What is disease? How does it arise? How does it show itself?

The answers to the above questions are important not only from a theoretical but even from a more practical point of view, for it is not until we have gained a clear insight into the nature of disease that we are in a position to arrive at once at the real method of cure, and so obviate all empirical groping about in the dark.

The way which we pursue is that in which all natural laws are discovered. We start from observations, draw our inferences from these, and finally prove the correctness of our inferences by experiment.

First of all, our observations must be extended to all symptoms which constantly re-appear and which occur in the case of every patient.

These symptoms are essential ones, and must be taken from a starting point in our inquiry into the nature of disease.

In certain diseases striking alterations occur in the form of the body; and it is these circumstances which caused me to observe further whether such alterations did not occur in the case of all patients.

And this, as observation has proved again and again, is in fact the case; the face and the neck are especially affected by such changes which can therefore be most easily traced in these parts.

For years I have made it my study to find out whether with the alteration of the outward form, the state of the health also changed in every case; thus it has been invariably.

Thus I came to the firm conviction that there must be a particular normal form for every body, which is always to be seen in health, and that every change from this normal form is the result of disease. It became clear to me from the changes of form in the neck and face a trustworthy idea of the state of health of the individual could be gained.

The alterations which we perceive in the neck and face take place in the corresponding parts of the abdomen and rump in a still greater degree, because as we shall see, they originate in the abdomen itself; so that merely by examining the neck and face of the patient we gain an exact idea of the condition of his bodily condition as a whole. These external alterations in the neck and face are perceptible, firstly, when the morbid matter has penetrated in between the muscular tissues, whereby the body, which is as elastic as india-rubber, becomes distended (this condition is the less dangerous); secondly, through increased tension, caused by the induration of the separate tissues. You will be most readily able to form an idea of this state if you think of a sausage. Filled as it usually is, it can be bent in every direction. If it be stuffed fuller and fuller, as long as the skin will hold, the sausage will become so tense and hard that it can no longer be bent at all, except by bursting the skin. Similarly, the body can expand only up to a certain limit, when tension of the tissues takes place. Such tension is very distinctly remarked when the patient turns his head and neck. This stage is worse.

If now the room between the tissues no longer suffices to receive deposits of foreign matter, the latter is deposited in lumps beside the muscular tissues under the skin, being then distinctly visible on the neck. Where we find such lumps on the head and neck we do err in concluding from these indications that there is a far greater number of such lumps in the corresponding parts of the trunk. On the abdominal covering these lumps may in such cases be easily felt and seen in all sizes. For the lumps in the neck are not formed until after lumps are deposited in the abdomen.

On the other hand, we see in lean patients how the normal tissues of the body are actually displaced by morbid matter, so that only the remains of the former, shrivelled together as it were, are still to be seen amongst the foreign matter.

The various discolourations of the skin also form a sure aid in the recognition of diseases, and in certain illnesses are never wanting.

What do these alterations in the form of the body teach us in regard to the nature of disease? In the first place, there is no doubt that elevations and swellings result from the deposit of matter of one kind or another. At first, one does not know if this is matter the system can utilise, and which has simply been deposited in the wrong place; or whether it is matter which does not belong in the body at all. Nor do we know at first whether it is the matter that causes the disease, or whether the latter is the cause of the deposit. Further observation, however, brings us nearer the truth, for the deposits almost always begin on one side of the body, and are much more abundant there than on the other; and this is invariably the side on which we are accustomed to sleep. We thus see that the morbid matter obeys the law of gravitation, settling, as it were, on the bottom. But this side always being the more diseased, it follows that the matter is the cause of the sickness; otherwise the disease would assuredly sometimes begin on the other side. Further on, more proof will be given in support of this.

We may also conclude from this that the said matter must be foreign matter, that is, such as does not belong to the body, at all event not in its present form. For we cannot assume that nutritive material follows the law of gravitation in the body, otherwise deposits on one side only would take place in the healthy body as well, if the person were in the habit of sleeping regularly on the same side.

Besides, the system itself evidently endeavours to throw off the matter. Ulcers or open sores are formed, or there is violent perspiration, or eruptions break out, these being the means whereby the system tries to rid itself of the morbid matter. Should it succeed, a pleasant feeling of relief follows that of sickness, provided, of course, that enough matter has been expelled.

by Louis Kuhne^†