Excerpt from The New York Medical Journal, 1877, Vol. 26

A six years' service as interne in a hospital unsurpassed in opportunity for clinical observation, enables me to invite discussion at least, not on theories - for I have no special the ory to establish - but on some points elicited by a careful analy sis of a large number of cases, the records of which are taken from the Hospital for the Ruptured and Crippled. During my long sojourn among the truly af¿icted I have had frequent occasion to question and to gravely doubt many a fine-spun theory advanced in current literature. Without any sense of egotism, I take occasion, in this connection, to refer to im pressions made on the mind of James Henry Bennett, found in his monograph on Pulmonary Consumption. He reverts to two years of his early life spent in charge of a scrofulous ward of the Hospital of St. Louis, in Paris, where were eighty young females, from fifteen to twenty years of age, nearly all of whom had glandular swellings, with or without scrofulous disease of the bones, ankles, knees, or elbows. He pathetically closes the paragraph with, a sad assemblage these poor girls were. It is impossible for a physician to be long connected with a dispensary or hospital in a large city without coming to the conclusion that some vice, either hereditary or acquired, must underlie the constitutions of the vast majority of the poor who seek medical assistance. In one instance, the shape and configuration of the head attract your attention, in another, the peculiar expression of the eye, the hue of the face, the irregularity of the teeth, in another instance, the contour of the chest, the general carriage, etc., etc. It is difficult, in fact, to predicate strumous of one particular type of expression. Some children who are undoubted subjects of this diathesis have light hair, and some have dark hair, the skin in some is almost transparently light, in others it is very dark.

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