Are There Internal Causes of Illness? 



Irregularities in Development It seems logical to distinguish from the 

 external sources of harm possible internal sources. But these are not so easy 

 to recognize or to classify. Wc have learned a great deal about spontaneous 

 disturbances in metabolism, but that idea is a hard notion to deal with scien- 

 tificallv- For to say "spontaneous" is really to say that we do not \now how 

 such disturbances arise. The endocrine system may be thrown out of bal- 

 ance, for example, by faulty nutrition, as by a deficiency of iodine or of 

 calcium. Generally speaking, however, most cases of hormone imbalance do 

 not seem to arise in that manner. 



Individual differences in development not only bring about obvious 

 changes in the proportions of the various organs, they bring about also ob- 

 scure changes in the workings of different organs. Thus, as one grows 

 older, a change in the shape of the eye lens may make one more and more 

 farsighted. A change in body weight may put an increasing burden upon 

 the heart. Other changes may alter the quantities of various hormones pro- 

 duced; for example, diabetes may appear "normally" in some individuals 

 past a certain age as a part of the developmental changes. 



Disturbed metabolism shows itself in growths that have no adaptive value 

 to the organism (as certain kinds of tumors) or that may be destructive (as 

 in the case of cancer). Some of these abnormal growths are no doubt due 

 to local irritation or to some chemical disturbance from the outside. We are 

 unable, however, to find a universal formula for these diseases or for diseases 

 in general. 



Ways of Living The mode of life influences the internal adjustments 

 and may bring about an organic imbalance even if no specific cause can be 

 found for illness. 



Many of the inner processes are affected by our "habits" — exercise, work, 

 rest, recreation, posture — and states of mind. That is to say, fatigue and 

 circulation, breathing and excretion, anxieties and worries, excessive eager- 

 ness or fear, exaggerated emotional activity, are so closely associated with 

 endocrine disturbances that it is often difficult to say which is the cause and 

 which the effect. Much dyspepsia or heart disease, for example, may mean 

 not any specific defect in stomach or heart structure, but faulty workings of 

 organs in response to high-pressure living or to constant anxiety. Thus 

 physicians distinguish between organic and junctional disorders. They em- 

 phasize the idea that aches and pains and difficulties indicate a disturbance 

 of the organism's unity, or wholeness, but not necessarily the cause of the 

 disturbance. This is a practical distinction in medical treatment, for it 

 means that we are to remove the sources or causes of a patient's disunity 

 rather than merely get rid of the symptoms. 



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