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August 27, 1932


JAMA. 1932;99(9):714-717. doi:10.1001/jama.1932.02740610012004

The more one sees of chronic disease the more keenly one appreciates that what has been observed are not sharply defined genera but transitions of morbid states from one to another. One realizes that much of the differentiation that has resulted from more refined observation and more detailed laboratory investigation has tended to confuse rather than to simplify the issue and has caused the classification of disease to be more artificial than biologic. Too often diseases are classified according to a mere grouping of signs and symptoms, rather than in relation to a precise etiology or a well observed consistent pathogenesis. Many chronic diseases, like biologic species, present an evolution from the primitive or embryonic to a full-fledged form. It would be just as consistent to classify the earliest, the intermediate and the final phases of disease as separate entities as it would be to classify the tadpole and the