Dr Jaimin R Chotaliya
ABSTRACT
Health is multifactorial and interaction between these factors determines the state of health in an individual. An altered state of health is called disease and every physician in medical science works with the goal of bringing patient back from disease to healthy state. The emergence of holistic concept of health in the medical field opens many new important spectrums in medical research and clinical settings. Apart from biochemical factors, social and environmental factors are also gaining attention for their role in shaping a state of health. In the medical research field, collective understanding of biomedical and socio-environmental factors helps physician/researcher to learn the natural history of particular disease. Homoeopathic system of medicine, also emphasis on understanding about natural history of disease as it plays a crucial role in every phase of case management from case taking to cure or death of patient. So, it is imperative to learn medical factors in context of health & its flow in development of disease condition to ultimate result death.
KEYWORDS – Medical Factors, Homoeopathy, Natural history of disease
INTRODUCTION
In the medical field, some medical factors affect health directly while some indirectly play a role in manifestation of health status. Favourable integration of these factors results in health and unfavourable disease. Fig.1 displaying various medical factors & their flow in order to understand their role in health & disease. (1)
Above mentioned examples, distal factors work from behind & give opportunity to proximal factors to emerge when other conditions are favourable to develop disease condition. (They also contribute to maintaining state of health in individual/community.)
Integrated action of above factors precedes physiological and pathological changes in body. For example, all medicos are well aware of the role of personality traits in aetiology-pathology of Psychiatric disorders. Environmental factors influence incidence & Prevalence of various respiratory & Gastrointestinal disease which shows seasonal trends of disease in community. So, all these factors are antecedent to outcome called diseases.
HOMOEOPATHIC ASPECT
In Homoeopathic Science, the Holistic concept was introduced by Dr. Hahnemann (founder of Homoeopathy) which roots all the theories & practical methods of Homoeopathic science. Dr. Hahnemann was aware about these distal and proximal factors of medical science & described it as fundamental, exciting & maintaining cause in Homoeopathic field. He mentioned it in his book organon of medicine, aph. 5 as following, “Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease, to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations, the ascertainable physical constitution of the patient (and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age, sexual function, etc., are to be taken into consideration.” (2)
Other pioneers in the Homoeopathic field also experienced the influence of these factors in their practice. Writings of some pioneers show their opinions about the role of these factors in the development of disease conditions.
Dr. Stuart Close
Dr. S. Close mentioned the role of this factors in his book as follows, “No germ or bacillus is the sole or absolute cause of any disease, but only a proximate or exciting cause under certain conditions. Other predisposing, contributing, antecedent causes must exist before the germ becomes operative.” Here, he clearly shows the existence of distal or proximal factors that provide a soil to grow bacteria to initiate Patho-Physiological changes in body. (3)
Dr. Guernsey
Dr. Guernsey mentioned the role of these distal & proximal causes in aetiology of Hemorrhoidal cases. He stated, “The exciting causes are, use of stimulants, such as, spirits, coffee, spices, and., or frequent use of cathartics; constipation or the contrary; depressing emotion, great mental exertion, sedentary life, riding on horseback.” (4)
Dr. Ruddock
Dr. Ruddock in his book the common disease of children mentioned about role of these factors in aetiology of scrofulous (glandular disorders in children), he said, “Hereditary taint; want of pure air in living and sleeping rooms; new, damp dwellings; want of sunlight; deficient or poor food; insufficient clothing; want of cleanliness; or unhealthy discharge in the mother. Measles, Scarlatina, Whooping cough, Catarrh, etc., are exciting causes.” (5)
Dr. P. Sankaran
Dr. P. Sankaran mentioned the importance of having knowledge about these factors in case taking and way to uncover them during interrogation. He said, “Experience teaches us that in the majority of cases, through careful interrogation and by association of facts and circumstances, the exciting cause can be arrived at. The patient was once a healthy individual and something has happened to upset the balance called health. Knowledge of this factor – this “something” – is very important. It might have been an injury, an emotional upset, shock, a loss, greed, disappointment, fright, anxiety or vexation, an exposure to cold damp, heat or sun, an indiscretion in diet or activity, overexertion, suppression of discharges or eruptions, etc., or anyone of the numerous morbid influences which excite or activate disease conditions, and which the careful physician can uncover by close and intelligent questioning.” (6)
Dr. Small A.E.
Dr. Small A.E. described the role of environmental factors in the origin & development of intermittent fever. He mentioned about it in following words, “The predisposing causes are generally believed to be impurities in the atmosphere arising from low, boggy districts or marshes, from stagnant pools, when acted upon by the heat of summer, and from the fact that intermittents usually occur in the latter part of the warm season or early in the fall, when the temperature of the nights begins to diminish, it is very probable this is the case; living in a deteriorated atmosphere any great length of time evidently weakens or debilitates the system so that almost any exciting cause may develop the disease. After passing through the heat of a warm day, exposed to these influences, without very careful protection against the change of temperature and dampness of the night, persons will be very liable to the disease.” (7)
Medical Model Representing Medical Factors in Homoeopathy
CONCLUSION
Exciting & Fundamental causes in homoeopathy are nothing but distal & proximal factors those are responsible for development of disease conditions. All these factors are having prime importance in homoeopathic case Management as consideration of these factor & their influence on health also decides the achievement of holistic cure in sick person.
REFERENCES –
- Indrayan A. Basic methods of medical research. New Delhi: AITBS Publishers; 2008.
- Hahnemann S. Organon of medicine. B. Jain publishers; 2005.
- Stuart C. The Genius of Homoeopathy-Lectures and Essays on Homoeopathic Philosophy.2000
- Guernsey E. Homoeopathic Domestic Practice: Containing Also Chapters on Physiology, Hygiene, Anatomy, and an Abridged Materia Medica. William Radde; 1868.
- Ruddock EH. The Common Diseases of Children. B. Jain Publishers; 2000.
- Sankaran P, Sankaran R. The elements of homoeopathy. Mumbai, India: Homoeopathic medical publishers; 1996.
- Small AE. Manual of Homoeopathic Practice: For the Use of Families and Private Individuals. William Radde; 1868.
Dr. Jaimin R. Chotaliya, M. D. (Hom.)
Assistant Professor [CL-2], Dept. of Repertory
Govt. Homoeopathic Medical College & Hospital, AT & PO Dethali, Ta. – Siddhpur, Dist. – Patan, Gujarat.
Email – jaiminchotaliya@gmail.com
