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Defenses are not actually explanations of disease, but because They are so often confused with other manifestations of disease we list them here. A fair-skinned person with severe pneumonia may take on a dusky hue and have a deep cough. These two signs of pneu- monia represent entirely different categories, one a manifestation of a defect, the other a defense. The skin is blue because hemoglobin is darker in color when it lacks oxygen. This manifestation of pneumo- nia is like a clank in a car’s transmission. It isn’t a preprogrammed response to the problem, it is just a happenstance result with no par- ticular utility. A cough, on the other hand, is a defense. It results from a complex mechanism designed specifically to expel foreign material in the respiratory tract. When we cough, a coordinated pat- tern of movements involving the diaphragm, chest muscles, and voice box propels mucus and foreign matter up the trachea and into the back of the throat, where it can be expelled or swallowed to the stomach, where acid destroys most bacteria. Cough is not a happen- stance response to a bodily defect; it is a coordinated defense shaped by natural selection and activated when specialized sensors detect cues that indicate the presence of a specific threat. It is, like the light on a car’s dashboard that turns on automatically when the gas tank is nearly empty, not a problem itself but a protective response to a problem.

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