1 68 



hereditary jaundice observed by Kerkring, many other 

 observers have seen interesting cases of women, afflicted 

 during their pregnancy with icterus, having been delivered 

 of jaundiced children. No less scarce are the cases where 

 all the members of a family have been attacked by jaundice 

 at the same age; and an especially remarkable one is 

 described by Boerhaave. 1 



That there is an especial predisposition on the part of the 

 patient to the hepatic congestion induced partially by 

 dietetic irregularities, peculiar to middle life, cannot be 

 doubted, and if we consider how different individuals are 

 differently affected by free indulgence in innutritious diet and 

 irritative articles of food, whilst at the same time leading a 

 sedentary and inactive life, the reason is not far to seek, for 

 as individuals differ from each other in every respect, 

 physiologically, psychologically, and pathologically, so must 

 each individual differ from every other in his inherited 

 tendencies. How else can we explain the reason why 

 amongst a set of freely-living indolent men one will suffer, 

 in consequence of his mode of life, from hepatic congestion, 

 another from obstruction, another from constipation, another 

 from haemorrhoids, etc., while others remain free from any 

 such disorders ? Apparently the mode of life has much to 

 do with the production of such conditions, but primarily, 

 the inherited predisposition influencing every organ and 

 tissue of different individuals in various ways and degrees, 

 alike in health and disease, constitutes the real reason. 

 Virchow has already demonstrated very considerable in- 

 dividual differences in the conditions of the arterial walls : 

 why then should the occurrence or non-occurrence of the 

 above-mentioned conditions under precisely similar circum- 

 t Steinau. 



