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we are at least assured that it is associated with defective 

 vitality ; that it is markedly hereditary, and that its diathesis 

 involves a special predisposition to the many forms of 

 scrofulous or tuberculous diseases. 



The Rheumatic Diathesis. Two forms of this diathesis 

 have been described viz., the vascular, allied to gout, and 

 the strumous, with external characteristics of scrofula ; thus 

 showing that, whilst individuals are very frequently found 

 who are distinct and typical examples of each form of dia- 

 thesis, in the case of others there will be one diathesis 

 forming, as it were, the basis, and another, or others, super- 

 imposed upon it, as, for instance, the strumous and rachitic 

 often possess gouty characteristics. Dr. Laycock gives the 

 following sketch of the physiognomical peculiarities of those 

 possessing the rheumatic diathesis : " They are usually well- 

 built and well-nourished, and the complexion healthy and 

 florid. In those who have the rheumatic cachexia this is 

 not so, being pallid and dingy, often with patches of pig- 

 ment deposit. In a certain class with tendency to fibroid 

 degeneration there is a yellow bronzing of the face; the 

 teeth are characteristic, being unusually regular, sound, and 

 firm ; the hair is abundant ; the skin less thin and dry than 

 in the scrofulous form." This diathesis is distinctly here- 

 ditary, and tends to run in families. By this is meant not 

 that the disease itself, but only the family tendency to it, is 

 transmitted in a word, a greater or less liability to contract 

 it. Dr. Maclagan says "The difference between a rheu- 

 matic and a non-rheumatic subject is, that the motor appa- 

 ! ratus of the former contains that special ingredient which is 

 \ requisite to the propagation and action of the rheumatic 

 poison, while that of the other does not. Between the 

 fibrous tissues of the two men there is no difference that 



