action which occasionally seems to aggravate the bleeding. Nourishing food and stimulants to maintain the strength, are also indicated. I can but believe that a less exclusive reliance on direct efforts to stop the hemorrhagic flow, would have led to more favorable results in these 178 cases than the recovery of 16.3 per cent. The combination of an early application of the ligature en masse, with appropriate internal medication would, I think, lessen essentially the mortality, as exhibited in the table, on which the foregoing analyses are based. With regard to the prophylaxis of the disease, I quote from Dr. Minot's comprehensive essay, the suggestion of Dr. Perry, before alluded to. "I am indebted to Dr. M. S. Perry for a valuable suggestion concerning the prophylactic treatment to be employed by women who have already given birth to children, with the hemorrhagic diathesis, when again pregnant. Observing that women, accustomed to take alkalies in considerable quantities during pregnancy, for dyspeptic or other symptoms, were peculiarly liable to hemorrhage after parturition, he has been in the habit of interdicting such remedies, and of substituting for them the mineral acids, with very satisfactory results. Dr. Perry suggests that the use of the mineral acids, during pregnancy, by women whose children have been affected with umbilical hemorrhage, might be followed by favorable results; the experiment is worth trying." I am not aware that it has ever been instituted.

I am not willing to close this report, without acknowledging the courtesy which has in so many instances aided me in its progress. To all the gentlemen who have afforded me material relating to my theme, my cordial thanks are rendered, and especially are they due to Dr. Francis Minot, of Boston, whose table of cases, unfortunately unpublished with his essay, was placed at my disposal. I am happy too to acknowledge my obligation to Dr. Wm. F. Holcomb, of New York, and to Drs. Edmund Arnold and Max. Reinfelder, of Yonkers, for valuable assistance in translation from the German,

J. FOSTER JENKINS.

REPORT

ON

INFLUENCE OF MARRIAGES OF CONSANGUINITY

UPON

OFFSPRING.

BY

S. M. BEMISS, M.D.,

LOUISVILLE, KY.

REPORT ON INFLUENCE OF MARRIAGES OF CON

SANGUINITY UPON OFFSPRING.

Is the offspring of marriages of consanguinity equal physically and mentally to the offspring of parents not connected by ties of blood-both classes being supposed to be similarly circumstanced in respect to all other causes affecting the integrity of their issue?

A question of similar import to this has at times engaged popular attention probably for many ages, and yet no facts have hitherto been collected of sufficient number and authenticity to determine its solution. This neglect to accumulate statistical testimony as to the results of family intermarriage could not have proceeded from paucity of material, since, not only do the pages of history teem with instances of such marriage, but they are found in almost every social circle, and should receive the earnest scrutiny of physiologists. Surely, no questions can concern us more closely than those which relate to the prevention of the numerous congenital abnormities of our species, among the causes of which, intermarriage of members of the same family blood may appear not the least important.

Passing allusions to the evil consequences of marriages of consanguinity may be found in a number of authors, but the subject has not been made a point of special inquiry, so far as I have been able to learn, except by Rev. Charles Brooks in a lecture before the American Association for Advancement of Science in 1855; by two French writers, Rilliet and Menière in 1856, and by the present reporter in 1857.

To Dr. John Bartlett, of Keokuk, belongs the credit of having projected the first effort to set the question at rest by accumulating a sufficient number of facts to furnish positive testimony either corroborating or refuting the popular idea of deterioration of offspring from such marriages. A loss of health compelled him to

abandon, for a time at least, his intentions, and he has generously placed his material in my hands for the benefit of the Association. and profession at large.

Dr. H. P. Strong, of Beloit, Wisconsin, had also collected accounts of instances of family intermarriage for the purpose of deducing and publishing observations upon the subject. But so soon as he heard of the appointment of a committee by the American Medical Association to collect facts in regard to marriages of consanguinity, he placed his many carefully detailed cases at the disposal of the Association through their committee. Such instances of generous sacrifice of labor and purpose as the two foregoing demand our highest appreciation.

It was the design of the reporter to collect not only a sufficient number of observations of marriages of consanguinity to enable us to declare positively in regard to their own essential results, but also to collect a sufficient number of observations of marriage where no such influence obtains, to constitute an authoritative standard, so that by comparing the results of the two classes we might establish beyond controversy the affirmative or negative of the question premising this report.

With regard to the first class, or marriages of consanguinity, my success in collecting facts has been beyond my expectation; my tables will exhibit results of near nine hundred such marriages, a sufficient number to warrant the belief that any additions thereto, if procured in the same manner, would not materially affect the ultimate result. Of marriages of the second class, or between parties neither themselves related nor the descendants of blood relations, I regret to say that my exertions to collect observations have not been so successful. My tables comprise only one hundred and twenty-five observations of this character, which, however correct they may be in selection and statement, are not ample enough in number to justify me in offering them as the average results of marriage where no influence of consanguinity prevails. And unfortunately, there are no researches, so far as I have been able to learn, which establish the average fecundity and vital statistics of marriage in the United States.

The original statistics which appear in my report, have been furnished exclusively by reputable physicians in the various States to which they are credited. The respectable sources from whence they are derived should stamp them as high authority, and I bear cheerful testimony to their accuracy and reliability, feeling satisfied