Disease is a vital process, not an entity.

 The Unity of Normal and Abnormal Processes 
Vol. XXXIV March, 1973 No. 8 
The Unity of Normal and Abnormal Processes
 Herbert M. Shelton 

Most of the early Hygienists held to the principle of the unity of disease. Jennings and Nichols were perhaps the most outspoken in affirming this principle. Jennings was not the first to suggest that the seeming multiplicity of diseases represents a unity. Dr. Benjamin Rush, who was Surgeon General of the Continental Armies during the Revolutionary War, stressed the importance of the principle. Samuel Thompson, founder of the medical system known as Physiomedicalism made the principle a fundamental part of his system. Dr. Samuel Dickson, of England, founder of the medical system known as Chrono-thermalism, published his book The Unity of Disease in 1838. He later defended this theory in his book, Fallacies of the Faculty. The allopathic medical profession rejected the principle of unity of disease 75 and adhered to the notion that there are many diseases. When I was a student the textbooks listed 407 diseases, but the process of fragmentation was already under way and today many thousands of diseases are listed. 

Today, when the effort is being made with more or less success to interpret all natural phenomena as parts of one pattern, or as expressions of one universal form of progress, the medical profession still clings to its dualisms about health and disease and to its old belief that there are hundreds of diseases. They refuse to recognize the single underlying phenomenon of which their many diseases are but varied and evanescent expressions. 

Life, health, disease are ultimately to be interpreted as different aspects of an underlying process. It is our own shortsightedness that blurs for us the wholeness and unity of life. The terms and expressions of contemporary medical literature which we have inherited from the past carry implicit assumptions regarding the general nature of disease, and one of our main tasks is to show where they are invalid.

 Man is not always sick despite the fact that he lives in a sea of extraneous causes that are said to cause disease. Indeed, these extraneous causes fail more often than they succeed. Yet we know that disease is always a potential in man. Abnormal though it is, it is just as natural as health. In fact, if we can ever escape from our dualisms of thought we will recognize that health and disease are but two phases of the same living processes. We will discover that there is no distinct line of demarkation between health and disease and that they are not so unlike as we now believe. We will readily understand that disease is a manifestation of life itself and that there is a fundamental unity in all of life's manifestationsnormal or abnormal. 

The principle of continuity and unity becomes a guide to the correct organization of pathological knowledge, which is already vast, in conformity with the laws of nature. This principle provides for a major and all important reorientation which eliminates the prejudices and false views that have hitherto obscured our vision and made it impossible for us to see the woods for the trees. The change of position thus produced transforms the interrelations of everything so that a simple order is revealed.

Change is as constant in pathology as in all other departments of existence, yet the change is not arbitrary; each change develops continuously out of the preceding developmentearlier and later developments do not confront each other as the senseless juxtaposition of one chaos beside another, but are linked by similarities which pervade all change.

 The meaningful order which underlies the progressive changes seen in pathological evolution is realized in the continuity of the sequence of change. Fundamentally, there are but few pathological changes, both of structure and function, that can occur in even the most complex organism. Great and complex variations in the appearance of these fundamental changes are possible, due to the many differentiations of tissues and to the wide variety of functions subserved by them. The 76 basic pathology (atrophy) in atrophy of the liver and atrophy of the pancreas is the same, but the complex of systemic changes of functional aberrations that is based on this atrophy varies as the functions of the two organs vary. Basically, the "special pathology" in the lungs in pneumonia and that in the kidneys in acute nephritis, is the same. Differentiating symptoms and changes relate to the differences of structure and function of the two organs. Inflammation of the stomach may check the secretion of gastric juice and inflammation of the pancreas may check the secretion of insulin, but in both cases the fundamental change is the checking of secretion. The kind of secretion that will be checked will depend upon the kind of secretion turned out by the inflamed organ. Duly considered, this simply means that the many different so-called diseases are not different diseases. They are but different locations and different stages in one and the same process. 

The diagnoses and classifications of diseases listed in medical textbooks are all illusions that grow out of the medical man's notions that the symptom-complexes, though richly variable even for the same so-called disease, represent entities instead of being symptomatic of an underlying substratum common to all symptom-complexes. The same unity of the body is preserved in disease as in health. We deal with a sick whole, not merely a sick part. Just as in physiology the whole widely extended state of function is a unit, so in pathology the whole widely extended state of processes that constitute the remedial process is a unity. When there is irritation of the nose, throat, sinuses, and elsewhere, this represents a systemic condition, not a series of local infections. Should any part of the digestive tract from the mouth to the anus become inflamed the name given the "disease" will correspond to the part involved, and the state of the inflammation will be: first irritation or inflammation, then ulceration, then induration and cancer.

 All pathologic change is named in keeping with the part involved. Inflammation of the stomach is called gastritis; when ulceration develops out of inflammation, it is called gastric ulcer; when the ulceration takes on induration (hardening), it is called gastric cancer; if the development involves the pyloris, it is named pyloric cancer. If the inflammation extends to the duodenum, it is called duodenitis; if the duodenum ulcerates, it is called duodenal ulcer; if induration follows, it is duodenal cancer. While we tend to think of so-called diseases as local affections, the entire body is always involved in the process. This is not to give utterance to the stupid prevalent notion that every "local disorder" deranges all the functions of the body; rather, it is meant to express the idea that the whole organism is involved in every remedial process. In the case of a diarrhea, for instance, it is a disturbance only in relation to a larger and otherwise unitary whole which it interrupts. There is no thought of derangement, but of redirection. The central and basic powers of life are those engaged in nutrition, including those of digestion, respiration, circulation, assimilation, excretion, and reproduction. The normal performance of these functions is health. When any or many of these powers are much modified to meet abnormal conditions, the modification is disease. The modification is protective, reparative, expulsive, remedial. All such modifications are 77 in the service of life, not in the service of death. These modifications are integral to life, not foreign agents at work in the body. Disease is a vital process, not an entity. 

A local disease is an impossibility. Every so-called local disease is but the local manifestation of a general condition. Every local pathological manifestation is an expression of a systemic pathological condition. This is so because the body is a unit. Local diseases, so-called, are the local expressions of general states. For the successful care of the sick, therefore, it is not sufficient to confine our attention to the organ or part affectedwe must care for the whole organism. When indigestion produces irritation of the stomach lining, inflammation, or gastritis develops. When irritation occurs to the point of irritation it becomes a point of toxemic crisis. The hairsplitting seen in differential diagnosis is made necessary by a lack of knowledge of cause. It is a compensation for ignorance, an effort to appear scientific when there is no science. 

When we know that the processes and elements of disease are the same as the processes and elements of health, is it probable, nay, is it possible that disease, any disease should have no order in its seeming disorder, that diseases should present no unity in their seeming multiplicity, should suffer no explanation by the discovery of some central and sublime law of mutual connection? If all organs of the body are governed by the same laws why such a multiplicity of diseases as are recognized by so-called medical science? Each organ has its own peculiar histology (tissue or structure peculiarity) and each has its own peculiar function to perform. Every organ of the body, and this includes the brain, is under the same physiological and pathological laws. By the co-operating principles of causation and differentiation do we derive the many so-called diseases out of a common source. The many so-called diseases of the medical nosology are but symptom-complexes of a constitutional toxemic state; they are the effects of accumulated waste products of metabolism. 

Every inflammation has symptoms all its own, yet all inflammations are basically the same. Although the symptoms of tonsillitis differ greatly from those of acute gastritis, the inflammation is identical in the two organs; although the symptoms of pneumonia are greatly different from those of hepatitis, the inflammation in the liver is the same as the inflammation in the lungs. The dissimilarity of these so-called diseases is due to the varying functions of the organs inflamed and to the differences in histologieal (tissue) structure of these different organs. Why do professional pathologists, trained also in histology and physiology, continue to view inflammation in many different parts of the body and imagine that each inflammation is a specific disease? 

The shades of differences existing in the different so-called disease are apparent because of the different tissues involved. It is our confirmed opinion that too much attention is given to minute pathological distinctions and too great value is placed upon these. Every part of the body, when irritated, gives rise to its own symptomcomplex, or what is known as a special disease. The brain and nervous system have their own complexes; the liver, kidneys, lungs, etc., each has its own complex. Singling out one or more of the 78 pronounced symptom-complexes that make up the composite of the sick man's symptoms, diseases, complications, etc., all of which arise out of the one and only efficient cause-toxemiaand specializing in its treatment, is an important procedure in what is known as "modern scientific medicine." Congestion and inflammation may develop simultaneously in different organs; or, what is more frequently the case, one organ may become congested and inflamed; and, as time passes and the general health of the individual declines, one after another of several structures may be-come congested or inflamed. It is in this manner, in part, that complications always develop in longstanding chronic castes. As the chronic disease continues due to the persistence and intensification of the cause of the disease, one after another of the organs of the body is brought into the pathological field; the complications become more numerous. Thus, it is true that many complications are due to the persistence and increase of cause. The sick man sets out, at the beginning of his suffering with dyspepsia. After ten or twenty years he finds that he has disease of the throat and lungs, bowels, liver, kidneys, heart and perhaps of the spine. If the individual is a woman she probably finds that she also has one or more "female diseases." All so-called diseases are but varying symptom-complexes growing out of a common cause. True, there are many causes, but if they are carefully studied, it will be found that they are all auxiliary to one universal, efficient cause-toxemia. Disease-inducing habits are responsible for many symptoms. Many complexes of symptoms are given distinctive names and listed as specific diseases. The regular profession labels almost every symptom inducted by bad habits as a separate diseaseunless they decide to call them "syphilis." Add to the symptoms induced by bad habits, those induced by drug poisoning, and you have about all the symptoms that man presents when he is sick. 

Herbert M. Shelton