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third edition
Medical-Surgical
N u rs i n g
Critical Thinking for Person-centred Care
LeMone • Burke • Bauldoff • Gubrud • Levett-Jones • Hales

Berry • Carville • Dwyer • Knox • Moxham • Raymond • Reid-Searl
v o lu m es 1 – 3
Copyright © Pearson Australia (a division of Pearson Australia Group Pty Ltd) 2017—9781488611759—LeMone/Medical–Surgical Nursing Vol 1 3e
detailed contents vii
Magnesium imbalance 222 response 282; Adaptive immune response 286; The
Overview of normal magnesium balance 222; The person person with natural or acquired immunity 291
with hypomagnesaemia 222 Interprofessional care 291
Interprofessional care 223 Nursing care 293
Nursing care 224
Normal immune responses 294
The person with hypermagnesaemia 224 The person with tissue inflammation 294;
Interprofessional care 225 Pathophysiology and manifestations 294
Nursing care 225 Interprofessional care 297
Phosphate imbalance 225 Nursing care 298
Overview of normal phosphate balance 225; The person The person with an infection 300; Healthcare-
with hypophosphataemia 225 associated infections 303; Antibiotic-resistant
Interprofessional care 226 microorganisms 304
The person with hyperphosphataemia 227 Nursing care 312
Interprofessional care 227
Chapter 12 Nursing care of people with altered
Nursing care 227
immunity 317
Regulation of acid–base balance 227
Overview of the immune system 318
Buffer systems 227; Respiratory system 228;
Renal system 228; Assessment of acid–base Changes in immune function in the older adult 318
balance 228 Assessment of altered immune system
function 319
Acid–base imbalance 230
Health history 319; Physical assessment 319
Compensation 231; The person with metabolic
acidosis 231 The person with a hypersensitivity reaction 320
Interprofessional care 233 Pathophysiology 320
The person with metabolic alkalosis 235 Nursing care 327
Interprofessional care 235 The person with an autoimmune disorder 329

Nursing care 236 Pathophysiology 330
The person with respiratory acidosis 237 Interprofessional care 330
Nursing care 238 The person with a tissue transplant 331
The person with respiratory alkalosis 240 Pathophysiology 332
Interprofessional care 240 Interprofessional care 333
Nursing care 241 Nursing care 334
Chapter 10 Nursing care of people experiencing The person with HIV infection 339
trauma and shock 244 Incidence and prevalence 339; Pathophysiology and
manifestations 340
The person experiencing trauma 245
Components of trauma 245; Types of trauma 245; Effects Interprofessional care 345
of traumatic injury 246 Nursing care 349
Interprofessional care 250 Chapter 13 Nursing care of people with cancer 359
Nursing care 257
Cancer and theories of carcinogensis 360
The person experiencing shock 260
Overview of cellular homeostasis and
Incidence and mortality 360
Risk factors 361
haemodynamics 260; Pathophysiology 260; Types
of shock 264 Pathophysiology 364
Interprofessional care 268 Normal cell growth 364; The cell cycle 364; Differentiation
Nursing care 270 364; Theories of carcinogensis 365; Known carcinogens
365; Types of neoplasms 367; Tumour invasion and
Chapter 11 Nursing care of people with metastasis 368
infections 277
Physiological and psychological effects of cancer 370
Overview of the immune system 278 Disruption of function 370; Haematological
Immune system components 278; Innate immune alterations 370; Infection 370; Haemorrhage 371;
viii detailed contents
Anorexia–cachexia syndrome 371; Paraneoplastic The person with actinic keratosis 450
syndromes 371; Pain 372; Physical stress 372; The person with non-melanoma skin cancer 450
Psychological stress 372
The health burden of non-melanoma skin cancer 450;
Interprofessional care 373 Risk factors 451; Pathophysiology 451
UNIT 4 Nursing care 453
Responses to altered integumentary The person with malignant melanoma 454
structure and function 409 Incidence 454; Risk factors 455;
Pathophysiology 455
Chapter 14 Assessing the integumentary system 410 Interprofessional care 457
Anatomy, physiology and functions of the Nursing care 458
integumentary system 411
The person with a pressure injury 460
The skin 411; Skin appendages 413; The hair 413;
Incidence 460; Pathophysiology 461; Risk factors 461
Skin colour 414
Assessing the integumentary system 414
Nursing care 467
Health assessment interview 414; Physical assessment
416; Diagnostic tests 418; Genetic considerations 421 The person with a skin tear 470
Preventing skin tears 471; Skin tear management 471
Chapter 15 Nursing care of people with
integumentary disorders 429 The person with a disorder of the hair 472
Pathophysiology 472
The person with pruritus 430
The person with dry skin (xerosis) 430
Nursing care 473
The person with benign skin lesions 431
Cysts 432; Hypertrophic scar 432; Keloids 432; Naevi The person with a disorder of the nails 473
432; Angiomas 433; Skin tags 433; Keratoses 433 Pathophysiology 473
The person with psoriasis 433 Interprofessional care 474
Pathophysiology 434; Manifestations 434 Nursing care 474
Interprofessional care 434 Chapter 16 Nursing care of people with burns 477
Nursing care 435
Types of burn injury 479
The person with a bacterial infection of the skin 436 Thermal burns 479; Chemical burns 479; Electrical burns
Pathophysiology 437
480; Radiation burns 480; Cold injury 481; Inhalation
Interprofessional care 438 injury 481; Friction burns 481
Nursing care 438
Burn classification 481
The person with a fungal infection 439 Depth of the burn 481; Extent of the burn 484; Phases of
Pathophysiology 439 burn management 486
Interprofessional care 440 Burn wound healing 488
Nursing care 441 Post-burn itch 488
The person with a viral infection 441 The person with minor burns 489
Pathophysiology 441 Pathophysiology 489
Nursing care 443
The person with major burns 490
The person with a parasitic infestation 444 Pathophysiology 490
Pathophysiology 444
Nursing care 502
Nursing care 445
The person with dermatitis 445 UNIT 5
Pathophysiology 445 Responses to altered endocrine
Interprofessional care 447 function 511
Nursing care 447
The person with acne 447 Chapter 17 A person-centred approach to
Pathophysiology 448 assessing the endocrine system 512
Interprofessional care 448 Pituitary gland 513
Nursing care 449 Anterior pituitary 513; Posterior pituitary 515
detailed contents ix
Thyroid gland 515 Chapter 19 Nursing care of people with

Parathyroid glands 515 diabetes mellitus 560
Adrenal glands 515 Incidence and prevalence 561
Pancreas 516 Overview of endocrine pancreatic hormones
Gonads 516 and glucose homeostasis 561
An overview of hormones 516 Hormones 561; Blood glucose homeostasis 562
Assessing endocrine function 517 Pathophysiology of diabetes 563
Health assessment interview 517; Physical Type 1 diabetes 563; Type 2 diabetes 564; Diabetes in the
assessment 519; Diagnostic tests 520; Genetic older adult 566
considerations 525 Interprofessional care 566
Acute complications of diabetes 581
Acute complications: alterations in blood
endocrine disorders 529 glucose levels 581
People with hyperthyroidism 530 Interprofessional care 584
Pathophysiology and manifestations 530 Interprofessional care 586
Interprofessional care 533 Chronic complications 587
The person with hypothyroidism 537 Glossary G-1
Pathophysiology and manifestations 539
Index I-1
Nursing care 540
VOLUME 2
The person with cancer of the thyroid 543
The person with hyperparathyroidism 543
Unit 6
Pathophysiology and manifestations 544 Responses to Altered
Interprofessional care 544 Gastrointestinal Function 603
Nursing care 545
chapter 20 A person-centred approach to
The person with hypoparathyroidism 545 assessing the gastrointestinal system 604
Nutrients 605
Interprofessional care 545 Carbohydrates 606; Proteins 606; Fats (lipids) 608;
Nursing care 545 Vitamins 608; Minerals 608; Dietary fibre 610; The mouth
The person with hypercortisolism 610; The pharynx 610; The oesophagus 611; The
(Cushing’s syndrome) 545 stomach 611; The small intestine 612; The large intestine
Pathophysiology 546; Manifestations 546 612; The accessory digestive organs 613
Interprofessional care 546 Metabolism 614
Nursing care 548 Assessing nutritional status and
gastrointestinal function 614
The person with chronic adrenocortical insufficiency
Health assessment interview 614; Physical assessment
(Addison’s disease) 550
618; Diagnostic tests 618; Genetic considerations 618
Pathophysiology 551; Manifestations 551;
Addisonian crisis 551 chapter 21 Nursing care of people with nutritional
Interprofessional care 552 disorders 635
Nursing care 552
The person with obesity 636
The person with pheochromocytoma 555 Incidence and prevalence 636; Risk factors 637; Overview
The person with disorders of the anterior of normal physiology 637; Pathophysiology 637
pituitary gland 555 Interprofessional care 638
Pathophysiology and manifestations 555 Nursing care 642
Interprofessional care 555 The person with malnutrition 644
Nursing care 556 Incidence and prevalence 645; Risk factors 645;
The person with disorders of the posterior Pathophysiology 645
pituitary gland 556 Interprofessional care 646
x detailed contents
Chapter 22 Nursing care of people with upper Interprofessional care 702

gastrointestinal disorders 661 Nursing care 705
The person with stomatitis 662 The person with constipation 706
Pathophysiology and manifestations 662 Pathophysiology 706; Manifestations 706
The person with oral cancer 665 The person with irritable bowel syndrome 713
Pathophysiology and manifestations 665 Pathophysiology 713; Manifestations 713

The person with gastro-oesophageal reflux disease 669 The person with faecal incontinence 715
Pathophysiology 715
Pathophysiology 669; Manifestations 670
Nursing care 716
Nursing care 673
The person with appendicitis 717
The person with a hiatal hernia 673
Pathophysiology 717; Manifestations 718; Complications 718
The person with impaired oesophageal motility 674
The person with oesophageal cancer 674 Nursing care 719
The person with peritonitis 720
Nursing care 675 Complications 721
Overview of normal physiology 677 Interprofessional care 721
The person with nausea and vomiting 677 Nursing care 722
Pathophysiology 677 The person with gastroenteritis 725
Interprofessional care 678 Pathophysiology 725; Manifestations 725;
Nursing care 678 Complications 726; Specific types of gastrointestinal
infections 726
The person with gastrointestinal bleeding 679
Pathophysiology 680 Interprofessional care 729
Nursing care 731
Nursing care 680 The person with a protozoal bowel infection 731
The person with gastritis 682
Pathophysiology 682
Nursing care 733
Nursing care 683 The person with a helminthic disorder 735
Pathophysiology 735
The person with peptic ulcer disease 684 Interprofessional care 735
Risk factors 685; Pathophysiology 685;
Nursing care 737
Manifestations 688; Complications 688; Zollinger–Ellison
syndrome 688 The person with inflammatory bowel disease 737
Ulcerative colitis 738; Crohn’s disease 741
Nursing care 748
The person with cancer of the stomach 693
Risk factors 693; Pathophysiology 693; Manifestations 693 The person with sprue 752
Pathophysiology 752; Coeliac disease 753;
Tropical sprue 753
Nursing care 697
Chapter 23 Nursing care of people with Nursing care 755
bowel disorders 701 The person with lactase deficiency 756
The person with diarrhoea 702 Manifestations 756
Pathophysiology 702; Manifestations 702; Interprofessional care 756
Complications 702 Nursing care 756
detailed contents xi
The person with short bowel syndrome 756 Interprofessional care 803
Nursing care 757 The person with cancer of the liver 810
The person with polyps 757 Pathophysiology 810; Manifestations 811
Pathophysiology 757; Manifestations 758 Interprofessional care 811
Nursing care 759 The person with liver trauma 811
The person with colorectal cancer 759 Pathophysiology and manifestations 811
Pathophysiology 760; Manifestations 760; Interprofessional care 812
Complications 760 Nursing care 812
Interprofessional care 760 The person with liver abscess 812
Nursing care 763 Pathophysiology and manifestations 812
The person with a hernia 768 Interprofessional caRE 812
Pathophysiology 768; Manifestations 768; Nursing care 812
Complications 769
The person with pancreatitis 813
Physiology review 813; Pathophysiology 813
Nursing care 769
The person with intestinal obstruction 770 Nursing care 816
Pathophysiology 770
The person with pancreatic cancer 819
Nursing care 772
The person with diverticular disease 774
Pathophysiology 774
Interprofessional care 775 Unit 7
Nursing care 776 RESPONSES TO ALTERED URINARY
The person with haemorrhoids 777 ELIMINATION 825
CHAPTER 25 A person-centred approach to
Interprofessional care 778 assessing the renal system 826
Nursing care 779
The kidneys 827
The person with an anorectal lesion 779 Formation of urine 829; Maintaining normal
Anal fissure 780; Anorectal abscess 780; composition and volume of urine 831
Anorectal fistula 780; Pilonidal disease 780
The ureters 832
Nursing care 780
The urinary bladder 833
Chapter 24 Nursing care of people with The urethra 833
gallbladder, liver and pancreatic disorders 784 Health assessment, diagnostics and documentation 833
The person with gallstones 785 Health assessment interview 833; Physical
Physiology review 785; Pathophysiology and assessment 834; Diagnostic tests 835; Genetic
manifestations 785 considerations 835
Interprofessional care 786 Chapter 26 Nursing care of people with
Nursing care 787 urinary tract disorders 845
The person with cancer of the gallbladder 791 The person with urinary tract infection 846
Physiology review 791; Common manifestations Risk factors 846; Physiology review 847;
of liver disorders 791 Pathophysiology and manifestations 847
The person with hepatitis 792 Interprofessional care 849
The person with urinary calculi 855
Nursing care 797
Incidence and risk factors 855;
The person with cirrhosis 798 Physiology review 855; Pathophysiology 855;
Pathophysiology 798 Manifestations 856; Complications 857
xii detailed contents
Interprofessional care 857 Neurological effects 909; Musculoskeletal effects 909;

Nursing care 859 Endocrine and metabolic effects 909; Dermatological
effects 909
The person with a urinary tract tumour 863
Incidence and risk factors 863; Pathophysiology 863; Interprofessional care 910
Manifestations 863 Nursing care 913
Interprofessional care 864 The person with end-stage kidney disease 916
Nursing care 865 Kidney replacement therapy 916; Dialysis 916;
Supportive care 916; Haemodialysis 917; Peritoneal
The person with urinary retention 870
dialysis 919; Continuous renal replacement therapy 921;
Physiology review 870; Pathophysiology 870;
Collaborative care 921
Manifestations 870
Kidney transplantation 921
The person with a neurogenic bladder 871 Unit 8

Pathophysiology 871
Responses to altered
Nursing care 873
cardiovascular function 935
The person with urinary incontinence 874 Chapter 28 A person-centred approach to assessing
Incidence and prevalence 874; Pathophysiology 874 the cardiovascular and lymphatic systems 936
Interprofessional care 875 Structure and function of the cardiovascular system 937
Nursing care 877 Chambers and valves of the heart 938; Systemic,
pulmonary and coronary circulation 939; The cardiac
Chapter 27 Nursing care of people with cycle and cardiac output 940; The conduction system of
kidney disorders 883 the heart 943
Renal insufficiency: towards a new understanding 884 The peripheral vascular system 943
Structure of blood vessels 943; Physiology of arterial
Age-related changes in kidney function 884
circulation 946
The person with acute kidney injury 885
Incidence and risk factors 885; Physiology review 886; Structure and function of blood 947
Pathophysiology 886; Clinical course and manifestations Red blood cells 947; White blood cells 950; Platelets 950;
of acute kidney injury 891; Diagnostics 891 Haemostasis 950
Interprofessional care 892 Structure and function of the lymphatic system 951
Nursing care 894 Health assessment and documentation 954
Health assessment interview 954; Diagnostic tests of the
The person with kidney trauma 897
cardiovascular and lymphatic systems 955; Physical
assessment 966; Genetic considerations 967
Interpretation of normal and aberrant data
Nursing care 897 obtained from cardiovascular and lymphatic
The person with a renal tumour 897 system assessment 969
Pathophysiology and manifestations 897 Chapter 29 Nursing care of people with
Interprofessional care 898 coronary heart disease 981
Nursing care 898
The person with coronary heart disease 982
The person with a congenital kidney malformation 901 Incidence and prevalence 982; Physiology review 982;
The person with chronic kidney disease 901 Pathophysiology 982; Risk factors 986
The burden of kidney disease on Indigenous peoples 902; Interprofessional care 989
Physiology review 903; Pathophysiology 903
The person with angina pectoris 991
The person with a renovascular disorder 905 Pathophysiology 991; Course and manifestations 993
Hypertension 906; Renal artery occlusion 906; Renal vein
occlusion 906; Renal artery stenosis 906; Polycystic
Nursing care 995
kidney disease 906
Manifestations and complications of CKD 907 The person with acute coronary syndrome 998
Uraemia 907; Fluid and electrolyte effects 907; Pathophysiology 998; Manifestations 998
Cardiovascular effects 909; Haematological effects 909; Interprofessional care 998
Immune system effects 909; Gastrointestinal effects 909; Nursing care 1005
detailed contents xiii
The person with acute myocardial infarction 1005 The person with cardiomyopathy 1082
Pathophysiology 1007; Manifestations 1007; Pathophysiology 1082
Complications 1008 Interprofessional care 1085
Nursing care 1014
The person with a cardiac arrhythmia 1017 vascular and lymphatic disorders 1090
Physiology review 1018; Pathophysiology 1019 Physiology review 1091
Primary hypertension 1092
Nursing care 1036 Incidence and risk factors 1092; Pathophysiology 1094;
The person with sudden cardiac death 1038 Manifestations 1095; Complications 1095
Nursing care 1040 Secondary hypertension 1106
Hypertensive crisis 1108
cardiac disorders 1044 The person with an aneurysm 1109
The person with heart failure 1045
Incidence, prevalence and risk factors 1045; Physiology
Nursing care 1113
review 1046; Pathophysiology 1047; Classifications and
manifestations of heart failure 1048; Complications 1050 Physiology review 1115
Interprofessional care 1050 The person with peripheral vascular disease 1115
Nursing care 1054 Incidence and risk factors 1116; Pathophysiology 1116;
Manifestations and complications 1116
The person with pulmonary oedema 1058
Nursing care 1118
Nursing care 1059 Acute arterial occlusion 1121
The person with rheumatic fever and rheumatic
heart disease 1060 Interprofessional care 1121
Incidence, prevalence and risk factors 1060; Nursing care 1122
Pathophysiology 1061; Manifestations 1061 The person with thromboangiitis obliterans 1123
Interprofessional care 1062 Incidence and risk factors 1123; Pathophysiology
Nursing care 1062 and course 1123; Manifestations and
complications 1123
The person with infective endocarditis 1064
Incidence and risk factors 1064; Pathophysiology 1064; Interprofessional care 1124
Manifestations 1065; Complications 1065 Nursing care 1124
Interprofessional care 1065 The person with Raynaud’s disease 1124
The person with myocarditis 1067 Interprofessional care 1125

Incidence and risk factors 1067; Nursing care 1126
Pathophysiology 1067; Manifestations 1068 Physiology review 1126
Interprofessional care 1068 The person with venous thrombosis 1126
The person with pericarditis 1068 Interprofessional care 1127
Complications 1069 The person with chronic venous insufficiency 1134
Interprofessional care 1070 Pathophysiology 1134; Manifestations 1134
The person with valvular heart disease 1072 Nursing care 1135
Physiology review 1073; Pathophysiology 1073 The person with varicose veins 1136
Interprofessional care 1078 Incidence and risk factors 1136; Pathophysiology 1136
Nursing care 1080 Manifestations 1137; Complications 1137
xiv detailed contents
Interprofessional care 1137 The person with disseminated intravascular

Nursing care 1138 coagulation 1193
The person with lymphatic system compromise 1140
Lymphadenopathy 1140; Lymphoedema 1140 Interprofessional care 1194
Nursing care 1194
Nursing care 1141 Glossary G-1
Index I-1
haematological disorders 1146
VOLUME 3
The person with anaemia 1147
Physiology review 1147; Pathophysiology and Unit 9
manifestations 1147 Responses to altered
Interprofessional care 1155 respiratory function 1203
Nursing care 1157
Chapter 33 A person-centred approach to
The person with myelodysplastic syndrome 1160
assessing the respiratory system 1204
Interprofessional care 1161 The upper respiratory system 1205
Nursing care 1161 The nose 1205; The sinuses 1206; The pharynx 1206;
The larynx 1206; The trachea 1206
The person with polycythaemia 1162
The lower respiratory system 1206
Pathophysiology 1162
The lungs 1206; The pleura 1208; The bronchi and
Interprofessional care 1163 alveoli 1208; The rib cage and intercostal muscles 1208
Nursing care 1163
Mechanics of ventilation 1208
The person with leukaemia 1164 Respiratory volume and capacity 1209; Air pressures
Incidence and risk factors 1164; Physiology review 1164; 1210; Oxygen, carbon dioxide and hydrogen ion
Pathophysiology 1164; Manifestations 1165; concentrations 1211; Airway resistance, lung compliance
Classifications 1165 and elasticity 1211; Alveolar surface tension 1211
Interprofessional care 1169 Gas transport and affinity 1211
Nursing care 1171 Blood gases 1211
The person with malignant lymphoma 1175 Assessing a person’s respiratory function 1212
Incidence and risk factors 1176; Health assessment interview 1212; Physical
Pathophysiology 1176 assessment 1213; Diagnostic tests 1213;
Interprofessional care 1178 Genetic considerations 1213
Nursing care 1180
The person with multiple myeloma 1183 upper respiratory disorders 1222
Incidence and risk factors 1183; Pathophysiology 1183;
The person with viral upper respiratory
Manifestations 1183
tract infection 1223
Interprofessional care 1184 Pathophysiology 1223; Manifestations and
Nursing care 1184 complications 1223
The person with neutropenia 1185 Interprofessional care 1223
Interprofessional care 1186 The person with respiratory syncytial virus 1225
Nursing care 1186 The person with influenza 1225
The person with thrombocytopenia 1186 Pathophysiology 1226; Manifestations 1227;
Physiology review 1186; Pathophysiology 1187 Complications 1227
The person with haemophilia 1189 The person with sinusitis 1229
Physiology review 1189; Pathophysiology 1189; Physiology review 1229; Pathophysiology 1229;
Manifestations 1190 Manifestations and complications 1229
detailed contents xv
The person with pharyngitis or tonsillitis 1231 Interprofessional care 1272

Pathophysiology and manifestations 1231; Nursing care 1272
Complications 1232 The person with tuberculosis 1272
Interprofessional care 1232 Incidence and prevalence 1272; Risk factors 1272;
The person with a laryngeal infection 1234 Interprofessional care 1278
Epiglottitis 1234; Laryngitis 1234 Nursing care 1279
The person with pertussis 1234 The person with a fungal infection 1281
Pathophysiology 1234; Manifestations 1235 Pneumocystis carinii pneumonia 1281;
Aspergillosis 1281
Nursing care 1282
The person with epistaxis 1236
Pathophysiology and manifestations 1237 The person with pleuritis 1282
Interprofessional care 1237 The person with a pleural effusion 1283
Nursing care 1238
The person with nasal trauma or surgery 1239 Nursing care 1283
Pathophysiology and manifestations 1239;
Complications 1239 The person with pneumothorax 1285
Nursing care 1287
The person with laryngeal obstruction or trauma 1241
Pathophysiology and manifestations 1242 The person with haemothorax 1289
Interprofessional care 1242 The person with a thoracic injury 1290
The person with obstructive sleep apnoea (OSA) 1242
Nursing care 1291
Risk factors 1243; Pathophysiology 1243; Manifestations
1243; Complications 1243 The person with inhalation injury 1292
Interprofessional care 1243 Pathophysiology and manifestations 1293
Nursing care 1295
The person with nasal polyps 1244
Pathophysiology and manifestations 1245 The person with lung cancer 1296
Interprofessional care 1245 Incidence and risk factors 1296; Pathophysiology 1297;
Nursing care 1245 Manifestations 1297; Complications and course 1297
The person with a laryngeal tumour 1245
Nursing care 1301
Risk factors 1245; Pathophysiology and
manifestations 1245 Chapter 36 Nursing care of people with gas
Interprofessional care 1246 exchange disorders 1309
Nursing care 1251
The person with asthma 1310
Chapter 35 Nursing care of people with Prevalence and risk factors 1310; Physiology review
1311; Pathophysiology 1311; Manifestations and
ventilation disorders 1257
complications 1312
The person with acute bronchitis 1259 Interprofessional care 1314
Nursing care 1320
Chronic obstructive pulmonary disease 1322
Nursing care 1259
Incidence and risk factors 1322; Pathophysiology 1322;
The person with pneumonia 1260 Manifestations 1324
Physiology review 1260; Pathophysiology 1261 Interprofessional care 1325
Nursing care 1267
The person with cystic fibrosis 1334
The person with lung abscess 1271 Incidence and prevalence 1334; Pathophysiology 1334;
Pathophysiology and manifestations 1271 Manifestations 1335
xvi detailed contents
Interprofessional care 1335 The person with a fracture 1393

Nursing care 1336 Pathophysiology 1393; Fracture healing 1394;
Manifestations 1395; Complications 1395
The person with atelectasis 1337
The person with bronchiectasis 1337
Fractures of specific bones or bony areas 1404
The person with an occupational lung disease 1338
Physiology review 1338; Pathophysiology and Nursing care 1408
manifestations 1338 The person with an amputation 1412
Interprofessional care 1339 Causes of amputation 1412; Levels of amputation 1413;
Nursing care 1339 Types of amputation 1413; Amputation site healing 1413;
Complications 1414
The person with sarcoidosis 1340
The person with pulmonary embolism 1340 Nursing care 1415
Incidence and risk factors 1341; Physiology review 1341;
Pathophysiology 1341; Manifestations 1342 The person with a repetitive use injury 1419
Nursing care 1420
The person with pulmonary hypertension 1345
Pathophysiology 1345; Manifestations 1346; Chapter 39 Nursing care of people with
Complications 1346 musculoskeletal disorders 1422
Interprofessional care 1346 The person with osteoporosis 1423
Nursing care 1346 Risk factors 1423; Pathophysiology 1424; Manifestations
1425; Complications 1425
The person with acute respiratory failure 1347
Pathophysiology 1347; Manifestations and course 1348 Interprofessional care 1425
Nursing care 1426
Nursing care 1356 The person with Paget’s disease 1430
The person with acute respiratory distress syndrome 1361 Complications 1431
Nursing care 1362
The person with gout 1433
Unit 10 Complications 1434
responses to altered Interprofessional care 1434
musculoskeletal function 1370 Nursing care 1437
Chapter 37 A person-centred approach to The person with osteomalacia 1437

assessing the musculoskeletal system 1371 Pathophysiology 1438; Manifestations 1438
The skeleton 1372; Muscles 1374; Joints, ligaments and Interprofessional care 1439
tendons 1377 Nursing care 1439
Assessing musculoskeletal function 1378 The person with osteoarthritis 1439

Health assessment interview 1378; Physical Risk factors 1440; Pathophysiology 1440; Manifestations
assessment 1378; Diagnostic tests 1380; 1440; Complications 1441
Genetic considerations 1381 Interprofessional care 1441
Nursing care 1445
musculoskeletal trauma 1390 The person with muscular dystrophy 1447
The person with a contusion, strain or sprain 1391
Nursing care 1448
Nursing care 1392
The person with rheumatoid arthritis 1449
Pathophysiology 1449; Joint manifestations 1450;
The person with a joint dislocation 1392 Extra-articular manifestations 1451; Increased risk of
Pathophysiology 1392; Manifestations 1392 coronary heart disease 1451
detailed contents xvii
The person with ankylosing spondylitis 1459 The person with common foot disorders 1483
Pathophysiology 1459; Manifestations 1459 Pathophysiology 1483
The person with reactive arthritis 1460
Manifestations 1460 UNIT 11
Interprofessional care 1460 Responses to altered
Nursing care 1460
neurological function 1489
The person with systemic lupus
erythematosus 1461
assessing the nervous system 1490
Nerve cells, action potentials and neurotransmitters
1491; The central nervous system 1492; The peripheral
Nursing care 1464
nervous system 1497; The autonomic nervous
The person with polymyositis 1466 system 1498
Manifestations 1466 Assessing neurological function 1500
Interprofessional care 1466 Health assessment interview 1500; Physical
Nursing care 1467 assessment 1502; Diagnostic tests 1502; Genetic
considerations 1503
The person with osteomyelitis 1467
Pathophysiology 1467; Manifestations 1468 Chapter 41 Nursing care of people with
intracranial disorders 1515
Nursing care 1469 The person with altered level of consciousness 1516
Pathophysiology 1517; Prognosis 1520
The person with septic arthritis 1470
Nursing care 1521
Nursing care 1471 The person with increased intracranial pressure 1524
The person with bone tumours 1471 Cerebral oedema 1525; Hydrocephalus 1525; Brain
Pathophysiology 1472; Manifestations 1472 herniation 1526
The person with systemic sclerosis The person with a headache 1531
(scleroderma) 1474 Pathophysiology 1531
Nursing care 1476 The person with epilepsy 1536
The person with Sjögren’s syndrome 1476 Incidence and prevalence 1536; Pathophysiology 1537;
Pathophysiology 1476 Manifestations 1537
Nursing care 1540
Nursing care 1477
The person with a skull fracture 1544
The person with fibromyalgia 1477
Nursing care 1545
Nursing care 1478
The person with a focal or diffuse traumatic
The person with spinal deformities 1478 brain injury 1545
Pathophysiology 1478 Pathophysiology 1545
The person with lower back pain 1480 The person with a central nervous system infection 1553
Pathophysiology 1480; Manifestations 1481 Pathophysiology 1553
xviii detailed contents
The person with a brain tumour 1559 Interprofessional care 1617

Incidence and prevalence 1559; Pathophysiology 1559; Nursing care 1621
Manifestations 1559
The person with Parkinson’s disease 1625
Interprofessional care 1559 Incidence and prevalence 1625;
Nursing care 1562 Pathophysiology 1625; Manifestations 1625;
Complications 1627
cerebrovascular and spinal cord disorders 1568 Interprofessional care 1627
Nursing care 1629
The person with a stroke 1569
Incidence and prevalence 1569; Risk factors 1569; The person with Huntington’s disease 1632
Pathophysiology 1570; Manifestations 1571; Pathophysiology 1633; Manifestations 1633
Complications 1572 Interprofessional care 1633
Nursing care 1576 The person with motor neurone disease 1635
The person with an intracranial aneurysm 1582 Pathophysiology 1635; Manifestations 1636
Incidence and prevalence 1582; Pathophysiology 1582; Interprofessional care 1636
Manifestations 1582; Complications 1582 Nursing care 1636
Interprofessional care 1583 The person with myasthenia gravis 1638
Nursing care 1583
The person with an arteriovenous malformation 1584 Complications 1639
Pathophysiology 1584 Interprofessional care 1639
Nursing care 1585 The person with Guillain–Barré syndrome 1644
The person with a spinal cord injury 1585 Pathophysiology 1644; Manifestations 1644
Incidence and prevalence 1585; Risk factors 1585; Interprofessional care 1644
Complications 1588
The person with trigeminal neuralgia 1646
Nursing care 1591
The person with a herniated intervertebral disc 1596 Nursing care 1647
Incidence and prevalence 1596; Pathophysiology 1597;
Lumbar disc manifestations 1597; Cervical disc The person with Bell’s palsy 1648
manifestations 1598 Pathophysiology 1649; Manifestations 1649
The person with a spinal cord tumour 1602 The person with Creutzfeldt–Jakob disease 1650
Classification 1602; Pathophysiology 1602; Pathophysiology 1650; Manifestations 1650
Manifestations 1602 Interprofessional care 1651
Nursing care 1603 The person with postpoliomyelitis
syndrome 1651
neurological disorders 1606
Dementia 1607 Nursing care 1651
The person with Alzheimer’s disease 1608
The person with rabies 1652
Incidence and prevalence 1608; Risk factors and warning
signs 1608; Pathophysiology 1608; Manifestations 1609
Nursing care 1652
Nursing care 1612
The person with multiple sclerosis 1616 The person with tetanus 1653
Incidence and prevalence 1616; Pathophysiology 1653; Manifestations 1653
Pathophysiology 1616; Interprofessional care 1653
Manifestations 1617 Nursing care 1653
detailed contents xix
The person with botulism 1654 The person with glaucoma 1697
Pathophysiology 1654; Manifestations 1654 Incidence and risk factors 1697; Pathophysiology 1697
The person with age-related macular
UNIT 12 degeneration 1705
Responses to altered visual and Pathophysiology 1705; Manifestations 1705
auditory function 1659 Interprofessional care 1705
Nursing care 1706
The person with diabetic retinopathy 1706
assessing the eye and ear 1660
Extraocular structures 1661; Intraocular structures 1661;
The visual pathway 1663; Refraction 1663 Interprofessional care 1707
Nursing care 1707
Assessing the eyes 1664
Health assessment interview 1664; Physical assessment The person with a retinal detachment 1707
of the eyes and vision 1664; Diagnostic tests 1666; Pathophysiology and manifestations 1707
Genetic considerations 1667; Vision assessment 1668 Interprofessional care 1708
The external ear 1672 Nursing care 1708
The middle ear 1673 The person with retinitis pigmentosa 1709
The inner ear 1674 The person with HIV infection 1709
Sound conduction 1674; Equilibrium 1674
The person with an enucleation 1710
Assessing the ears 1674 The person with otitis externa 1711
Health assessment interview 1674;
Physical assessment of the ears and hearing 1675;
Diagnostic tests 1676; Genetic considerations 1678; Interprofessional care 1711
Hearing assessment 1679 Nursing care 1711
The person with impacted cerumen or a
Chapter 45 Nursing care of people with eye foreign body 1712
and ear disorders 1682 Pathophysiology and manifestations 1712
The person with conjunctivitis 1683 Interprofessional care 1713
Interprofessional care 1685 The person with otitis media 1713
The person with a corneal disorder 1686 Interprofessional care 1714
Physiology review 1687; Pathophysiology and Nursing care 1715
manifestations 1687
The person with acute mastoiditis 1716
Pathophysiology and complications 1716;
Nursing care 1689
Manifestations 1716
Disorders affecting the eyelids 1691 Interprofessional care 1716
The person with chronic otitis media 1716
Nursing care 1692
The person with otosclerosis 1717
The person with eye trauma 1692
Pathophysiology and manifestations 1692 The person with an inner ear disorder 1718
Nursing care 1720
The person with uveitis 1695
The person with cataracts 1695 The person with an acoustic neuroma 1721
Incidence and risk factors 1695; Pathophysiology 1695; The person with hearing loss 1721
Manifestations 1695 Pathophysiology and manifestations 1721
xx detailed contents
UNIT 13 Interprofessional care 1765

Nursing care 1766
Responses to Altered Reproductive
Function 1730 The man with prostatitis 1767
Chapter 46 A person-centred approach to Interprofessional care 1767
assessing the male and female reproductive Nursing care 1768
systems 1731
The man with benign prostatic hyperplasia 1768
Males: The breasts 1732; The penis 1732; The scrotum
1732; The testes 1732; The ducts and semen 1732; The
Manifestations 1768; Complications 1769
prostate gland 1733; Spermatogenesis 1733; Functions
of the male sex hormones 1733 Interprofessional care 1769
Nursing care 1772
Assessing the male reproductive system 1734
Health assessment interview 1734; Physical assessment The man with prostate cancer 1773
1734; Diagnostic tests 1736; Genetic considerations Risk factors 1774; Pathophysiology 1774; Manifestations
1740 1775; Complications 1775
Females: The breasts 1741; The external genitalia 1741; Interprofessional care 1775
The internal organs 1741; Functions of the female sex Nursing care 1778
hormones 1743; Oogenesis and the ovarian cycle 1743;
The menstrual cycle 1743 The man with gynaecomastia 1781
The man with breast cancer 1781
Assessing the female reproductive system 1744
Health assessment interview 1744; Physical
Chapter 48 Nursing care of women with
assessment 1745; Diagnostic tests 1747; Genetic
reproductive system and breast disorders 1784
considerations 1750
Disorders of female sexual function 1785
Chapter 47 Nursing care of men with Pathophysiology 1786
reproductive system and breast
Nursing care 1786
disorders 1757
The woman with premenstrual syndrome 1786
The man with erectile dysfunction 1758
Nursing care 1787
Nursing care 1760
The woman with dysmenorrhoea 1789
The man with ejaculatory dysfunction 1761 Pathophysiology 1789; Manifestations 1789
The man with phimosis or priapism 1761
Nursing care 1790
Nursing care 1762 The woman with dysfunctional uterine bleeding 1790
The man with cancer of the penis 1762 Interprofessional care 1791
Nursing care 1793
Nursing care 1762 The woman with a uterine displacement 1794
The man with a benign scrotal mass 1763 Interprofessional care 1795
Nursing care 1796
Nursing care 1763
The woman with a vaginal fistula 1796
The man with epididymitis 1764 Interprofessional care 1797
Nursing care 1764
The woman with cysts or polyps 1797
The man with orchitis 1764 Pathophysiology 1797; Manifestations and
Interprofessional care 1764 complications 1797
The man with testicular torsion 1764 Interprofessional care 1797
Nursing care 1798
The man with testicular cancer 1764
Risk factors 1765; Pathophysiology 1765; The woman with leiomyoma 1798
Manifestations 1765 Pathophysiology 1798; Manifestations 1798
detailed contents xxi

The woman with endometriosis 1799 The person with a vaginal infection 1836
Pathophysiology 1799; Manifestations 1799 Pathophysiology and manifestations 1836
The woman with cervical cancer 1801 The person with chlamydia 1838
Risk factors 1801; Pathophysiology 1801; Pathophysiology 1838; Manifestations 1838;
Manifestations 1802 Complications 1838
The woman with endometrial cancer 1805
The person with gonorrhoea 1839
Manifestations 1806
Complications 1840
Nursing care 1806
Nursing care 1840
The woman with ovarian cancer 1807
The person with syphilis 1842
Risk factors 1807; Pathophysiology 1807; Manifestations
1807; Complications 1807
Nursing care 1843
Nursing care 1808
The person with pelvic inflammatory disease 1845
The woman with cancer of the vulva 1809
Complications 1846
Nursing care 1810
Nursing care 1846
Menopause 1810
The physiology of menopause 1810;
Manifestations 1810 UNIT 14
Interprofessional care 1811 Special topics in medical–surgical
Nursing care 1811 nursing 1851
The woman with a benign breast disorder 1813 Chapter 50 Mental healthcare in the
Pathophysiology and manifestations 1813 Australian context 1852
Interprofessional care 1814 Mental health and mental illness 1854
Nursing care 1815 Diagnosis 1854; Definitions 1855; Stigma 1855;
The woman with breast cancer 1815 The role of the mental health nurse 1856; Mental health
Risk factors 1815; Pathophysiology 1815; legislation 1859; Recovery 1860
Manifestations 1817 Mental state assessment 1863
Interprofessional care 1817 Types of mental illness 1865
Nursing care 1820 Psychotic disorders 1865; Non-psychotic
disorders 1867; Treatments in mental health 1868
Chapter 49 Nursing care of people who have
sexually transmitted infections 1828 Chapter 51 Community care 1872
Incidence and prevalence 1829; Pathophysiology, What is a community? 1873
manifestations and nursing care 1829; Prevention and
Community care in Australia 1874
control 1830
Models of health and community care 1877
The person with genital herpes 1831 The biomedical model of health 1878;
The biopsychosocial model of health 1878; The social
Interprofessional care 1832 model of health 1878
Nursing care 1832
Social determinants and community health 1878
The person with genital warts 1833 Early life factors 1879; Income and socioeconomic
Prevention 1833; Pathophysiology 1834; conditions 1879; Living conditions 1880; Other factors
Manifestations 1834 1880; Levels of determinants and interventions 1881
xxii detailed contents
Primary healthcare and primary care 1881 Primary healthcare and social determinants
Primary healthcare 1882; Primary care 1882 of health 1896
Health education and health promotion 1884 Indigenous health considerations in regional, rural
Individualist health promotion 1884; Structuralist– and remote areas 1897
collectivist health promotion 1885 Working in an Indigenous community 1897
Community care exemplars 1885 The regional, rural and remote nursing workforce 1898
Caravan Park Project 1885; Practice nursing 1887; Competency to practise 1900
Managing acute illness at home 1888 Role of the nurse in regional, rural and
remote Australia 1901
The way forward 1889
Health promotion 1901; Screening and prevention
strategies 1901; Acute assessment 1901; Emergency
Chapter 52 Nursing care of people in regional,
nursing care 1902; Establishing boundaries 1905;
rural and remote areas of Australia 1894
Teleconsultations/videoconsultations 1905; Liaison and
Challenges and rewards 1895 advocacy 1906; Provision of care for the person from a
The differences between ‘regional’, ‘rural’ regional, rural or remote area 1907
and ‘remote’ 1895 Appendix—Standard precautions A-1
Regional, rural and remote nursing 1895
Glossary G-1
Primary healthcare and regional, rural and
remote nursing 1896 Index I-1
about the authors
PRISCILLA LEMONE-KOEPLIN RN, DSN, FAAN
Priscilla LeMone-Koeplin spent most of her career as a nurse educator, teaching medical–surgical nursing
and pathophysiology at all levels from diploma to doctoral students. She has a diploma in nursing from
Deaconess College of Nursing (St Louis, Missouri), baccalaureate and master’s degrees from Southeast
Missouri State University, and a doctorate in nursing from the University of Alabama-Birmingham. She is
retired as an Associate Professor Emeritus, Sinclair School of Nursing, University of Missouri, but continues
to keep up to date in nursing both as an Adjunct Associate Professor at the Ohio State University, College of Nursing and as
an author of nursing textbooks.
Dr LeMone-Koeplin won numerous awards for scholarship and teaching during her more than 30 years as a nurse educator.
She is most honoured for receiving the Kemper Fellowship for Teaching Excellence from the University of Missouri, the
Unique Contribution Award from the North American Nursing Diagnosis Association, and for being selected as a Fellow in the
American Academy of Nursing. Dr LeMone-Koeplin currently lives in Ohio. She enjoys travelling, gardening, knitting and
reading fiction.
She believes that her education gave her solid and everlasting roots in nursing. Her work with students has given her the
wings that have allowed her love of nursing and teaching to continue through the years.
KAREN M. BURKE RN, MS

Karen Burke has been a nurse educator for much of her career, teaching basic and advanced medical–
surgical nursing and pathophysiology. She retired as director of the nursing and health occupations
programs at Clatsop Community College in Astoria, Oregon, subsequently serving as nursing education
consultant and program manager for the Oregon State Board of Nursing. She currently provides consulting
services for nursing and higher education.
Ms Burke earned her diploma in nursing from Emanuel Hospital School of Nursing in Portland, Oregon, later
completing baccalaureate studies at Oregon Health & Science University, and a master’s degree in nursing at the University
of Portland. She has been actively involved in nursing education and clinical nursing education reform, as well as in
initiatives to address the nursing faculty shortage. Ms Burke is co-author of another text, Medical–Surgical Nursing Care
(3rd edition), with Elaine Mohn-Brown and Linda Eby.
Ms Burke highly values the nursing profession and the importance of providing a strong education in the art and science of
nursing for students preparing to enter the profession, no matter which educational path is being pursued.
GERENE BAULDOFF RN, PhD, FAAN

Gerene Bauldoff is a Professor of Clinical Nursing at The Ohio State University College of Nursing in
Columbus, Ohio. She has been a nurse educator for 14 years, teaching medical–surgical nursing,
translational science and evidence-based practice courses at the baccalaureate, master’s, and doctoral
levels. Prior to her nursing educator role, her clinical background included home health nurse, lung
transplant coordinator and pulmonary rehabilitation coordinator. Dr Bauldoff has a diploma from the
Western Pennsylvania Hospital School of Nursing, Pittsburgh, Pennsylvania, and a BSN from LaRoche
College in Pittsburgh. Her graduate education is from the University of Pittsburgh, with an MSN in medical–surgical
nursing (cardiopulmonary clinical nurse specialist) and a PhD in nursing in 2001, training under Leslie Hoffman, PhD,
RN, FAAN.
Dr Bauldoff is an active member of multiple professional organisations including the American Academy of Nursing (AAN),
Sigma Theta Tau International Honor Society of Nursing, the American Association of Cardiovascular and Pulmonary
xxiv about the authors
Rehabilitation (AACVPR), the American Thoracic Society Nursing Assembly and the American College of Chest Physicians
(ACCP). She is a recognised expert in medical–surgical nursing, focusing on the care of the patient with chronic pulmonary
disease, serving on committees focusing on patient-centred outcomes in pulmonary rehabilitation. She has been honoured
with fellowships in the AAN, AACVPR and ACCP. In 2013, Dr Bauldoff was the keynote speaker at the Nanning Nursing
Education Conference in Nanning, China, attended by representatives from more than 100 nursing schools in China.
Dr Bauldoff views nursing as the greatest profession, using scientific evidence to provide the highest quality of care while
maintaining the personal relationship with patients and their families. Her experiences provide her with insights and
lessons learned that she shares with her students.
Dr Bauldoff resides in central Ohio. She enjoys travelling, walking, bicycling, golf and spending time with her family and
friends.
PAULA GUBRUD-HOWE RN, MS, EdD, FAAN

Paula Gubrud-Howe is Senior Associate Dean for Academic Affairs and an Associate Professor at Oregon Health
and Science University (OHSU) School of Nursing. She has more than 25 years of experience as a nurse
educator involving multiple levels of programs from LPN to doctoral education. Dr Gubrud-Howe is a founding
leader and co-director of the Oregon Consortium for Nursing Education, an award-winning consortium that
includes the five campuses of OHSU and nine community colleges. She also has more than 20 years of
experience in medical–surgical nursing, critical care, home health and hospice. Dr Gubrud-Howe earned a baccalaureate
degree in nursing from Walla Walla University (1980), an MS in community-based nursing from OHSU (1993) and an EdD in
post-secondary education from Portland State University (2008). She is a frequently invited speaker at national and
international nursing education conferences and consults with other states and countries on the development of
competency-based curricula and nursing education consortiums designed to promote academic progression in nursing
education. Her research activity is focused on clinical education redesign and the integration of simulation into nursing
curricula.
Dr Gubrud-Howe is passionate about nursing and the opportunities it provides to members of the profession. She values
the sacred relationship nurses experience with patients as they promote health, treat illness and provide comfort and
palliative care. She believes the nation’s health depends on highly qualified nurses who are dedicated to lifelong learning
in pursuit of evidence-based, patient-centred care.
TRACY LEVETT-JONES RN, PhD, MEd & Work, BN, DipAppSc(Nur)

Professor Tracy Levett-Jones is the Deputy Head of School (Teaching and Learning), School of Nursing and
Midwifery, and the Director of the Research Centre for Health Professional Education at the University of
Newcastle. Her research interests include clinical reasoning, interprofessional education, empathy,
belongingness, cultural competence, simulation and patient safety. Tracy has authored 10 books, the most
recent being Clinical reasoning: Learning to think like a nurse and Critical conversations for patient safety, as
well as over 150 book chapters, reports and peer-reviewed journal articles. Tracy has been the recipient of nine research
awards and 10 teaching awards including an Australian Learning and Teaching Council (ALTC) Award for Teaching Excellence
(2010), a NSW Minister for Education and Training Quality Teaching Award (2007) and a Pearson/Australian Nurse Teacher
Society Nurse Educator of the Year Award (2011). She has been awarded nearly $2 million in grant funding and has led and
been involved in a number of Category 1 funded projects.
TRUDY DWYER RN, PhD, MClinEdu, GCFlexLearn, BHlthScn(Nsg), NrCert, ICUNsgCert

Trudy Dwyer completed a hospital-based nursing program at the Rockhampton Hospital, Queensland, where
she developed an enthusiasm for critical care nursing and travel. Trudy currently holds the position of Associate
Professor (Research Intensive) at CQUniversity. She has extensive experience coordinating undergraduate
courses/programs and research higher-degree supervision. Her research interests include patient safety,
recognition of deterioration, resuscitation and simulation. She has published in international refereed scholarly
journals, book chapters and is the co-author of the highly successful Student nurse: Clinical survival guide.
Another random document with
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The Project Gutenberg eBook of Marxism and
Darwinism
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Title: Marxism and Darwinism

Evidence, speeches, and papers in its favour
Author: Anton Pannekoek
Translator: Nathan Weiser
Release date: November 11, 2023 [eBook #72095]
Language: English
Original publication: Chicago: Charles H. Kerr & Co, 1912
Credits: Tim Lindell, Donald Cummings, and the Online

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(This file was produced from images generously made
available by The Internet Archive/Canadian Libraries)
*** START OF THE PROJECT GUTENBERG EBOOK MARXISM

AND DARWINISM ***
Marxism and Darwinism
BY
ANTON PANNEKOEK
Translated by Nathan Weiser.
CHICAGO
CHARLES H. KERR & COMPANY
CO-OPERATIVE
Copyright, 1912
By
Charles H. Kerr & Company
“SURVIVAL OF THE FITTEST.”
In northern climes, the polar bear
Protects himself with fat and hair,
Where snow is deep and ice is stark,
And half the year is cold and dark,
He still survives a clime like that
By growing fur, by growing fat.
These traits, O bear, which thou transmittest
Prove the Survival of the Fittest.
To polar regions waste and wan,

Comes the encroaching race of man,
A puny, feeble, little bubber,
He has no fur, he has no blubber.
The scornful bear sat down at ease
To see the stranger starve and freeze—
But, lo! the stranger slew the bear,
And ate his fat and wore his hair;
These deeds, O Man, which thou committest
In modern times the Millionaire

Protects himself as did the bear:
Where Poverty and Hunger are
He counts his bullion by the car:
Where thousands perish still he thrives—
The wealth, O Croesus, thou transmittest
Proves the Survival of the Fittest.
But, lo, some people odd and funny,

Some men without a cent of money—
The simple common human race
Chose to improve their dwelling place:
They had no use for millionaires,
They calmly said the world was theirs,
They were so wise, so strong, so many,
The Millionaires?—there wasn’t any.
These deeds, O Man, which thou committest
—Mrs. Charlotte Stetson.

CONTENTS.
PAGE.
I. Darwinism 7
II. Marxism 16
III. Marxism and the Class Struggle 19
IV. Darwinism and the Class Struggle 22
V. Darwinism Versus Socialism 27
VI. Natural Law and Social Theory 33
VII. The Sociability of Man 36
VIII. Tools, Thought and Language 42
IX. Animal Organs and Human Tools 50
X. Capitalism and Socialism 54
MARXISM and DARWINISM
I. DARWINISM.
Two scientists can hardly be named who have, in the second half
of the 19th century, dominated the human mind to a greater degree
than Darwin and Marx. Their teachings revolutionized the conception
that the great masses had about the world. For decades their names
have been on the tongues of everybody, and their teachings have
become the central point of the mental struggles which accompany
the social struggles of today. The cause of this lies primarily in the
highly scientific contents of their teachings.
The scientific importance of Marxism as well as of Darwinism
consists in their following out the theory of evolution, the one upon
the domain of the organic world, of things animate; the other, upon
the domain of society. This theory of evolution, however, was in no
way new, it had its advocates before Darwin and Marx; the
philosopher, Hegel, made it even as the central point of his
philosophy. It is, therefore, necessary to observe closely what were
the achievements of Darwin and Marx in this domain.
The theory that plants and animals have developed one from
another is met with first in the nineteenth century. Formerly the
question, “Whence come all these thousands and hundreds of
thousands of different kinds of plants and animals that we know?”
was answered. “At the time of creation God created them all, each
after its kind.” This primitive theory was in conformity with the
experiences had and with the oldest information that could be got.
According to the information, all known plants and animals have
always been the same. Scientifically, this experience was thus
expressed, “All kinds are invariable because the parents transmit
their characteristics to their children.”
There were, however, some peculiarities among plants and
animals which gradually forced a different conception to be
entertained. They so nicely let themselves be arranged into a system
which was first set up by the Swedish scientist Linnaeus. According
to this system, the animals are divided into main divisions; these
divisions are divided into classes, classes into orders, orders into
families, families into species, each of which contain a few kinds.
The more semblance there is in their characteristics, the nearer they
stand towards each other in this system, and the smaller is the group
to which they belong. All the animals classed as mammalian show
the same general characteristics in their bodily frame. The
herbivorous animals, and carnivorous animals, and monkeys, each
of which belongs to a different order, are again differentiated. Bears,
dogs, and cats, all of which are rapacious animals, have much more
in common in bodily form than they have with horses or monkeys.
This conformity is still more obvious when we examine varieties of
the same species; the cat, tiger and lion resemble each other in
many respects where they differ from dogs and bears. If we turn
from the class of mammals to other classes, such as birds or fishes,
we find greater differences than we find in the other class. There is
still, however, a slight resemblance in the formation of the body, the
skeleton and the nervous system are still there. These features first
disappear when we turn from this main division, which embraces all
the vertebrates, and go to the molluscs (soft bodied animals) or to
the polyps.
The entire animal world may thus be arranged into divisions and
subdivisions. Had every different kind of animal been created entirely
independent of all the others, there would be no reason why such
orders should exist. There would be no reason why there should not
be mammals having six paws. We would have to assume, then, that
at the time of creation, God had taken Linnaeus’ system as a plan
and created everything according to this plan. Happily we have
another way of accounting for it. The likeness in the construction of
the body may be due to a real family relationship. According to this
conception, the conformity of peculiarities show how near or remote
the relationship is; just as the resemblance of brothers and sisters is
greater than between remote relatives. The animal classes were,
therefore, not created individually, but descended one from another.
They form one trunk that started with simple foundations and which
has continually developed; the last and thin twigs are our present
existing kinds. All species of cats descend from a primitive cat, which
together with the primitive dog and the primitive bear, is the
descendant of some primitive type of rapacious animal. The primitive
rapacious animal, the primitive hoofed animal and the primitive
monkey have descended from some primitive mammal, etc.
This theory of descent was advocated by Lamarck and by
Geoffrey St. Hilaire. It did not, however, meet with general approval.
These naturalists could not prove the correctness of this theory and,
therefore, it remained only a hypothesis, a mere assumption. When
Darwin came, however, with his main book, The Origin of Species, it
struck like a thunderbolt; his theory of evolution was immediately
accepted as a strongly proved truth. Since then the theory of
evolution has become inseparable from Darwin’s name. Why so?
This was partly due to the fact that through experience ever more
material was accumulated which went to support this theory. Animals
were found which could not very well be placed into the classification
such as oviparous mammals (that is, animals which lay eggs and
nourish their offspring from their breast.—Translator), fishes having
lungs, and invertebrate animals. The theory of descent claimed that
these are simply the remnants of the transition between the main
groups. Excavations have revealed fossil remains which looked
different from animals living now. These remains have partly proved
to be the primitive forms of our animals, and that the primitive
animals have gradually developed to existing ones. Then the theory
of cells was formed; every plant, every animal, consists of millions of
cells and has been developed by incessant division and
differentiation of single cells. Having gone so far, the thought that the
highest organisms have descended from primitive beings having but
a single cell, could not appear as strange.
All these new experiences could not, however, raise the theory to
a strongly proved truth. The best proof for the correctness of this
theory would have been to have an actual transformation from one
animal kind to another take place before our eyes, so that we could
observe it. But this is impossible. How then is it at all possible to
prove that animal forms are really changing into new forms? This
can be done by showing the cause, the propelling force of such
development. This Darwin did. Darwin discovered the mechanism of
animal development, and in doing so he showed that under certain
conditions some animal-kinds will necessarily develop into other
animal-kinds. We will now make clear this mechanism.
Its main foundation is the nature of transmission, the fact that
parents transmit their peculiarities to children, but that at the same
time the children diverge from their parents in some respects and
also differ from each other. It is for this reason that animals of the
same kind are not all alike, but differ in all directions from the
average type. Without this so-called variation it would be wholly
impossible for one animal species to develop into another. All that is
necessary for the formation of a new species is that the divergence
from the central type become greater and that it goes on in the same
direction until this divergence has become so great that the new
animal no longer resembles the one from which it descended. But
where is that force that could call forth the ever growing variation in
the same direction?
Lamarck declared that this was owing to the usage and much
exercise of certain organs; that, owing to the continuous exercise of
certain organs, these become ever more perfected. Just as the
muscles of men’s legs get strong from running much, in the same
way the lion acquired its powerful paws and the hare its speedy legs.
In the same way the giraffes got their long necks because in order to
reach the tree leaves, which they ate, their necks were stretched so
that a short-necked animal developed to the long-necked giraffe. To
many this explanation was incredible and it could not account for the
fact that the frog should have such a green color which served him
as a good protecting color.
To solve the same question, Darwin turned to another line of
experience. The animal breeder and the gardener are able to raise
artificially new races and varieties. When a gardener wants to raise
from a certain plant a variety having large blossoms, all he has to do
is to kill before maturity all those plants having small blossoms and
preserve those having large ones. If he repeats this for a few years
in succession, the blossoms will be ever larger, because each new
generation resembles its predecessor, and our gardener, having
always picked out the largest of the large for the purpose of
propagation, succeeds in raising a plant with very large blossoms.
Through such action, done sometimes deliberately and sometimes
accidentally, people have raised a great number of races of our
domesticated animals which differ from their original form much
more than the wild kinds differ from each other.
If we should ask an animal-breeder to raise a long-necked animal
from a short-necked one, it would not appear to him an impossibility.
All he would have to do would be to choose those having partly
longer necks, have them inter-bred, kill the young ones having
narrow necks and again have the long-necked inter-breed. If he
repeated this at every new generation the result would be that the
neck would ever become longer and we would get an animal
resembling the giraffe.
This result is achieved because there is a definite will with a
definite object, which, to raise a certain variety, chooses certain
animals. In nature there is no such will, and all the deviations must
again be straightened out by interbreeding, so that it is impossible for
an animal to keep on departing from the original stock and keep
going in the same direction until it becomes an entirely different
species. Where, then, is that power in nature that chooses the
animals just as the breeder does?
Darwin pondered this problem long before he found its solution in
the “struggle for existence.” In this theory we have a reflex of the
productive system of the time in which Darwin lived; because it was
the capitalist competitive struggle which served him as a picture for
the struggle for existence prevailing in nature. It was not through his
own observation that this solution presented itself to him. It came to
him by his reading the works of the economist Malthus. Malthus tried
to explain that in our bourgeois world there is so much misery and
starvation and privation because population increases much more
rapidly than the existing means of subsistence. There is not enough
food for all; people must, therefore, struggle with each other for their
existence, and many must go down in this struggle. By this theory
capitalist competition as well as the misery existing were declared as
an unavoidable natural law. In his autobiography Darwin declares
that it was Malthus’ book which made him think about the struggle
for existence.
“In October, 1838, that is, fifteen months after I had begun my
systematic inquiry, I happened to read for amusement Malthus on
population, and being well prepared to appreciate the struggle for
existence which everywhere goes on from long continuous
observation of the habits of animals and plants, it at once struck me
that under these circumstances favorable variations would tend to be
preserved, and unfavorable ones to be destroyed. The result of this
would be the formation of new species. Here, then, I had at last got a
theory by which to work.”
It is a fact that the increase in the birth of animals is greater than
the existing food permits of sustaining. There is no exception to the
rule that all organic beings tend to increase so rapidly that our earth
would be overrun very soon by the offspring of a single pair, were
these not destroyed. It is for this reason that a struggle for existence
must arise. Every animal tries to live, does its best to eat, and seeks
to avoid being eaten by others. With its particular peculiarities and
weapons it struggles against the entire antagonistic world, against
animals, cold, heat, dryness, inundations, and other natural
occurrences that may threaten to destroy it. Above all, it struggles
with the animals of its own kind, who live in the same way, have the
same peculiarities, use the same weapons and live by the same
nourishment. This struggle is not a direct one; the hare does not
struggle directly with the hare, nor the lion with the lion—unless it is
a struggle for the female—but it is a struggle for existence, a race, a
competitive struggle. All of them can not reach a grown-up age; most
of them are destroyed, and only those who win the race remain. But
which are the ones to win in the race? Those which, through their
peculiarities, through their bodily structures are best able to find food
or to escape an enemy; in other words, those which are best
adapted to existing conditions will survive. “Because there are ever
more individuals born than can remain alive, the struggle as to which
shall remain alive must start again and that creature that has some
advantage over the others will survive, but as these diverging
peculiarities are transmitted to the new generations, nature itself
does the choosing, and a new generation will arise having changed
peculiarities.”
Here we have another application for the origin of the giraffe.
When grass does not grow in some places, the animals must nourish
themselves on tree leaves, and all those whose necks are too short
to reach these leaves must perish. In nature itself there is selection,
and nature selects only those having long necks. In conformity with
the selection done by the animal breeder, Darwin called this process
“natural selection.”
This process must necessarily produce new species. Because too
many are born of a certain species, more than the existing food
supply can sustain, they are forever trying to spread over a larger
area. In order to procure their food, those living in the woods go to
the plain, those living on the soil go into the water, and those living
on the ground climb on trees. Under these new conditions
divergence is necessary. These divergencies are increased, and
from the old species a new one develops. This continuous
movement of existing species branching out into new relations
results in these thousands of different animals changing still more.
While the Darwinian theory explains thus the general descent of
the animals, their transmutation and formation out of primitive
beings, it explains, at the same time, the wonderful conformity
throughout nature. Formerly this wonderful conformity could only be
explained through the wise superintending care of God. Now,
however, this natural descent is clearly understood. For this
conformity is nothing else than the adaptation to the means of life.
Every animal and every plant is exactly adapted to existing
circumstances, for all those whose build is less conformable are less
adapted and are exterminated in the struggle for existence. The
green-frog, having descended from the brown-frog, must preserve its
protecting color, for all those that deviate from this color are sooner
found by the enemies and destroyed or find greater difficulty in
obtaining their food and must perish.
It was thus that Darwin showed us, for the first time, that new
species continually formed out of old ones. The theory of descent,
which until then was merely a presumptive inference of many
phenomena that could not be explained well in any other way,
gained the certainty of an absolute inference of definite forces that
could be proved. In this lies the main reason that this theory had so
quickly dominated the scientific discussions and public attention.
II. MARXISM.
If we turn to Marxism we immediately see a great conformity with
Darwinism. As with Darwin, the scientific importance of Marx’s work
consists in this, that he discovered the propelling force, the cause of
social development. He did not have to prove that such a
development was taking place; every one knew that from the most
primitive times new social forms ever supplanted older, but the
causes and aims of this development were unknown.
In his theory Marx started with the information at hand in his time.
The great political revolution that gave Europe the aspect it had, the
French Revolution, was known to everyone to have been a struggle
for supremacy, waged by the bourgeois against nobility and royalty.
After this struggle new class struggles originated. The struggle
carried on in England by the manufacturing capitalists against the
landowners dominated politics; at the same time the working class
revolted against the bourgeoisie. What were all these classes?
Wherein did they differ from each other? Marx proved that these
class distinctions were owing to the various functions each one
played in the productive process. It is in the productive process that
classes have their origin, and it is this process which determines to
what class one belongs. Production is nothing else than the social
labor process by which men obtain their means of subsistence from
nature. It is the production of the material necessities of life that
forms the main structure of society and that determines the political
relations and social struggles.
The methods of production have continuously changed with the
progress of time. Whence came these changes? The manner of
labor and the productive relationship depend upon the tools with
which people work, upon the development of technique and upon the
means of production in general. Because in the Middle Ages people
worked with crude tools, while now they work on gigantic machinery,
we had at that time small trade and feudalism, while now we have
capitalism; it is also for this reason that at that time the feudal nobility
and the small bourgeoisie were the most important classes, while
now it is the bourgeoisie and the proletarians which are the classes.
It is the development of tools, of these technical aids which men
direct, which is the main cause, the propelling force of all social
development. It is self-understood that the people are ever trying to
improve these tools so that their labor be easier and more
productive, and the practice they acquire in using these tools, leads
their thoughts upon further improvements. Owing to this
development, a slow or quick progress of technique takes place,
which at the same time changes the social forms of labor. This leads
to new class relations, new social institutions and new classes. At
the same time social, i. e., political struggles arise. Those classes
predominating under the old process of production try to preserve
artificially their institutions, while the rising classes try to promote the
new process of production; and by waging the class struggles
against the ruling class and by conquering them they pave the way
for the further unhindered development of technique.
Thus the Marxian theory disclosed the propelling force and the
mechanism of social development. In doing this it has proved that
history is not something irregular, and that the various social systems
are not the result of chance or haphazard events, but that there is a
regular development in a definite direction. In doing this it was also
proved that social development does not cease with our system,
because technique continually develops.
Thus, both teachings, the teachings of Darwin and of Marx, the
one in the domain of the organic world and the other upon the field of
human society, raised the theory of evolution to a positive science. In
doing this they made the theory of evolution acceptable to the
masses as the basic conception of social and biological
development.

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(Original PDF) Medical-Surgical Nursing

Critical Thinking for Person-Centred

(eBook PDF) Winningham's Critical Thinking Cases in

(eBook PDF) Workbook for Introductory Medical-Surgical

(eBook PDF) Workbook for Introductory Medical-Surgical

(eBook PDF) Study Guide for Medical-Surgical Nursing:

Medical-Surgical Nursing : Concepts for

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(eBook PDF) Lewis's Medical-Surgical Nursing:

LeMone • Burke • Bauldoff • Gubrud • Levett-Jones • Hales

Interprofessional care 235 The person with an autoimmune disorder 329

Thyroid gland 515 Chapter 19 Nursing care of people with

Chapter 22 Nursing care of people with upper Interprofessional care 702

Interprofessional care 666 Interprofessional care 713

Interprofessional care 857 Neurological effects 909; Musculoskeletal effects 909;

The person with a neurogenic bladder 871 Unit 8

The person with myocarditis 1067 Interprofessional care 1125

Interprofessional care 1137 The person with disseminated intravascular

The person with pharyngitis or tonsillitis 1231 Interprofessional care 1272

Interprofessional care 1335 The person with a fracture 1393

Chapter 37 A person-centred approach to The person with osteomalacia 1437

Assessing musculoskeletal function 1378 The person with osteoarthritis 1439

The person with a brain tumour 1559 Interprofessional care 1617

UNIT 13 Interprofessional care 1765

Interprofessional care 1799 Interprofessional care 1834

KAREN M. BURKE RN, MS

GERENE BAULDOFF RN, PhD, FAAN

PAULA GUBRUD-HOWE RN, MS, EdD, FAAN

TRACY LEVETT-JONES RN, PhD, MEd & Work, BN, DipAppSc(Nur)

TRUDY DWYER RN, PhD, MClinEdu, GCFlexLearn, BHlthScn(Nsg), NrCert, ICUNsgCert

Title: Marxism and Darwinism

Author: Anton Pannekoek

Translator: Nathan Weiser

Release date: November 11, 2023 [eBook #72095]

Original publication: Chicago: Charles H. Kerr & Co, 1912

Credits: Tim Lindell, Donald Cummings, and the Online

*** START OF THE PROJECT GUTENBERG EBOOK MARXISM

To polar regions waste and wan,

In modern times the Millionaire

But, lo, some people odd and funny,

—Mrs. Charlotte Stetson.

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