The Normal and the

Pathological
Part II, Chapter IV: DISEASE, CURE, HEALTH

Shikha Soni
 Distinguishing anomaly from pathological state, perceive the
onset of disease to the individual himself.
Statistically obtained average does not allow us to decide
whether individual is normal or not. (Goldstein)

Sigerist-
Individual relativity of the biological norm. (norm and average)
(e.g. pulse)

What is normal can be pathological in another situation if it

continues identical itself
Individual is the judge of the transformation
Goldstein
Pathological abnormal state does not consist in the absence of very
norm. Disease is inferior norm (changing itself to another norm)
Pathological phenomenon are the regular modifications of normal
phenomenon
Sick person even though capable of similar reaction like before, can
arrive to these reactions by different path

To define organisms state:

Normal state: Preferential behavior (most order and stability)
Disease state: Catastrophic reaction
Sick person is not abnormal because of the absence of the norm but
because of his incapacity to be normative
Disease is not a variation on the dimension of health, it is a new
dimension of life.
Jackson:

Disease is both deprivation and change

In every interpretation of pathological symptoms the negative as well as positive

aspects must be considered

Take note of what the patient really understands and avoid terms such as
amnesia, alexia, word deafness etc.

The abnormal can be evaluated only in terms of a relationship. There is no

pathological disturbance in itself.

As disease is dissolution, it is also regression.

Disease is a new life, characterized by new physiological constants and new

mechanisms for obtaining apparently unchanged results.

The cure can be interpreted as a change from one arrangement to another, as

Delmas- Marslet:
What disease shows up as abnormal to put is exactly as new. (Brain Plasticity)
The cure can just be well interpreted as a change from one arrangement to another as
seen as a restitution of the initial state.

Leriche, A.G Weiss, Klein:

Neuroma
Disease is not merely the disappearance of the physiological order but the appearance of a
new vital order

Goldstein Idea of cure:

Being well means capable of ordered behavior which may prevail in spite of impossibility of
certain performances which were formally possible.
New normality
To become well again, in spite of defects, involves certain loss in essential nature of the
organism.
Newly formed constants guarantee new constants. If interfered-create disease (e.g.
increase in fever)
 Health:
Initial boundless capacity to institute new biological norms.
Being healthy means not only being normal in a given situation but also normative
in this and other eventful situations.
Possibility of tolerating infractions of the habitual norm and instituting new norm in
new situation (e.g one kidney, mother)
Health is the margin of tolerance for the inconstancies of the environment.
For living being life is not the monotonous deductions.
Health is the security in the present and the assurances for the future.
To be in good health means being able to fall sick and recover, biological luxury
(e.g. inflammation)

Disease is reduction in the margin of tolerance for the environment inconstancies.

Man feels in good health- only when he feels more then normal
Power and temptation to fall sick are essential characteristics of the human
physiology
 In order to discern what is normal or pathological for the body itself, one must
look beyond the body (e.g. normal or abnormal at different times in
environment)

Health is a feeling of assurance in life to which no limit is fixed.

Health is a way of tackling existence as one feels that one is not only
possessor or bearer but also, if necessary, creator of value, establisher of
vital norm.
 Physiology as the science of laws or constants of normal life would not
be considered
Physiology is also a science in terms of its search of its constants or
invariants
Object of science (laws of inertia, life as a evolution, historical matter)
Raphael Dubois -> Defined Physiology based on Hippocratic
theory(Unlike tautological or etymological)
Sigerist example of Baroque artist
Wolfflin says a Baroque artist sees not the eye but the gaze
Object for Physiology is movement. Each physiological problem leads us
to the source of life and permits us to escape an infinity.
 Two modes of life:
A) Propulsive mode (truly normal in virtue of their normativity)
B) Repulsive mode ( Death of normativity)
Immunity & Anaphylaxis
After 1st modification& second break-in
Immunized ( Normality is normal)
Anaphylaxis ( Normal is Pathological)
Virchow Pathology as Physiology with obstacles. Ex : sick man
Brown Sequard: Endocrinology (1856)
Thank you