such cases that the initial fault 

 is with the feeding, or other external conditions, and not with 

 the child, or, even if with the child, that it was a mere tempo- 

 rary fault, one which, with judicious management, might have 

 been easily overcome. And day by day the disease becomes 

 more fixed, more difficult of cure ; day by day the child grows 

 more delicate, and the parents are more and more convinced 

 that all the evil is due to an inborn weakness. When we re- 

 member that a mal-E acts perniciously in proportion as it acts 

 early in life, we shall have no difficulty in seeing how a child's 

 whole constitution may be modified for ill by a small initial 

 neglect — that a long train of troubles may result from a simple 

 malady which might very easily have been nipped in the bud. 

 It has been to me, for several years, a very interesting task 

 to compare the health of brothers and sisters, and I have come 

 to the conclusion that when one or two of a family are delicate 

 while the others are healthy _, the delicacy has always had such 

 an accidental beginning, as we may call it ; and, further, that 

 in most cases where the majority, or all, the children are sickly, 

 the cause is not an inherited weakness, but the faulty system 

 of bringing-up to which all the children have been subjected. 



