BY JOHANNES ORTH 



[Johannes Orth, Professor of Pathological Anatomy and General Pathology, 

 University of Berlin, since 1902. b. Wallmerod, Herzogthum Nassau, Janu- 

 ary 14, 1847. M.D. Bonn; Assistant am Pathologischen Institut, Bonn, 1870-73; 

 ibid. Berlin, 1873-78; Regular Professor, University of Gottingen, 187&-1902. 

 Privy Medical Councilor; member of the Royal Scientific Deputation for 

 Medical and Sanitary Science; Royal Association of Science of Gottingen; 

 Imperial Leopold and Caroline Academy of Natural History; and a number 

 of scientific and learned societies. Author of Cursus der Normalen Histologie; 

 Pathologisch-anatomische Diagnostik; Manual of Pathological Anatomy; and 

 numerous other memoirs and works on pathological anatomy. 



WHOEVER has to speak of pathology in general, as is my task, 

 must first determine what he includes in pathology, for the ideas 

 which are evoked by this term are not always the same. The opinion 

 is common that pathology is synonymous with "science of disease," 

 "nosology; " but this, as Rudolph Virchow 1 has attempted to prove 

 repeatedly, is not true. Doubtless disease, or rather the diseased 

 individual, is the most important object of consideration of patho- 

 logy; it is, however, not the only one. The conception of pathology 

 is much more comprehensive. To pathology belongs, on the one hand, 

 every deviation from the normal structure and the normal composi- 

 tion of the body, and, on the other, every deviation from the normal 

 function of its parts. It therefore includes every variation from 

 what we consider the type of an organism. Variation from type is, 

 however, not disease. Disease is, as Boerhaave was the first to say, 

 " Vita praeter naturam," and life presupposes activity. When there 

 is no functional activity and thus no deviation from normal function, 

 there can be no disease. But not even every functional variation 

 from the normal indicates disease. The variation must be pernicious 

 in character, if it is to bear the name of disease. When there is no 

 detriment, there is no disease, although whenever a variation from 

 the normal exists, we have to do with a pathologic condition, no 

 matter whether the variation is morphologic or functional. 



Purely morphologic variations without detrimental influence on 

 the rest of the body are found, especially among anomalies and 

 malformations, and who will deny that these belong to the realm 

 of pathology? An individual with a supernumerary nipple, a person 

 with polydactilism, a woman with uterus septus or bicornis, all are 

 pathologic, although none are sick. Thus, while the biologic phe- 

 nomena of the diseased state form the greater part of the realm of 

 pathology, they do not complete it. Its limits must be extended 

 much further, but how far is the point of contention. 



1 Handb. d. spec. Pathol. u. Therapie, 1854, pp. 6 5. 



