Popular Science Monthly/Volume 77/July 1910/The Nature of Disease and of its Cure

THE NATURE OF DISEASE AND OF ITS CURE

By Dr. JAMES FREDERICK ROGERS

YALE UNIVERSITY

THE earliest explanation of disease, corresponding to the ideas of nature which first impressed the dawning human consciousness, was that the usual working of the body had been upset by the entrance into it of an evil spirit. This spirit proceeded to disturb the "ease" of the body of the sick man, causing it to reject and eject food, racking it with pain, and burning it with the slow fire of fever, and even talking through its lips in incoherent or mysterious utterances. So satisfactory an explanation did this seem that, in modified form, it has a hold with the more superstitious even in the present day.

Such being the cause for his sufferings, the primitive man was prompt to see that the cure should be the driving out of the evil spirit which had taken up its abode in the body, by the most appropriate methods. The medicine man of the tribe assumed a superior knowledge in such affairs and took upon himself the responsibility of dealing with these unseen powers. Working upon the reasonable assumption that what appealed to human senses must also appeal to the dwellers in the spirit realm, that what was agreeable or disagreeable to one must be agreeable or disagreeable to the other, this healer proceeded to make it very unpleasant for the tormentor of the sick man by appearing before him in his most hideous garb, by the repetition of frightful cries and thunderous thumpings upon his tom-tom, while draughts made of the most vile and disgusting substances were poured down the throat of the victim in the hope that the spirit would be induced to let go his hold and depart. It was the most logical treatment imaginable, and it seemed so proved by the fact that the sick man very often recovered. Nor did the primitive mind stop at the mere driving out of the source of disease, but followed up its success in this direction by equally rational attempts at prevention by the wearing of some magic object to keep away the demon of sickness in the future.

As men became more observant and thoughtful, it became apparent that certain physical conditions seemed to have much to do with the presence of sickness. While the spirit realm might be finally responsible for the singling out of the sufferer, yet extremes of heat and cold, dampness, lack of food, and some other agencies were seen to be get-atable causes. Moreover, it was discovered, more or less accidentally, that the application of heat and cold, bathing, rubbing, and the use of certain plants often gave comfort and apparently often helped the sick man to recover. So arose the more materialistic cure of disease and the profession of physicians.

By those who studied disease from the more material standpoint many theories were devised to explain the phenomena displayed by the sick. The lack of knowledge of the minute or even the gross structure of the body and its working in health, necessarily made all these attempts at explanation more or less crude and imperfect. Every conceivable "cure" was tried from age to age, and, no matter what the means employed, whether gold or clay, sassafras or tar water, whether the patient was bled or whether sharp hooks were applied to his flesh in order to "draw out the humors," always a certain percentage of patients recovered from the disease and survived the treatment. For the time, at least, the "cure" was apparently justified by the results, and held its place in practise until a change of theories or an unusually long list of failures threw it into disrepute, and it was relegated to the list of things which "have been used but are now found of little value."

The more obvious causes of disease—intemperance, exposure to heat and cold, exhaustion, etc.—were early connected with certain forms of bodily ailments, and even diseases like malaria were known to depend somewhat on local conditions of living, but it is only within recent years that such common affections as pneumonia, tuberculosis, influenza, etc., have been found to have a tangible cause working within the body. With the discovery of bacteria and their poisons there still remained the questions, What is disease? Why, even in times of plague, are some persons exempt? and why do certain persons recover and others succumb even with the same treatment?

We can no longer look upon sickness as due to the presence within or without us of an evil-natured personality. We must reverse the idea and say that disease is the manifestation of a good consciousness within us, a consciousness which seeks to maintain life by endeavoring to rid the body of a harmful material presence. We realize through abnormal sensations that we are sick—that the body has undergone a change from the condition of health, but within us is a more elemental intelligence of which we are not aware, an older body-mind which, whether we sleep or wake, and even before we are born into consciousness of self, looks after the highly complex and interdependent structures on which life depends, constantly directing its complicated affairs with unerring faithfulness. Disease may be said to be the effort made by the body, directed by this deeper mind, in its attempt to rid itself in most appropriate ways of whatsoever it finds harmful to it, or that threatens its destruction. A fit of vomiting, in which the conscious mind takes a passive and even unwilling part, is but the wise attempt on the part of this inner consciousness to rid the body of that which it finds to be harmful. In the case of the presence of bacteria, they are at once detected by this bodily consciousness, though the higher consciousness is unaware of their presence. The agencies within the blood, capable of destroying the germs and of neutralizing their poisons, are set to work at high pressure. To the higher consciousness and to the observing mind of another person these efforts become apparent in higher bodily temperature (fever), a more rapid pulse and increased respiration. The bodily machinery is stirred to higher activity, its fires are heightened, and its organs are quickened. Germ-destroying substances are being made in greatest possible amount. The "signs and symptoms" of the disease, or these outward manifestations of internal activity, differ with the kind of germs and with their numbers, the body working more or less characteristically in each case, so that for each germ the "symptoms and signs" are an index to the cause.

Such a disease or body-fight must "run its course," and, no matter what the treatment, that course can at best only be shortened, or the struggle of the body with its enemy made less exhausting by help from without. Where the number of bacteria is large or especially vicious, or where the bodily powers are inadequate for promptly developing its resisting powers, the fight of the body may be of no avail, even with the most skillful aid. On the other hand, if the bacteria are few and the bodily powers are vigorous, the patient will recover even with the most absurd treatment. It is easy to see why the medicine man of primitive society and the miracle workers of a later age often succeeded in "driving out" disease and in effecting apparently marvelous cures.

After once having an infectious disease, such as typhoid, or measles, the body is often exempt from an attack by the same germ. We now know it is not because of special divine favor bestowed upon the individual, but because the body, after passing through one struggle with the bacteria, keeps on hand afterwards a defensive material which quickly destroys any germs of the same kind which find an entrance.

Even in times of epidemics and among those associated with the sick, a certain number of persons always escape without serious signs of the prevailing disease. While the germs no doubt often attack such persons, their protective powers are so perfect that the machinery of the body does not have to be put at work in such a degree as to produce any conscious outward signs of the disease.

For some of these bacterial invasions modern medicine has invented the wonderful expedient of producing, in other animals, similar substances to those which the human body manufactures in its fight against the germs. By inoculating these into the human body the microbes can be prevented from gaining a lodgment, or the body can be greatly aided in its fight against them. Although the body can be thus aided in diphtheria and meningitis, for the attacks of most germs it must still depend on its own resources in a successful fight against the marauders.

Most of the infectious diseases are of short duration, the body triumphing or failing in its fight in from one to five or six weeks; yet some such fights are long drawn out, and, as in tuberculosis, may cover many years, the disease—the fight—varying in success with the resources of the body and with the amount of drain of bodily energy in other directions. Whether brief or long drawn out, whether acute or chronic, the bodily antagonists often leave scars in the shape of damaged organs—lasting ills which serve to render the body less perfect in its working than before, and also leave their impress on the higher consciousness in feelings of weakness and discomfort.

Besides the bacteria and their poisonous products, other things produce disease more or less insidiously. While the body naturally rids itself through certain organs of the waste matter—the ashes and smoke of its daily activities, continued excesses in eating or drinking throw extra work upon those organs, which in time wear out under added burdens. Exhausting work, excesses of heat or cold, and other unusual conditions also bring about reaction of the inner bodily consciousness to adjust the body to its surroundings. The body makes the best of a bad matter and does its utmost to bring itself into harmony with its outer conditions.

Disease is, then, a life-saving effort of the body, directed by its inner consciousness, in ridding itself of harmful substances within, or of compensating for injured or overworked organs. It is the next best thing to health in that it is nature's way of attempting to bring the body back to that harmonious working of all parts which we call health, and often also of producing protecting substances which prevent future injury from the same source.

While the treatment rendered by the earliest healer, the medicine man, must seem to us absurd, so far as any direct alleviation of suffering is concerned, we can not but guess that the hope which his presence and his, to us, useless efforts inspired in the sufferer, helped not a little to stimulate, through the mind, the failing bodily forces. Mind and body are so intimately related that what affects the one affects the other, and throughout the history of the treatment of disease mental influence has always been used directly or indirectly, consciously or unconsciously, to aid in restoring the body to its state of health.

The higher conscious mind is intimately a part of, or a manifestation of, the body, and is affected by bodily conditions of well or ill being. While it can take little part in directing the defense against foes which have gained an entrance to the body, the mental conditions—the emotions of hope or discouragement—indirectly support or depress the whole of the bodily fighting machinery, for the organ through which the mind works is closely connected with every other organ of the body and so influences digestion, circulation and all other functions. Likewise the mind is affected by the bodily states. The ill working of damaged organs may produce a mental state of pain or depression. These feelings may be heightened or diminished by mental effort, or may be more or less forgotten, for the time at least, by directing consciousness into some other channel of activity. Disease is, in every case, modified more or less by the mind, and the mental state may sometimes help to determine the success or failure of bodily fight against destructive agencies. If appeal to the mind seems to cure the bodily ill, it does not indicate that the patient would not have recovered anyhow, and does not signify that the mind itself effected the return to health. No amount of faith or other mental state can take the place of insufficient body-resources—can restore a damaged lung or a missing limb.

Disease being thus the attempt of the body to restore itself to its usual condition by ridding itself of destructive agents, the treatment of disease must be directed toward helping the body to this end, by putting the mental and muscular forces at rest, by proper nourishment and by such antitoxins or drugs as aid it in its natural efforts to rid itself of harmful conditions. Better still are the efforts toward prevention of infectious and other injuries by the avoidance of intemperance in eating and drinking, by breathing fresh air, by cleanliness, and by such other means as the body demands to keep it at its best working power. Lastly, the mind should be trained not to meddle too much with bodily affairs, save as it observes the laws of hygiene, and it should be educated to deal readily with the trials and vexations of life in a way that will not affect the general health through depressing emotional discharges.

It will be seen that our modern faith healers make no difference between diseases as regards their cause. In their ignorance, comparable only to that of the primitive medicine man, they deal with all sickness alike. While the condition of the mind has much to do with some diseases, with others it has little or no part in the cure, and the body itself must work out its salvation through that wise inner body-directing intelligence which the higher mind can not know nor—but to a slight extent—influence. The faith curist in the conceit of his ignorance takes the credit for the cures which, through good fortune plus a grain of mental stimulus, often come to pass under his administrations, while he who has studied into the physical nature of disease is perfectly aware that when his patient recovers he has only assisted nature more or less in what she would probably have accomplished without his help though usually not so easily and completely and sometimes not at all. It is this humble knowledge of the limitations of his art that makes the physician the more anxious, in this age, to prevent disease, for he realizes it is much easier to remove the cause than to help the body in its efforts to throw off the attack. By the purification of drinking water he has greatly reduced the amount of disease from typhoid; by furnishing pure milk the sickness and death of infancy have become much less; by recommending life in pure air tuberculosis is less frequent, etc. Mere faith or mind cure has done and can do nothing of the sort. Medical teaching has also warned against intemperance of all kinds, and against other insidious destroyers of bodily harmony.

The physician has in all ages made use of mental treatment, for, no matter what his remedy in physical form, there has always gone with it a grain of hope. Where he finds the mind especially at fault he may even appeal to it directly, and thus relieve suffering which had its origin chiefly in mental depression or in a too exuberant and untutored imagination. He often succeeds in producing more harmony in bodily working by establishing a happier mental and moral view of life.

As the prevention of the entrance of bacteria or of any other injurious agent into the body is far more economical than the helping to overcome the damages these may produce, so the prevention of unhappy and unhealthy mental states is far better than an attempt to restore a mind to right habits from which it has lapsed.

In primitive times one minister looked after both the spiritual and bodily health of the individual. As the doctor of medicine later assumed the cure of the body, so the doctor of divinity took as his special province the cure of the soul. Mind and body react upon each other, and he who ministers to the one can not but influence the other to some extent. While the priest has abundant opportunity for helping to heal soul-injuries, his larger work, like that of the physician, lies in surrounding those he would help with better social conditions, and in developing, through religious and philosophic training, their individual powers of resistance to the stresses to which the moral nature is daily subjected. For both physical and spiritual ailments prevention is far easier and better than cure.