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This paper examines the content and presuppositions of a specific somatic and psychological conception of disease, which can be found in the history and philosophy of medicine, and which defines disease not as the condition itself, but as the reaction against this condition. According to this conception, a symptom can be construed both as an organ and as an obstacle. It also assumes that it is possible to distinguish between a factual and a fundamental aspect of disease. Finally, it presupposes that the concept of "breakdown" can be given a rigorous definition. However, this conception, which equates disease with a means towards health, is limited by such an implicit finalism and optimism.