Disease patterns

Chapter 10 Disease patterns



Steps to the assessment of disease patterns 210
Level of manifestation 210

Element of organ or system 211

Characteristics of symptom patterns 211

Nature of signs and symptoms 212

Associated signs and symptoms 212

Aggravating and ameliorating factors 212

Cause of disruption 212

Examples of disease patterns 213
Rheumatoid arthritis (RA) 213

Osteoporosis 214

Acute bronchitis 215

Essential hypertension 216

Irritable bowel syndrome (IBS) 217

Multiple sclerosis (MS) 218

References 219

Further reading 219

Often when a patient comes to see a naturopathic practitioner they have already been diagnosed with a disease. Every disease, and its associated symptoms, carries a pattern that assists the practitioner in determining the causal factors. A practitioner’s knowledge of the pathophysiology and the etiology of disease assists in guiding the breadth of the holistic intake, physical exam, and associated tests. For example, if a patient presents with cholelithiasis during the intake a practitioner would be listening and looking for factors that are associated with gallbladder concerns, such as dyspepsia, intolerance to fatty foods, belching, bloating, fullness, and nausea (Merck Manual 1999). As the gallbladder is a fire organ (see Table 5.6) a practitioner would also be listening and looking for lifestyle and external factors that have a ‘fire’ quality, such as increased alcohol consumption, spicy hot food; situations that are irritating, frustrating, or that cause anger; cigarettes or medications that ‘heat’ up the body; and a life style that a patient feels is too hectic or too busy.


Every disease conveys a pattern with specific qualities and attributes. Together they tell a story and reveal a pattern of disharmony. This pattern relates back to the disrupting factors. When exploring the qualities and characteristics of diseases it is important to remember that there can be more than one explanation for any symptom. For example, a lack of water, an excess of fire, and an excess of air all cause dryness; stiffness can be due to an excess of earth or a lack of water. Human beings are dynamic, complex systems with all parts networked in a specific pattern. The factors behind disease are multi-factorial and the site of disease does always indicate where the disease pattern originated. When assessing a disease, look for the range of possibilities and the relationship between all parts of the body.



STEPS TO THE ASSESSMENT OF DISEASE PATTERNS


The aim of assessing the patterns of disease is to see how the qualities and characteristics of a patient’s diseases and symptoms overlap with the qualities and characteristics of the patient’s temperament, lifestyle, life events, and external factors. The following steps provide a guide for determining the patterns of diseases.



Level of manifestation


Start by identifying the organ system, or part of the body that is associated with the primary and secondary levels of manifestation. All systems of the body are networked, as well as all levels of the body, and within each network there is a hierarchical relationship between the parts. Identifying the primary and secondary levels of manifestation provides a guide as to the relationship between the levels. For example, if the chief concern is chronic neck pain the practitioner would want to assess the whole structural aspect of the body due to the relationship and correlation between the neck and other structural parts of the body. Likewise, the assessment would also include functional and psychological causes of neck pain. The following are examples of the level of manifestation of different parts of the body:


• scoliosis – structural is primary, psychological and functional are secondary

• dysmenorrhea – functional is primary, psychological and structural are secondary

• anxiety – psychological is primary, functional and structural are secondary.


Element of organ or system


Identify the organ or system associated with the primary level and the element associated with that organ or system. This provides the overall pattern or area of disharmony, the characteristics then provide the specifics. Refer to tables in Chapter 5 to determine the elemental correlation of the organs and systems. For example:


• nervous and respiratory system are a characteristic of the air element

• muscles and digestive system are a characteristic of the fire element

• lymphatic and reproductive systems are a characteristic of the water element

• urinary system and bones are a manifestation of the earth element.


Characteristics of symptom patterns


Identify the signs and symptoms that are being manifested, and the associated qualities and characteristics. Identify the characteristics associated with both the primary and the secondary levels of manifestation. For example, if the chief concern was asthma the characteristics associated with the respiratory system (primary level) would be considered as well as those associated with the psychological and structural levels, which are secondary. The symptoms that manifest indicate the stage and progression of disease.


Chapter 5 explores symptom patterns in detail, such as the patterns of internal and external, Yin–Yang, excess and deficiency, and the five elements. There is often a blending of the qualities, such as an excess of fire, a deficiency of Yang. The symptom pattern can either mirror or balance the disrupting factor. For example, if the disrupting factor is the consumption of too much food that is causing dampness, the symptom will likely be one of dampness, if the disrupting factor involves worrying too much (excess air) the body may balance that disruption with a symptom of constricted or deficiency of air, i.e., wheezing in the lungs, or constipation. Below is a review of the five elements and a look at how excesses and deficiencies in these elements might manifest.


• Earth represents the strength and structure of the organs. An excess of earth is seen as a decrease in flexibility, stiffness, and heaviness. The formation of cysts, tumors, or lumps denotes an earth quality. Earth conditions also tend to be more consistent and deep. A deficiency of earth is seen as an inability of body parts to hold their structure or shape or to keep things in. A deficiency of earth also manifests as weakness or atrophy.

• Water is the fluid aspect of the body and relates to the production of body fluids. Swelling and an increase in weight or the presence of fluid are signs of excess water. Dehydration and dryness are signs of deficiency. A deficiency of water manifests as areas feeling cold and weak or empty, or a lack of body fluids.

• Fire is the impulse behind movement. It denotes the warmth of the body. Excess fire is seen when areas are red and hot. Irritability, frustration, and restlessness are also signs of excess fire. A deficiency of fire manifests as a lack of enthusiasm or motivation, a lack of impulse to move, or a lack of warmth.

• Air is the primary element of movement especially as it relates to the nervous system. Air imbalances are seen as pain that moves around, symptoms that come and go at random, and/or the presence of gas, and dryness.

• Ether is represented by the quality of space. An ether imbalance occurs when there is the sense of not having enough space, or not liking the space you’re in.


Nature of signs and symptoms


The nature of signs and symptoms provides information on the onset, intensity, and frequency of the symptoms (refer to Chapter 6). It also provides information on the degree that the symptom pattern has impacted health. The nature of signs and symptoms provides an insight as to the factors that have disrupted health and the length of time an individual has been in a state of overwhelm.



Associated signs and symptoms


Symptoms are considered associated with each other when they relate to the same organ or system, or when the onset started around the same time. Symptoms that are associated by timing or the same triggers are often part of the same pattern. Associated signs and symptoms can also be an indication of the progressive nature of a disease pattern. Each associated sign and symptom can be further assessed using the same criteria described above. In doing so, the window of assessment often becomes more focused on deeper subsystems of the human network. The same principles of assessment apply. For the purpose of the examples below the associated signs and symptoms will not be included.



Aggravating and ameliorating factors


The awareness of aggravating and ameliorating factors assists a practitioner in clarifying the causal factors and the patterns of systems and diseases. This awareness is captured in the holistic intake.



Cause of disruption


This last step involves relating the patterns of disease to a patient’s temperament, lifestyle, life events, or environmental and external factors. It involves relating the patient’s subjective recall of their life to the practitioner’s objective findings. Once the pattern of the symptoms and disease has been assessed, and the factors that have contributed to the disruption have been identified, a treatment strategy can be determined.



EXAMPLES OF DISEASE PATTERNS



Rheumatoid arthritis (RA)


RA is defined as a chronic syndrome characterized by non-specific, usually symmetric inflammation of the peripheral joints, potentially resulting in progressive destruction of articular and periarticular structures (Merck Manual 1999).


• Level of manifestation. Arthritis primarily affects the structural aspect of the body, with the functional and psychological being secondary.

• Element of organ or system. Joints are associated with the ether element and they relate to the relative freedom of movement of the body. Joints allow for movement, the extent of which is determined by their structure and alignment (Legge 1997).

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Mar 24, 2017 | Posted by in NURSING | Comments Off on Disease patterns

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