702 REPORT—1904. 
3. A Comparison of the Physical Characters of Hospital Patients with those 
of Healthy Individuals from the same Areas, with Suggestions as to the 
Influence of Selection by Disease on the Constitution of City Popula- 
tions. By F. C. Surupsaun, M.D. 
I. Distribution of Physical Characters among Hospital Patients. 
Certain physical features are found in greater frequency among hospital patients 
suffering from specified diseases than among the general populace of the areas from 
which the patients are drawn. 
Stature.—Adult sufferers from tonsillitis, acute rheumatism and its sequele, 
such as heart disease, present a higher average stature, while sufferers from tuber- 
culosis, nervous and malignant diseases, present a lower average stature than the 
healthy individuals also observed. 
Cephalie Index.—No appreciable difference in London between hospital patients 
and the general population; but in Switzerland and South Germany the proportion 
of broad-headed individuals appeared to be rather greater among the inmates of the 
Volks-sanatoria for tuberculosis than among the healthy population. 
Pigmentation.—Blond traits appear with greater frequency among sufferers from 
disorders of a ‘rheumatic’ nature, such as tonsillitis, acute rheumatism, and heart 
disease, than among the general populace. Brunet traits predominate among 
patients with pulmonary tuberculosis, nervous disorders, particularly epilepsy, and 
cancer. The remaining disorders showed no very special selection. 
These results have been found to hold, not only in London, but also in Inver- 
ness, York, Shrewsbury, Newbury, Southampton, Dorchester, Chard, Paignton, and 
Wadebridge; and though the numbers investigated in these latter places were very 
small, the results all pointed in the same direction. Full details will be found in 
the ‘St. Bartholomew’s Hospital Reports,’ vol. xxxix. Further confirmatory 
evidence as regards tuberculosis has been obtained from the public and private 
sanatoria at Davos and in the Black Forest. 
A study of the distribution of mortality in different countries shows in broad 
lines some correspondence between the prevalence of fatal cases of disease and the 
physical type of the populations. 
A study of the results of treatment of patients during the last two years at the 
Brompton Hospital shows that, as regards pulmonary tuberculosis, patients of the 
blond type respond slightly better than brunets, while for heart diseases the posi- 
tions are reversed. The numbers available, some 1,500 in all, are, however, so far, 
too small to enable any very decided opinion to be formed. 
IL. Distribution of Physical Characters according to Length of Residence in 
London. 
The classification adopted is that introduced by Ammon :— 
Urban.—When two more generations have resided in London. 
Semi-urban.— When the parents were immigrants from the country, but the 
individual observed was born in London. 
Semi-rural.—When the individual was born in the country but lived most 
of his life in London. 
Rural.—When the individual was born and always lived in the country. 
Observations have been taken in hospital patients and controlled for the same 
class by observation made on their friends on visiting days. 
It was found that stature shows a progressive diminution in successive genera- 
tions of city life, both among patients and visitors. Similarly in pigmentation 
brunet traits showed (a) among the visitors a steady increase with each successive 
generation, passing from rural to urban, while (4) the distribution among the 
patients was irregular, the greatest proportion of blond traits occurring among the 
semi-rural class. This suggests that the blond elements feel more acutely the 
change in their environment, and that those born in the country are relatively less 
