the subjects of phthisis than males. M. Louis concurs in this idea;* but, until the publication of our Medical Report, already referred to, a sufficient number of cases had never been analyzed to justify any inference whatever upon the subject.† The thousand cases which fell under my own observation, consisted of-males, 582; females, 418; which give the following numbers per cent.

It can, therefore, no longer be doubted, that, at least in and around our metropolis, consumption is more frequently to be seen in males than in females.

Influence of Stature.-There appears to be some relationship between the phthisical diathesis and the growth of the body, the greater number of consumptive persons, especially those of an early age, being tall, many of them, indeed, much exceeding the average height. I cannot give a numerical

*Researches on Phthisis."

†The number of consumptive patients under treatment at the Brompton Hospital, up to the year 1849, was as follows:Males, 2,679; females, 1,679; showing a great excess on the part of the male sex.

statement upon this subject, not having measured a sufficient number of patients to justify it; but I do not entertain the slightest doubt of its truth, and have several times heard it remarked by gentlemen who have been present during the attendance of the out-patients at the Brompton hospital. I have rarely seen decidedly short persons the subjects of phthisis, whilst it is very common to find decidedly tall ones affected by it; and in reference to this, the familiar expression of "outgrowing the strength", so popularly associated with the origin of the disease, is not unworthy of notice, since, like many others of the same class, it contains within it a fundamental truth. We see in the whole theatre of life, that organic beings which arrive the soonest at maturity, are often destined to the shortest career; and both plants and animals springing up prematurely, or excelling others of their race in growth and beauty, seem frequently designed to show us nothing more than the evanescent nature of such qualities, and how often they are only the harbingers of early dissolution.

Influence of Constitution.-The power of resisting disease-so commonly expressed by the terms good or strong, weak or delicate, constitution-is supposed to exercise an important influence upon the developement of phthisis, but such an opinion seems to be more conjectural than founded upon accurate observation. An infirm constitution, whether inherited or acquired, must, of course,

contribute to the liability to disease, but it appears to have no necessary connexion with the generation of consumption. The greater number of phthisical patients who come under my notice, are not, on the first appearance of their malady, what would generally be designated of delicate constitution; many of them indeed are robust, and might be looked upon as more than average specimens of good physical developement.

The "delicate" female is, perhaps, less frequently attacked with phthisis than others of her sex who are, to all appearance, stronger and more healthy; her more usual lot is to be affected with dyspeptic, nervous, anæmic, and, in later life, malignant, diseases. Amongst the male sex, also, the same thing may be remarked; the fragile, timid, and backward youth, having perhaps less often within him the seeds of consumption, than his more active and vigorous associate. Such conclusions, however, must be taken only as general, and are open to many exceptions, consumption sparing neither the young nor old, the delicate nor the robust; but they are suggestive of the following practical lesson,-that, under no circumstances of apparent strength, should the various conditions to health be thought unimportant, nor those conducive to phthisis be disregarded.

Influence of Temperament.-The peculiar connexion of the mental with the physical developement, termed temperament, has been said to have

a material influence in the production of tubercular diseases; but my experience upon this subject, as upon the last, is counter to general opinion. I have hitherto failed to observe amongst consumptive patients an excess of what might be called one particular temperament. The colour of the hair and skin,—the developement of the subcutaneous tissues, the condition of the abdominal organs,— the state of the nervous system,-all of which are looked upon as the indices to temperament, do not appear to me to offer the slightest assistance in the diagnosis of phthisis, nor to bear any necessary relationship to the disease. Consumption does not, as is commonly supposed, show any preference to those whose gentle nature or mental endowments claim a more than usual amount of admiration: it is true that these are too often its victims; but the practical physician finds that the pleasing form and brilliant genius are not oftener its prey than are the unattractive, or the feeble in intellect; and he has to encounter murmuring and discontent, scarcely less frequently than he is called upon to admire cheerfulness and resignation.

Hereditary transmission appears to have a smaller share in producing phthisis than is generally supposed. In the thousand cases already spoken of, three hundred and sixty-seven, or rather more than one-third, were members of consumptive families; whilst, in the remaining six hundred and thirtythree, or in somewhat less than two-thirds, the

disease could not be shown to have proceeded from

hereditary causes.

TABLE VI.

Showing the Influence of Hereditary Predisposition, as exhibited in 1000 Cases of Phthisis.

It is certain, however, that this scarcely shows the full extent of hereditary taint, since it embraces only the preceding generation (statements referring anterior to this being too vague to be depended upon); and it is well known that phthisis, like other diseases so propagated, may remain dormant for one, two, or even more generations, exhibiting itself again at a remote period, when, perhaps, its original existence in a family has been long lost sight of. The table, therefore, must be considered only as an approximation to the truth, or as exhibiting the frequency with which hereditary influence can be demonstrated.

We are justified, however, in deducing from it the following interesting conclusions.-(1.) Males more frequently derive the disease from the father than from the mother; whilst females, on the other