Volume 1

The principles of pathology / by J. G. Adami and A. G. Nicholls.

  • Adami, J. George (John George), 1862-1926.
Date:
1910-11
Catalogue details

Licence: In copyright

Credit: The principles of pathology / by J. G. Adami and A. G. Nicholls. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    29/1080 (page 21)
    In the forthcoming chapters we shall have to consider the more important features V)earing upon the production of the conditions of disease, and the reaction of the organism to the same whereby a con- dition of health or relative health is brought al)out. In the meantime it will be well to afford a working definition. Hearing in mind that the.se terms are, and can only be, relative, it is well to consider health as a condition of metabolic efpiilibrium—a condition in which the organism or the part, is attuned, or in complete adaptation to its surroundings; disea.se as a condition in which ecpiilibrium and adecpiate adaptation are wanting. In other words, to employ a metaphor encountered by chance iii the works of a seventeenth century Italian theologian, “health is harmony, disea.se di.scord,” a statement which can be applied to either general or local bodily condition, and which, to continue the metaphor, acknowledges or embraces the fact that the harmony may be in a minor key. That individual is regarded as enjoying good health, and in fact actually does enjoy good health, who neverthele.ss may for years have had extensive local di.sease of the heart valves, which in its tuni has cau.sed hypertrophy of the heart muscles in rc.spon.se to the increa.sed work thrown on the organ. It is true that in such a one any sudden excitement or demand for increased work, which would have no dele- terious effect u])on tlie normal organs, suffices to bring on indications of heart failure. Hut within certain limits, employing ordinary caution, a subject of valvular di.sea.se of the heart may for long years enjoy life and carry out well all the ordinary duties without obvious bodily di.s- turbance. Diseases and Affections.—From the time of (ialen onward there has been di.scu.ssion and confusion regarding the relationship between local and general disturbances, .so that as an aid to exact thinking and clear conce])tion an increasing number of French and (ienuaii writers empha- size the distinction between “maladie” and “affection,” “Krankheit” and “Leiden.”' Disease is the ])roce.ss leading to ajfeefion of one or other organ. Pneumonia, as Roger aptly illustrates, is at the .same time an infectious di.sea.se ainl an affection of the lungs. It is urged that to .speak of “heart di.sea.se” or “kidney di.sease” leads to an incorrect mental imagery, to wrong ideas as to the nature of the malady, and very po.ssibly to wrong treatment. In a ca.se of thickening and contraction of the mitral valve in a young adult the morbid proce.ss that has led to the stenosis of the v:dve is acute rheumatism, and that is the di.sea.se wliich has resulted in the afl'ection known as stenosis. And it is recom- mended that to indicate that the various resultant states in the different organs are not jufmary diseases but resultant states, we should designate the.se as pal hies—cardiopathies, ucphro))athies, neuropathies, etc. With the.se recommendations we are wholly in accord, provided that it be kept ever in mind that a cardiopathy, for exani])le, may in itself * I'Vjr a rt'.suiiK'* of Krcncli o|)inion.s ihhui tliis suliji'ct see Hofrei’, in Boiicfianl’s l’ii.tlir)logi(; (|(''iH''i'ale, I : 18(1.5: IS; and forl lie lato.st fleiinan pronounceinent, Aschoff, Uehirden KrinilAieilshi'firi (f wd verieamlle licf/rijlc, Ileuf, incd. tt'ocli., ll)U!l:.‘r!.