The multiplication of names is almost limitless. We find malnutritional edema labeled, ship dropsy, prison dropsy, and famine dropsy, depending on the circumstances under which the victim of malnutrition lives. There are several kinds of pneumonia depending on what portions of the lungs are affected, or upon which germ or other agent is regarded as the causitive agent. There are at least there kinds of typhoid fever, several kinds of arthritis, many kinds of insanity, two kinds of Blight's disease, etc. The absurdity of nosological distinctions becomes more and more apparent, the more we view the subject.

However much advantage may have come from the more acute and discriminative study of local conditions, such investigations and local differential diagnoses have not always served the best interests of the patient and the physician. Specialization in diagnosis tends to unequal appreciation of the elements of pathology so that those parts receive chief attention which assume chief importance in the mind of the specialist and therefore have undue weight in the general estimate that is made of the condition.

Viewed superficially, "diseases" do appear to be exceedingly numerous and very diversified. When these are subjected to close analysis, they are found to be made up of a comparatively few constituent states of "derangement," by various combinations and numbers of which, in various locations and in varying degrees of development, the apparently great diversity is produced. The actual factor-elements of "diseases" are few, while a multitude of forms exists as a result of the complexities of the human organism.

Looking at the entire aggregate of "diseases" with which man suffers, we see almost endless variety, no two cases, even, of the same so-called "disease," being identical. But the whole are bound together in one continuous series in such an unbroken continuity that it is impossible to tell where "one disease" ends and "another disease" begins. There does not exist, therefore, a multitude of diseases, as is commonly supposed, but merely many varieties and stages of one systemic degeneration.

The complex structure of organs and the close relations existing between the various tissues and organs, through the media of the nerves, circulatory systems, and the general system, furnish the basis for wide diversity and extensive combinations of symptoms.

As no one organ can be impaired without involving the other organs to some degree, no case ever presents a single symptom, or even a single class of symptoms (as nervous symptoms only) ; but in every case there is a variety of symptoms multiplied according to the number and complexity of organs involved and the extent of their involvment. And, as the condition of the organism does not remain stationary, but varies from hour to hour and from day to day, so the symptoms of disease fluctuate from one day to another, even at different times of the same day.

The reason for calling one form of disease catarrh, another diarrhea, or appendicitis or phrenitis, or tonsillitis, or metritis, or nephritis ,or asthma, or headache, etc., is not because of any real essential difference in the "disease", nor even in the cause of the "disease", but rather because of the difference in location. Each organ has its own way of acting and feeling and this gives rise to "different" symptoms. The real difference in one disease and "another" disease is in the structure and function of the organ affected. All disease is essentially one, every form having essentially the same general characteristics and, at basis, due to the same causes.

The conception of "specific disease" is slowly passing from the realm of mental "diseases." Psychologists, psycho-analysts and neurologists have recognized that "sanity" and "insanity" are not antithetical entities--the insane are no longer possessed--they are seen to be varying conditions of the same thing--mind. It is now recognized that 'insanities are not really so different from sanities, that they need a new special language to describe them, nor are they so separated from other nervous disorders by lines of demarkation as to render it wise to distinguish every feature of them by a special technical nomenclature." It needs now only to be recognized that so-called mental and nervous "diseases" are one with the so-called physical "diseases." Once the essential unity of all these "diseases" is recognized it will be apparent that these neuropathological conditions depend upon the same causes for their genesis, development and continuity, as does pathology of the heart, or lungs, or kidneys, or liver.

The apparent differences in "diseases" are given to them by the differences in functions and correlations of the organs most involved and by the degree of their affection. The symptoms of any "disease" are characteristic of the part affected. The brain can't vomit and the stomach can't become insane. The liver can't urinate and the kidneys can't produce bile. The bowels can't cough and the lungs can't give rise to a diarrhea. The heart can't sweat and the skin can't miss pulsations. Each tissue has its own work to perform and when affected or deranged gives rise to its own peculiar symptoms--that is each deranged organ speaks its own language or dialect. Thus, if the meninges of the brain and cord are affected, stupor and delirium will be present; if the lungs are affected, respiratory difficulties are present; if the stomach, intestine or bowels are affected, the symptoms will be characteristic of these organs. Inflammation in the kidneys gives rise to different symptoms to those produced by inflammation of the liver, not because the inflammation is different, but because the liver and the kidneys differ. It is the tissue that is affected and the degree of the affection that lends individuality to disease. All the specific characters of disease are derived from the tissue or organ affected and not from some specific character of the "disease" itself. The apparent individuality belongs to the organ, not to the "disease".

Tilden declares, "It is true that an inflammatory process presents symptoms a little different with each anatomical location. Inflammation of the stomach causes vomiting of mucous, and the symptoms are nausea, pain and vomiting. In duodenitis there is usually jaundice, and not always diarrhea; this inflammation frequently follows burns to the surface of the body, and may be expected in catarrh of the gall bladder and with gall stones.

"When the inflammation is of the small intestine there will be colicky pains about the navel region and large liquid discharges, with mucous well mixed with the movement. In inflammation of the large intestine-- colitis--there is much colic and the pain is lower than the navel, and if the inflammation is great there will be long, ropy discharges. Sometimes the mucous has the appearance of sloughed mucous membrane. In acute colitis and sigmoiditis there are large watery discharges at times; then, again small discharges, mixed with blood, after the disease has lasted from three to seven days. This disease is especially marked by backache and distress in the legs reaching down to the feet. A severe attack is exceedingly distressing." Criticisms of the Practice of Medicine, Vol. 2 p. 206.