HEALTH AND DISEASE

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HEALTH AND DISEASE

• Prof. J. Hanacek, M.D., Ph.D.,

Technical co - operation Lila Surinová, Ing. M.
Vrabec
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• Health and disease two essential categories
• of medicine
• Definition of health
• Health is defined as a state of optimal
  physical,
• mental, and social well-being and not merely
• the absence of disease and infirmity
• (according to W.H.O.)

• Health can be defined as a state of the person
  
• who is able to meet the demands placed on
• his/her body and to adapt to these demands or
• changes of the external environment so as
  to
• maintain reasonable constancy of the
  internal
• environment

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• There are ways of measuring health in a negative
• sense. They measure the "5 d?s" - death,
  disease,
• discomfort, disability, and dissatisfaction.

? In health there is freedom. Health is the first
of all liberties
? Holistic view to a health recognises the
inter relatedness of the physical,
psychological, emotional, social, spiritual,
and environmental factors that contribute to
the overall quality of a person?s life.
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• Two aspects of health
• Subjective it is formed by sensations and
  feelings
• of a person suffering
  from some disease
• 2) Objective its basis is formed by objective
• parameters obtaned by
  measurement of
• strutures and functions
  of a person during
• disease
• Subjective and objective aspects of a health can
  differ
• e.g. Man with ? systemic BP can feel
  healthy
• Oposite Man can feel ill despite no measurable
  changes of
• structure and/or functions can be
  find

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Positive cosequence of WHO definition of
health change of health care
phylosophy Previous phylosophy Diseased person
? doctor ? diagnosis ? therapy New phylosophy
healthy person
health promotion
prevention of disease onset and development
health protection
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Two dimensions of health according Nordenfeld
(1986)

• Scientistic atomistic-biological dimension of
  health
• - quantitative dimension of
  life
• Non-scientistic holistic-humanistic view on
  health
• - rather qualitative dimension of life
• - seeing health as the totality of a person?s
  existence
• Summary ? health is defined by set of objective,
  
• measurable parameters of
  structure and
• functions
• ? health is defined also by
  set of subjective
• parameters

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? Positive wellness involves
1. being free from symptoms of disease and pain
as much as possible
2. being able to be active - able to do what you
want and what you have to do at the
appropriate time
3. being in good spirits most of the time
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Concept of normalcy
Norm (normal, within the norm) parameters or
values ranging from - to of bodily or mental
functions or quantitative measurements of
biological indexes derived statistically from
"healthy persons" of the specific group
(length, height, body mass, heart frequency,
respiration, blood, body temperature,
blood pressure etc.) Norm ? Health Health
Norm Health it is more qualitative term Norm
it is more kvantitative term Normal parameter
parameter presents most
frequently in healthy population
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Interindividual variability each
person has its own profile of structures and
functions, and almost each person is extreme
in some of sign, and in different one
in population is created by influence of
many factors a) internal e.g.
genetik b) external physical,
chemical, biological, social... can be
one explanation for different level of health in
different people, and different
proneness to disease
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Definitions of disease

• Disease can be defined as a biosocial phenomenon
• characterized by interactions of pathological
  
• processes, defensive and adaptation processes
• resulting in damage of the organism as a whole,
  in
• limitation of the organism ability to adapt to
• living condition.

• Disease can be defined as a changes in
  individuals
• that cause their health parameters to fall
  outside
• the range of normal

• The term disease means a deviation from or an
• absence of the normal state

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The essential aspects of disease
1. disease is a new quality of life
2. disease is the result of one or more causes
(noxas) and suitable conditions
3. disease is the unity of damaging, adaptive,
defensive and compensation mechanisms
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A picture of diseaase is created by
pathologic reactions pathologic processes
pathologic states

• Paathologic reaction
• It is the most simple, mainly short-lasting,
• quantitativly and/or qualitativly non-adequate
• response of organisms to some noxa
• Examples syncopa, short-lasting increase of BP,
• tachycardia, bradycardia
  vomiting,
• diarhoe, hyperventilation ...

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Pathologic process It is the complex of
pathologic and defensive- - adaptive reactions
induced by influence of noxa on organism
Examples inflammation, fever, hypoxia, growth
of tumor, edema, acidosis,
alkalosis... Pathologic state Pathological
change which is stabile or it changes very
slowly and very small range during time period
Examples congenital valvular heart disease,
deafness, blindness, colour
blindness...
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Dynamics of disease Disease is a definite morbid
process haveing a characteristic train of
symptoms and signs
Dynamics of disease is characterized by stages
of disease 1st stage latent incubation (in
infections diseases) Its
duration is measured by time present between
beginning of noxa influence of body
and beginning of first
non-specific symptoms and signs of disease There
are no manifestations of disease during this
stage 2nd stage prodromal
Arising first non-specific symptoms and signs of
disease
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3rd stage manifestation of disease
There are specific symptoms and signs of
specific disease 4th stage disease
conclusion a) healing and
convalescence b) chronic
disease c) death

• Forms of healing
• restitutio, or sanatio ad integrum
• sanatio per compensationem

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• Time course of disease
• Peracute
• Acute
• Subacute
• Chronic

Exacerbation of disease usually sudden increse
of
symptoms and signs of
chronic disease Recidivation of
disese returning of previosly healed
disease Remision
of disease decrese intensity of simptoms
and signs of disease
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ILLNESS AND DISEASE
? It is more important to know what sort of
patient has a disease, than what sort of
disease a patient has.
? A person may "feel ill" without a disease being
evident or diagnosed likewise, a person may
have a disease without experiencing any illness
or suffering.
? Illness tends to be used to refer to what is
wrong with the patient, disease to what is
wrong with his body.
? Illness is what the patient suffers from, what
troubles him, what be complains of, and what
prompts him to seek medical attention.
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? When we say "a person is ill " we mean he
feels uncomfortable, he is suffering from
certain symptoms such as nausea, headache,
abdominal cramps, or just fatigue that cant
be explained on the basis of exertion
? Disease refers to various structural disorders
of the individual?s tissues and organs that give
rise to the signs of ill - health.
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? The principal factors accounting for nearly all
diseases are
1. heredity - inherited (genetic) diseases,
2. infectious organisms - infectious diseases,
nosocomial
disease
3. lifestyle and personal habits - lifestyle
diseases
4. accidents
5. physical, chemical noxas (poisons and toxins)
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? Most standard medical textbooks attribute
anywhere from 50 to 80 of all disease to
psychosomatic or stress-related origins.
Examples of psychosomatic diseases
- peptic ulcer, essential hypertension, bronchial
asthma, hyperreactive thyroid, rheumatoid
arthritis, ulcerative colitis.....
Partially or wholly psychosomatic disorders
hay fever, acne, diarrhea, impotency, warts,
eczema, tinnitus, bruxism (grinding of
teeth), nail biting, tension headaches, back
pain, insomnia.....
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? Psychosomatic illness are caused by negative
mental states and attitudes that harmfully
change the physiology.

• Psychosomatic illness are real - as real as
• appendicitis or pneumonia.

? Placebo effect the healing that results from
a person?s belief in substances or treatments
that have no medical value in themselves.
? The power of healing does not reside so much
in the healer as in the belief of the patient.
The cures that results from placebo effects
sometimes seem miraculous but actually are
caused by physiological changes brought about
by peoples? beliefs and mental states. The
mind is healer!!!
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? In nature there are neither rewards nor
punishments - only consequences.
? All manifestations of human disease are the
consequence of the interplay between body,
mind, and environment.