Disease and Immunity,

14
Wellness and Fitness
After you have finished reading this chapter, you should be able to:
Compare and contrast the various factors that cause disease.
Identify the body’s defenses against disease-causing organisms.
Describe the structures and functions of the human immune system.

And it is well to superintend the sick to make them well, to care for the
healthy to keep them well, also to care for one’s own self, so as to observe
what is seemly.
Hippocrates, Precepts

Introduction
In the past, many people believed that evil spirits were the cause of
human illness. If someone became ill, the treatment prescribed was often
horrific. The patient might be beaten, tortured, or starved. One technique
used in some cultures involved drilling a hole in the ill person’s skull to
allow the evil spirit to leave. If a sick person didn’t die from the disease,
he or she might die from the “cure.” (See Figure 14-1 on page 296.)
How different is our understanding of disease today! We have achieved
this understanding from the careful thinking, experiments, and observa-
tions of many people over a long period of time. Twenty-four hundred
years ago, the physician and teacher Hippocrates lived on the small Greek
island of Kos. Through his work, Hippocrates did a great deal to move
medicine away from superstitions. For this, Hippocrates has been called
the “father of medicine.” An article, “Airs, Waters, and Places,” written by
Hippocrates—or one of his students—discussed how disease, rather than
coming from the gods, may have been related to the weather, drinking
water, and winds in the town. The idea that diseases have understandable

295
296 Maintaining a Dynamic Equilibrium

Figure 14-1 In an ancient medical procedure,

the Incas carved a hole in the patient’s head,
attempting to cure an illness.

causes was becoming part of medical knowledge. It followed logically that

once the causes of diseases were known, sensible treatments could be
offered. The need to understand the causes of disease and to discover suc-
cessful treatments for diseases continues.

■■ DISEASE: A LACK OF HOMEOSTASIS

Homeostasis, the theme we have been studying, emphasizes the need for
organisms to maintain a carefully controlled internal set of conditions, a
dynamic equilibrium. Maintaining these conditions—including pH, tem-
perature, water and salt balance, and levels of CO2 and O2—allows an
organism’s cells to function normally. Living organisms allow changes
within very definite limits to occur. Changes outside normal limits disrupt
homeostasis, producing illness, disease, and possibly even death.
There are many reasons why the body can be pushed beyond its nor-
mal limits. These reasons, or factors, are often the causes of disease, causes
that ancient peoples did not understand. An inherited defect in a genetic
trait might be a cause of disease. The disruptions of homeostasis in such
a disease would be caused, in a sense, by a factor inside the body. Many
other diseases result from some influence outside the body, in the
environment.

■■ FACTORS THAT CAUSE DISEASES

Diseases may be caused by one of the following factors, or by a combi-

nation of several of these factors.

◆ Inheritance. Defective genetic traits can be passed from parents to

offspring. Often the parents may not have the disease, but both may
carry a single allele (the form of a gene) for the disease. It is the com-
bination of these two defective alleles in the child that gives him or her
the disease.
 Chapter 14 / Disease and Immunity, Wellness and Fitness 297

Figure 14-2 This scanning

electron micrograph of red blood
cells (magnified more than 7000
times) shows the distorted shape
of a cell with flawed hemoglobin.
The cause, sickle-cell anemia, is
an inherited disease that disrupts
homeostasis by obstructing blood
flow in capillaries.

A well-known example of an inherited disease is sickle-cell anemia. In

this condition, hemoglobin, the protein that carries oxygen in red blood
cells, is flawed. As a result, the red blood cells may, at times, get twisted
out of shape and resemble a sickle, a crescent-shaped tool used to cut
grass. (See Figure 14-2.) In the human body, homeostasis is disrupted
when the sickle cells obstruct capillaries. The normal movement of blood
is interrupted. In addition, the flawed hemoglobin is unable to carry as
much oxygen as is normal. At present, sickle-cell anemia cannot be cured.
However, problems that arise from the disease are successfully treated.

◆ Microorganisms. Microorganisms that cause disease are called

pathogens; they include certain fungi, bacteria, protozoa, and viruses.
Some diseases caused by microorganisms may be passed, in a variety
of ways, from one person to another. These are called infectious dis-
eases. (See Figure 14-3.) Microorganisms, or microbes, most often enter
the body through respiratory pathways, the digestive system, or the
urethra. Infections may also occur through breaks in the skin. Some

Figure 14-3 Certain microorganisms,

such as these rod-shaped bacteria, can
cause infectious diseases.
298 Maintaining a Dynamic Equilibrium

diseases are more easily transmitted from one person to another than
other diseases.

Tuberculosis is a disease caused by an infectious microorganism, a rod-

shaped bacterium. The bacteria that cause tuberculosis travel in the tiny
water droplets released into the air when an infected person coughs or
sneezes. The bacteria enter the body of another person through the nose
or mouth. Once inside the body, the tuberculosis bacteria can infect any
tissue, but most often they infect the tissues of the lungs. A person may
carry the bacteria in his or her body and not show symptoms of the dis-
ease. However, tests can determine if a person has been exposed to the
bacteria that cause tuberculosis, even if the person shows no symptoms
of this disease. A person with a positive test for the tuberculosis bacteria,
or a person who has the disease, is treated with antibiotics. Along with
antibiotics, rest and time are necessary for a recovery. However, the prob-
lem of antibiotic resistance (discussed in Chapter 1) applies to tubercu-
losis, too. Some types of tuberculosis have developed that are resistant to
the usual course of antibiotics. As a result, new drugs must be produced
all the time.

◆ Pollutants and poisons. Chemical agents present in the environment

may upset the body’s normal functioning and produce disease. These
pollutants include coal dust, asbestos, lead, phosphorus, mercury,
polychlorinated biphenyls (PCBs), and many others. For example,
when asbestos fibers enter the respiratory system, they cause asbesto-
sis, a disease of the lungs. Years later, cancer in the lungs and chest
may result from the inhalation of asbestos fibers. Poisons such as the
chemical element arsenic and the toxin from the bacterium Clostrid-
ium botulinum are extremely toxic. They quickly cause death. Amaz-
ingly, however, both—in very tiny doses or in different forms—are
now being used to treat and cure many diseases and ailments. Botox
is helping with some 40 ailments, such as cerebral palsy and Parkin-
son’s, as well as troubles like migraines, excessive sweating, and facial
wrinkles.
◆ Organ malfunction. A disease may develop when one or more of the
body’s organs malfunction. When an organ such as the liver, lung,
heart, stomach, or kidney does not function properly, serious effects
on the body result. As you saw in Chapter 13, problems in the
nephrons of the kidneys may lead to kidney failure. This causes the
disease uremia. Waste products that should have been removed by the
kidneys begin to build up in the blood.
 Chapter 14 / Disease and Immunity, Wellness and Fitness 299

Figure 14-4 Dialysis machines

can take the place of kidneys,
but only temporarily.

Today, technology offers hope to people with kidney failure. Dialysis,

featured in Chapter 13, is a process in which a person’s blood is pumped
LIVING ENVIRONMENT
through an artificial BIOLOGY,
kidney to2e/fig. 14-4 s/s removing the wastes from the
be cleansed,
blood. (See Figure 14-4.) But dialysis provides only temporary help. Kid-
ney transplant operations offer a more permanent treatment.

◆ Harmful lifestyles. The way one lives can also be an important fac-
tor in causing disease. Specifically, tobacco, alcohol, and drugs in the
body can disrupt homeostasis, producing illness. In addition, overeat-
ing, not exercising, having unsafe sexual experiences, and living with
stress can lead to certain diseases. Hypertension, or high blood pres-
sure, is one such disease. Hypertension involves an increased pressure
on the walls of arteries. Untreated, hypertension can lead to heart
attacks, strokes, and damage to the kidneys, nervous system, and eyes.
While medications are used to treat severe hypertension, a less stress-
ful lifestyle combined with a diet that is low in sodium may help lower
a person’s blood pressure. Moderate exercise, on the advice of a physi-
cian, is also an important treatment for hypertension.

■■ THE BODY’S DEFENSES AGAINST DISEASE

Our bodies are surrounded by microorganisms trying to get into us. Some
of them succeed, through the nose, through cuts in our skin, or along with
the food we eat. Many of these microorganisms cause serious problems if
they survive and reproduce inside us without challenge. Controlling these
300 Maintaining a Dynamic Equilibrium

microscopic invaders is as important to homeostasis as is regulating body

temperature and chemistry.
The methods by which the body keeps out, or deals with, invading
microorganisms are called lines of defense. The lines of defense can be
either nonspecific or specific. A nonspecific line of defense keeps out any
microorganism. It does not matter what particular invading microorgan-
ism it is. A specific line of defense attacks only a particular microorgan-
ism, one type at a time.
The first line of defense against infection is nonspecific. It consists of
physical barriers that block the entry of microorganisms. The skin is the
main physical barrier in our body. Because it is made up of a continuous
layer of flat, tough cells, it protects the body from invaders as long as it is
undamaged. Fluids are also released at certain places on the body to keep
out microorganisms. For example, mucus in the passages of the respira-
tory system, saliva in the mouth, and tears around the eyes all contain
substances that kill microorganisms. The strong acid in the stomach is
very effective in killing microorganisms in the food we eat.
A second line of defense is present when microorganisms get through
our physical barriers. We have all experienced a cut or scrape on the skin.
In time, the injured area becomes warm, reddened, and perhaps swollen
with pus. What is happening? The events described are called inflam-
mation. (See Figure 14-5.) When the injury occurs, chemicals are released
by the damaged tissues. In the body, these chemicals act like an alarm.
They cause an increase in the blood flow to the site of the injury. Respond-
ing to the alarm, special white blood cells that can attack invaders arrive.

Warm, reddened White blood cells

Bacteria swollen area of phagocytizing
Splinter Epidermis inflammation Bacteria bacteria
Dermis

White blood cells

Blood vessels A migrating through B
vessel walls

Figure 14-5 Inflammation is the body’s second line of defense against disease.
 Chapter 14 / Disease and Immunity, Wellness and Fitness 301

Figure 14-6
During
inflammation,
phagocytes engulf
and destroy
microorganisms,
which prevents
more serious
infection.

Bacterium

Phagocyte

These cells are phagocytic. Like an ameba, phagocytes surround and

engulf microorganisms, destroying them
LIVING ENVIRONMENT by ingesting
BIOLOGY, them. All of this
2e/fig. 14-6 s/s
activity helps to prevent a more serious infection from developing. The
redness, warmth, and pus are signs that the body is healing itself. (See
Figure 14-6.)
Vertebrates have evolved a very important system that attacks specific
invaders. This is the immune system. The immune system knows who
the “bad guys” are. The immune system goes after very specific invaders
to try to keep them from disrupting normal body functions.

■■ THE IMMUNE SYSTEM

An English physician, Edward Jenner, attempted a very famous and very

risky experiment in 1796. (If he were alive today, Jenner probably would
have been prevented from carrying out this kind of research.) Jenner
noticed that people who worked with cows did not usually contract the
deadly disease smallpox. He therefore intentionally infected an eight-year-
old boy with cowpox, a mild disease similar to smallpox. Jenner suspected
that cowpox in some way protected people from catching smallpox. His
302 Maintaining a Dynamic Equilibrium

Antibiotics, Infections, and You

Antibiotics are used to treat infections in people and animals. Due to the
enormous success of antibiotics, their use is very common worldwide.
When we are ill, we have come to expect quick, effective treatment with
antibiotics. Physicians often prescribe antibiotics at the earliest sign of an
infection.
One result of the widespread use of these important medicines is a growing
number of antibiotic-resistant strains of bacteria. Some scientists have
suggested the alarming possibility of infections that will not be treatable
by the antibiotics we have. Already, one disease, tuberculosis—which was
largely under control—has reappeared in a strain that is much more
difficult to treat with antibiotics.
Recently, scientists became alarmed when they found—in food being given
to chickens—bacteria that are resistant to the most powerful antibiotics.
Even though those particular bacteria were harmless, the finding raised the
disturbing possibility that these bacteria could pass on their antibiotic
resistance to disease-causing bacteria in chickens and, ultimately, in
humans. One possible reason that such drug-resistant bacteria are being
found more frequently is the heavy use of antibiotics to promote health
and growth in farm animals.
This is an issue for everyone to be aware of and concerned about. Science
has provided us with a group of wonder drugs to treat diseases that once
killed many people. However, we must be thoughtful and wise in the use of
antibiotics. The laws of nature—in this case, the process of natural selection
that produces resistance to antibiotics—can never be ignored.

observation that people who worked with cows often came down with
cowpox, but rarely if ever contracted smallpox, formed the basis of his
hypothesis. After the boy recovered from cowpox, Jenner deliberately
injected the boy with smallpox. The boy did not get sick! Did cowpox
protect the boy from smallpox? How could a previous illness protect a
person from getting sick again?
We now know that the immune system defends our bodies against
very specific invaders. Each invader—usually a bacterium or virus—has
specific protein molecules attached to its surface. Each such molecule is
called an antigen. It is these molecules that are detected by the body’s
immune system.
When the immune system detects an antigen, it produces antibodies
—the molecules that an individual produces as a defense against disease.
Antibodies provide this defense by binding to the antigens. Once this
 Chapter 14 / Disease and Immunity, Wellness and Fitness 303

occurs, the invader can be destroyed by the body. As it turns out, the cow-
pox and smallpox antigens are almost identical. After he was injected
with cowpox, the boy’s immune system made antibodies against the cow-
pox antigen. Later, when he was injected with smallpox, the boy’s body
was ready with a defense. The smallpox virus was destroyed with the help
of the antibodies that the boy had made against cowpox antigens. That
is why he did not get sick. (See Figure 14-7.)

Antibody A
Antigen-binding sites

Figure 14-7 Antibodies,

Antibody B Antigen part of the immune system,
bind to antigens—specific
Antibody C protein molecules on an
invader’s surface.

This technique came to be known as vaccination. Vacca is the Latin

word forENVIRONMENT
LIVING “cow.” Today, vaccines
BIOLOGY, offer
2e/fig. protection
14-7 s/s against a number of dis-
eases. People are now given harmless antigens in a vaccine, which cause
the body to produce antibodies.

Check Your Understanding

How is the immune system more “specific” in its defense against
infection than the defenses presented by the skin and by inflamma-
tion reactions?

■■ B CELLS AND T CELLS

The immune system also includes B cells and T cells, actually two types
of macrophages. These macrophages are kinds of white blood cells that
are produced in bone marrow, the thymus gland, the spleen, the lymph
nodes, and the tonsils. (See Figure 14-8 on page 304.) Macrophages are the
cells (phagocytes) we have already mentioned, which move to infected
areas to engulf and digest invading microorganisms. B cells are the ones
that respond to specific antigens by beginning to produce antibody pro-
teins that will bind only with that antigen.
As time goes on, the body contains many different types of B cells, each
producing antibodies for one specific antigen. After having been invaded
once by an antigen, some special B cells that recognize that antigen remain
304 Maintaining a Dynamic Equilibrium

Tonsil

Thymus gland

Lymph nodes

Spleen

Bone marrow
Figure 14-8 Macrophages are
produced in bone marrow, the
thymus gland, the spleen, the
lymph nodes, and the tonsils.

in the body for the rest of your life. These are called memory B cells.
Because they are already present in the body, you instantly start making
LIVING ENVIRONMENT BIOLOGY, 2e/fig. 14-8 s/s
antibodies the moment you encounter the same invading microorgan-
isms again. That is why individuals usually do not get measles or chicken
pox a second time. The immune system remembers the first exposure to
the disease and is ready! This type of protection is called active immunity.
(See Figure 14-9.)
Passive immunity is related to active immunity. In passive immunity,
a person is injected with a large quantity of the correct already formed
antibodies to a particular antigen. These antibodies protect the body from
a disease only for as long as the antibodies remain in the body. However,
the body is passive, uninvolved in this protection. It did not make the
antibodies and, more important, does not “remember” how to make
them. You therefore have protection for a limited time from passive
immunity.
Antibodies are good at recognizing antigens on invaders only when
the invaders are in the fluids in your body but not inside your cells. The
problem is that many bacteria and all viruses quickly get inside body cells.
Once inside your cells, bacteria and viruses begin to multiply, to really
make you sick. To make matters worse, the antibodies cannot find the
 Chapter 14 / Disease and Immunity, Wellness and Fitness 305

B Cell Populations
[Model Types]

1. Antibodies B B B B B

2. Assorted
Antigens

3. Antigen-
Antibody B B B B B
complexes

Figure 14-9 In active immunity, memory B cells in the body from a previous
exposure can instantly make antibodies when they encounter the same antigen.

LIVING ENVIRONMENT BIOLOGY, 2e/fig. 14-9 s/s

invaders once they are inside cells. It is for this reason that the immune
system has T cells. One type of T cell is called cytotoxic, or killer, T cells.
Through protein receptors on their surface, they can recognize cells in
the body that have been infected with invading microorganisms. This
recognition occurs when an antigen present on the surface of an infected
cell binds specifically with a receptor protein projecting from the cell
membrane of a T cell. Then the killer T cells punch holes in the mem-
branes of the infected cells, sometimes injecting poison into them. The
infected cells are killed and the invaders in these cells are destroyed. (See
Figure 14-10.)
In addition, another important type of T cell acts as a helper. Helper
T cells assist both B cells and killer T cells. Without helper T cells, the
other members of the immune system family cannot do their job. Just

Figure 14-10 Killer T cells can

recognize cells in the body that
have been infected by invading
microorganisms.
306 Maintaining a Dynamic Equilibrium

Bone marrow

Circulation in blood B cell migrates into the bloodstream

Immature
lymphocytes Lymph nodes, spleen,
Thymus other lymphold tissues and
loose connective tissues

T cell migrates into the bloodstream

Mature B and T cells

Mature B and T cells

recirculate in blood and lymph

Figure 14-11 Mature B and T cells are white blood cells that circulate through the
body to fight infection.
LIVING ENVIRONMENT BIOLOGY, 2e/fig. 14-11 s/s (rev. 10/13/03)

how important helper T cells are is shown by the fact that they are the
cells destroyed by the human immunodeficiency virus (HIV), which
results in the disease called AIDS. (See Figure 14-11.)

■■ WHEN THINGS GO WRONG:

DISEASES OF THE IMMUNE SYSTEM
The immune system helps maintain the internal dynamic equilibrium
necessary for life. However, the immune system can become out of bal-
ance. It can be overactive or underactive, and in either case the body’s
equilibrium is upset.
Allergic reactions result from overactivity of the immune system. The
body responds inappropriately to common substances such as dust, mold,
pollen, or certain foods. The immune system begins making a special type
of antibody to these substances, which under normal conditions would
not stimulate the immune system. These antibodies cause cells in the
body to release substances, including histamines, which cause many
allergic symptoms, such as extra fluid in the nasal pathways, difficulty
breathing, or inflammation (hives). Allergies are often treated with anti-
histamines, drugs that stop the release of histamine. Some severe allergic
 Chapter 14 / Disease and Immunity, Wellness and Fitness 307

reactions may be life threatening. These reactions may need other types
of medications. Allergies should be treated by a physician.
Sometimes the immune system begins to attack normal body tissues.
These are called autoimmune diseases and are very serious. Autoimmune
diseases include myasthenia gravis, rheumatic fever, lupus erythemato-
sus, and rheumatoid arthritis. (See Figure 14-12.) In all autoimmune dis-
eases, the body is literally rejecting its own tissues. A similar kind of
rejection also often occurs when an organ is transplanted from one person
to another. Medications that keep the organ recipient’s immune system
from attacking and rejecting the newly transplanted organ must be taken.

Figure 14-12 These hands

have joints that are affected by
rheumatoid arthritis, an
autoimmune disease.

Recent studies seem to indicate that the process of inflammation,

which protects us when we are young, may actually contribute to crip-
pling diseases when we get older. For example, only three out of ten heart
attacks occur in people whose arteries have narrowed. Researchers now
suspect that many heart attacks are caused when a rupture develops in the
wall of an artery—brought on by overactive immune system cells causing
an inflammation. Sudden clotting occurs, the artery gets blocked, and a
heart attack or a stroke may occur.
Disease also occurs when the immune system is underactive instead of
overactive. These are called immunodeficiency diseases. AIDS, acquired
immunodeficiency syndrome, is an immunodeficiency disease. AIDS is
caused by a virus that can be transmitted from one person to another.
(This disease is not inherited; that is why it is called “acquired.”) AIDS
develops when the human immunodeficiency virus, HIV, destroys a per-
son’s helper T cells. The body is no longer able to protect itself from dis-
eases that may attack it.
On rare occasions, an individual is born without a functioning
immune system. Such children have SCIDS, severe combined immuno-
deficiency syndrome, and they have almost no defense against diseases.
308 Maintaining a Dynamic Equilibrium

Sadly, life expectancy is short for such persons, but progress is being made.
Early detection of this condition, followed by bone marrow transplants,
has resulted in significant improvements in some children.
Drugs that are used to kill cancer cells in the body can also interfere
with the immune system. This is called depressed immunity and can
cause complications in the treatment of cancer.

■■ DISEASES AND CHOICES: REDUCING RISKS

Certain automatic behaviors, such as simple reflexes, reduce the risk of

infection. An eye’s blink is a reflex action that protects the eye from par-
ticles or objects that could harm it. Conscious thoughts and actions can
reduce the risks of contracting certain diseases. Some of the choices we
make can have important influences on our health. Factors that cause
diseases may be controllable or uncontrollable. When you think about
reducing the risk of disease, it is necessary to think about what risks are
under your conscious control.
For example, if there is an inherited tendency in one’s family to
develop lung cancer, this cannot be controlled. On the other hand, risk
factors can also influence the development of lung cancer. Smoking cig-
arettes has been identified as a risk factor that can cause lung cancer.
Smoking or not smoking is a choice people make; thus, it can be con-
trolled. The damaging effects of cigarette smoking include a much higher
risk of developing not only lung cancer but also heart disease and the
painful, fatal disease emphysema. What a person needs to ask is: With
what is known about the risks of cigarette smoking, do the risks outweigh
the benefits of the activity? Should I begin to smoke? Should I continue
to smoke?
Reducing risks can also include avoiding exposure to sources of infec-
tious microorganisms. These sources may include polluted water, con-
taminated food, animals, or people with contagious diseases. However, it
is necessary to be informed about the risks. For example, breathing air in
the same room as a person with tuberculosis over a long period of time
may result in your being infected. On the other hand, sharing a room
with a person infected with HIV, even shaking hands, will not make you
become infected. However, contact of your body fluids with his or her
body fluids, by your blood mixing with his or her blood, sharing a nee-
dle, or having sexual intercourse, may certainly cause you to become
infected. Reducing the risk of contracting a particular disease is often a
matter of behavior and choices.
 Chapter 14 / Disease and Immunity, Wellness and Fitness 309

■■ WELLNESS AND FITNESS

What is wellness? Wellness is defined as a lifestyle, that is, how one lives.
How one lives is a result of many factors. Some factors are outside of one’s
control. The inherited characteristics that a person has from birth are one
such factor. Other factors are within one’s control. It is mostly these con-
trollable factors that determine how you live.
Wellness involves all the various components that make up one’s life.
These components are called dimensions. The dimensions of wellness
include:

◆ emotional wellness—maintaining good mental health, a positive atti-

tude, high self-esteem, and a strong self-image
◆ physical wellness—maintaining good nutrition, getting regular exer-
cise, and getting adequate sleep
◆ social wellness—having positive interactions with and enjoying being
with others
◆ intellectual wellness—having a sense of curiosity and a strong desire
to learn
◆ environmental wellness—maintaining a way of life that protects the
environment and minimizes harm to one’s surroundings
◆ cultural wellness—being aware of one’s own cultural background
while respecting the diversity and richness of the cultures of others
◆ spiritual wellness—paying attention to personal values and beliefs

What is fitness? Fitness is more specifically about one’s own body. Fit-
ness has been defined as the ability to carry out normal activities while
having enough energy and strength left over to meet an unusual chal-
lenge. A fit person can walk to work and then climb eight flights of stairs
to the office without suffering physical discomfort. A person who is not
fit runs out of breath very early in the climb up the stairs. (See Figure
14-13 on page 310.)
How does the body of a fit person differ from the body of a person
who is not fit? Remember that for the body to function, it always needs
matter and energy. To be fit, there must be an optimum relationship
among the different tissues in the body for matter and energy to be used
most efficiently. One way of comparing tissues is to look at the ratio of
muscle (matter) to fat (stored energy). The amount of fat in one’s body is
not as important as the percentage of fat and the amount of muscle. Too
little fat limits one’s energy; too much fat can cause many life-threatening
 Figure 14-13
Fitness is the
ability to perform
normal activities
yet have enough
energy and
strength to meet
an unusual
challenge.

conditions, such as heart disease. The ideal body fat percentage for men
ranges from 15 percent to 18 percent and for women from 20 percent to
22 percent.
How does a person develop physical wellness and physical fitness? Eat-
ing properly is most important. A person’s daily diet should include the
proper amount of carbohydrates, fats, proteins, vitamins, minerals, and
water (see Chapter 8).
An individual requires a certain number of calories in the diet. For
example, the average teenage boy needs about 3000 calories and the aver-
age teenage girl needs about 2000 calories per day. The number of calo-
ries a person needs is also affected by his or her body size, age, general
level of activity, and physical health.
For physical wellness and fitness, it is also very important to exercise
regularly. Exercise includes aerobic activities, which concentrate on the
respiratory and circulatory systems, and strength-training activities,
which improve one’s muscles and skeletal system. A combination of both
kinds of activities should be a normal and regular part of one’s lifestyle.
Finally, adequate rest is essential to good health. Being well rested
helps a person feel less stress during the day. The reduction of stress is
one of the most important ways of promoting wellness.
LABORATORY INVESTIGATION 14
How Does an Earthworm Respond
to a Change in Temperature?

INTRODUCTION
In order to stay healthy, and thus alive, all organisms must maintain rel-
atively constant internal conditions, even when the environment around
them changes. In this investigation, you will study the circulatory sys-
tem of an earthworm as it experiences changes in the temperature of its
environment. It is easy to observe the rate of blood flow in an earthworm
by studying the pulsing of the dorsal blood vessel, which can be seen
through the earthworm’s skin.

MATERIALS
Paper towels, rectangular pan, live earthworm, clock or watch with second
hand, tap water, laboratory thermometer, ice, warm-water bath

PROCEDURE
1. Place an earthworm on a paper towel lining the inside of the pan.
2. Find the dorsal blood vessel, located in the middle of the worm’s dor-
sal surface. Observe the pulsing of the blood vessel. Count the num-
ber of beats in one minute.
3. Propose a hypothesis that explains the relationship of the pulse rate of
the dorsal blood vessel to the temperature of the worm’s environment.
4. Expose the worm to at least five different temperatures, from nearly
freezing to warm. Keep the temperature below 45°C, however. For each
temperature, mix hot and cold water, then pour a few centimeters of
water into the pan. It is not important to mix the water to an exact
temperature.
5. Let the worm adjust to the new temperature for at least three minutes.
Then take the temperature of the water and count the number of times
the earthworm’s dorsal blood vessel pulses in one minute. Pour off the
water and let the earthworm breathe for at least three minutes.
6. Repeat with water of a different temperature. After collecting your
data, let the worm rest again.

Chapter 14 / Disease and Immunity, Wellness and Fitness 311

 7. Plot the data on a graph, with the independent variable (the temper-
ature) on the x-axis and the dependent variable (pulses) on the y-axis.
You may also enter data from other students and you should share
your data with them. Study the graph for a pattern and, if possible,
draw a best-fit curve for the data points.

INTERPRETIVE QUESTIONS
1. Why was it necessary to wait for several minutes each time before you
took another pulse rate?
2. Why was it necessary to pour off the water to let the worm breathe?
3. Describe any relationship you see in the data on the maintenance of
body temperature in the earthworm.
4. What are some possible sources of error in this investigation?
5. Did your data support your hypothesis?

312 Maintaining a Dynamic Equilibrium

 Chapter 14 / Disease and Immunity, Wellness and Fitness 313

■■ CHAPTER 14 REVIEW

Answer these questions on a separate sheet of paper.

VOCABULARY
The following list contains all of the boldfaced terms in this chapter. Define
each of these terms in your own words.

active immunity, allergic reactions, antibodies, antigen, antihistamines,

autoimmune diseases, cytotoxic (killer) T cells, dialysis, fitness,
histamines, hypertension, immune system, immunodeficiency diseases,
infectious diseases, inflammation, macrophages, passive immunity,
pathogens, vaccination, wellness

PART A—MULTIPLE CHOICE

Choose the response that best completes the sentence.

1. Diseases that are contagious, or “catching,” are said to be

a. infectious b. hereditary c. viral d. nonspecific.
2. Fitness includes a. being aware of your cultural heritage
b. interacting positively with other people c. the ability to carry
out normal activities and to meet unusual challenges d. having a
healthy lifestyle.
3. Passive immunity a. occurs after a person has had a disease
b. wears off after a period of time c. is induced by injecting
antigens into the body d. involves the response of memory
B cells.
4. An example of an inherited disease is a. tuberculosis b. AIDS
c. chicken pox d. sickle-cell anemia.
5. Phagocytes help to protect the body by a. forming a tough
physical barrier b. containing acids that kill microorganisms
c. eating invading microorganisms d. producing antigens that
bind to disease-causing microorganisms.
6. Diseases can be prevented by a. performing the correct
religious ceremonies b. keeping windows tightly shut at night
c. reducing exposure to harmful chemicals d. scaring the
diseases out of sick people, so the diseases do not spread.
7. Dialysis is used to treat a. sickle-cell anemia b. uremia
c. antibiotic-resistant tuberculosis d. severe combined immune
deficiency syndrome.
8. Hypertension is often associated with a. a high-sodium diet
b. asbestos c. inflammation d. histamines.
314 Maintaining a Dynamic Equilibrium

9. Thrush, a yeast infection of the mouth, is rarely seen except in

infants, people with AIDS, and people who have received organ
transplants. Thrush is thus a sign of a. autoimmunity
b. allergies c. inherited disorders d. immune deficiency.
10. Histamines a. provide passive immunity b. cause allergic
symptoms c. bind to antigens on microorganisms d. cause
autoimmune responses.
11. B cells a. manufacture antibodies b. recognize cells that have
been infected by invading microorganisms c. stimulate other
macrophages to fight infection d. provide passive immunity.
12. Smoking increases your risk of developing a. cancer
b. emphysema c. heart disease d. all of these.
13. Edward Jenner contributed to medical science by a. showing
that diseases were caused by natural rather than supernatural
forces b. developing a vaccine against smallpox c. discovering
killer T cells d. demonstrating that juvenile diabetes is an
autoimmune disease.
14. AIDS can be transmitted by a. sneezing b. shaking hands
c. unprotected sexual intercourse d. all of these.
15. Because the antigens on strep bacteria are similar to those on
human tissues, an untreated strep infection may result in the
production of antibodies that attack the heart valves. This is an
example of a. an immunodeficiency disease b. a severe allergic
reaction c. a disease-promoting lifestyle d. an autoimmune
disease.

PART B—CONSTRUCTED RESPONSE

Use the information in the chapter to respond to these items.

16. On a separate sheet of paper, complete the following table. What is

described in the table?

DIMENSION DESCRIPTION

Being aware of your own cultural background and respecting the

culture of others
Environmental
Interacting positively with others
Emotional
Spiritual
Obtaining good nutrition, regular exercise, and adequate sleep
Intellectual
 Chapter 14 / Disease and Immunity, Wellness and Fitness 315

17. Select three dimensions from the table and describe how you can
improve them in your own life.
18. List three nonspecific defenses of the body and explain how each
protects against disease.
19. Relate disease to homeostasis.
20. How does a vaccine prevent disease?

PART C—READING COMPREHENSION

Base your answers to questions 21 through 23 on the information below and
on your knowledge of biology. Source: Science News (February 1, 2003): vol.
163, p. 78.

As Population Ages, Flu Takes Deadly Turn

The annual toll of influenza has risen dramatically since the late 1970s,
according to an analysis of U.S. death statistics. One major factor is the
advancing average age of the population. Another is the increasing
prevalence of virulent strains of the flu virus.
Influenza is typically not a direct cause of death, but researchers at the
Centers for Disease Control and Prevention in Atlanta, estimated the dis-
ease’s contribution to mortality by noting seasonal fluctuations in deaths
that might have resulted from underlying flu infections. Bacterial pneu-
monia, for example, can be a fatal consequence of severe flu.
Such calculations suggest that influenza claimed more than 68,000
lives on average during each of the last three flu seasons of the 1990s,
William W. Thompson and his colleagues report in the Jan. 8 Journal of
the American Medical Association (JAMA). That’s well up from about
16,000 annual deaths attributable to flu during a similar period 2
decades earlier.
People over age 65 are nearly 100 times as likely to die from flu than
people 5 to 50 years old are, and the efficacy of flu vaccinations wanes
in older adults.
Responding to the new findings in the same issue of JAMA, David M.
Morens of the National Institutes of Health in Bethesda, Md., urges
physicians to get annual flu shots, in order to avoid transmitting the
virus to patients. They should also encourage their patients, especially
older ones, to get the shots, he says. “Even an imperfect vaccine, used
optimally, can prevent many thousands of deaths,” says Morens.

21. State two explanations for the increasing number of deaths from
influenza in the United States.
22. Explain the connection between bacterial pneumonia and the flu.
23. Describe the actions that doctors are being advised to take to help
limit the number of deaths from the flu.