Disease
by
For over twenty years, I have taught an undergraduate seminar whose central question has been, “What is disease?” In the first class, I often evoke the parable of the visually impaired and the elephant. Depending on which parts they touch, each person perceives something different. Similarly, what disease is depends on when, where, and with what tools and preconceptions you encounter it. As a framework for understanding the range of disease meanings, it is hard to improve upon Temkin’s (1977) philosophical and historical reflections on the tensions between ontological and physiological conceptions of illness. By “ontology,” Temkin meant how specific diseases impact different individuals in similar ways, while the physiological view captured the multiple and idiosyncratic ways individuals are sick. Depending on the types of suffering most prevalent in any era and place, ontological or physiological conceptions might have the upper hand. The arch-ontologist Thomas Sydenham (1624–89) practiced in London during plague years, and plague, Temkin quipped, did not distinguish much among individuals. Temkin also weighed some of the advantages and disadvantages of these ideal types. Sigmund Freud’s physiological, dimensional approach to the human psyche in the early twentieth century placed the self-evidently sick and the possibly well on a...
This essay may be found on page 65 of the printed volume.