U9 



fact that neither their ancestors or parents, nor the circum- 

 stances of their own lives, have tended to produce or develop 

 such conditions. This is a fact which, though recognised, 

 is far too often lost sight of in diagnosing the actual condition 

 of patients, as the knowledge thus gained of their individ- 

 uality as exemplified by their predispositions, vital energy 

 and endurance, so far as they can be estimated, is of far 

 greater importance than any mere physical diagnosis, how- 

 ever exact, for whilst the latter, as Dr. Milner Fothergill says, 

 may be a mere series of barren facts, the former mode is 

 pregnant with potential hypotheses. Whilst it is obvious 

 that these hereditary predispositions to particular diseases or 

 morbid conditions cannot be quite neutralised or removed 

 by medical art, yet if we also know, and can, by any means, 

 obviate, the immediate agents which are the causes of these 

 diseases, we may often do much towards their ultimate 

 prevention. 1 



Are cardiac or vascular diseases heritable as such? I 

 think I may safely reply in the affirmative : at least there 

 can be no doubt that the organic or textural peculiarities 

 which predispose to them are unquestionably transmitted 

 from parents to their child or children. As I have already 

 said, however, the entire subject is so comparatively new, 

 and this particular question has received so comparatively 

 little detailed attention, that the facts in support of an 

 affirmative reply are not so numerous as they might other- 

 wise have been. There is at least one case recorded by 

 Lancissius, who says that he saw an enlargement of the 

 right heart in a man whose father, grandfather, and great- 

 grandfather were all known to have had the same abnormal 

 structure of this organ. My friend, Dr. Ernest Sansom, 

 1 Dr. G. H. Barlow. 



