History of Circumcision from the Earliest Times to the Present | Page 7

Black, Albutt, and Richardson, so that if I have totally ignored the old conventional systems, with their hide-bound classification of diseases to control the etiology, I have not done so without some reliable authority. In studying the etiology of diseases we have, as a rule, been content to accept the disease when fully formed and properly labeled, being apparently satisfied with beginning our investigation not at the initial point of departure from health, but at some distant point from this, at the point where this departure has elaborated itself, on favorable ground, into a tangible general or local disease. As truthfully observed by T. Clifford Albutt: "The philosophic inquirer is not satisfied to know that a person is suffering, for example, from a cancer. He desires to know why he is so suffering,--that is, what are the processes which necessarily precede or follow it. He wishes to include this phenomena, now isolated, in a series of which it must necessarily be but a member, to trace the period of which it must be but a phase. He believes that diseased processes have their evolution and the laws of it, as have other natural processes, and he believes that these are fixed and knowable." To do this, the physician must travel beyond the beaten path of etiology as found in our text-books. He must follow Hutchinson in the train of reasoning that elucidates the pre-cancerous stage of cancer, or tread in the path followed by Sir Lionel Beale, in finding that the cause of disease depends on a blood change and the developmental defect, or the tendency or inherent weakness of the affected part or organ; to fully appreciate the inherent etiological factors that reside in man, and which constitute the tendency to disease or premature decay and death, we must also be able to follow Canstatt, Day, Rostan, Charcot, Rush, Cheyne, Humphry, or Reveille-Parise into the study of the different conditions which, though normal, are nevertheless factors of a slow or a long life. We must also be able to appreciate fully the value of that interdependence of each part of our organism, which often, owing to a want of equilibrium of strength and resistance in some part when compared to the rest, causes the whole to give way, just as a flaw in a levee will cause the whole of the solidly-constructed mass to give way, or a demoralized regiment may entail the utter rout of an army. As described by George Murray Humphry, in his instructive work on "Old Age," at page 11:--
"The first requisite for longevity must clearly be an inherent or inborn quality of endurance, of steady, persistent nutritive force, which includes reparative force and resistance to disturbing agencies, and a good proportion or balance between the several organs. Each organ must be sound in itself, and its strength must have a due relation to the strength of the other organs. If the heart and the digestive system be disproportionately strong, they will overload and oppress the other organs, one of which will soon give way; and, as the strength of the human body, like that of a chain, is to be measured by its weaker link, one disproportionately feeble organ endangers or destroys the whole. The second requisite is freedom from exposure to the various casualties, indiscretions, and other causes of disease to which illness and early death are so much due."
In following out our study of diseases, we have been too closely narrowed down by the old symptomatic story of disease; we have too much treated surface symptoms, and neglected to study the man and his surroundings as a whole; we have overlooked the fact that there exists a geographical fatalism in a physical sense as well as the existence of the influence of that climatic fatalism so well described by Alfred Haviland, and the presence of a fatalism of individual constitution as well, which is either inherited or acquired. The idea that Charcot elaborates, that, as the year passes successively through the hot and the cold, through the dry and the wet season, with advancing age the human body undergoes like changes, and diseases assume certain characteristics, are also points that are overlooked; and nowhere is this latter view seen to be more neglected than in the relations the prepuce bears to infancy, prime and old age, as will be more fully explained in the chapters in this book which treat of cancer and gangrene. Admitting that Haviland has exaggerated the influence of climate as an etiological factor in its specific influence in producing certain diseases; or that M. Taine claims more than he should for his "Thèorie des Milieux," or influence of surroundings; or that Hutchinson has drawn the hereditary and pedigreeal fatherhood of disease too finely; it must also be admitted