164 



there cannot be the least doubt ; and if in one case, why 

 not in all ? It is only fair to assume, that at the time this 

 distinguished and original writer published his magnum opus 

 (1858), the subject of heredity in relation to disease was 

 comparatively little understood, and that the mind of the 

 author had not been especially directed towards its con- 

 sideration. It has long been generally acknowledged that 

 the heredity of cancer is well established, and "that which 

 applies to cancer, in general, self-evidently and as a matter of 

 experience, equally applies to cancer of individual organs." 1 

 Statistics are not very reliable as a rule, but even these prove 

 without a doubt that cancer is hereditary. Thus of 1127 

 cases reported by Paget, Cooke, Sibley, Lebert, Lafond, 

 Hess, Moore, and others, 192, or 17 per cent, were found to 

 have been inherited ; and I have already elsewhere recorded 

 a case in the practice of the late Dr. G. H. Barlow, in which 

 a lady was the fifth victim of cancer of the liver in two 

 generations. 



In such a case as the last, one cannot fail to be struck 

 with the hereditariness of cancer ; but it should never be 

 forgotten that, although diseases and predispositions, being 

 subjected to the influences of other diseases and predis- 

 positions, are not unfrequently reproduced hereditarily in a 

 modified form, yet that the heritable influence always exists 

 in one form or another. Cirrhosis of the liver offers a case 

 in point. What are its causes? (i) Spirit drinking, a 

 predisposition to which is undoubtedly heritable ; and who 

 can say that a predisposition to its effects corporeally is not 

 also transmissible ? (2) Syphilis ; can there be any doubt 

 as to the inheritance of this disease ? (3) Malaria, as we 

 have seen in the consideration of the malarial diathesis, is 

 1 Leichtenstern. 



