i 7 6 



sequela of acute rheumatism (which generally attacks pre- 

 disposed persons), and if, as is admitted, this predisposition 

 is transmissible, there seems no reason to doubt that to 

 some extent, at least, a predisposition to this sequela may 

 also be inherited. All constitutional affections, unless 

 neutralised by circumstances, as marriage into a new stock, 

 must be inherited in some form or degree ; but it is not 

 necessary that the inheritance transmitted to the child 

 should be exactly alike, or assume the identical form 

 characteristic of his parent. I have already referred to 

 metamorphoses in transmission, which account for such 

 facts as the scrofula of one generation becoming tubercle in 

 a subsequent one, or cancer alternating with tubercle or 

 scrofula : we must not on this account deny the potency 

 and efficacy of heredity, which is the rule, however individual 

 peculiarities may differ, but rather believe that, despite such 

 metamorphoses and dilutions which we may not be able to 

 understand or appreciate, the law of heredity is inexorable, 

 and like all other natural laws its potency can never be lost. 

 In this way we may account for the fact of a constitutional 

 affection like acute rheumatism or rather a predisposition 

 to it being inherited, whilst the effects of heredity are less 

 potent as regards one of its local sequela^ chronic articular 

 rheumatism. That any one, however, who has inherited a 

 predisposition to acute rheumatism, subsequently surfers 

 from it, and later on in life develops chronic articular 

 rheumatism, can in turn transmit a predisposition to the 

 one, without, at the same time, transmitting some suscepti- 

 bility to the other however diluted or whatever form it may 

 assume, I, for one, cannot admit. The one thing we have 

 to remember is that heredity is the rule ; that, however, it 

 may be altered by circumstances in form or degree, its 



