Food, the air, exercise, and the ordinary circumstances by which we are surrounded, adequately supply the stimuli to the organism requisite to preserve it in health; but as the organism is liable to disease, we must inquire into the cause of its production.
The causes of disease are twofold, predisposing and exciting. (We may for the present pass over the so-called proximate cause, that signifying the intimate structural change produced by the other two in the organism, which gives rise to the aggregate of symptoms that we term disease).
A PREDISPOSING CAUSE may be defined to be, in the words of John Fletcher, “some permanent condition of the body which, though insufficient under ordinary circumstances to produce a morbid change, still, in co-operation with an exciting cause, does so; an EXCITING CAUSE may be defined to be some accidental variation of the circumstances affecting the body which, though likewise insufficient in itself to produce a morbid change, may still co-operate with a predisposing cause in doing so.” (Fletcher’s Pathology page 1).
We can, it is true, suppose an exciting cause that shall be capable of producing a disease without the intervention of any peculiar predisposing cause; thus all are liable to a wound from external violences but where no predisposing cause exists, the wound will heal kidneys where there exists, however, a predisposing case, we may have, in one, erysipelas, in another tetanus, in a third traumatic fever, in a fourth an unhealthy ulcer, and so on. However, the definition just given is quite sufficient for all practical purpose, as the wound or other effect of external violent cannot be considered as a disease, in the proper acceptation of the term, but is, strictly speaking, only to be regarded as an exciting cause of disease.
The PREDISPOSING CAUSES of disease are numerous. As we have not time, and it is foreign to my purpose, though by no means so to my subject, to enter particularly into all the points bearing upon general pathology, I must content myself with doing little more than making a mere enumeration of human, believing that you are already adequately indoctrinated on these subjects, and that therefore a mere allusion to them will be sufficient. Among these predisposing causes, one of the most important is Age. It may be said, in a general way, that in early life there is a greater pronounces to disease of the head; in middle life to those of the chest; and in old age to disease of the abdomen. There are likewise special disease to which each age is exclusively or in a greater degree liable, and these depend manifestly on the peculiarity of structure or of function that accompanies each age. This subjects has latterly revived considerable attention, especially from the Vienna pathologists; and I would counsel those of any hearers who desire to study this subject more in detail to pursue some papers by Professor Engel, in the fourth and fifth volumes of the British Journal of Homoeopathy, on the condition of the blood at different periods of life.
Sex may be considered as another predisposing cause of disease. Independent of the different confirmation of the two sexes, rendering each liable to their proper disease, it has been ascertained that in some disease to which both are liable, they are not so equally: thus, in star omnium I may state that it has been alleged and statistically proved that males are less liable to lunacy than females. The experience of St. Luke’s Hospital is, that of 18, 754 patents treated there during the century of its existence, 11, 167 were women, 7587 men. (House hold Words. Jan. 17, 1852, p. 387.) Esquirol also makes the proportion in favour of females. Males are more liable to tubercle than females, whilst females are more prone to spasmodic and convulsive diseases, to anaemia, and some other affections. In the period of adult life, woman seems on the whole more disposed to disease whereas in old age the liability of the two sexes to disease seems to be, if anything, reversed.
Temperament is another predisposing cause, which I need not dwell on.
Idiosyncrasy, from which few, if any, are except, may be defined as the weak point in every individual, rendering him liable to inordinate impressions from certain stimuli, which may act little or not at all on the generality of mankind. Some historical examples of idiosyncrasy I may refer to. Thus Henry III of France could not bear a cat: Tycho Brahe trembled at the sight of a hare; Erasmus was always thrown into a fever when he ate fish; Wladislaus, king of Poland, ran away at the sight of an apple, and the same fruit made John de Quercito, secretary to Francis I., fall a bleeding. Garden, the philosopher, could not endure eggs; Cresses had an insurmountable dislike to bread; Scaliger was convulsed by the sight of cresses; and Cardinal Hauy de Cardonne swooned at the smell of a rose. Orfila mentions of a woman that she could not be- is a place where decoction of linseed was being made, without swelling of the face, followed by fainting. I know a lady who faints at the smell of musk, and several members of a family who immediately get a violent headache on entering a room where there is a sprig of mignonette; and I have a lady as a patient whose face and had swallow, and whose body becomes covered with blotches, if she but swallow a small quantity of any vegetable acid. In her the idiosyncrasy commenced late in life, and sees to increase from year to year; so that whereas at first it was only vinegar or lemon-juice that produced these peculiar symptoms, now the smallest quantity of any fruit, raw, baked, or preserved, has precisely the same effect.
Habit of body has been reckoned as another predisposing cause. It implies the condition of general strength or weakness, of obesity or leanness, of plethora and the reverse, these states being produced generally, in the first instance, by climate, diet, mode of life, etc.
Climate and season, as predisposing causes, need not be dwelt on, the greater liability to certain affections in cold climates and seasons, and to certain others in the reverse circumstances being perfectly familiar to all of you.
Diet, as a predisposing cause, is also generally recognized. Thus those reared on a rich and nutritious diet are subject to quite another class of affections from those who have only a poor and perhaps insufficient diet within their reach. Individual articles of food, in themselves wholesome, may in excess be exciting causes of disease.
Regimen, habits of life, and external circumstances may obviously all constitute predisposing causes of disease.
In respect to all such predisposing causes, it is wonderful the power human beings have of adapting themselves to different circumstances of climate, diet, mode of life, etc.
Healthy specimens of the human race are met with from the pole of the tropics; in the highest mountain ranges, on the sandy plain, and in the deepest valleys; enjoying the most constant change of scene and air, and living a sedentary life in close and ill-ventilated apartments; following the chamois from rock to rock over tracts of dazzling snow, or groveling like the mole far underground in the murky mine, illumined only by the feeble glimmer of the veiled “Davy,” and inhaling an atmosphere highly impregnated with noxious gases; exposed t wet and cold like the fisherman, or half-roasted all day long before a glowing furnace like the glass blower; subsisting on vegetables and water, or washing down the richest meats with deep potations of strong wines; reclining all day long on the softest couches, with no more violent exercise than is occasioned by turning over the pages of a new novel, or toiling from morning till night like a horse, and reposing the weary limbs at night upon the hard ground.
That however all these circumstances may occasionally act as predisposing causes to disease we are well assured by the fact that a certain large proportion of persons exposed to any of these extremes are subject to certain ailments; but at the same time the above facts teach us there is a considerable range within which health may be maintain, and we know that a strict adhesion to a uniform mode of life is not the best possible mode of preserving health, and that exceeding carefulness of avoid fancied causes of disease, and with respect to trifles, is by no means rarely the indirect cause of disease, by increasing the susceptibility.
A study of predisposing causes of disease is necessary for the physician, both for enabling him to prevent the occurrence of malady, and also for the removal of disease when it does occur. It is, moreover, on a knowledge of them that he must chiefly build his system of hygiene.
The EXCITING CAUSES OF DISEASE conspire with the predisposing cause to the production of disease; they may be divided into ordinary and accidental.
The first or ordinary class comprises temperature, light, electricity, air, miasms, parasites, food, sympathy, passions, etc.; the accidental class, wounds, contusions, poisons, etc.
Robert Ellis Dudgeon practiced at the London Homeopathic Hospital and specialised in Optics.
Robert Ellis Dudgeon wrote Pathogenetic Cyclopaedia 1839, Cure of Pannus by Innoculation, London and Edinburgh Journal of Medical Science 1844, Hahnemann’s Organon, 1849, Lectures on the Theory & Practice of Homeopathy, 1853, Homeopathic Treatment and Prevention of Asiatic Cholera 1847, Hahnemann’s Therapeutic Hints 1847, On Subaqueous Vision, Philosophical Magazine, 1871, The Influence of Homeopathy on General Medical Practice Since the Death of Hahnemann 1874, Repertory of the Homeopathic Materia Medica, 2 vols 1878-81, The Human Eye Its Optical Construction, 1878, Hahnemann’s Materia Medica Pura, 1880, The Sphygmograph, 1882, Materia Medica: Physiological and Applied 1884, Hahnemann the Founder of Scientific Therapeutics 1882, Hahnemann’s Organon 1893 5th Edition, Prolongation of Life 1900, Hahnemann’s Lesser Writing.