4 i8 SCIENCE PROGRESS 



constitutes the disease, and this combination never exists in the 

 body of the patient ; for all the disorders are never present 

 in him at the same time. The combination is in the mind 

 of the observer : it is he who constructs the disease, which has 

 no existence outside of his mind. When we speak of treating 

 a disease, or of a disease getting better or worse, we are using 

 convenient but inaccurate figures of speech. We do not 

 administer drugs to the disease : we administer them to the 

 patient. It is the patient, not the disease, that is put to bed, 

 poulticed, fomented, and bathed. It is the patient, not the 

 disease, that gets better or worse, that recovers or dies. A 

 disease in the human body no more has any existence in rebus 

 natures or in rerum naturd than a riot in the body of the 

 community. When three or more persons behave violently 

 in the street, we call the combination a riot ; but there is no 

 such single thing in the street as a riot. The riot is a mental 

 construct. What exists in the street is a number of persons 

 behaving riotously, and we mentally combine these several 

 instances of riotous conduct into a single concept, and call the 

 concept a riot. If a person is injured or killed in a riot, we do 

 not say, nor can we think, that he was killed by the riot. He 

 was killed by one or more of the rioters. The police do not 

 charge or disperse the riot : they charge and disperse the rioters. 

 It is easy in this case to see that the malady of the community is 

 a mental construct and not a perceptible thing ; and it is easy 

 to appreciate because lawyers have strictly denned what they 

 mean by a riot, and when they speak of a riot they know what 

 they are talking about ; but doctors do not recognise that a 

 disease is a mental construct, because they have never denned 

 a disease, and when they speak of a disease they do not, with 

 all deference to them, know what they are talking about. 



There are two other terms in medicine that clamour for 

 definition. These are ' functional disease ' and ' organic 

 disease/ which are commonly used as complementary and 

 antithetic. 



Every disease is of necessity functional, in the sense that 

 it includes defect or disorder of function as an integral and 

 necessary part of its composition. In fact, if we include in 

 function the intrinsic as well as the extrinsic function, every 

 disease consists entirely of disorders of function and of nothing 

 else ; and in this sense, every disease is of necessity purely 



