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How individuals become physically sick is clarified in a book called “Impaired Health,” by J.H. Tilden, M.D., first published in 1921. His explanation for the disease process may offer a reasonable explanation why mental disorders develop. Dr. Tilden calls his theory, “A Cycle of Disease Reactions.” Briefly, his theory is this: What is ingested is digested, assimilated, and then eliminated. What is not digested or assimilated, and is retained, becomes toxic.


Ingestion → Digestion → Assimilation → Elimination


What is ingested is digested (food, water, air, ‘cognitions’)

What is digested is assimilated (nutrients, learning, ideas, and thoughts)

What is not assimilated is eliminated (waste, useless information)

What is not eliminated becomes toxic (poisons the system)


Etiology of the Disease Process


STRESS (Physical, emotional, environmental stress) results in

STRAIN (Tension, contraction, rigidity, anxiety, fear) results in

ENERVATION* (Weakening and failure of nerve force) results in

INEFFICIENT ELIMINATION (Constipation, resistance, holding on)

Retention of Toxemic Waste

Resulting in



Medically, Toxemia is poisoned blood. Psychologically, 'toxemic waste,' is the grief, anger, hostility, fear, grudges, anxieties, depressions, guilt and shame that people find it necessary to hold onto. They hold onto it because they are either overwhelmed, don't know how to get rid of it, discharge it, deal with it, or they are inflexible or unadaptable. Therefore, they have a disease reaction that Tilden calls, “acute crisis, chronic, or degenerative disease.” One of the more important medical questions in the physical examination is, “Do you suffer from constipation?” Psychologically, an affirmative answer may tell you the patient is holding onto something that he or she does not want to let go of. If they are holding onto something, it will eventually become toxemic waste.


Definition of Toxemia: “In the process of tissue building, metabolism, there is cell building, anabolism, and cell destruction, catabolism. The broken down tissue is toxic and in health, when energy is normal, it is eliminated from the blood as fast as evolved. When nerve energy is dissipated from any cause, physical or mental excitement, or bad habits, the body become enervated. Then enervated elimination is checked, causing retention of toxin in the blood, or Toxemia. This accumulation of toxin when once established will continue until nerve energy is restored by removing the causes. This so-called disease is nature's effort at eliminating the toxin from the blood. All so-called diseases are crises of Toxemia.” J.H. Tilden, M.D. Impaired Health, 1921


* Enervation means lack of vitality or loss of energy, for example, a depressed person feels tired.

page from, The Comprehensive Mental Status Exam, A Primer for Counseling Interns © Rojo Chispas, (1980), Theredone Press, San Francisco, Ca.






pagemple, a depressed person feels tired.

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