Chapter 7 Health and disease
How practitioners define health and disease, and their expectations and beliefs about wellness, influences every aspect of assessment, diagnosis, and treatment. It dictates what information is sought and how it is interpreted. It determines whether the emphasis of the patient–practitioner relationship is on addressing the factors that caused the disease or just treating the symptoms. Whether health and disease are viewed as logical or random, and whether a practitioner is trained to integrate all aspects of a patient or just address specific pathological conditions, impacts the meaning that is assigned to symptoms and diseases and the approach used.
No doctor since the beginning of time has ever cured a patient. No doctor ever will, for Nature alone can cure. Physicians are not meant to work wonders or perform miracles. A true physician is a teacher who helps his or her patients work through their problems at all levels. Doctors are meant to use their knowledge of the patient’s past illnesses and present conditions to intuit future possibilities for health and establish a healing strategy for the patient. True physicians leave the miracles to Nature, offering themselves as channels through which Nature can work her magic (Svoboda 1989).
HEALTH – THE HOMEODYNAMIC STATE
The natural, or desirable, state of existence, is health. In a healthy state, the waves of a patient are in sync. Health is order; disease is disorder. ‘It is determined by the quantity, quality, and distribution of the body’s constituents and the harmonious interaction of the organ networks’ (Beinfield & Korngold 1991). A patient’s view of health and disease changes as they mature and age, as a result of life experiences and the perception of what is healthy or not is also affected culture, religion, economics, race, class, gender, and other social and biological factors (Duffin 2007).
Health is an attitude, and the desirability of the outcome depends on one’s beliefs, expectations, and upbringing. For some this means the absence of signs or symptoms in the functional and structural aspects of the body; for others it represents an awakening on a psychological or spiritual level. For others health is the absence of any symptoms that impact daily life; with the tolerance for symptoms varying greatly. Some people perceive themself as healthy, even when they are aware that they have a disease or disability (Justice 1998). In this book, health is defined as the harmonious vibration of the psychological, functional, and structural aspects of a patient with their personal essence and their external environment.
The study of human health must include a wider perspective than just a patient. Human beings are not isolated entities; they are born, live, and die, inseparable from the larger contexts of physical, social, political, and spiritual influences (Vithoulkas 1981). The study of human health needs to include, at a minimum, a patient’s lifestyle, their habits, the environment in which they life, their work, their community, and a patient’s sense of spirituality or inner life force. A patient’s assessment of their own health is a better predictor of their mortality than a physician’s evaluations or laboratory tests (Idler & Kasl 1991). Hence, understanding what a patient views as health, and where they see themselves on the continuum of health and disease is an essential part of the assessment process.
To understand how a patient shifts from a state of health to one of disease it is helpful to first understand how they maintain health. Human beings are complex, non-linear, self-organizing systems that constantly exchange energy with their surroundings in a dynamic process in order to maintain themselves (Rubik 2005 in Louise 2007). They are continuously responding to, compensating for, and balancing the various internal and external stimuli that they encounter. There are periods of development, growth, and maturation as they are continually replacing, healing, and nourishing every aspect of themself. There is continual change and movement in both the tangible and intangible aspects of human life. Throughout all of this, the aim is to maintain a homeodynamic state.
Human beings go through cycles in their lives similar to the seasons in nature – beginning in birth and ending in death, with stages of growth, maturity, and decay in between (Beinfield & Korngold 1991).
The question of health or disease often comes down to patient responsibility. In this context, responsibility means choosing a healthy alternative over a less healthy one. If you want to be healthy, simply make healthy choices (Murray & Pizzorno 1991).
The responsibility of each patient is to provide the building blocks to health; the body knows how to do the rest. The primary goal of naturopathic medicine is to enhance the innate healing potential of a patient, and restore the normal harmonic state of health by addressing the factors of disease and tuning the body as a unit. Health is more than just the absence of disease; it is a vital dynamic state which enables a patient to adapt to, and thrive in a wide range of environments and stresses. For example, people who ‘catch’ every cold that comes by are not healthy when they are symptom free; they can be considered healthy only when they stop being overly susceptible to infection (Murray & Pizzorno 1991).
Key indicators of health
Every component of a patient functions autonomously to some degree, yet it is interdependent on every other component in the body. For example, the digestive system has its own internal control mechanism, yet it is impacted by the nervous system, the respiratory system, and every other system of the body. If one component of the patient is in a state of deficiency or excess, it will impact other components. As a result, other aspects compensate to ensure that vital organs and functions are preserved. Through feedback loops, internal cellular processes, and the constant exchange of energy, a patient is able to handle tremendous fluctuation before becoming overwhelmed.
Elimination of wastes
A patient has many ways of eliminating the waste products that are produced by the body. Urine, stools, carbon dioxide, and sweat are the primary waste products produced. In order to maintain optimal function, a patient must be able to eliminate their wastes on an ongoing basis (Frawley 1989). In most Eastern medical systems, and in naturopathic medicine, one of the first steps in treatment is to ensure that the routes of elimination are open and functioning appropriately and adequately.
The waste products of the body serve physiological functions and are essential to their respective organs. The urinary system removes the water, salt, nitrogenous wastes, and other substances and is required to maintain the normal concentration of electrolytes within the bodily fluids. For example, excessive urination decreases perspiration production and excessive perspiring results in a scanty volume of urine. Excessive perspiration reduces body temperature and creates dehydration. In the same way, too much urination creates dehydration and causes coldness of the hands and feet (Lad 1998).
Sleep
Sleep can be disrupted by many factors, such as: poor dietary habits, ingestion of stimulants, like caffeine and sugar; excessive mental activity, too much physical activity right before bedtime, musculoskeletal pain, poor sleep environment, stress, excessive television or computer usage, too much noise or light, shift work, a sense of discontentment at one’s core, or it can be affected by deeper pathologies, such as anaemia. Sleep is required for healing and repair. In a healthy state, sleep follows the circadian rhythm which is linked to the natural day–night cycle (Roehrs & Roth 2008). What is normal, with respect to sleep, for each patient depends on their constitution. What is noteworthy is when the normal pattern of sleep changes or when the sleep pattern is not conducive to health.
Appetite and thirst
A noticeable increase or decrease in a patient’s typical appetite or thirst, or a patient’s pattern of eating, is a sign that needs to be explored further. Water, food, and air are the primary nutrients required to sustain life and ‘feed’ the body. Thirst and appetite depend on a patient’s digestive fire, previous water and food intake, and physical activity level. Cravings, excess desire for food or water, or lack of desire often are indicators of deeper issues. Based on a patient’s constitution each patient has also ‘normal’ level of appetite and thirst. The type and amount of food and water depends on a patient’s current level of health, the current season, and the level of activity that they are involved in (Maciocia 1989).
Energy level
A patient’s sense of energy is a subjective quality. What one patient views as having a high amount of energy another patient might view as low. What is important is when the amount of ‘normal’ energy for a patient changes. How and when the energy changes provides information as to the factors that have affected energy. For example, some patients experience low energy after a large meal, for others it drops after specific foods, and for some energy increases after eating. Having great energy when you wake up that decreases throughout the day tells a practitioner a different story than if a patient wakes up with low energy that stays low all day long. For some energy level is dependent on what a patient is doing or who they are with. The impact of exercise on energy also is valuable in understanding what the message of low energy is conveying.
Healing potential
The kidney has no value to the man, and in spite of its own inherent vitality, very rapidly loses significance. By the same token, a dysfunctional kidney can affect the vitality of a man with an otherwise extremely vital heart; if both kidneys fail, the vitality of the system fails (Mitchell 2007).
Constitution
A patient’s constitution is their baseline, their starting point. It represents their natural tendencies, their primary makeup, their appearance, and their disposition. It represents their inherent strengths and their weaknesses. It can be thought of as the energetic blueprint of their personal essence. A patient’s basic constitution is determined at conception, but it is also influenced throughout life due to learned behavior and patient experiences.
From an Ayurvedic medicine perspective, a patient’s constitution is inborn and governs all the biological, psychological and physiopathological functions of the body, mind and consciousness. A patient’s constitution determines their temperament, natural urges and personal preferences for foods, flavors, temperatures and so on (Lad 1998).
From a Chinese medicine perspective a patient’s constitutional strength and resistance comes from their essence. This essence is composed of the prenatal essence and the postnatal essence. The prenatal essence reflects the blending of energies at conception and it determines each patient’s basic constitutional make-up, strength, and vitality. It is what makes each patient unique. The postnatal essence is derived from food, drink, and air. It is a reflection of a patient’s lifestyle. The overall essence determines growth, reproduction, development, maturation, conception and physiological functions (Maciocia 1989).
Constitution is a way of describing a patient’s energetic qualities. Terms such as hot/cold, dry/moist or air/fire/water/earth are used. Patients are complex systems and the qualities that they naturally possess vary on the psychological, functional and structural aspects. For example, a patient can have an earth body build – square, solid, thick – an air mind – quick, many thoughts, spontaneous – and have high internal fire – quick digestion and metabolism, and a tendency to be hot and excitable. The section in the book on Energetic Patterns (Chapter 5) provides a detailed breakdown of these qualities and how they might manifest in different constitutions. Recognizing the constitutional uniqueness of each patient is the basis of disease prevention, health maintenance, and longevity enhancement. It is also an integral part of the treatment of disease.
A patient’s constitutional strength indicates their healing potential and their resistance to disease. For some, their constitution is weak, and they struggle with different diseases throughout their life; while others experience health most of their life. The strength of the constitution is a reflection of the energies derived from the parents and the accumulation of life experiences. Healing potential is strengthened when a patient knows how to live a life that balances, and is in harmony with, their constitution.
Susceptibility
Susceptibilities often are thought of, not in relationship to a patient, but in relationship to specific aspects of a patient such as a susceptible immune system, digestive system, or emotional tendency. Susceptibility refers to the ability of different aspects of a patient to resist disease, to adjust and compensate to disturbing factors, and to heal. A patient’s constitution indicates the susceptibilities they are born with. However, susceptibilities also arise over time because of aggravating lifestyle factors, life experiences that eventually take a toll on the body, and isolated situations and incidences that have had a significant impact. Unresolved symptoms or diseases either create an area of weakness or intensify an existing area of susceptibility. An example is a patient who claims that ever since their accident 5 years ago they have a tendency to have weakness or numbness on their left side. Or a patient who catches colds more easily ever since they had a bad chest infection; or a patient who states that their blood pressure has been high ever since their divorce. When there is an increase in susceptibility after a specific event, situation, or acute illness, it is valuable for a practitioner to look at the impact that the situation had and whether it is still impacting the patient. Also, look at how the symptoms manifested and how they were treated. What you are looking for is whether the underlying cause was ever addressed and whether all aspects of a patient were supported and allowed to heal.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
