Secondary cause

“ The Common Fundamental Cause in the Nature of Diseases All the phases of the process of development of the medical science, including those of the earliest periods of civilization, have in their way of understanding the causal nature of diseases that one thing in common that the diseases, owing to external causes, enter into the human body and thus, by force of a necessary or at least unavoidable law, disturb it in its existence, cause it pain and at last destroy it. ”

“ The rejection of a specific acrimony as the cause of each disease, has unfortunately been followed by a belief in as many specific actions as there are different forms and grades of disease, and thus perpetuated the evils of our ancient systems of medicine. However varied morbid actions may be by their causes, seats, and effects, they are all of the same nature, and the time will probably come when the whole nomenclature of morbid actions will be absorbed in the single name of disease. ”

“ Undoubtedly one of the most important steps which medicine has made in its development, is the recognition of the difference between disease itself and those symptoms which may be caused as the result of such disease. We shall find that in most, if not in all, of the older writers on medicine, the treatment of the physician was directed towards the alleviation of those prominent symptoms, which, then not so much looked upon as symptoms, were only recognized as the main cause of the attack. ”

“ In the search for causes of disease throughout the ages, this field, so fruitful in material, has been left almost unexplored. The disclosures of the early future will wonderfully change the sentiments entertained in regard to the cause of a large proportion of our diseases. ”

“ Whence comes it that from any given exposure to an exciting cause, no two persons will be affected alike, or in the same degree? Some may suffer severely, others be slightly affected, while by far the greater number will escape altogether. ”

“ Is the circumstance of intercourse with the sick followed by the appearance of the disease in a proportion of cases so much greater than any other circumstance common to any portion of the inhabitants of the place under observation, as to make it inconceivable that the succession of cases occurring in persons having that intercourse should have been the result of chance? If so, the inference is unavoidable, that that intercourse must have acted as a cause of the disease. ”

“ Yet, in this respect, the prevailing notions are much less correct than they ought to be, and numbers are daily regarded as in perfect health, who, on a very slight examination, would shew evidences of such derangement of function, as only awaited an adequate exciting cause to be aroused into disease of the most intense activity. The habit too much obtains of ascribing the degree of severity of disease to the activity of the exciting cause. Much more truly would it be imputed to the state of constitution to which the exciting cause is applied. ”

“ Hence the difficulty of determining, under what class of diseases parturition should be arranged, consists in there being two kinds of diseased actions comprehended under one word; which have each their different proximate cause.
In Sect. XXXIX. 8. 4. and in Class II. 1. 1. 1. we have endeavoured to give names to four links of animal causation, which conveniently apply to the classification of diseases; thus in common nictitation, or winking with the eyes without our attention to it, the increased irritation is the proximate cause; the stimulus of the air on the dry cornea is the remote cause ”

“ Disease occurs when the sum of vital force which tends to neutralize all causes of disturbance, (in other words, when the resistance offered by the vital force) is weaker than the acting cause of the disturbance. ”

“ The term Epidemic ought in strictness to signify a disease which, as we have before stated, attacks numbers at or nearly the same time, without any reference 105to the cause from which it may have originated, or be diffused ”

“ As you observe in your letter, everyone believes in molecular movements of some kind; but to offer this as a full explanation of heredity seems to me like saying that the cause, say, of an obscure disease like diabetes, is the persistence of force. No doubt this is the ultimate cause, but the pathologist requires some more proximate causes if his science is to be of any value. ”

“ What is the cause of disease? The question does not apply to any one particular form of disease or class of diseases, but to disease generally, as a concrete term meaning any disorder which may manifest itself by individual disturbances in the body; for such disturbance is but a variation in quantity or quality of one general disturbance, a variation in the mechanism that controls the work of keeping the existing cells in proper condition and replacing those cells which are constantly being destroyed. It is a variation in the process of regeneration, which we term life. ”

“ When the macroscopic changes are of moderate degree, and the disturbance of function relatively slight, while the concurrent alterations elsewhere, from the simultaneous action of the same cause, are predominant and characteristic of the disease, the condition is conveniently regarded as a degeneration occurring in the course of the latter, rather than an inflammation. ”

“ Just so it is with epidemic diseases. The cause is invisible, and, until it becomes discoverable by our senses, it can never be known; for, as has already been observed, a cause never can be known merely by its effects, unless we have seen it, or somebody who has seen it gives us information. ”

“ What is disease for one person because of a departure from his normal health might not be recognized as disease in another person of different normal vitality. Nor is it possible to assign any particular and special cause for disease since the condition recognized as disease is the result, usually, not of one but of a series of causes or circumstances more or less connected and linked together, and in many cases not obviously associated with the resulting disease. ”

“ All diseases originate in the exuberance, deficiency, or retrograde action, of the faculties of the sensorium, as their proximate cause; and consist in the disordered motions of the fibres of the body, as the proximate effect of the exertions of those disordered faculties. ”

“ If he enter without any cause for the disease, why is the individual into whose body he enters not always sick? If he enter into a body that contains already a natural cause of disease, how far does he contribute to the disease? The natural cause is sufficient to produce the disease. It would be ridiculous to suppose that the disease would have a cause, but that, as soon as this cause is active there would be a demon ready to come and assist it. ”

“ He said:
'To treat proxima causa as the cause which is nearest in time is out of the question. Causes are spoken of as if they were as distinct from one another as beads in a row or links in a chain, but-if this metaphysical topic has to be referred to-it is not wholly so. The chain of causation is a handy expression, but the figure is inadequate. ”

“ When we enumerate causes of disease we see among them many that under ordinary circumstances minister to life, health, and enjoyment; and I can hardly refer at all to the varying circumstances under which they become the medium of pain, disease and death. These circumstances are so various, so many of them are apt to be put in operation at the same time, and so little power have we of excluding them one after the other, so as to ascertain the exact efficiency of each, that our observation respecting their actual effects are open to much fallacy. ”

“ The possibility that heart conditions could be separated one from another, and that some of them could be proved to be comparatively harmless, some of them liable to cause lingering illness, while others were surely associated with the probability of sudden fatal termination, was scarcely dreamed of. ”

“ The discovery that a diseased condition of the blood leads to certain bodily disturbances which we call disease, was soon followed by the realization of the fact that one of the main conditions which bring about such disturbances is predisposition, which in many cases is hereditary. ”

“ Long continued and abundant laboratory and clinical research have about decided certain questions negatively in regard to its etiology, so that in a measure the field is cleared for the study of some of the possible basic causes of the disease in question. ”

“ Nowadays, all this is past, in medical science. As to the causes of disease, we know that they are facts of nature,—various, but distinguishable by diagnosis and research, and more or less capable of prevention or control or counter-action. ”

“ There are, indeed, various cases, of frequent occurrence, in which the study of the remote causes of disease is as practically important as anything that can be learnt as to their history, or the effects of remedies upon them. ”

“ If we would undertake to write the history of a Disease, the very first thing needful is to frame in one’s own mind a clear conception of what the History of a Disease in a general way is, for it is from a right preliminary conception, that the right conditions will follow which a Historian as such is bound to fulfil. ”

“ The common exciting causes to which so many of our ordinary maladies are imputed, and from which they doubtless in part arise, never produce their effects save on constitutions prepared to suffer by their influence. ”

“ To discover the nature of an uncommon disease, or to account for an unusual symptom, puzzles his invention.—Ignorant of every true principle, from which, by a just reasoning, he might be able to deduce practical inferrences, he knows not what prognostic to make, or what plan of treatment to observe.—Unsteady and irresolute, he attempts a variety of means ”

“ When, however, we anxiously look for any explanation as to the cause of the malady, we are told that it must have been a direct visitation from Heaven, in consequence of the eccentric characters exhibited in its wide-spreading influence, in not yielding to the scrutiny nor bending to the laws known to prevail, and to regulate the course of other diseases: neither country nor clime, age nor sex, the strong and healthy, nor the weakly and previously diseased, could be said to be free from its indiscriminate destruction. ”

“ This difference in diseases themselves seems to be one great cause of the difference of opinion among physicians on practical points, each party finding some countenance in experience for 407 their general doctrine, do not make allowance for the varieties that exist in nature ”

“ Shall we begin by taking it as a general principle—that all disease, at some period or other of its course, is more or less a reparative process, not necessarily accompanied with suffering: an effort of nature to remedy a process of poisoning or of decay, which has taken place weeks, months, sometimes years beforehand, unnoticed, the termination of the disease being then, while the antecedent process was going on, determined? ”

“ Disease arises, like other mental conditions, from association. It being a law of mortal mind that certain diseases should be regarded as contagious, this law obtains credit, through association, — calling up the fear that creates the image of disease, and its consequent manifestation in the body. ”

“ The very notion of Diagnosis in our modern sense of the word depends upon Morbid Anatomy. The older physicians seldom attempted to determine the seat of an ailment. [8] Disease was looked upon not as a condition depending upon disordered physiological functions, but as something external, attacking a previously healthy person, disturbing, and, if not expelled by art, finally destroying him; while any structural changes which were found after death were regarded rather as the effects than the causes of the symptoms during life. ”

“ His object was, to generalize the phenomena of disease, as they are exhibited in the human frame; and it was obvious to him, as to every one else, that the human frame consists partly of solids and partly of fluids. The peculiarity of his pathology is, that he reasons almost entirely from the laws of the solids, and makes so little account of the fluids, that he will only allow them to be the indirect causes of disease, which, in a scientific view, are to be deemed strictly subordinate to the direct causes, as represented by the solid constituents of our body. ”

“ Cure in the Secondary Stage.—The estimation of the prospect of recovery when the secondary symptoms have appeared and the germs are in the blood is difficult, owing to the rapid changes in our knowledge of the disease, which are taking place almost from day to day. The patient usually presses his physician for an estimate of his chances, and in such cases, after carefully explaining why our knowledge is fallible and subject to change, I usually estimate that for a patient who will absolutely follow the advice of an expert, the prospects are well over 90 per cent good. ”

“ There is, however, one precaution which must be observed, and without which the whole of the system just described is as uncertain and conditional as the rest of science. Before we can argue from what is to what has been, we must first know for certain what is. Before we can conclude that a patient has been healed by faith or cured miraculously of an incurable complaint, we must first have medical evidence to show that he had the disease. ”

“ The combinations, too, of these symptoms are so infinitely diversified, that many associations of them appear too rarely to establish a definite disease; and to an unknown disease, there cannot be a known remedy. ”