Licence: Public Domain Mark
Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
25/974 (page 7)
![standing by them such changes as have no recognised morbid anatomy, but such as depend upon corresponding changes in the finer processes of nutrition. We do not believe that there is any altered function without a correlated change in the nutrition of the organ; but what we assert is that such change, as a matter of fact, is of such kind as to be undiscoverable by our senses, and as a matter of inference, from what we know of the relation betv/een nutrition and function, is of such nature that it may always be beyond the reach of observation. No healthy function is performed without nutrition-change: no morbid function can exist without altered nutrition-change ; but the relation between the two elements, structure and function, is the same in the two conditions. Il^ATUEAL History of Disease.—Under this phrase are recorded the symptoms or phenomena of disease, their causes, the manner of their development, their duration, and the different modes of their termination, whether the termination be in death, or in a return to health. In the natural history of disease no theory is involved; we have to deal only with facts. Causes.—Commencing with that which precedes the appearance of symptoms, viz. the causes of disease, there are some principles which it is important to lay down ; inasmuch as our ideas of the causation of disease are determined, in great measure, by our concep- tions of what disease itself is. ISTothing is more easy sometimes than the discovery of a cause, and its distinct separation from a particular and well-known malady. Eor example, a healthy child is brought into a room where some one is suffering from scarlet-fever, and after a certain period it exhibits symptoms of the same malady, and passes through all its stages. Here we say there was direct communication of the malady; but we must not forget two facts, first that some children so exposed do not take the fever, although they have not previously had the disease ; and secondly, that those who have suffered from it once rarely take it again, although they may be exposed to infection. We suppose a constitutional disposition in one case, an indisposition in a second, and assert the existence of the latter in a third. Still, when the cause has operated we feel that we tread on safe ground when asserting broadly that the cause is infection. iNTothing however is more difficult in some cases than to say what the cause of a disease has been. For example, six people take an indigestible meal, and one of them suffers nothing, a second is troubled with dyspepsia, a third with asthma, a fourth has an epileptic fit, a fifth an attack of gout, and a sixth is disturbed with diarrhoea. One element in the causation of all these maladies is the same, viz. an indigestible meal, but the results vary widely ; and we say that this is owing to constitutional conditions which predispose to these particular affections. These have been called predisposing causes; but we must inquire what they are, and how they are related to these diseases, if we would understand the ]atter. Among the predisposing](https://iiif.wellcomecollection.org/image/b2198010x_0001_0025.jp2/full/800%2C/0/default.jpg)
