238 NEUROLOGY 



In conclusion, then, I offer the following propositions: 



Every organism, whether we call it diseased or well, presents 

 itself to our view as a web of interwoven "energies," which, in order 

 to study them by anatomic means, we must break artificially into 

 fragments that have, in reality, no correspondingly separate exist- 

 ence. 



These energies, under tendencies which countless ages of evolution 

 have established, have woven themselves into a mechanism of inter- 

 locking functions, forming an endurable and relatively stable equi- 

 librium, which we denominate as health. This equilibrium, however, 

 must always remain but relative, and would become a real equi- 

 librium if that were possible only at the sacrifice of further evolution 

 and progress. 



The processes of mutual modification and adjustment through 

 which such an organism seeks to gain and to maintain this equilibrium, 

 under the ordinary conditions which we classify as health, are the 

 only means which it possesses to meet the more serious needs created 

 by the unusual conditions that we call disease. 



It rarely happens that these efforts 1 at readjustment (after any 

 considerable disturbance of this equilibrium) are thoroughly success- 

 ful, and in the abortive or exaggerated reactions on the part of the 

 organisms, energies are set free and habits are established which 

 are often hostile to the main interests of the organism as a whole, 

 and therefore are reckoned as evidences of disease. 



In many cases the processes of readjustment are taken part in by 

 various functions of the organism which do not seem to be at first 

 sight related to the changes primarily at stake, to such an extent that 

 the earlier effects of the original lesion are overshadowed, and we 

 seem to be in the presence of what would be called a change of type 

 rather than a disease. In this way, for example, what are called by 

 biologists the "secondary sexual characters" arise. Clinical exam- 

 ples of this tendency toward such a generalization of the process of 

 readjustment have already been suggested. 



Although these processes of readjustment do not seem to be guided 

 by teleologic influences, and although they often fail to benefit the 

 organism, and, instead, work it great mischief, yet in many instances 

 they do have all the outward appearance of being under the direction 

 of some general principle analogous to that which governs the pro- 

 cesses of growth, and is manifested in the repair of lost parts among 

 the simpler forms of life. 



The tendency, according to which the processes of repair are 

 governed by a "general principle," presents interesting analogies 

 with the government of the flow of thought and memory by a "lead- 



1 It is to be understood, as stated above, that the term " efforts " is here used in 

 a descriptive sense alone. 



