THE

Journal of Health and Disease.

NOVEMBER, 1845.

PHYSIOLOGY IN REGARD TO THE LAWS OF INCREASE, AND THE INFLUENCE OF PARENTS ON OFFSPRING.

CHAPTER II.

SECTION II. Scrofula, its transmission.-Undeniable evidences thereof.-Lugol, Physician of St. Louis.-Characteristics of the scrofulous habit.-Excessive mortality among the scrofulous.-Abortion caused by scrofula.-The absurdity of legislative interference.-Consumption transmissible.-Proofs.-Noble conduct of a celebrated female political writer.

THE concluding part of the preceding section embraced the influence of hereditary transmission in affections of the CHEST, with which the subject of consumption is intimately connected.

This important subject will admit of more correct investigation after the subject of SCROFULA has been considered; it being an ascertained fact that the scrofulous condition of the system is one which renders its possessor peculiarly prone to consumption.

For the most important facts and views contained in this section LUGOL is the authority.*

The hereditary transmission of scrofula is not to be doubted. The evidences of such transmission are, the general occurrence of the disease in the family infected, and the mortality occasioned by it.

* "Researches and Observations on the causes of Scrofulous Diseases. By J. G. Lugol, Physician to the Hospital of St. Louis, &c." The translation of Dr. Ranking has been used. Lugol has had an experience in reference to scrofula surpassing that of any person living, having been twenty years physician to the hospital of St. Louis-an institution, which, besides containing one hundred and fifty beds appropriated to scrofulous patients, has an out-patient department exceedingly extensive. In private practice he is, in reference to this disease, at the head of the profession in France.

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The former kind of evidence is that which has the closest relation to the subject under review, and the latter kind will afford some incidental notices. It may be useful to detail the signs of the scrofulous constitution.

Scrofulous families may be known at once by the general aspect of debility which pervades the children; their state of health is at the best negative, and totally deficient in the attributes of robust and healthy organization.

There is always a greater or less want of harmony in the external configuration of scrofulous children; their trunk and extremities are not proportionably developed; the limbs are either too long or too short, with large joints, and are awkwardly attached to the body. The middle line of the body is frequently not in the centre, the lateral halves of the body appearing unequal, and as it were improperly joined together. This conformation is of the worst augury as regards future disease. In certain scrofulous children, the chest is keel-shaped, the different divisions of the breast-bone being distinctly visible beneath the skin, and tilted forwards. The ribs are, in such cases, variously distorted, and the from front to back diameter of the chest greatly exceeds the lateral. This unnatural condition of the walls of the chest, though sometimes improving between eight and twelve years, is more commonly persistent, and by preventing the due expansion of the lungs, betrays plainly that the taint of scrofula has struck deep root into the system.

The mouth of scrofulous persons is either small and arched, or much too large; the first and second dentition, but especially the latter, is tardy, and the teeth are dark coloured and friable. The spongy portion of the bones is much too abundant, in proportion to the compact tissue and the surrounding soft parts. This condition of the bony system is rendered very evident by the following signs, which may co-exist in various combinations:-The cheek bone is too prominent, and the lower jaw too much developed, giving a peculiarly rickety appearance to the individual; the extremities of the long bones are too large, and the feet and the hands attain in many cases a dispropor

tionate and most ungraceful size; the bones forming the hips are often enlarged to a degree which, in females may be productive of serious inconveniences in after-life, by offering an obstacle to parturition. The body of the long bones is ordinarily of small calibre and slight.

The growth of scrofulous subjects presents in different instances the very opposite extremes; some being at twenty only four feet seven inches, some under four feet, and some six feet four inches. In these tall persons, however, there is no more symmetry or proportion than in those whose growth has been arrested: they have generally a head too small for the trunk; they carry themselves badly, and are utterly without energy.

The digestive organs of scrofulous persons are generally in a state of weakness, in consequence of which the assimilative functions are continually disturbed. Many scrofulous children are never hungry: they do not eat a sixth part of the food which a healthy child of their age would consume.

In other, but less common cases, the appetite is voracious; but the food does not nourish,-in fact, the strength of such individuals is as much deteriorated as it is in those whose appetite is below par. This state of the alimentary canal coincides in general with an habitual pastiness of countenance, at this time often a precursory sign of pulmonary tubercle; the eyes are dull, the breath fetid, and the patient is annoyed with a constant itching at the nose.

The alvine functions are irregular, constipation usually alternating with diarrhoea. The skin and cellular tissue are either extremely attenuated, or in a state of flabby puffy fullness. In many scrofulous persons it is dry and covered with lichen or prurigo, but in others it is occasionally bedewed with partial acid perspirations.

The physiognomy appears to be in advance of the age during the period of infancy alone; for, in after years, the contrary is observed; the limbs resemble those of a younger person, not having either the development or the strength proportionate to the age. A kind of nonchalance or mental apathy is a frequent characteristic of this constitution. We frequently notice child

ren who can be induced to walk only by dragging them along by the hand, so great appears to be the disinclination to move

ment.

Scrofulous children are subject to a spontaneous feeling of lassitude, which is aggravated rather than relieved by repose. Sleep fatigues more than it renovates them, and they wake more tired than they went to bed. The same thing is observed in the greater number of scrofulous diseases, and especially in pulmonary consumption. The tumidity of the upper lip, which is so characteristic of the scrofulous temperament, is more perceptible in the morning than in the remainder of the day.

The scrofulous habit, although it is in general characterized by indolence and apathy, is not altogether incompatible with a certain amount of bodily activity; this very activity, however, instead of tending to the increase of the physical strength and development, as in healthy persons, on the contrary assists in diminishing its powers; we therefore observe, that scrofulous children, in whom this more than usual activity is manifested, are quickly fatigued, and are slow in repairing their exhaustion.

The genital organs of scrofulous subjects are generally more or less retarded in their development, and seldom acquire the vigour which characterizes a healthily constituted individual; young men of eighteen years of age or even older, are often in this respect little more advanced than children of eight or nine years.

Young females are no less backward in their development than the other sex, often presenting no signs of nubility at the age of eighteen years.

It may be stated as a general rule that scrofulous subjects are impatient both of bodily fatigue and mental disturbance. They possess in some cases considerable intelligence, but rarely the powers of application and concentration of ideas; they have no energy, either physical, intellectual, or moral; there is nothing normal in their whole condition; they have neither strength nor powers of endurance: in a word, all the phases of their existence are abortive; they know neither puberty nor manhood; the difficulties which oppose themselves

to their development are endless; they are beings physically and morally incomplete.

Scrofula rarely shows itself in persons of light hair and complexion; more than half are dark, and among the remainder the hair is generally of various shades of auburn. The same may be said of the colour of the eyes.

Another striking feature connected with the scrofulous condition is the outward resemblance of the different members of a scrofulous family.

Even when the family similarity is not at first evident, it becomes so at last. A lady whose constitution appeared excellent, much to her surprise became the mother of scrofulous children. She had two sisters; one who, like herself, gave birth to a scrofulous offspring, the other diminutive and rickety. Between the latter and herself not the slightest resemblance could be traced in early life; but since they have both passed the critical age, their mutual likeness has become most striking. This cannot be looked upon as a purely accidental circumstance; neither can it be attributed to the influence of imitation, for they had lived apart for more than thirty years.

Such being the indications, the evidences of the transmission of this diseased state are to be noticed.

Lugol writes, "If there be one fact more impossible than another, it is that one child should be scrofulous, and his brothers and sisters perfectly free from the taint." He adds further, "We can safely aver, that we have never seen a scrofulous infant whose brothers and sisters were not also scrofulous; and it would indeed be contrary to nature that the same parents should generate offspring with constitutions so widely different as are those of the healthy and the scrofulous child." And this celebrated writer adds further, "We make this assertion WITHOUT ANY QUALIFICATION."

The points of view under which the facts, demonstrating the transmission of scrofula present an irresistible character, may be best seen if exhibited in the following order :

The first class of cases, proving the transmission of scrofula,