Health and Sickness

HEALTH AND SICKNESS.
Sec. XV.

In what, then, according to Scripture, consists the essence of sickness? Many will think that an answer to this question is neither to be sought nor found in Scripture; yet Scripture does, in truth, give us the profoundest disclosures on the essence of sickness. It tells us what is the essential origin of sickness,— namely, wrath. It tells us what is the essential condition of sickness,—namely, Turba. It tells us what is the essential process of sickness,—namely, dying, or a tendency to death.

The essential reason of sickness is wrath. "We are consumed," says the Israel of the wilderness (Ps. xc. 7), "by Thine anger, and by Thy wrath we are troubled. Thou hast set our misdeeds before Thee, and our secret sins in the light of Thy

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countenance." Death is declared (Gen. iii. 19) to be a wrathful decree of God; so therefore is sickness, that "lightning of death." A man's falling sick indeed, as the book of Job shows, may also be a dispensation of divine love, which desires to chastise and prove him; but sickness on that account just as little fails to be an effect of anger as death does, the sting of which is sin (see Num. xxvii. 3, where the daughters of Zelophehad say of their father, who was not implicated in the sin of the company of Korah, np iKtpna, he died through his own sin). Sickness is an effect of the wrath that prevails in the world, and especially in humanity, in consequence of sin; and its relief—the relief of sickness in its entire extent—is for that very reason declared in Matt. viii. 17 to be the office of the Redeemer. By Him, love has made wrath subject to itself, in order to bring itself in hunaanity through sin and death to the sole dominion. But although the will of wrath has become a pure will of love towards all who lay hold of the finished redemption, yet the natural consequences of wrath still continue; and our sinful body must first yield to the fire of wrath, before the love set free by the Redeemer can begin its work of glorification in it.

The fundamental peculiarities of wrath, moreover, are also really the fundamental peculiarities of sickness: it drives man into a dull, obtuse, gloomy condition of inward being, breaks forth in violent pains, transposes the action of the wheel of life into a feverish, fiery oscillation, for which reason so many names of sickness express the ideas of burning and glowing heat.¹ Sickness thus manifests itself as an abnormal enhancement of the three first forms of life, and as a hostile exaggeration of them above the others.

For its essential condition is Turba. Sickness is always a fiery excitement, alternating with dark depression, which disturbs the equilibrium of the powers, and puts them in opposition to one another. It is always 3*1 (Job xxxiii. 19), the opposite of Dife. How profound a fact it is, that the Old Testament language has the same word for health or soundness (yaletudo), and peace, (e.g. Gen. xxix. 6)! When in the relations and mutual relations of the bodily, and psychical, and spiritual powers, peace prevails, the man is sound,—a condition

which, since sin has gained possession of humanity, is never predicable in an absolute, but merely in a relative manner. Sickness is dissolution of this relative harmony. It is no parasitic form of life, which intrudes by the side of those which constitute the life of man:¹ it is a partial or total, a greater or less, setting of these themselves at enmity one with another.

Moreover, its essential process is dying, or tending towards death. Scripture gives to this fundamental feature of sickness a very definite expression in naming recovery (^np), (e.g. Josh. v. 8; 2 Kings i. 2, xx. 7). Sickness is therefore always a disposition towards death, a slow decease, as convalescence is always a reviving.² It is in this sense that the threat, "In the day that thou eatest thereof, dying thou shalt die," is actually fulfilled on the day of the transgression. Men are from that time not merely mortal, but dying. Their healthy life, for the nourishment and strengthening of which the tree of life was appointed, is from that time forward subject to the wrathful decree of death, and does not incur it immediately, only for the reason that grace maintains the decaying organism. It is still always thus. That living we die, is the result of God's wrath; that although dying we nevertheless live, is the result of God's grace.

Since sickness has God's wrath as its essential reason, and man's sin as its cause, the root of sickness lies in the spirit. Sickness in humanity began in the fact that the spirit of man became sick; both soul and body became sick only after the spirit had become so. This indeed ill accords with the view of the later psychiatry. "That, in the true sense of the word, the spirit or the soul can be sick," says an acute French maddoctor,³ " no one can possibly grant. It is logically impossible that a spiritual potentiality—a power of pure unity and pure activity—can be affected by anything at all, that would be analogous to our idea of sickness. Sickness is a peculiarity, or

- ¹ Thus v. Riogseis in his so-callod " Ontokgic" Medicine; and thus also, among the older physicians, Leonh. Fuchs, in the time of Flacius (v. Preger, Matth. Flacius, ii. 235), calls sickness a substance by the side of, and in the substance of man.

² [The point of the original antithesis of expression is lost in the translation: ableben and aufleben=living-down and living-up, have no exact English equivalent.—Tb.]

³ Buchez, bei Edel. Untersuchungen iiber das IntelleciueUe Leben, p. 9.

rather a destiny of things in the corporeal world, i.e. of things that are composed of parts, of things which are not unconditionally one like the soul, but, on the contrary, are formed by an aggregation of manifold molecules, which are mutable, and subjected to a constant change." On this view, according to which soul-sicknesses or soul-disturbances are properly only bodily-, and indeed brain-sicknesses, it is maintained that the spirit of a crazy man is perhaps related to the outer world, somewhat as the performer on an instrument spoiled and out of tune, to his auditors; and that sickness of soul or of spirit can only be spoken of per synecdochen, just as, when a man has ragged clothes, he himself is called a ragged man. But that axiom of the modern psychiatry is false. For the soul, although not composite, is still not simple; and although not simple, it is nevertheless a unity. The same is true of the spirit. Scripture teaches, in the archetype of the Spirit, which is the essence of God the Triune, that unity and simplicity are absolutely not coincident ideas. Assuredly spirit and soul fall sick in their manner, as the body in its manner. The bodily sickening affects the material means of self-representation of the soul's seven forms of life; the psychic-spiritual sickening affects these seven forms of life themselves, and the three fundamental powers of the spirit.

As Scripture names the result of departure from God spiritual death, so must it also be said, since this death does not consist in annihilation of the spirit and the soul, that the life of both is sick in the ethical sense, when it either is tending to spiritual recovery or ends in spiritual decease. In this sense we read in 1 Tim. vi. 4, voaeiv, of a morbid desire of the spirit (vow) after a knowledge indifferent to the blessedness of God, and estranged from it; and in similar reference, in 1 Tim. vi. 5, 2 Tim. iii. 8, of men with corrupted spirit (Su^dapfievoi rbv vovv). And Jeremiah says (xvii. 9) of the heart of man as it is by nature, that it is uneven or rugged (comp. Isa. xl. 4; Ps. cxxxi. 2), and deadly sick (E'UN), in a manner that is only altogether manifest to God. The relation of the spirit and the soul to God, to themselves, to their own corporeity, and to the world, has sustained a perversion militating against the will of God and the destination of man, which is of necessity at the same time a morbid affection of the constituent powers of the nature of the soul and spirit (Div. III. Sec. II.). But if soul and spirit be morally perverted, the body also is not in a normal condition. The primal sin of the first created men had decease of their bodies as its consequence; and the inherited sin, in which it is propagated, has a manifoldly diversified, but still never absolutely failing, bodily inherited sickness as its accompaniment. And as inherited sin breaks forth into actual sins, so does the inherited sickness, in consequence of those actual sins, break forth into all kinds of actual sickness. Spirit and soul, when they in a conscious manner pervert themselves, make the body sick, either by making use of it directly as an instrument of their sinful impulses and lusts, or by consuming it by their passions (e.g. sensual love, 2 Sam. xiii. 2), or by not knowing how to regulate it, by reason of the discord prevailing in themselves and thus disproportionately cultivating it, wantonly exposing it to danger, and generally disturbing and distorting the compact co-operation of its elements. The prevailing sin in the human race, into which the individual is entangled by his birth and relation, is the cause of all sickness; and the actual sins of the individual are the cause of many sicknesses. Very few physicians have a perception of these sources of sickness. One who really cares for the soul is here the best physician, but power and blessing come from God the Saviour.

We class the sicknesses caused by excessive affections with those that are caused by actual sins. "Hope deferred," says Solomon (Prov. xiii. 12), " maketh the heart sick." Deep inward sympathy, anxious care, is called directly, in 1 Sam. xxii. 8, «WI (yid. Ges. TJies.); and the highest degree of heartsorrow bears the name of t?UK (Isa. xvii. 11; Jer. xxx. 15). Experience corresponds to this manner of speaking. If the affections, by which passing or abiding feelings are accompanied, become so strong and deep, that they make the life of the body sick, or altogether destroy it, it is always the inward man who first allows himself to be overpowered by them. As the sicknesses of the first kind are rooted in the fact that the spirit, perverting itself to sin, perverts also the life of the soul and body; so the sicknesses of the latter kind are based in the fact, that the spirit having altogether, or even only for a season, forfeited its power over itself in God, knows not how to maintain itself against forcible impressions, but itself exposes to their attacks, together with itself, the life of the soul and body. This powerless subjection of the spirit has its degree. If it goes down to a very low grade, the man becomes mad (Vjpa, Deut. xxviii. 34). Thus, moreover, in such cases the - psychical-bodily sickness has its issue in the spirit. The essential condition of man would not be that of personal unity, if those were right who think that the human spirit would remain unaffected in such a! case, and be suspended on high unapproachably, like the moon behind the clouds. But if the spirit, as we maintain, be at once interested in a primary manner, then the sicknesses of this second kind also have their mediate final source of origination in sin. For the powerlessness of the spirit, its immediate ground of origination, is the consequence of its separation and remoteness from God. United with God, it would participate in God's blessed peace and power, to subdue all disturbances of the same. We are not forgetting in this, that there is also a divine zeal which consumes the corporeity (Ps. lxix. 9); a guiltless pure love (Cant. ii. 5); a justifiable affliction over the decay of the church (Amos vi. 6); a salutary repentant sorrow, and other holy affections which draw the body into sickness in sympathy. But this proves nothing against the point that we have asserted above. For that holy affections should produce destructive effects upon the corporeity, would be impossible, if the mutual relation of man's' inner and outer life had not by means of sin become an incongruity.

In the two kinds of sickness alluded to, the spirit gives the impetus to the sickness. But because the pervading reciprocally conditioning relation of the spiritual-bodily natural condition of man has become abnormal through sin, soul and spirit fall sick frequently also by the agency of the body. Morbid conditions of the body, founded in causes of an inward or outward physical nature, act upon the soul and spirit; and not merely in such a way that they beget the feeling of displeasure and of pain (^n, Prov. xxiii. 35, Jer. v. 3), but also by opposing all kinds of obstacles to the psychic-spiritual activities, so far as these are instrumentally carried out and conditioned, and bringing disturbances into their action.

If spirit and soul are strong enough to hold their ground against the impulse of these obstacles and disturbances, and to make an effectual resistance, they will, in the carrying on of such a contest and victory, become so much the stronger, more independent, and more rich in experience. On the other hand, the sickness of the body acts with such overmastering power, that it either loses all self-manifestation of the spirit and the soul in the passivity of the feeling of sickness, or else takes prisoner the innermost personal life by delusive ideas. In the latter case, the sickness of the soul or spirit appears in a more restricted sense. Scripture designates it as an alteration¹ of the understanding (toy? fUE*, of which Pi. is, "to behave as spiritually sick"), or as a change of the heart (Dan. iv. 13). There is hardly a class of spiritually diseased persons who are not mentioned in the Scripture. The maniac is called (Prov. xxvi. 18) H¹-?^?¹?; and probably 3^ n?30 (Lam. iii. 65) is a name for insanity. We have an instance of melancholy (njn nn) in Saul, and an instance of metamorphosis (insania zoanihropica) in Nebuchadnezzar. David assumes the behaviour of a lunatic (WET?) in the house of Achish, in order to preserve himself (1 Sam. xxi. 14-16). The characteristic of the frenzy, if this be apprehended as a conception of spiritual disorder, is this, that the illusion of another new personality is substituted in the place of one's own real one: wherefore, on the one hand, VSETp or ?*lK (Hos. ix. 7) is applied as an opprobrious name to the prophets, because the word of Jehovah is derided in them as exaggerated fancy, i.e. sick dreams in a waking state; on the other hand, Ka3nn (1 Sam. xviii. 10) is also used of the speech and demeanour of a really spiritually disordered person; because prophecy and mania, according to an ingenious observation of Schleiermacher, symphonize, and are associated as true speech, and deceitful speech. The former, ^IK, in Hosea (properly, the loose, sluggish man), indicates rather a deranged than an insane man: the deranged or crazed man has not the compact false personality that is peculiar to the insane;, the Ego of the latter is absolutely decomposed by false illusions, and hurried away by desultory disconnectedness of thought. Another name of this spiritual disorder is TVi'Mn (Eccles. x. 13, comp. ii. 2), the folly enhanced to sickness (of the soul) (r.i^3p). Finally, the Scripture is not wanting also in an

¹ Not alienation; for iej?B rot? does not mean, his understanding is gone, alienata est, but, it has become changed.

appropriate designation of imbecility and stupidity (torpor), namely 3!? JinDn (coupled with fWW, Deut. xxviii. 28).

There are, moreover, bodily sicknesses which have ethical, and which have sentimental, and which have physical causes. And there are diseases of soul and spirit which proceed from ethical self-perversion, or from sentimental disturbance of equanimity, or from physical restraint and interference: the two first have bodily anomalies as their result, and the last have such as their cause. A dynamical disturbance of the cerebral life, or generally of the nervous system, is associated with every spiritual disorder, of whatever kind it may be: without an abnormal affection of the nerves, it can attain no substantial existence. But that, without exception, all psychical diseases have physical causes and reasons, is contrary to experience; and even if it were true that, in the post mortem examinations of spiritually diseased people, pathologic circumstances of the brain were found¹ for the most part to confirm this, it would still in no way follow therefrom. There are psychical diseases which have their root manifestly in the various kinds of spiritual selfishness, as pride, envy, avarice, and vices of this kind; and therefore in the personifying fundamental powers of the spirit, and which begin from thence to draw the body into special sickness. Certainly, as there are for psychical disorders of a sentimental kind physical inducements, so for psychical disorders of a purely ethical kind there are physical attractions, —to wit, for all that are associated with the sexual life. But these physical attractions still only then operate in a way of disorder, when the soul and the spirit are wanting in power of resistance, to prevent their growing powerful over themselves, to their own disturbance. The fact of the transmission of sinful dispositions embraces here, indeed, a world of mysteries which cranioscopy has undertaken to ventilate; but the hereditary

¹ Comp. F. W. Hagen, Psychiatrie und Anatomie, 1855, p. 46: "The post mortem results in the brains of spiritually disordered persons are not of such a kind, that we could seek in them the proximate causes of psychical disease;" and ibid. p. 54, "Anatomical experiments hitherto ought surely to have taught sufficiently, that as the specially inner life of the brain is not visibly material, even its aberrations cannot always be expected to be such as you can grasp with the hand." The change of substance does not usually appear till the later stages. There are abnormal conditions which predispose to disease; but most of these are not causes, but consequences.

sinful destination, in their individual blending, is just the ethical problem into which man finds himself planted; and for which, moreover, when he comes in general to full consciousness, and is not from his birth of a checked and troubled spirit, he is sufficient, so far as he draws powers from God, and collects his powers in God.