Philosophy of the Unconscious

by Eduard Von Hartmann

  Another objection is, that the procedure of the organism is not always suitable, but that the same phenomena which at one time effect a cure at another time produce disease, or aggravate an existing morbid condition. I hold this to be entirely untrue. I assert, on the contrary, in the first place, that diseases never arise spontaneously from the psychical basis of the organism, but that they are imposed and thrust on it by disturbances from without; and, secondly, that all the changes effected by the organism in the normal condition of its functions with direct reference to these disturbances are adapted to their removal; assertions which I shall at once proceed to make good.

  The first question is, What is disease? Disease is not abnormity of form, for there are abnormal forms, as giants, dwarfs, excessive number of fingers, irregular course of veins, which nobody accounts diseases. Disease is not a state which endangers the continued existence of the organism, for many diseases do not do this. It is not a state which causes pain and trouble to the consciousness of the individual, for this, too, is not the case in many diseases. Disease is an abnormity in the organic functions, which certainly may have abnormities of structure both as cause and as consequence. In the former case we are wont to term even abnormity of structure disease. Taken strictly, however, another abnormity of the functions must have preceded this abnormal formation as its cause; for as long as all functions are exercised normally, the occurrence of abnormal formations is impossible. E.g., phthisis may be caused by tubercles; these can be inherited, but in the individual from which the tuberculosis of the family takes its rise, the tubercles, in case they are not again inherited or grafted by contagion (through tuberculous nurse’s milk, milk of tuberculous cows, inhalation of the products of decomposed pulmonary tubercles, &c.), must necessarily have arisen through abnormal functions. When thus we investigate into the cause of a disease, we must in every case come back, in the last resort, to an abnormity of function with normal structure of the functioning organs; for as long as structural abnormities co-operate, we have not tracked the causal series to the end.

  If we now ask how the primary cause of all diseases, abnormity of function with normal structure, is possible, experience and speculation agree in answering, Only through disturbance from outside, but not from within through a spontaneous psychical act of the organism. These disturbances may be of very various kinds:—(1.) Mechanical influences, as all kinds of inner or outer injury. (2.) Chemical influences, (a) through the introduction of substances which directly disturb the normal relations by causing new combinations, e.g., in poisoning by arsenic, sulphuric acid, most mineral medicines; (b) through chemical contagion, infection in the widest sense, also by atmospheric changes which predispose to diseases not properly infectious. (3.) Organic influences, introduction of (microscopically minute) vegetable or animal organisms, which, feeding on the body and propagating, disturb the chemical composition or the morphological cell-structure of the affected organism. In many diseases it is still doubtful whether their infectious character is to be referred to chemical action by contact or to organic germs (e.g., plague, syphilis, variola, diphtheria, typhoid fever, cholera, intermittent fever, &c.), although the latter is ever gaining more probability. (4.) Abnormity in the proportion of the ingesta and egesta. If the latter preponderate, there ensues loss of bulk, weakness, &c.; if the former, generally hypertrophy, which is manifested in different forms according to the matters in excess (tubercles, scrofula, gout, obesity, &e.) (5.) Unsuitable quality of the ingesta, producing disturbances in the digestive organs, and through abnormal composition of the blood also in the nutrition. Bad air can in this way, by altering the composition of the blood, produce putrid fever, &c, (6.) Improper modes of living, e.g., absolute inaction of a muscle produces weakness and atrophy, since its alimentation is based on the supposition of movement. Sedentary occupations disturb digestion on the same ground, and transference to a foreign climate demands accommodation of the body to the new environment, or is followed by disease. (7.) Inherited bodily defects or tendencies to disease. Here the primary external causes of the disease are to be found in the act of generation, where the transmission is effected, and all succeeding members of the family inheriting the disease receive at birth the fatal germs as their portion on the journey of life, which the remedial energy of Nature is just as little able to cope with, as a chronic illness directly aroused by outer disturbances.

  I believe that all diseases may be referred to these or similar disturbances, if it be always at the same time borne in mind that one has to go back to the first cause of the phenomenon, and not to consider the superficial symptoms of the disease itself. Nay, even the latter is frequently already an act of the vis medicatrix, the crisis of a series of preceding diseases or abnormities, which are only more or less-withdrawn from consciousness (thus, e.g., in all eruptive diseases, gout, fevers, inflammations, &c.) The vis medicatrix, with its crises, sometimes even anticipates the outbreak of that disease which must result from an abnormity of formation (as, e.g., in the killing and evacuation of the fœtus which could not be born); and so far it is correct that phenomena are called forth through spontaneous psychical acts of the Unconscious in the organism, which we term disease, because they are abnormal, and in part painful processes. In that case, however, they only obviate a more dangerous disease; they are the choice of a lesser evil intentionally called forth to avoid a greater one, and are thus, strictly regarded, processes not of disease, but of healing. It may also happen that death ensues in this spontaneously evoked crisis, because the unconscious will does not possess sufficient power for getting the better of the disturbances; but then it would quite certainly have occurred without the test of a crisis, whilst there was the bare possibility of the vis medicatrix being victorious. Should some diseases still remain inexplicable as external derangements, this would not impair the correctness of the principle that the psychical basis of organic formation cannot become diseased, for almost all the facts tell in favour of this principle, and none against it, since the tracing back of the few exceptions to external disturbances may be expected from the science of the future. I cannot, therefore, adopt the hypothesis set up by Carus to explain the similarity of diseases, viz., that the IDEA of the organism is, as it were, seized and possessed by the IDEA of a disease. The fact seems to me sufficiently explained by the similar reaction of similar organisms on similar disturbances; and, in truth, the same disease never wears precisely the same appearance, but is at least as different as the individuals themselves. This circumstance alone tells against the above hypothesis, that no pathological formation has yet presented itself, which has not its prototype in normal physiological formations. Virchow says (Cellularpathologie, p. 60): “There is no other kind of heterology in morbid tissues than the improper mode of origination, and the impropriety consists in this, that a tissue is produced at a place or time when it should not have been produced, or in a degree which deviates from that of the typical form. Every heterology is then, more exactly characterised, a heterotopy, an aberratio loci, or an aberratio temporis, a heterochrony, or, lastly, a merely quantitative deviation, heterometry.” The theory of ideal types of disease, which take possession of organisms, could only have a certain figurative authorisation where animals or plants are the causes of disease, as in prurigo, rot, corn-blight, &c., i.e., in the science of parasites, in the modern sense of the term.

  As concerns the so-called mental diseases, the traditional, and, in spite of opposition, still generally accepted view, is, that every disturbance of conscious psychical action is produced, by a disturbance of the brain, as the organ of consciousness, whether this cerebral disturbance be brought about directly or through disease of the spinal cord and nerves. Even where psychical shocks bring on mental disease, we must probably assume a cerebral diathesis, mostly inherited, which is only revealed by such an exciting cause. Without doubt, even in these cases, a disturbance of the brain is to be assumed as the cause of the disturbance of consciousness, this disturbance of the brain
being provoked, indeed, not by a material, but by a psychical shock, but at all events produced by an external influence, of which the conscious mental states are only reporters and interpreters. The proposition that the Unconscious itself neither falls sick nor can produce sickness in its organism, but that all sickness is the result of a disturbance from without, thus remains unimpeached.

  As for the second point, the doubtful propriety of the precautions of the vis medicatrix against disease, the most important factor, which must not be left out of sight, is the limitation of the power of the will in mastering its circumstances. If the will of the individual were omnipotent, it would not be finite and individual; accordingly there must be disturbances which it cannot get rid of. As now the points in the organism which the will can lay hold of are likewise very limited, i.e., its power has very different limits in different parts, a preconceived end must naturally often be reached by the most wonderfully circuitous paths, so that the representation of the end with the means employed by the organism often entirely escapes the unpractised eye, and is only understood by the profounder glance of science, which perceives the impossibility of shorter cuts to the goal. As now scientific Physiology and Pathology are still so young, one need not be surprised if they even yet have only penetrated a very little way into the operations of organic life, and if they must often have to put up with a guess concerning the multitude of connecting links, but also, and more, frequently, fail to settle the question whether there might not have been a still more appropriate course than the one actually chosen. Every perceived adaptation is proof positive of psychical action not to be invalidated, but a thousand ill-understood connections of cause and effect can afford no negative argument against the existence of a psychical basis. This is by no means, however, the state of the case, but in almost all instances where we see a manifestly unsuitable action on the part of the organism, we can render a satisfactory account of the phenomenon. The spontaneous origin of disease, which might also have been included in the list, has been already dealt with. A great number of other cases are accounted for as follows:—The means offered for getting rid of the disturbance do not conform to the intentions of the organism, because disturbances from other quarters prevent this, so that by a second malady the efforts to suppress the first are rendered fruitless. This case is of very frequent occurrence, only it is often difficult to discover the second disturbing cause, which may be very deep-seated, and at the same time be very insignificant in itself. In the last resort it is then always again the insufficient power of the individual will (in the present instance in setting aside the second disturbance), whereby the means applied are misdirected, and do not lead to the goal. A special case of insufficient power is when, on a particularly intense strain in a certain direction, the will is not able to keep within definite bounds. Thus, e.g., in the healing of a broken bone, when an active tendency to the formation of bone is required, the surrounding portions of muscle and sinew mostly become ossified also; but in that case the organism afterwards repairs its error as far as possible; thus, in the present instance, the ossified contiguous parts are reduced after healing to their normal condition.

  How limited is the power of the individual will is also shown by the following example:—During pregnancy, when the unconscious will must be concentrated on the formation of the child, occasionally osseous fractures will not at all heal, whilst after a successful delivery they heal quite well.

  The last possible objection would be this: The appropriate reaction follows on every disturbance in virtue of a mechanism provided for the creature, without the participation of the individual pysehe. Whoever has followed my exposition thus far will require no refutation of this. We have seen the impossibility of a material mechanism; that of a psychical one is evident to any one who weighs the endless multiplicity of the disturbances which occur, and considers that the function of each single organ, as of the whole body, is no other than that of ceaselessly warding off and neutralising approaching disturbances, and that only in this way is existence maintained. Accordingly, if the fitness of these compensations for the purpose of self-preservation be once granted, it is impossible to avoid the idea of an individual providence, for it can only be the individual itself that conceives the purpose according to which it acts. The truth which emerges so clearly in this and the foregoing chapter cannot fail to reinforce the refutation of the same objection in the case of Instinct, since we have already recognised a fundamental resemblance. It would be folly to suppose a special instinctive faculty, a special faculty for reflex movement, a special faculty for the vis medicatrix, since in all these phenomena we have perceived nothing more than an adaptation of means to an end unconsciously presented and willed, and it is only the different kinds of exciting external circumstances that call forth different classes of reactions, whereby, however, the differences are not so pronounced that they do not shade into one another. That the healing operations in the organism are not results of conscious thinking and willing will be doubted by nobody who reflects how small a share his consciousness has had in the healing of a wound or a fracture; nay, the most powerful curative effects take place at the time when consciousness is as far as possible in abeyance, as in deep sleep. To which may be added, that the organic functions, so far as they are at all dependent on nerves, are regulated by sympathetic nerve-fibres, which are not directly subject to the conscious will, but are innervated by the ganglionic centres from which they spring. If, nevertheless, there reigns in the organic healing functions so wonderful a harmony tending to a single goal, this can never be explained by the material inter-communication of these different ganglia, but only by the unity of the over-ruling principle, the Unconscious.

  VII.

  THE INDIRECT INFLUENCE ON ORGANIC FUNCTIONS OF CONSCIOUS PSYCHICAL ACTIVITY.

  1. THE INFLUENCE OF THE CONSCIOUS WILL.

  (a.) Muscular Contraction.

  MUSCULAR contraction is manifestly by far the most important organic function dependent on conscious volition, for it is that whereby we move and act on the external world, through which we communicate in speech and writing. It takes place through the influence of the motor nerves, by a nerve-current flowing from centre to periphery, a current which is evidently related to the electrical and chemical streams, as we find them to be convertible, and of whose intensity we can form no mean idea when we see the contracted muscles of the athlete, attached to the long lever arms of the limbs, moreover, sporting with hundredweights, and then consider what colossal galvanic currents would be required to lift such a load with an electro-magnet. We have already seen that any muscular movement is explicable only by the repeated intervention of unconscious volition and thought, because otherwise it would not be apparent, how the motor impulse could affect the part of the nervous centre answering to this consciously represented movement rather than any other. We have further seen that the more immediate centres for most movements lie in the spinal cord and medulla oblongata, and that these movements are there so determined and ordered that they are to be looked upon as reflexes of these centres, occasioned by the stimulus of a relatively small number of fibres proceeding from the cerebrum, so that the first motor impulse must be referred to the central endings of these fibres in the cerebral hemispheres. It may well be that several of such reflex actions take place in different nerve-centres more and more remote from the brain before a complex movement is executed, that, e.g., in walking, at first some few fibres carry the impulse over from the cerebrum, where the conscious will to walk arises, to the cerebellum (the organ which is said to co-ordinate the larger motor groups), that then from there a larger number of fibres carry forward the impulses to different centres of the spinal cord, and finally to the crural nerves. On occasion of every such reflexion the unconscious willing and conceiving of the specific motor instinct of the particular centre chimes in, and thus it becomes explicable how such complex movements run their course appropriately and orderly without any mental effort whatsoever. In every centre th
e impulse is felt as stimulus and converted into a new impulse, so that in the strictest sense we can only speak of the motor nerve-current from the last centre.

  The question now arises, how the will is able to produce the innervating current. We can only fall back on the analogies of the related and (physically) better known currents, and on the a priori suggestion, that the entire apparatus of the motor nervous system has probably been inserted in the organism with the object of making it possible for the will to produce the necessary mechanical effects with the smallest possible mechanical effort; in other words, that the motor nervous system is a mechanical power like the winds, or more truly as the wall-shattering ordnance, to which the individual man has only to apply the match. To produce mechanical motion without mechanical energy is impossible, but the energy which ushers in the movement may be reduced to a minimum, and the remaining part of the work can be handed over to forces previously stored up for use. In artillery this is the chemical energy of the powder, in the animal that of the food, which therefore must stand in the same relation to muscular energy as the quantity of powder to the force of the shot. Without some mechanical energy, however, the stored-up forces cannot be liberated from their imprisoned state; accordingly the will must, at all events, be made capable of performing mechanical work. If, however, the quantity of this energy were of no consequence, it could put the muscles into motion directly; we must therefore assume that the critical point of the motor system consists in this: How to reduce the necessary mechanical performance of the will to a minimum,—somewhat as the regulating of the levers by the engineer represents a minimum of effective energy in relation to the performances of the steam-engine.