Sunday, September 03, 2006

Meaning Of Disease

Definition of disease: Health is a condition in which all of the body functions are integrated and are being maintained within the limits of optimal design. Disease is divergence from the normal (Gaussian mean) but not all deviation is disease because of the reserve capacity and ability of the body to adjust. In most cases, a deviation must also be related to other adverse changes to be able to constitute disease. The demarcation between pathology and normal physiological variation can be fine. Hunger and thirst for example are psychological warning signs and are not pathological conditions. A hungry person is not in immediate danger. When the situation of food deprivation persists over a long time then physiological disturbances within the compensatory range occur. Pathological changes appear if food deprivation extends beyond that.

Relativity in Disease Definition
The definition of disease is very relative. A high blood pressure in an elderly person does not have the same implication as the same level in a younger person. Temperature levels have different interpretations in neonatal and adult infections. Adolescent behavior that may be normal would be considered illness in adults. There are changes in the body that should be accepted as normal processes of aging and not as diseases. There is a space-time variation in definition and perception of disease depending on the culture, beliefs, attitudes, and prevalence of diseases. In localities where the burden of major diseases is high, some minor ailments may be ignored whereas in other places they are taken as serious diseases. There are diseases that may be associated with social status. Some diseases become reclassified with changing public opinion for example homosexuality was considered a mental disorder half a century ago but is now accepted as normal sexual expression in Europe and America. New diseases continue to be defined due to changes in the causative agents, host factors, or new scientific knowledge.

Multi-dimensional definition of disease
Definition of disease considers several dimensions that may operate singly or in combination: moral/spiritual, biological/pathological, psycho-social, or normative/statistical. Loss of spiritual equilibrium is a disease in itself and soon leads to physical disease. Most diseases involve disturbances in the equilibrium of the normal body physiology. These biological disturbances may be within the range of normal physiological variation or may be clearly pathological. The psycho-social dimension of disease is associated with loss of equilibrium and may precede or follow physical disturbances. The normative or statistical dimension is the most confusing. Sometimes people are branded ill because they fall at the extreme end of the health-illness spectrum. In the final analysis it is the perception of disease by the victim, the family or the health care givers that defines disease. The underlying pathology need not correspond with the victim’s disease complaint; perception operates in between.

Superstitions and Disease
The growth of scientific knowledge about the pathology of disease has contributed to a marked decrease in superstitious beliefs that have plagued mankind for centuries. Superstition is an attempt to understand and come to terms with frightening and dangerous disease phenomena that afflict humans. In the absence of true knowledge there is resort to superstitious beliefs and explanations. Most superstitions have been passed down generations; some even have a religious basis. Despite much progress in scientific medicine, the majority of humans still suffer from the consequences of superstitious beliefs.

Pathology is concerned with abnormalities of structure and function, which result from disease or are produced by disease. It seeks to explain the why of a disease, which includes etiology, pathogenesis, morphological changes, and the functional impairment. Most of pathology is about the reactions of the body and its adjustment to insults. As mentioned before, the line between compensatory change in normal physiology and pathology can be very fine.

Manifestations of Disease
Disease manifests as symptoms or signs. Symptoms are subjective patient complaints or description of disease. Signs are objectively verifiable disorders. A syndrome is a combination of symptoms and signs associated with a disease condition. Symptomatology is perhaps a better indication of disease severity because it includes the personality of the patient and reactions. Thus the same pathology does not produce the same symptomatology in all patients. Those with strong iman may complain less about pain than others. Fear of death also affects worry and complaint about disease. Fever is the commonest non-specific symptom of disease following pain.

Diagnoses are measures including history, physical examination, and logical deduction or induction that lead to definition of a disease. A definitive diagnosis need not be made before treatment starts. Treatment is started using a tentative diagnosis. The true diagnosis may be deduced from the response to treatment. One of the strengths of empirical science is that a disease can be treated successfully without fully understanding its pathogenesis or even how the treatment works at the molecular level. This occurs for example in cases when a new unknown chemical compound is tried on animals and then on humans with good results. It is then adopted as a treatment. The mechanism of action is established only later or may never be established definitely. However this strength has a back-side to it. Using treatments whose mechanisms of action are not well understood can lead to side effects and adverse effects later.

Prognosis is an empirical estimate of the future course of the disease.

Relation between diseases of the heart and diseases of the body :
There is a 2-way interaction between physical and spiritual maladies. Disbelief leads to a lot of human cruelty like genocide because of lack of moral restraint. Diseases of the heart such as jealousy lead to violence and even death. Lack of self-restraint in appetite leads to obesity and attendant diseases. Addiction to alcohol leads too much physical and mental derangement. Protein energy malnutrition of the poor manifests social injustice in the community. Lack of spiritual equilibrium leads to inability to handle the normal stresses of life such that the victims become addicted to alcohol and psychoactive substances with consequent physical illness. Addiction to power and sex leads to violence. Physical diseases may cause so much depression and loss of hope that they develop diseases of the heart. A hedonistic life-style is responsible for family breakdown. Children grow in one-parent families. They do not get the social and psychological balance needed for them to function well as adults.


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