less liability to contract it : that peculiar condition of the 

 tissues of the motor apparatus which renders them a fitting 

 nidus for the propagation of the rheumatic poison. He 

 continues, "That some peculiar condition of the motor 

 system is handed down in rheumatism, we know. That 

 this condition declares itself by a special susceptibility of the 

 tissues of the motor apparatus to the action of the rheumatic 

 poison, we also know but more than this we cannot say 

 for in this, as in all other cases of hereditary transmission, 

 we can only indicate, not explain, the fact." Acute rheuma- 

 tism is one of those diseases, an attack of which so affects 

 the tissues of the motor apparatus as to render them 

 peculiarly susceptible to further and more aggravated 

 attacks ; so that, cateris paribus, the more strongly the 

 rheumatic habit is thus developed, the more potent will be 

 the influence of heredity in its transmission. The real 

 nature of the rheumatic poison is still sub judice ; but what- 

 ever revelations science may yet make as to this interesting 

 question, there can be no shadow of doubt that a predis- 

 position to acute rheumatism is recognised by experience ; 

 also that this predisposition is indubitably and strikingly 

 hereditary. 



It may be regarded as an axiom that the more a disease 

 is constitutional, the greater will be the influence of heredity 

 in its transmission ; we can, therefore, easily understand 

 why there should be some doubt as to whether chronic 

 articular rheumatism is hereditary or not, being essentially a 

 local affection. Bearing in mind, however, the fact that the 

 majority of those who suffer from it, have already in earlier 

 life undergone an attack, or attacks of acute rheumatism, 

 and that the former affection is almost exclusively confined 

 to the latter half of life, it certainly seems as if it were a 



