THE NAMES OF DISEASES. xiii 



have been named. Some are called after a prominent symptom, such, for example, 

 as whooping-cough and writer's cramp. Some are named after the rash which they 

 present, as nettle-rash, small-pox, scarlet fever, and so on. Other names indicate 

 that the disease is characterised by a certain change occurring in some particular 

 organ or region of the body, thus we speak of bronchitis, which is inflammation of 

 the bronchial tubes, and of peritonitis or inflammation of the peritoneum, the 

 termination itis in these cases signifying inflammation. Then again the names of 

 certain diseases end in cemia, as, for example, anaemia, leucocythaemia, pyaemia, and 

 so on, the termination in these cases signifying that it is the blood which is primarily 

 at fault. This is undoubtedly a bad way of naming a complaint, for in many other 

 diseases, such as small-pox and scarlet fever, there can be no doubt that the blood is 

 essentially affected. It occasionally happens that a disease is named after the 

 physician who first recognised it, or who devoted special attention to the elucidation 

 of its nature and treatment, and we have familiar examples of this in Blight's 

 disease and Addison's disease. 



The terms " functional," and " structural " or " organic," are so frequently 

 employed in connection with disease that it is absolutely necessary that we should 

 arrive at some definite idea as to what we mean by them. We will not attempt 

 any formal definition, but will endeavour to convey our meaning by one or two 

 simple illustrations. In ulcer of the stomach and in cancer of the stomach a certain 

 change takes place in the organ in question, which is at once recognised. There is 

 something there which we can see and which we can feel. This is something 

 tangible, something having distinct physical properties, something we can point to 

 and say, this is the cause of death. Now this is what we call organic disease. 

 But, on the other hand, a man may have suffered for many years from indigestion 

 and marked derangement of the stomach, and yet after death the most practised 

 anatomist, with all the means and appliances of modern science at his command, 

 may fail to discover any change to account for them. This is what we call functional 

 disease. To employ a very rough simile we may say that in the one case our engine 

 is rusty and won't work, and in the other the piston is broken. As a rule an 

 organic disease is of more importance, and is more likely to interfere with the 

 duration of life than a purely functional one, but it is not always so. It may be 

 more trouble to take the whole of an apparatus to pieces and clean it, than simply 

 to restore one part that happens to have suffered. 



Then again we speak of " general " or " constitutional," and " local " disease, but 

 this is not a strictly accurate division. For example, we know that pneumonia is 

 inflammation of the lungs, but it is absurd to call this a purely local disease. Look 

 at your patient ; his face is flushed, his tongue is furred, his skin is hot, his pulse is 

 quick, and, in fact, he is ill all over. It is not only the lung that is at fault, but 

 the whole body is suffering. You must treat the man, and not the lung Doctors 

 too often forget that they have to treat the patient, and not the disease. Now 

 take the case of gout. No one supposes for a moment that this is a local disease. 

 No one would maintain that if we were to cut off the patient's big toe we should 

 relieve him of his pain, or cure him of his malady. And so it is with many 

 complaints that are supposed to be local. The local signs or symptoms are 



