Diagnosis is a mystifying subject, because, unless great care is used, affections will be mistaken for primary disease, and treated as such until the organ takes on such pathologic changes as to become organically changed. For example, irritation of the stomach, kept up long enough, ends in cancer.

Inasmuch as mistakes of this kind are being made all the time, and not alone by mediocre professional men, too much caution on this subject cannot be preached.

When tumors are removed without even a thought of their cause, it is time to get busy on cause.

When gallstones are removed, when the appendix and ovaries are removed, without a thought being given to the cause of the derangements, we think of lack of etiological efficiency in high places.

Bacteriology is to blame for a great deal of shiftless laziness on the part of average physicians.

There are several orders of phenomena to be noticed in every disease; namely, direct cause, and reactory effects. A morbific cause starts up a physical or mental derangement; then follow organic affections. For example: Excessive eating brings on indigestion; indigestion causes gas distention of stomach and bowels. The pressure from gas on the diaphragm causes thoracic symptoms, such as dyspnea, oppression, heart palpitation; eructating gas causes irritation of the throat. In time a sensitive throat and catarrh, enlarged tonsils, adenoids, and all the diseases peculiar to the mucous membrane of the nose and throat, will in turn be added.

The gas distention kept up by heavy eating causes distention in the lower bowels causes displacement of the stomach and bowels, and constipation. Constipation causes colitis, typhlitis, appendicitis, and inflammation of the lymphatic glands from absorption of putrefaction. Gas distension in the lower bowels causes displacement of the pelvic organs, interfering with the pelvic circulation, causing prolapsus, tumors, etc. The bladder also suffers from pressure; and in males this pressure produces irritation of the neck of the bladder and prostatic enlargement. The rectum becomes involved; piles, proctitis, and prolapsus develop. While these and many minor and obscure affections are in process of development, the nervous system is being affected; enervation is established to such a degree that resistance to disease-producing influences is lost; the environmental influences, which once were passed unnoticed, affect profoundly. Digestion and assimilation are profoundly affected. At this stage, germs become a complicating cause. This is the stage in this vicious pathological circle where tuberculosis and glandular involvement show up. In all this morbid circle, germ influence is an after-consideration; for in about a year and a half after tuberculosis has started in the lungs, germs are discovered, and it is said that the germs are not found earlier except in cases that progress rapidly. Man, like an apple, resists decay until resistance is lowered. Germ decay follows a bruise to the apple. In man, germ influence follows enervation.

Epidemic, infectious, and contagious influences get their work in after mankind's resistance is lowered by a thousand-and-one influences that break down resistancethat enervate.

The graphic picture of affections following the single cause--namely, overeating--must vary in keeping with the peculiarities of the patient. This vicious circle may be established in a child or adult who looks well to the unprofessional eye. Yet he is inflammable, so to speak, and only waits for the fulminant, which may be a germ of diphtheria, scarlet fever, measles, or some other external morbific agent.

After enervation, the affection follows the cause--overeating; then germ or contagious and infectious influences become secondary causes.

When a pathological chain of causes and reactions, as described above, is once started, it is obvious how very impossible it would be to fit a satisfactory nomenclature to it. Nomenclature forces too much attention to names, and so-called diseases are nothing more than affections set up by morbid sympathies. A nomenclature has, however, been evolved, and it is safe to declare that, instead of its being a benefit to the profession, it is a hindrance to right thinking; for it is almost impossible to find two expert physicians who will agree on a diagnosis.

Much to the disgrace of the profession, it is generally known that, if a score of physicians are consulted, the patient, when through with his last counselor, will have from ten to twenty different opinions.

Why is this? No doubt there are many reasons that could be given of an irrelevant nature; but only one reason is necessary, and that one is that all these different diagnoses are right and they are all wrong.

The rhinologist finds adenoids and bony growths in the nose. His diagnosis is right! The throat specialist finds catarrh, enlarged tonsils, and follicular inflammation. He is right! The heart specialist finds an overworked heart; if the disease has been running on long enough, he will find a heart lesion. He is right! The stomach and bowel specialist finds ptosis of the stomach and transverse colon, retarded digestion, and retention of food in the stomach. He is right! The gynecologist finds inflammations, prolapsus, fibroid tumor, maybe an ovarian cyst. He is right! The abdominal surgeon finds appendicitis, ovaritis, tumors, misplacements, etc. He is right! The genitourinary specialist discovers an enlarged prostate, and a foul bladder from retained urine. He is right! The kidney specialist finds albumin or sugar in the urine, and his diagnosis is Bright's disease or diabetes, He is right! The syphilophobiac finds a positive Wassermann test, and his diagnosis is syphilis; and he is right!

All other specialists find something relating to their specialty; and they are all right, and, as stated before, they are all wrong. Their failure in curing the case is proof positive that they are all wrong. Of course, more or less palliation is given, but no cures need be expected; for all these so-called diseases are affections--sympathetic derangements--and, to get rid of them permanently, the cause must be removed. Such patients are better after taking the prescriptions of one doctor, and worse after taking the advice of another; but the ebbing and flowing, or the oscillating between better and worse, is the legitimate and characteristic progress of toxemia or intoxication, and the getting better or getting worse after taking a given treatment is simply coincidental. In this fool's paradise some doctors are made famous and others are ruined. It is largely a game of chance, except when social favoritism loads the dice. (Read in this connection chapter on "Crises.")