Disease and Its Causes — Context and Discussion

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Authors: Councilman, W. T. (William Thomas), 1854-1933 Digital Source: Project Gutenberg Gutenberg Release Year: 2005 First Publication Year: Not confirmed

Key Word: Diseases -- Causes and theories of causation Target Reader: Readers of public-domain and historical texts

Book Edition: Project Gutenberg digital edition Book Language: en

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Words 59,287

Reading time 258 min

Text sections 10

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This editorial note examines the structural organization of Councilman's 1913 medical text, focusing on how he moves from cellular biology to body surfaces, infection routes, and the interplay of environment and physiology, using recurring imagery of surfaces and barriers.

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DISEASE AND ITS CAUSES

W. T. COUNCILMAN, A.M., M.D., LL.D. Professor of Pathology, Harvard University

New York Henry Holt and Company London Williams and Norgate The University Press, Cambridge, U.S.A.

In this little volume the author has endeavored to portray disease as life under conditions which differ from the usual. Life embraces much that is unknown and in so far as disease is a condition of living things it too presents many problems which are insoluble with our present knowledge. Fifty years ago the extent of the unknown, and at that time insoluble questions of disease, was much greater than at present, and the problems now are in many ways different from those in the past. No attempt has been made to simplify the subject by the presentation of theories as facts.

The limitation as to space has prevented as full a consideration of the subject as would be desirable for clearness, but a fair division into the general and concrete phases of disease has been attempted. Necessarily most attention has been given to the infectious diseases and their causes. This not only because these diseases are the most important but they are also the best known and give the simplest illustrations. The space given to the infectious diseases has allowed a merely cursory description of the organic diseases and such subjects as insanity and heredity. Of the organic diseases most space has been devoted to disease of the heart. There is slight consideration of the environment and social conditions as causes of disease.

Very few authors are mentioned in the text and no bibliography is given. There is lack of literature dealing with the general aspects of disease; the book moreover is not written for physicians, and the list of investigators from whose work the knowledge of disease has been derived would be too long to cite.

It has been assumed that the reader has some familiarity with elementary anatomy and physiology, and these subjects have been considered only as much as is necessary to set the scene for the drama. I am indebted to my friend, Mr. W. R. Thayer, for patiently enduring the reading of the manuscript and for many suggestions as to phrasing.

DEFINITION OF DISEASE.--CHARACTERISTICS OF LIVING MATTER.--CELLS AS THE LIVING UNITS.--AMOEBA AS TYPE OF A UNICELLULAR ANIMAL.--THE RELATION OF LIVING MATTER TO ENVIRONMENT.--CAPACITY OF ADAPTATION TO ENVIRONMENT SHOWN BY LIVING MATTER.--INDIVIDUALITY OF LIVING MATTER.--THE CAUSES OF DISEASE EXTRINSIC.--THE RELATION OF THE HUMAN BODY TO THE ENVIRONMENT.--THE SURFACES OF THE BODY.--THE INCREASE OF SURFACE BY GLAND FORMATION.--THE REAL INTERIOR OF THE BODY REPRESENTED BY THE VARIOUS STRUCTURES PLACED BETWEEN THE SURFACES.--THE FLUIDS OF THE BODY.--THE NERVOUS SYSTEM.--THE HEART AND BLOOD-VESSELS.--THE CELLS OF THE BLOOD.--THE DUCTLESS GLANDS 9

NO SHARP LINE OF DEMARCATION BETWEEN HEALTH AND DISEASE.--THE FUNCTIONAL NUTRITIVE AND FORMATIVE ACTIVITIES OF CELLS.--DESTRUCTION AND REPAIR CONSTANT PROCESSES IN LIVING MATTER.--INJURIES TO THE BODY.--THE EFFECT OF HEAT.--THE ACTION OF POISONS.--THE LESIONS OF DISEASE.--REPAIR.--THE LAWS GOVERNING REPAIR.--RELATION OF REPAIR TO COMPLEXITY OF STRUCTURE AND AGE.--THE RESERVE FORCE OF THE BODY.--COMPENSATORY PROCESSES IN THE BODY.--OLD AGE.--THE DIMINUTION OF RESISTANCE TO THE EFFECTS OF THE ENVIRONMENT A PROMINENT FACTOR IN OLD AGE.--DEATH.--HOW BROUGHT ABOUT.--CHANGES IN THE BODY AFTER DEATH.--THE RECOGNITION OF DEATH 40

THE GROWTH OF THE BODY.--GROWTH MORE RAPID IN EMBRYONIC PERIOD.--THE COÖRDINATION AND REGULATION OF GROWTH.--TUMORS.--THE GROWTH OF TUMORS COMPARED WITH NORMAL GROWTH.--SIZE. SHAPE AND STRUCTURE OF TUMORS.--THE GROWTH CAPACITY OF TUMORS AS SHOWN BY THE INOCULATION OF TUMORS OF MICE.--BENIGN AND MALIGNANT TUMORS.--EFFECT OF INHERITANCE.--ARE TUMORS BECOMING MORE FREQUENT?--THE EFFECT PRODUCED BY A TUMOR ON THE INDIVIDUAL WHO BEARS IT.--RELATION OF TUMORS TO AGE AND SEX.--THEORIES AS TO THE CAUSE OF TUMORS.--THE PARASITIC THEORY.--THE TRAUMATIC THEORY.--THE EMBRYONIC THEORY.--THE IMPORTANCE OF THE EARLY RECOGNITION AND REMOVAL OF TUMORS 62

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Councilman opens Disease and Its Causes by grounding disease in the characteristics of living matter, using the amoeba as a type of unicellular animal to illustrate the relation of living matter to its environment. This cellular foundation recurs throughout the text, but the work's most distinctive structural feature is its repeated attention to body surfaces—the skin, respiratory tract, mouth, and eyes—as both protective barriers and portals for infection. Councilman treats each surface with a consistent analytical pattern: describing its normal flora, mechanical defenses, and vulnerabilities. The movement between these surfaces, from external to internal, gives the book a spatial logic that mirrors the path of pathogens.

From Cell to Surface: The Architecture of Explanation

Councilman builds his argument from the microscopic to the macroscopic. Chapter I defines disease through the lens of cellular individuality and adaptation, then shifts to the body's surfaces as interfaces with the environment. This progression is not merely sequential but causal: the properties of living matter—its capacity for adaptation and its individuality—determine how surfaces respond to injury. The author repeatedly returns to the concept of surfaces as both boundaries and sites of exchange. For instance, he notes that the skin protects via an impervious horny layer of dead cells, while internal surfaces rely on moisture and cilia. This architectural approach gives the text a coherent spatial framework, moving from the cell to the organ to the whole organism.

Recurring Imagery of Barriers and Breaches

Throughout the excerpts, Councilman employs a consistent set of images: surfaces as fortifications, bacteria as invaders, and bodily fluids as cleansing agents. The skin is described as having an 'impervious horny layer' that is 'constantly cleansed by desquamation.' Sweat glands offer 'mechanical cleansing,' while hair follicles are vulnerable because they lack such flow. The respiratory surface is protected by cilia that 'sweep out fine particles.' This imagery of washing, sweeping, and shedding creates a dynamic picture of the body as a self-cleaning system under constant assault. Councilman's language is precise and functional, avoiding metaphor in favor of mechanistic description, yet the cumulative effect is a vivid sense of the body's active defense.

Movement Between Environments: External and Internal

The text's structure mirrors the journey of pathogens from the external world into the body's interior. Councilman systematically examines each portal of entry: skin, respiratory tract, mouth, eyes, and internal surfaces. He notes that the mouth 'forms a depot from which bacteria may pass to communicating surfaces,' and that infection of the middle ear—'the most common cause of deafness'—occurs via this route. This movement is not just descriptive but analytical: each surface is assessed for its relative risk and protective mechanisms. The author's method is comparative, weighing the efficiency of different defenses. This spatial logic—from outside to inside, from surface to tissue—gives the book a narrative momentum that is unusual for a medical text.

The Role of Fluids and Cells in Defense

Councilman devotes considerable attention to the fluids of the body—blood, sweat, tears—as active agents in protection. Sweat is 'unfavorable for bacterial growth' and its flow 'acts mechanically in washing away organisms.' Tears are similarly described as 'constantly and easily accelerated' to remove foreign substances. The blood's corpuscles emigrate to injured parts as phagocytes, a process he details in the chapter on inflammation. This emphasis on fluid dynamics complements the surface imagery: the body is not a static fortress but a system of flows and exchanges. The author's recurring focus on movement—of cells, fluids, and bacteria—reinforces the text's underlying theme of dynamic equilibrium between organism and environment.

Readers approaching Disease and Its Causes will benefit from attending to Councilman's methodical progression from cellular biology to surface defenses. His consistent use of spatial and mechanical imagery—barriers, flows, cleansing—provides a unifying thread through what might otherwise seem a catalogue of pathologies. The text rewards those who read with an eye for structure, as the arrangement of chapters itself enacts the journey from health to disease and from the external to the internal.

Reading about Councilman’s surfaces and barriers, I remembered my grandfather’s worn copy of On the cattle plague: or, Contagious typhus in horned cattle. Its history, origin, description, and treatment — Reading Notes—how the old vet spoke of a farm’s fence line as if it were skin, keeping sickness out. Both books felt less like science, more like a quiet holding of breath.