Volume 2

Treasury of human inheritance / edited by Karl Pearson, R.A. Fisher, L.S. Penrose.

Date:
1909-
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Treasury of human inheritance / edited by Karl Pearson, R.A. Fisher, L.S. Penrose. Source: Wellcome Collection.

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    of the procedure described. (2) Eve and Bidwell’s Cases. We consider that neither bruising nor post partum haemorrhage, in the absence of other details, is sufficient to establish the diagnosis of haemophilia. (3) Burger s Case, III. 3. The great frequence of gastric ulcer in the female suggests a more likely diagnosis than the rare disease under consideration. (4) Wachsmuth’s Cases. Severe and fatal haemorrhage from laceration during the first coitus is a well recognised accident, apart from any abnormal tendency to bleed. Beyond this the evidence rests on the general state ment as to the occurrence of suggillations and dangerous bleedings after injuries. While we confess that such a condition must be considered abnormal, we submit that such vague evidence in a monograph otherwise replete with so many minute details is not to be relied on. It is not even stated which of the two girls was the one which died of rupture of the hymen. Wachsmuth was unable to give any data regarding the menstrual peculiarities of either. (5) H. Fischers Case. Bleeding from the nose is a very common condition, and bleeding from the gums might be due to many causes not differentiated in Fischer’s paper. (6) Max Fischer’s Cases. The preceding remarks apply to much of the evidence of haemophilia in these cases. The occurrence of haemorrhage after tooth extraction (IV. 50) is not of itself evidence of haemophilia even when associated with menstrual disorders. (7) Wright’s Cases. The first alleged female bleeder died of haemorrhage from a site not stated. This was probably from the uterus, and in the absence of details may have been due, at the age stated, to a carcinoma of that organ. Thus in none of the families of bleeders which have been comparatively well described and recorded in some detail do we find any unequivocal evidence of abnormality in the women, that is to say, any abnormality beyond what might be expected in any collection of females taken at random. That the females in bleeder families are abnormal in some unknown particular must readily be admitted. They are the active propagators of the disease. But if their abnormality is so slight as to escape notice, or entirely latent, as suggested by Immermann, further discussion of the question will be without profit until some method of diagnosis has been devised which does not depend on outward symptoms. Inheritance. It has always been considered one of the most remarkable features of haemophilia that it runs in families, and the earliest writers on the disease were so definite on this point that, even in 1820, Nasse had sufficient material at his command to assert that haemophilia is propagated entirely by the unaffected females to their sons. Subsequent experience led Grandidier to state that it was the most heritable of all heritable diseases, a view upon which there has been general con currence. We are, however, unacquainted with any work in which the data concerning the manner of transmission have been dealt with systematically. This we attempted to do, and on examining the material which has been published it became manifest, at an early stage, that in order to arrive at trustworthy results it was necessary to free a relatively small residuum from the great mass of inadequately reported cases, many of which did not bear the stamp of haemophilia at all. Any selection may appear to the reader to raise the question of bias, but in defence of our position it is