Family history (medicine)

In medicine, a family history (FH or FHx) consists of information about disorders of direct blood relatives of the patient. Genealogy typically includes very little of the medical history of the family, but the medical history could be considered a specific subset of the total history of a family. Accurate knowledge of a patient's family history may identify a predisposition to developing certain illnesses, which can inform clinical decisions and allow effective management or even prevention of conditions. Early mentions of family medical histories in medical literature date from the 1840s. Henry Ancell mentioned inquiring about the family history of a patient in a medical case study in 1842, noting that the patient's presenting concern appears to be present in relatives and remarking on the prolific reproduction of her female relatives. In 1849, W.H. Walshe argued in a lecture at University College Hospital that in addition to a history of the presenting disease itself, a physician should also collect family history. Walshe's lecture does not define or justify the family history, which may suggest that taking one was already in common practice. However, later 19th-century physicians did provide a specific apologia for family histories and in some cases explicitly noted that they were not yet being taken routinely. James Begbie argued that understanding the health of the entire family, including cousins, can help predict otherwise unpredictable illnesses that run in the family. Begbie's use of the family history for both predictive and normative evaluation of the family anticipated Francis Galton, who championed the routine family history as a eugenic strategy in his 1883 text, Inquiries into Human Faculty and Its Development. Galton writes: "The investigation of human eugenics—that is, of the conditions under which men of a high type are produced—is at present extremely hampered by the want of full family histories, both medical and general, extending over three or four generations.