Excerpt from The Medical and Surgical Reporter, Vol. 43: A Weekly Journal, Established in 1855, by S. W. Butler, M. D.; July December, 1880
Now, do such facts show any inherited disease? I think not. Unless we can find that either of the parents, previous to the conception or birth of that child, had exhibited distinct evidences of constitutional weakness, or a tendency to lung trouble, I do not think that we should say that the child bad inherited its tendency from the parents. Again, every one of us is liable to become the subject of some acute attack which may pass into phthisis; so that if, after the child is born, one of the parents gets a chronic pneumonia, which passes into phthisis, that is no proof that the child will have phthisis; but if the parent, before the birth of the child, had exhibited signs of phthisis, it is probable that the child will have a similar tendency; or, if the parents are fairly well, but several of the children show marked constitutional weakness, and a tendency to lung trouble, we must say, although we cannot exactly see how it is, that they have begotten children of a weak constitution, with a tendency to pulmonary phthisis.
I want to rid you of the idea that pulmonary phthisis occurs principally in those who may be said to have an inherited tendency to it. In deed, I do not think that you will be able to demonstrate such a tendency in more than one-half or one-third of your cases. If such a fallacy is allowed to exist, and a person feels that because there is no phthisis in his family he can expose himself to cold, damp, and other depressing causes without risk, there is the greatest possible danger that he will contract phthisis, for we know that at least in one half or two thirds of all cases of phthisis it is an acquired disease in those that have had no inherited predisposition to it. Everybody is liable to phthisis; some more so than others. Unquestionably, those are more liable to it who are born of parents of a weak constitution, especially if this has shown itself before the birth of the child, by a tendency to lung trouble, or if they have begotten other children with a tendency to phthisis. But it is not only an inherited predisposition that makes one more liable to phthisis than another. Any inherited delicacy of constitution, anything that makes the person more liable to be affected by depressing causes, anything, in short, that diminishes the vitality of the individual or his hold upon life, and tends to keep up an unhealthy type of physical action, all these are predisposing causes of phthisis. It is thus that such causes as starvation, bad food, bad hygienic surroundings, long nursing or improper food, impairing the primary assimilation during the period of development, act in a most powerful way in developing a weakness of constitution which may show itself later in a tendency to phthisis; so that a child may come into the world with this taint, or it may be developed during childhood by the causes I have mentioned; and, gentlemen, there is no time in the whole period of life when the causes that operate upon us to determine our future for good or for ill act so powerfully as during this period of childhood. A neglected catarrh, an untreated diarrh?a, may so act upon the system as to bring about this weakness of constitution. If we grasp this idea, it will lead us to infinitely greater carefulness in the hygiene and treatment of young children. The prophylaxis of phthisis you will find begins at birth, and the most important time for prophylactic treatment is during infancy.
But it is not only those who get the tendency by birth, or soon after birth, who are subject to phthisis. Many other causes tend to develop this susceptibility. Among these are various unhealthy occupations. Those that are sedentary, and keep the person in heated rooms, without proper ventilation, particularly if associated with the inhalation of irritating particles; occupations t. Это и многое другое вы найдете в книге The Medical and Surgical Reporter, Vol. 43 (D. G. Brinton)