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

man. It may be at a very far-distant period
that this evolutionary preputial extinction will take place,--probably
contemporary with the existence of Bulwer's "Coming Race,"--but not
at a too remote period for the proper and satisfactory tabulation of the
statistics.
The ideas of the etiology and pathological processes through which we
journey,--from a condition of health and good feeling to one of disease,
miserable feeling, and death,--as described in, or rather as they control
the sentiment and policy of, this work, are such as have been followed
by Hutchinson, Fothergill, Beale, 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