APPLICANTS ABOVE AVERAGE WEIGHT. TABLE III. DIAGRAM ILLUSTRATING THE INFLUENCE OF Overweight AND Family Record COMBINED IN MODIFYING THE PROPORTION OF CONSUMPTIVE DEATHS IN THE TOTAL MORTALITY. APPLICANTS BELOW AVERAGE WEIGHT. TABLE IV. DIAGRAM ILLUSTRATING THE INFLUENCE OF Family Record AND Underweight COMBINED IN MODIFYING THE PROPORTION OF CONSUMPTIVE DEATHS IN THE TOTAL MORTALITY. HEREDITY. "THE FAMILY HISTORY." "There is a destiny made for a man by his ancestors, and no one can elude, were he able to attempt it, the tyranny of his organization.” * Thus has Maudsley put that terrible law of inheritance, proclaimed in scripture and recognized by all men from time. immemorial. The unfavorable influence of inherited taint upon. longevity is recognized and respected by life insurance companies, and their medical examination blanks go into the question in a very searching and direct manner. The following form is usually adopted: IN REPORTING FAMILY HISTORY STATE AS FAR AS YOU KNOW, WHAT IS THE AGE AND PRESENT STATE OF HEALTH OF EACH OF 51. Have you or any of your blood relations ever attempted suicide, or suffered from insanity gout, rheumatism, epilepsy, consumption, cancer, apoplexy, or other hereditary disease? 52. Have any members of your immediate family (wife or children) suffered from consumption? 53. Are you intimately associated with any person having chronic cough? Alternative conditions. Syphilis. Frau Jurke. Alcoholism. It will be seen that inquiry is made concerning the parents, brothers, sisters, grandparents, and collaterals, and that the diseases covered are those in which the hereditary influence is unquestionable. Such are insanity, gout, heart disease, apoplexy (paralysis), epilepsy, rheumatism, hemophilia, cancer, and tuberculosis. Syphilis might be, but usually is not, added to this list. The question is one chiefly affecting hereditary predisposition to disease, and many of the conditions are alternative. Gout need not appear as gout in the second or third generation, but may manifest itself in any of those conditions in which gout is recognized as an etiologic factor. Such, for example, are apoplexy, Bright's disease, diseases of the heart and blood-vessels, or even a chronic eczema. The same statement holds true of nearly all hereditary diseases. Thus, insanity in the ancestors may in descendants appear as epilepsy, alcoholism, hysteria, chorea, or criminal impulse. Syphilis is so wide-spread as to be present in the great mass of humanity in varying degrees of dilution, and one writer has gone so far as to say that the higher our civilization, the more complete is our syphilization. Some striking examples of heredity appear in contemporary literature. Russell, in "A Plea for Posterity," refers to the Jurke family. Frau Jurke was chronic drunkard, who was born in 1740 and died in the year 1800; 709 of her 834 descendants were traced, with the following result: One hundred and six were illegitimate; 142 were beggars; 64 were charges of the State; 181 females were prostitutes; 69 were convicted of crime; and, all told, the descendants of this one dissolute and drunken woman cost the State during a period of seventy-five years a sum estimated at $1,250,000. Le Grain says that of 814 children born of parents who were alcoholics, 322 were degenerates and 174 died young. Of the survivors 17 per cent. were epileptic and 14 per cent. suffered from hysteria. Aside from specific diseases there are two distinct classes of families-the "long lived" and the "short lived." Long-lived Families.-In these there is in the individual a well-marked resistance to all forms of disease. Acute dis ease is well borne, chronic disease is long resisted, and even a physical blemish may leave such a one a better risk than an apparently healthy man of the "short-lived" family. Short-lived Families.-In such families no hereditary disease is necessarily present, yet there is a general tendency to early death of its members. The conditions are exactly opposite to those that prevail in the long-lived families, both acute and chronic diseases being met with feeble resistance and speedily proving fatal. Members of long-lived families are the most profitable risks that any insurance company can assume, whereas the short-lived people are worse subjects for insurance than those whose family is tainted by hereditary disease. An extremely bad family history of tuberculosis might prove an exception to this rule, as in such a case there would be a similar tendency to early death in family members. hazard." Heredity in Apoplexy.-Apoplexy is one of the most An increasing strikingly hereditary of all diseases, and inasmuch as its incidence depends upon degenerative processes in the blood-vessels, it at once becomes evident that with it must be considered such associated or alternative conditions as arteriosclerosis, chronic Bright's disease, particularly interstitial nephritis, aneurysm, and, to a less extent, heart disease. In this form of hereditary disease the tendency is for the family members to die in middle age, consequently, such a risk, if accepted, becomes an increasing hazard, such cases often being profitably insured under short endowments. The following history from the author's casebook may prove interesting in this connection. The patient presented himself in the terminal stage of an interstitial nephritis, of which he has since died: His maternal grandfather died, aged 53, of apoplexy His paternal grandmother His father. 66 66 66 40, One surviving brother reported in cause of impairment not known, no living. 66 45, 46," Bright's disease "fair health" fair health" in 1893, other member of family Remarkable case history. |