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can be detected either by the anatomist or the chemist ; 

 but in the one these tissues afford a nidus for the propaga- 

 tion of the rheumatic poison, in the other they do not. In 

 the one the tissues of the motor apparatus contain some- 

 thing which is wanting in those of the other. It is the 

 presence of this something which constitutes the peculiarity 

 of the rheumatic constitution. It is the tendency to the 

 development of this peculiarity which is transmitted from 

 father to son, and makes each generation susceptible to the 

 rheumatic poison." 



Although rheumatism when it occurs in the young is 

 usually transitory, yet the individual who has once suffered 

 from an attack will be ever afterwards liable to another, and, 

 as age creeps on, there is great danger that it may become 

 chronic, or even permanent. The rheumatic diathesis is 

 not only found associated with the catarrhal, the scrofulous, 

 and the gouty, but may be modified by any other condition 

 or influence which deleteriously affects the general powers 

 of the system. The rheumatic diathesis becomes so inti- 

 mately united with the gouty in hereditary transmission that 

 it is frequently impossible to distinguish between them. 

 Although no age is exempt from the development of rheu- 

 matism, attacks are most frequent between the ages of 

 sixteen and twenty, and the whole cycle of its operation 

 may be included between the fifteenth and fortieth years. 

 As already stated, previous attacks decidedly increase the 

 predisposition to the disease, and although ill-health, how- 

 ever induced, may predispose to a rheumatic attack, also 

 mental worry or depression, many individuals are attacked 

 when in, apparently, robust health. 



The Catarrhal Diathesis. There is an innate proclivity 

 of tissue, which is hereditary, predisposing to catarrhal 



