head and caudal extremity. They are seen in the urine after sexual intercourse, seminal emissions, etc., and have a trivial clinical import in most cases. FUNGI. The vegetable organisms most often observed in the urine are torula cervisiæ found in diabetes; penicilium glaucum, found in acid albuminous urine; and sarcina, whose origin is obscure. EXTRANEOUS MATTERS most common are fibres of cotton, wool or linen and the dust of sweepings. Soluble. Precipitates when cool. Soluble. Soluble. Nitrate of ammonia.. White or Phosphates pink. White. Gelatinous precipitate when ammonia is added. Granular precipitate when ammonia is added. Deposit on a watch glass, add two drops of nitric acid, evaporate, and when cool add ammonia; it turns to a rich purple color; called the murexide test. Shake, and deposit will mix. Cloudy. Insoluble. Insoluble. Insoluble. Deposit will not mix by shaking. Red. Insoluble. Insoluble. Insoluble. Discs under microscope. Yellow. Insoluble. Insoluble. Insoluble. Microscopic appearances. White. Insoluble. Insoluble. Insoluble. Deposits hexagonal plates Red. Insoluble. Insoluble. Soluble. when cool. PART III. DISEASES RELATING TO LIFE INSURANCE. A HEREDITARY INFLUENCES. TRANSMISSION OF DISEASE. TENDENCY to certain diseases may be transmitted from generation to generation, which the Examiner must be able to detect by making comparisons between the family record, previous history and present physical condition of the applicant. COLLATERAL PHYSIOLOGICAL CONDITIONS. 1. The relative ages of parents at the time of the applicant's birth should be considered a factor in the estimation of his future expectation of life. Great disparity of age militates against the offspring, even though other considerations are favorable. In order to beget vigorous children, the sexes ought to be of about the same age and in the prime of life. In case of marked disparity of age, the progeny is apt to inherit general debility or some particular disease from the weaker parent. 2. Consanguinity, or a too close blood relationship between father and mother, deteriorates the power of resisting disease in their issue. The unwritten law of life insurance should forbid marriage of cousins of the first degree, and place no bar against the descendants of the man who marries his deceased wife's sister. 3. The hereditary tendency to disease may have been outgrown, or not yet reached, according to the affinity existing between certain ages and certain diseases, as pointed out in the section on age. This inherited taint often remains latent for many years, or several generations, only to reappear when certain exciting causes enliven the dormant germs of disease. The family inclination to disease is more manifest among brothers and sisters than between parents and children. 4. Sameness of physical organization between father and mother, and likeness in the conditions under which they were reared, conspire to produce inferior progeny. 5. Intermarriage of different races is physiologically beneficial, unless it necessitates an extreme change of climate or manner of living. As a rule, the vigorous children of healthy English parents, born in tropical regions, pine away unless removed to a temperate zone. 6. Longevity of ancestors. The observation should extend over three generations. Longevity of both grandparents is most desirable, but the old age of grandparents on the maternal side is more apt to be reproduced in the grandchildren than that of the paternal side. Causes of death in the case of grandparents are essential, and any existing diathesis should, if possible, be traced back. At the same time, we must remember that the progress of civilization, hygiene and medical science has remarkably increased the average of human life, and still tends in the same direction. 7. Direct and indirect heredity. The direct implies the transmission of a specific taint from one generation to another. Indirect heredity means the production of constitutional peculiarities, not allied to organic disease, but due to impressions made through the mother during gestation which influence the subsequent development of the child. This is called the law of atavism, when certain qualities are traced back several generations. The intelligent use of this law has resulted in greatly improving domestic animals, and might be applied with equal benefit to mankind if stirpiculture were possible in organized society. TRANSMISSION OF CONSUMPTION OR TUBERCLE. The following are some of the theories, aside from the germ theory, which have been advanced by various authors with reference to this most prevalent constitutional taint. Discussion is purposely omitted: 1. Predisposition to it is more frequently inherited than acquired. 2. Maternal transmission is more virulent than the paternal. 3. Two consumptive parents intensify the tendency. 4. To transmit the taint, either one or both of the parents must be infected with the disease previous to gestation. Nevertheless, as an exception to this rule, the second generation often escapes and the third inherits the taint from the first generation-grandchildren from grandparents, 5. The adverse environment of the individual often starts up a fatal attack, after almost a lifetime of immunity from symptoms of inherited tendency. 6. Any wasting disease in the parents, especially if in advanced life, may superinduce this fatal malady in their children. 7. The first-born children are not as susceptible as those born after the prime of life, when the disease becomes developed in either or both of the parents. 8. Inherited consumption usually appears before the third decade of life is completed; the acquired form develops later in life. 9. Hard labor and exposures hasten its development. 10. The most robust physiques do not escape this latent tendency. II. Consumption as a cause of death in the family record should be perseveringly sought out by the Examiner. 12. Among children, tubercle generally attacks the brain or abdominal organs before it appears in the lungs. Tuberculosis should, therefore, be suspected as the cause of death, in lesions of the brain or abdominal organs, among the deceased brothers and sisters of the applicant. 13. The relative virulency of the consumptive dyscrasia is best measured by its effects upon the applicant's immediate family. 14. Liability to the disease, when inherited from the father manifests itself most actively from the tenth to the thirtieth year. From forty-five to sixty-five the danger is slight. 15. Liability from the mother is greater than from the father, the disease being of a more virulent type, but the period of susceptibility is shorter, say between the ages of fifteen and thirty, with few deaths after forty. 16. When two deaths in a numerous family have occurred, the one a parent beyond forty and the other a brother or sister below the applicant's present age, if the examination presents no other objection, the risk is fair. 17. The single death of brother or sister, when other points of family history and personal examination are favorable, should not prevent insurance. 18. Two deaths of brothers or sisters older than the candidate, unless the individual condition and environment are most desirable, should reject. 19. The death of both parents, even at an earlier age than the age of the applicant, should reject. present 20. Three or more deaths in the immediate family, comprising a parent and two or more brothers or sisters older than the applicant, even though personal points favor, should reject. 21. When the applicant exhibits the tuberculous diathesis, although the family record shows no death from consumption, it should reject. 22. When the infant mortality in the family has been great, and the surviving members, including the applicant, are quite young, or he is the only surviving member, the risk is hazardous. 23. The death of a grandparent and parent in the same line proves. that the taint exists in the applicant, and might be developed by any excit ing cause, and renders the risk hazardous. 24. When the applicant resembles the tainted parent, though disease is more transmissible through the mother, the risk is hazardous. 25. When both parents have died comparatively young, the one from phthisis, and the other from cancer, abscess, erysipelas, intemperance, heart, kidney or brain disease, the applicant inherits the taint of one or both. parents, and should be deemed a hazardous risk. 26. Deaths in the immediate family should make the Examiner suspect tuberculosis as a cause of death among more distant relatives, such as uncles, aunts, grandparents, etc. 27. Policies for limited periods may be issued in the case of some risks classed hazardous, when approved by the executive officers of the home office after receiving full information from the Medical Examiner. 28. Transmission of the scrofulous diathesis, which is akin to tubercle, as an expression of deficient and defective nutrition, must be detected and taken into account by the Examiner. TRANSMISSION OF CANCER. 1. Cancer is a specific disease, and in regard to the frequency of transmission stands next to consumption. 2. Cancer and tubercle may coexist, but cancer usually excludes the latter. 3. The development of cancer generally occurs between thirty-five and fifty, when the vital forces begin to wane. 4. Females are more liable than males, and the parts most frequently affected are the generative organs and breasts. 5. When both taints, the cancerous and tubercular, exist in his family, the applicant should be rejected. 6. When two or more deaths from cancer have occurred in the applicant's family, he should be rejected. 7. The death of one parent should not necessarily reject. 8. Sporadic cases of cancer, though rare, may be encountered. cases. TRANSMISSION OF GOUT. 1. Hereditary tendencies can be traced in more than one-half of the 2. When the gouty diathesis manifests itself before the age of thirtyfive, the risk is hazardous. 3. Where both parents, or a parent and grandparent, and an uncle or aunt, have had gout, the risk is hazardous. 4. When one parent or a grandparent has suffered from gout, the applicant himself having never had an attack, and being of good habits, if the physical examination proves satisfactory, he should be eligible for insurance. 5. If the applicant has passed the age of thirty-five without showing any symptoms of the disease, and his physical examination is unobjectionable, even though two ancestors exhibit a history of gout, he is eligible for insurance. 6. The inherited diathesis is not always manifested by a typical attack of gout, but by degenerations in the heart, blood vessels, kidneys and nervous system. |