The existence of hidden latent morbific causes of the sort that could account for the atavistic pattern, was then put under scrutiny by Louis. Under such a view of the hereditary, he writes:. Louis, in a sense, tries to turn the argument around. If such hidden causes will only take effect with the concurrence of external causes, the disposition could properly be known to have been in. It cannot be said either that a general tendency was shared by a whole family lineage, unless it could be proved that similar external conditions cannot have been the cause of similar patterns of ill health which to him seemed impossible.
Given that external factors obviously exist, are extremely numerous and complex, and so clearly play a much stronger causal influence than any supposed internal disposition, Louis argues, there seems to be no reason to make use of the latter anyway. The hypotheses of hidden causes were a dubious approach in principle. Louis finds a further reason for scepticism in the actual embodiment that any hidden, constitutional influence cause could take in order to exist in the germ before impregnation.
A perfect knowledge of this question would require a much better grasp of what actually occurs during conception, and what the word generation really means. Louis however does incorporate some general considerations about generation reproduction to back his sceptical approach to hereditary transmission. Basically, what he tries to argue is that no particular individual characteristic can be communicated by parents to the first rudiment of the embryo, and that all the so- called hereditary phenomena are caused by external influences.
The idea of a transmission or communication of the disposition to a given disease or any other accident or particularity is thus simply an illusion originated by the fixation of minds in the deceiving familial pattern of resemblances and recurrences. In order to develop this part of his argument, Louis considers the two basic alternatives within the disputes over reproduction generation: In preformed germs all constitutional alterations that could predispose to disease are necessarily posterior to the first forma-.
In successive generations, Louis argues, any conceivable transmission is made by a restricted portion the generative one of the parent's organization, so there is no way a grandparent could actually and particularly affect the organization of the grandchild By making this point, Louis dispels what for many medics was one of the main peculiarities of hereditary influences, namely their latency, or capacity to remain hidden in the individual's constitution for some time, or through several generations.
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In any case, Louis writes, to conclude this part,. What lies then at the root of Louis' scepticism is his strongly held belief that only general, non-individual characteristics are acquired by the new being through the act of generation: All idiosyncrasies are thus pushed, by Louis' argument, outside of the possible reach of the hereditary. The belief passed down by the medical tradition in an hereditary communication of temperament or constitution was, of course, at the basis of most medical men's unquestioned acceptance of hereditary transmission of certain constitutional diseases; it was in consequence the target of Louis' most skilful and rhetorical as well as heretical paragraph:.
Among the exterior influences Louis mentions the weather at birth, the suffering during birth, the amount of blood in the vessels at birth, the quality of the nurse's milk, the thickness of the air that was breathed during the first hours, etc.
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Like most physicians of his time, Louis believed the source and beginning of all illness resided within the individual's temperament, because it makes the person more or less susceptible to the effects that morbific causes can produce. Diversity of temperament is responsible for the differences of individual reaction to contact with such causes Louis admits that there are several diseases like gout, stone and phthisis that follow a striking familial pattern of occurrence, and he understands the naive movement of many simple minds in ascribing a hidden causal link to account for their transmission from parents to their offspring.
But, he says, all those cases can be more accurately described and explained by external causes. He chooses as an example the well-known example of Montaigne's bladder stone. The French essayist shared the infirmity with his own father and used the experience to raise his precisely worded inquiry concerning the power of nature to achieve hereditary transmission of such complex things through a medium as simple as. The fact that only Montaigne among his many brothers received the legacy, and that the communication occurred 25 years before his father realized he had the stone, should have warned him off such an explanation, Louis argued.
It is much more natural, he says, to imagine that the same combination of external influences, diet, habits, etc. Cases of gout and phthisis are similarly explained away by Louis as non-hereditary. Two factors are repeatedly used by him in these examples to point out the absurdity of an hereditary hypothesis: In his final attempt, Louis tries to invalidate the two possible physiological, non-external routes of disease communication between parents and offspring.
Not surprisingly, the two kinds of hereditary causes of disposition to disease that Louis can imagine are, on the one hand the humoral, and on the other, the solidist. Humoral hereditary vices are discarded by him for several reasons. It seems unlikely that they would not destroy such a fragile thing as a germ. Beside that, one inherited morbific humor would conceivably produce a whole variety of different diseases in several parts of the body at several times and in several circumstances, so the pattern of the same and only disease in the same family claimed by some hereditarians would seem unlikely When considering the solid communication of disposition to disease, Louis finds it difficult to believe in any latency whatsoever.
Could an organ, he asks, work well for 50 years if it were badly built? Worst of all for any solidist defence of the hereditary, there is no way to really visualize the transmission between solid, organized parts. Furthermore, there are very many cases, well known and authenticated, of patently defective individuals with diffor- mities or mutilations of solid parts who had given birth to healthy children blind parents with sighted children, hunchbacks with normal ones, etc.
Such cases seemed to be the rule rather than the exception. If the constitution of the solid parts of the parent really did as a rule have hereditary effect upon those of the child, how was one to explain such constant failures of the influence? And in any case, there was no easily conceivable way through which a physical flaw could affect the germ. Louis added in a note to the judges for the prize that his work was no doubt relevant to the question raised by the Academy, and therefore should not be excluded; moreover, if his reasons should be considered of any weight, all the other, positive, works were invalid.
The judges as we said were not convinced, or they had, as Ruffey suggests, made up their minds beforehand. The antecedents to Louis' revolt. This text, Louis claims mistakenly, was the only previous one, in modern times, which had the subject of hereditary disease as its main topic.
He also claims to have been surprised by the coincidences between his arguments and those of Lyonnet, who like him is sceptical about humoralist claims concerning hereditary transmission, and who would only accept a soli- dist cause as truly hereditary. That is to say, that only solid parts organs, tissues can be both the seat and the cause of a hereditary disease, and its transmission to a descendant has to be seen in terms of a solid-to-solid relationship. If to this premise, one adds the fact which Lyonnet had ignored that there is no conceivable solidist causal link between the parents' bodily frame and their offspring's, the conclusion follows that there is no such thing as hereditary transmission.
Ranchin was so persuaded that those medical men were mistaken Pujol adds that he was prepared to maintain that they were defending such a view against their own inner conscience, with perverted motivations such as the desire for fame and notoriety, and not in a disinterested pursuit of truth The revolt that worried Ranchin so much was probably related to the specualtive excesses of physicians like Jean Fernel ,. With the advent of these sceptical challenges, early 17th century authors gave increased attention to the hereditary transmission of disease, per se.
Where all previous authors had treated the subject in their more general discourses on generation or pathology, from the early 17th century on special volumes were dedicated to hereditary disease. Workable picturable transmission mechanisms based on solidistic causes or in a combination of these with humoral ones as in iatrochemical hypotheses were proposed and their influence lasted until well into the 18th century.
Perhaps the most influential and clear of them was written by the Irish clergyman Dermutius de Meara, who synthesized most of the clarifications gained by 16th century authors and managed to develop a very convincing argument in his Pathologia hcereditaria One of the main intentions of Meara' s treatise was to attack FerneFs view that all diseases are, or can be, hereditary and to return to the position of the ancients that only those diseases that depend on defects of the organized solid parts organs and tissues are communicable in a hereditary way through the semen No unorganized disease part like a tumour or an ulcer , nor any disease dependant on mobile humours like catarrh, feber, asthma was, according to him, hereditary, because.
Such fixity, Meara believes, is only possessed by those morbid influences that can actually insert their roots in the solid parts of the body. Adopting the proposals of a French medic, Joseph Du Chesne or , Meara proposed a iatrochemical explanation, based on two salts, sulphur and mercury, whose presence at critical times in the tissues predisposes the individual possessing them to certain diseases. Any constitutional disease that does not come in the semen male or female , Meara wrote, must be considered accidental, although most of them have to act in utero, while there is still some fluidity, or indefinition in the individual's constitution.
A typical accidental influence is exerted by the nutrients the body receives from the mother during gestation. These other influences are never however as strongly attached to the solid parts of the body as the roots of hereditary disease. A theme that Meara treats with some depth is atavistic transmission. He accepts the Aristotelian stance that there are, a priori, grounds for doubting the proposition that diseases, or any other characteristic, can be transmitted from grandparents, or any previous generation, to the newly born without it having been possessed by at least one of the parents.
First, it seems impossible that a causal agent could act without direct contact with the subject receiving the action. And second, to be able to transmit anything from a first party to a third one, the intermediary must at some point have it itself. If it is a disease, then one who is not afflicted by it, the Aristotelian argument would go, cannot transmit it. The medic, as the philosopher, should rather research the causes. Impurity however is very rarely suppressed by the mixture of parental semen, and can still form part of the semen of the offspring, as this can be said to be an extract or representation of the man.
Once transmitted to the following generation the impurity a salt, for instance can produce the disease even if the parent did not develop it. Such fixing of the root in the solid parts of the body is not however. The prohibition of Aristotelian philosophers is thus bypassed, he believes, because although all causes act by contact, it can be said that this contact need not be immediate, but can be mediated. A disease can be transmitted by the grandparent to a grandchild before it is born, in potency. There is something in the constitution of the intermediary parent that resists the expression of such potency, namely the healthy constitution of the other grandparent.
There are situations, he adds, when the same cause can produce different effects in the children and in the grandchildren. The hereditary influence can either be resisted or not. Atavistic reappearance of a hereditary disease in a descendant, after having been absent in the family for one or several generations, ceases under this description to be a mystery. Meara concludes his discussion on hereditary diseases by arguing that the curability of such diseases is related to the strength with which their roots are fixed to the solid parts of the body.
They are in general more difficult to cure than non-hereditary ones. The strength of the hold is proportionate, he seems to be saying, to the level of impurity at the moment of the mixture of semen in fecundation. Good marriages with healthy consorts improve the situation by diluting the impurity, making the root easier to be taken out by chemical media. The latter, he affirms, must be specific solvents capable of washing the salt away.
He also refers to an independent cycle possessed by hereditary diseases which makes them first increase, and then decrease their intensity within a family, as they are passed through the generations Meara' s account of hereditary transmission was based on solid causation of a kind.
He relied heavily on Paracelsian iatroche- mical physiology 43 , but his criticism of humoralist excesses, and his argument for a latency of hereditary causes brought closer the solidist dispositional account that characterized the most important medical authors of the late 18th century. The idea that it is not the disease itself but a disposition to it which is transmitted was a development of the use of Aristotelian potencies that pre-.
A dispositional cause can remain latent, and is best pictured as a defect or a pernicious element in the solid parts of the constitution, that makes the individual prone to react to triggering external factors. This left aside the question of whatever influences came to bear on the individual's constitution after it acquired its definite solid structure.
Familial illnesses could thus be distinguished between those with a properly hereditary cause which were stubborn and remained within a branch for generations , and those which the children also carried at birth, but were acquired through alternative routes, like the mother's blood the foetus' nutrient or even the mother's imagination strong impressions, frights, etc. Meara, as I said, tried to develop a workable picture of solid to solid transmission of disease, or its cause, through the seminal fluid.
He participated in the wave 44 of discontent with the previous century' speculative proliferation of hidden faculties and immaterial causes. Roger's book has shown how this reaction coincided with the growth of Cartesian mechanicism that had as a consequence the adoption of pre-existence as basically the most tenable view of the origin of organization and complexity in living organisms Pre-existence and the hereditary. By , when young Louis took the hereditary transmission of disease to task, the pre-existence of the germ had been for some.
Although, as I described above, Louis tried to make his general analysis applicable to both positions, the language and emphasis he makes give away his preference in favour of pre-existence. Both Maupertuis and Buffon had shown that the irregularities of the hereditary phenomena were one of the principal empirical obstacles in the way of pre-existence. Louis seems to have been clear about this. So did Albert Haller , who, when criticizing Buffon's double seminal view of generation and his use of hereditary resemblances as an empirical justification for it, produced a remarkably similar argument to Louis's This was a courageous argument based on denying the reality of such phenomena the resemblances between the physical constitutions of parents and children and undermining the evidence in its favour.
Both Haller and Louis seem to have viewed, at this stage of their respective careers, the widespread belief in hereditary transmission of details of temperament, resemblance, and malformations as a pernicious prejudice that had to be checked. In the case of Louis, the ubiquity of variation was his evidence and the multi-. According to his view, the original germ, pre-existent or not, was acted upon by innumerable non-natural external agents that could produce in it different sets of secondary, accidental qualities Only the more essential qualities and organization were given by the internal germinal route.
No deviation or peculiarity that distinguished any family or group could pass through such route, and so they could not be called, in any proper sense, hereditary. Louis made use of Boerhaave's well-established physiology of fibres as the solid elements of the body and humours to bring home his point about the secondary role of the latter:. So, in Louis' mind, morbific humours of any kind could only have superficial, erradicable influences. The obvious weakness of his position was — as his critics insisted — his stubborn dismissal, as mere coincidences or fairy tales, of all the striking cases of hereditary transmission of disease or malformation that had impressed most other medical men.
But pre-existence allowed at least another approach to the hereditary that was, paradoxically, based on humoral causes. The judges of the Dijon contest were not apparently disinclined towards such a view, as they gave a special mention to G. It is this development undergone by the undiffe- rentiated though organized germ that, according to Rey, made possible hereditary transmission of resemblance in general, and of disease in particular. The two suppositions that Rey puts forward as reasonable candidates for proof are: Both hereditary resemblance and disease, Rey argues, are a consequence of the transformations that these humours induce in the solid parts while they develop.
Only a liquid fluid cause, Rey adds, can account for the mixing of characters of both parents in hereditary transmission, and previous authors have been wrong in trying to deny this. Rey also argued that strange, or not completely compatible, liquids can act upon and distort a developing part because there can be partial affinities to them. Either because these hold the seed of a disease, or because of the influence of a different variety or species, these fluids could thus act upon.
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Two further crucial factual characteristics of the hereditary phenomena were dealt with by Rey in his humoral theory. The other characteristic he explained was atavistic transmission. Fluidity also explains the way that this communication, for instance from grandparent to grandchild, is effected. The hereditary influence of the seminal fluid can still be accepted in terms of an ovistic theory, with the further advantage of avoiding at the same time the problem of the female semen that plagued the double seminal accounts Both Louis and Rey wrote in an age when ancient humoral physiology was in decline, while arguments for pre-existence and against successive, epigenetic views of generation were quite powerful.
Despite the fact that humoral physiology and the Hippocratic-Galenic double seminal view of generation had, so to speak, the facts of hereditary recurrences on their side. Both irregularity of and resemblance to both parents and to ancestors, etc. The problem was that all appeal to proliferating humours, though still popular among many medics, was seen as completely regressive by those trying to leave behind the retarding weight of the ancients. Particularly questionable was the idea of humours which could have discriminative powers in order to act selectively and subtly, thus giving all the nuanced effects that were found in the hereditary If constitution or temperament was to be basically understood as dependent on the solid parts as a whole or as a set of separate organs , then disposition to disease was to be dependent on the organization or structure of the whole bodily frame, or of particular tissues or organs.
Most authors of the next generation could not see how to decide between the very coherent and complex arguments developed by the opposing factions according to the available evidence Some medics felt very uneasy about their appeals to hereditary transmission of constitution or temperament , because as a very basic supposition in most of their approaches to individuals with idiosyncrasies both of disease and of reaction to treatment, it did not have a solid enough physical or physiological base.
Beside that, the rhetorics of case collecting and storytelling very common in the medical tradition, and used to establish and disseminate the belief in hereditary disease were increasingly coming under attack by statistically-oriented, materialistic and mechanically- minded authors of the late 18th century Either because the origin of the disposition or diathesis was not considered crucial for its cure, or else at the other extreme because hereditary diseases or the dispositions were considered incurable.
The hidden humoralists associations it conveyed and the absence of a proper solidistic or other account of transmission increasingly worried the most theoretically minded physicians. In France, Louis' challenge had basically remained unconfronted. In Britain, similar sceptical arguments had begun to appear It was in this context that a second essay competition was organized amongst French physicians, with the subject matter of hereditary disease. Besides the purely conceptual reasons which as we saw were not few many medical men felt the need to meet the challenge of his, and other sceptics', arguments.
Eventually, this institution would promote the search for a solution to Louis' challenges in two successive competitions and As was pointed out above, the tone in which the questions were set made it clear that the Society expected the competitors to face Louis' challenge head-on, and did not want them to fall back on the old, received, presuppositions and unspoken assump-. According to the judges' annotations, there were 13 dissertations entered for the first contest. The length and quality of them vary very much, but there are several worth looking at, as they were both carefully researched and forcefully argued.
After what seems to have been difficult negotiations the evaluations of the judges that remain on paper 63 show that they favoured different candidates for the prize and that they were applying widely different criteria the jury decided not to award the prize, but to re-open the contest with the same questions but raising the prize money to livres. Although the jury declared itself not satisfied with the results, three dissertations were singled out as being of value. In the summing up, the report detailed further the discontent with the work entered for competition:.
The Society was here rephrasing Antoine Louis' old question. If, on the other hand, hereditary transmission of disease through humoral vices cannot be said to have any particular route or character that would justify the separation of it into a different category then there is no real sense in using the old analogy of inheritance. The first set of commissioners thought that the essays lacked a certain amount of scepticism, and that they also lacked any clear picture of how transmission can really not speculatively be accounted for. They wanted the contenders to fight Louis on his own terms.
Impression that is certainly reinforced by the fact that de Gellei's essay was praised in one of the judges' personal notes Thouret's; who was, by the look of it, the dominant judge for beginning by throwing doubts on the existence of hereditary disease and then proving their existence by refuting these doubts. On the other hand, the same judge criticized several of the dissertations including the missing one coded as F for admitting too readily the fact of their existence.
Several of the contenders of the second round some of them having rewritten their first version began their arguments by showing a certain surprise, and some outrage, at the Society's demand for further. They claimed that the overwhelming number of indubitable cases gathered in the literature — and seen in everyday practice — was enough to convince any reasonable person which was exactly what some of the judges did not want to hear. They complained of undue bias. One of them later wrote a personal account of how he saw the procedure of this contest and went as far as accusing the judges of having reversed a former decision that favoured him, for ideological anti-religious reasons The fact is that many of them were surprised that good, scholarly well-informed and well-argued dissertations did not manage to convince the judges.
Amoreux whose first dissertation had been the favourite candidate for the prize of at least one judge wrote that he did not see how anybody could satisfy the Society with more; had he not quoted almost every important author, ancient and modern, on the subject, and mentioned a fair number of reliable cases? Had he not argued fairly and clearly about causation with the prevailing physiological knowledge; what more could anyone do? He then proceeded to re-write his piece adding details to every one of its parts, especially to the already outstanding bibliographical research. Apart from the justifiable claim that most authors had been somehow begging the question in their entries, it can fairly be said that the many considerable analytic virtues of some of the essays submitted to contest were ignored in the first set of judges' reading.
Several authors displayed a striking clarity about the distinction between congenital and connate causes later praised by the second group of commissioned judges , emphasized the need for clearcut observational criteria to distinguish the hereditary from other influences like homochrony, specificity, curability, etc. Perhaps a reason why the first set of judges were not impressed is that these ideas were more common amongst French 18th-century medical men that appears at first sight.
The judges' reluctance did however provoke a sharpening of the arguments presented for the re-run of the competition. At least four dissertations of very high quality, although not agreeing in all aspects, made a strong and authoritative case for why a physician of the late 18th-century could and should defend the principle of hereditary transmission of disease or better still, of the disposition to it , regardless of what some theoreticians could sceptically say or write. These were the dissertations written by Amoreux, Pujol, Pages and Rougemont Although again not completely satisfied, the Royal Society commissioners decided to grant the prize to Joseph-Claude Rougemont' s contribution He carefully distinguished hereditary diseases from those contracted by the child within the mother's womb or during birth.
Some shortcomings in method, they added, were balanced by the clarity he brought to the whole subject. Aies received honorary mentions. Among their many merits, the Society again chose to praise their clear distinction between congenital and connate diseases Responses to the sceptics. As I have said the commissioners were not yet totally satisfied with the second, improved, round of essays.
But they awarded the prize all the same, because it already had been remitted once. However the commissioners stated that the question was not yet solved.
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This invitation to surpass the narrative, case quoting method that had plagued the subject for too long, and to gather the evidence in a more cumulative fashion, was a clear recognition that. However, Louis' methodological point was not the focus of so much attention in most of his rival's works as it was to become for hereditarians of the following century.
Other aspects of his challenge came to the forefront. Four of the issues raised by him were recurrently and vehemently taken up by the more acute participants; I will briefly describe how these issues were tackled by the more lucid competitors This was Louis' most dramatic challenge to 18th-century medical common sense. Hereditary communication of at least some of the components of an individual's temperament or constitution went unquestioned by the whole medical tradition.
According to humo- ralism all resemblances moral, physical, pathological within a family or other genealogical group could be attributed to similarities in the proportions of the different humours. With the rise of mechanistic solidism after the 17th-century, family and group resemblance became linked with the explanation of the origin of.
Alternative generation theories have different bearing on this issue. Constitution solid organization is something that comes with the pre-existent germ, and any predisposition to disease or diathesis is either already there, or is acquired, but not inherited; unless you widen your criteria and include humoral causes into the hereditary, in which case the problem exists of separating those causes from other, external humoral influences. As shown above, this is the position adopted by Rey in , and also — with variants — by many of the and competitors that were not prepared to abandon humoral hereditary influences The pre-existentialists among them especially Besu- chet [srm, d-2, 3] used Bonnet's ideas about the influence of seminal humours in the transformation of the germ during its development, which as I said were similar to Rey's.
The strongest solidist in the competition was Pages. Where others Pujol, Amoreux, etc. His solidism he related also to disputes over generation. Although he denied that generation theories should have a primal position in the discussion about hereditary disease 75 , he argued that dual seminal views like Hippocrates' and Buffon's made it easier to account for hereditary transmission of constitutional traits, both from father and mother, and from ancestors ; and would also help draw a line between real hereditary influences internal: In his view, only a small set of specifically- transmitted constitutional predispositions to certain diseases through generation, in semens deserve the adjective hereditary The obscurantist and abusive practice of many previous, and contemporary, physicians in applying the adjective to any — and every — disease could be checked, Pages believed, by means of precise external criteria, derived from a clear definition.
The principal criterion had to be the time of appearance of the disease. Pujol and Amoreux used it to separate humoral hereditary influences from non-hereditary ones. The transmission of the influence would occur through the semen or mother's blood and it would then either act upon the constitution during the first formation or remain in the body without effect until a later, determined stage, when it would produce its noxious symptoms. The other basis of Louis' scepticism concerning resemblance of general constitution was the uncontrollable proliferation of causes. To counter this argument, Amoreux first accepts that variation among children of the same family is a striking reality, and that it is due to various influences at the time of conception.
However, he adds, the weight each kind of cause has in shaping the individual's temperament is not equal. Primary, humoral and solid, hereditary causes far outweight the secondary, environmental ones. It seems undeniable to him, as to many others, that peculiarities of temperament and constitution run in families. This curiosity however was not to be limited to the superficial qualities of colour, height, weight, and form of the body, but to be extended to the internal constitution of tissues and organs.
Surgery provided, in the late 18th century, a new observational window that few of the contenders failed to mention. Resemblance within families could be traced to the minor details of inner configuration, revealing a multitude of other facts that increased both the number and the evidential strength of hereditary claims.
This was specially the case when peculiar hidden defects began to turn up in autopsies. Normal resemblance within families had since Hippocrates been used, in an analogical argument 81 , to justify the belief in pathological resemblance. The rise of solidism — and surgery — tightened this analogical move amongst physicians.
The emphasis on personal observation and accordingly less reliance on ancient reports and the attention to structural detail, reinforced the medical men's confidence in the reality of hereditary transmission of individual idiosyncratic constitutional characters in general, and of the predispositions to diseases that these could entail.
However the first rudiment or embryo came to be formed, they were convinced, there had to be a causal mechanism responsible for the impression on it of elements of both its parents' particular constitutional characters. For the want of a better model which generation theories did not provide Pujol described this by a metaphor:. Humoral morbific causes would always maintain the connotations of a poison: This strengthening of the analogical domain, by unifying it under one kind of causal mechanism of transmission and not a diversity opened the door to a further development: The challenge to the causal-physiological resource to humoral causes, and their confused and maleable non-specificity, or proteism.
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