In the earlier articles we have learnt what is health, disease and classification of disease. Knowing all the concepts let’s tabulate the precise picture of Healthy State of Being. While tabulating the systems in the extreme left column in Systemic Parameters portion, I have just mentioned the body parts or broader classification, however, it has no relevance medically to existing medical terminology. For example, where I have mentioned broader terminology as Head, Neck, Brain it relates to anatomical area head, neck, brain and does not include internal organs, functions. But here I have included internal organs, functions too as they relate to the area. Or major glands are anatomically located in the broader area mentioned. 

I am sure you have got the birds eye view of the life and living. The content / satisfaction in life leads to good health and wellbeing. Hence along with accumulation of wealth accumulation of satisfaction is more important and crucial to be in the state of wellbeing for longer time period. The longer you remain in the state of complete mental, physical wellbeing you experience Quality of Living which is the purpose and objective of Wellbiance® Quality of Living Clinic to help you achieve it.

Reference:

1. Wikipedia – accessed online – wikipedia.org
2. Academic (1986 to 1992) and Clinical Experience (1993 to 2020) of Dr. Ashutosh Pradhan

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In the earlier articles we have learnt what is health and disease. Now let’s understand the Classification of a disease or infirmity. As in the current times three major systems of medicine are prevailing, Allopathy, Ayurveda, Homoeopathy we will restrict ourselves to these classifications and will not deal with classification of disease as per Siddha and Unani.

Allopathic (Modern Medicine) Classification of Disease¹

• Topographic, by bodily region or system,
• Anatomic, by organ or tissue,
• Physiological, by function or effect,
• Pathological, by the nature of the disease process,
• Etiologic (causal),
• Juristic, by speed of advent of death,
• Epidemiological, and
• Statistical

Any single disease may fall within several of these classifications.

Ayurvedic Classification of Disease²

In Ayurveda multiple approaches are considered for classification of disease. The ayurvedic doctor has full liberty to consider newer approaches towards classification of disease.

Homoeopathic Classification of Disease^{3, 4}

Let’s understand Homoeopathic Classification of diseases and where homoeopathy can be effective. Dr. Samuel Hahnemann the founder of Homeopathic Science has scientifically classified disease into three major categories further sub-divided into other sub-categories:

1. Indisposition:

It is just a deviation from state of health. E. g. Indigestion from overeating, body ache (myofibrositis) due to lack of sleep. This category diseases needs no remedy and can subside on their own after correction in the cause leading to indisposition.

2. Surgical or Mechanical Cause related Diseases:

As the name suggests the disease is due to an external factor and has less of or no dynamism involved but is due to manual interference. Examples include fractures, big non reducible hernias. Diseases in this category will need surgical intervention and cannot be treated by any pathy.

3. Dynamic Diseases:

Diseases caused by deviation in lifestyle (irregular habits, wrong diet, mental & physical stress). This category is further sub-divided into:

(A) Acute Diseases: Such as flu, diarrhoea, etc.

(B) Chronic Diseases: Such as arthritis, hypothyroidism, hyperthyroidism, goitre, asthma, allergies, PCOS,   diabetes, blood pressure, etc.

Homoeopathy can successfully treat diseases from the third category.

Visit the URL: Diseases Cured by Homoeopathic Treatment: http://www.drpradhan.com/home/homoeopathic-articles-top/disease-specific-top

Reference:

1. Human Disease Classification. Encyclopaedia Britannica – https://www.britannica.com/science/human-disease/Classifications-of-diseases (accessed on April 4, 2020)
2. Rathod K. B. et al. A Review of Classification of Disease in Ayurveda. International Archives of Integrated Medicine, Vol.1, Issue. 2, October, 2014. P50-60. http://iaimjournal.com/wp-content/uploads/2014/10/7-A-review-of-classification-of-disease-in-Ayurveda.pdf (accessed on April 4, 2020)
3. Classification of Diseases in Homoeopathy – Centre for Health Informatics (CHI), set up at National Institute of Health and Family Welfare (NIHFW), by the Ministry of Health and Family Welfare (MoHFW), Government of India. – https://www.nhp.gov.in/Classification-of-diseases_mtl (accessed on April 4, 2020)
4. Pradhan A. C. Does a Homoeopath can treat all diseases? – http://www.drpradhan.com/home/homoeopathic-articles-top/disease-specific-top/80-can-homoeopathy-cure-all-diseases (accessed on April 4, 2020)

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               In the earlier article Health – Basic Concepts (Click Here to read it first if you have read it) we have dealt with the definition of health and its meaning as elaborated in various dictionaries. In this article we will elaborate in depth about what is health, what parameters tell us that we are in good health. These parameters in medical terminology are labelled as Determinants of Health.

Physical Well-Being

What are the parameters of physical well-being? We breathe in and out 12 to 18 times every minute. However, are you aware? Till I tell you the rate at which you are breathing per minute, do you know it? No! You can be aware of your breathing only when you are consciously focusing on your breathing. The same logic applies to each and every part / cell, organ within our body. Till the time you are not conscious / you are not aware of the part or process within our body in normal living you are enjoying health. Unless otherwise you deliberately become aware of these organs, functions such as in case of Yoga, when you deliberately focus your attention on breathing. Some parts and processes are even beyond our awareness. For example: movements of vocal cords. You are not aware how the movements are. The only time you are aware of your voice is when one loose one’s voice in acute laryngitis, yet the way vocal chords move, we are not aware of it. All the parts, cells, processes of the body are harmoniously functioning at it’s own normal pace with ease. When we loose the ease of action of a bodily part at which the part or the process is functioning we become aware of the part and process and then we are diseased. We are dis-eased! We are not at ease. We are diagnosed as diseased (dis-eased). The disease process makes you aware of the ailing part or of the ailing process. For example, when we suffer from common cold, breathing in air is difficult due to nasal obstruction and we experience nasal blockage. It is a well experienced fact that we are aware of our bodily parts and processes only when we are sick. Then how can one differentiate and become aware of healthy functions to label oneself as being in a complete state of physical health? Let’s consider the parameters that tell us whether the part or the functioning is normal or abnormal.

Park’s Textbook of Preventive and Social Medicine¹ describes physical health as having “a good complexion, a clean skin, bright eyes, lustrous hair with a body well clothed with firm flesh, not too fat, sweet breath, a good appetite, sound sleep, regular activity of bowels and bladder and smooth, easy, coordinated bodily movements. All organs of the body are of unexceptional size and function normally; all special senses are intact; the resting pulse rate, blood pressure and exercise tolerance are all within the range of normality for the individual’s age and sex.”

Complexion, clean skin, bright eyes, lustrous hair, and firm flesh reflect good nutrition. If the person is eating appropriate quantities and taking a balanced diet, there are no deficiencies seen. A state without any deficiencies reflects these signs good complexion, clean skin, bright eyes, lustrous hair, etc. Sweet breath reflects good oral health. Good appetite rules out many diseases. In diseases such as hepatitis, tuberculosis one tends to loose appetite. However, these are pathological states. A person suffering from indigestion or worm infestation may have poor appetite and bad breath. Seven to nine hours of sound sleep in adults indicate sound mind. Seven to nine hours of sleep rejuvenate cells which have been working round the clock for maintaining the bodily functions. (Do refer my earlier article on Optimum Sleep) Regular activity of bowels means passage of stools on regular intervals with sense of satisfaction. Regular bladder movements indicate absence of diseases such as diabetes or in case of males, diseases related to prostate. In females, diseases related to uterine or bladder prolapse. Coordinated body movements indicate normal functioning of brain in medical terminology normal function of central as well as peripheral nervous system. The other important parameters which need to be normal are: Temperature, Pulse, Respiratory Rate, Blood Pressure. Abnormal temperature, pulse, respiratory rate and blood pressure values are seen in many grievous diseases. Normal temperature, resting pulse, respiratory rate, blood pressure within normal range pertaining to age and sex are signs of physical well-being.

Mental Well-Being

If one thinks retrospectively there is definite difference between lower animals and higher animals. Lower animals the only goal of living is survival. They simply need to eat, drink, reproduce and survive. As against that human beings are higher animals and need to have a definite higher purpose of living. One of the important aspect of differentiation amongst lower animals is that we can smile / laugh. Human beings can think beyond survival. A mentally healthy person will search for objectives of higher purposes of living and will align it to the goals of living. 

Park’s Textbook of Preventive and Social Medicine¹ states mental well-being as “a state of balance between the individual and the surrounding world, a state of harmony between oneself and others, a coexistence between realities of the self and that of other people of the environment.” 

Park’s Textbook¹ further describes that a mentally healthy person is:

1. Free from Internal Conflicts and is not at “war” with himself or herself
2. Is well adjusted means he / she can get well along with others and can accept criticism and is not easily upset
3. Searches for identity
4. Has strong sense of self esteem
5. Knows himself / herself – his needs, problems, and goals (self-actualization)
6. Has good self-control-balances rationality and emotionality
7. Faces problems and tries to solve them intelligently, and can cope with anxiety and stress successfully

Free from Internal Conflicts and is not at “War” with self

Dilemma about making decisions is a stressor commonly experienced by individuals and it act as an indecisive force compelling one to change his / her decisions often and stay away from productive execution of ideas. The self-conflict can be between the conscience whether whatever steps am taking are right or wrong. Self-conflict can arise out of disproportionate perception of reality that whatever I do I will be criticized by the people around and in order to “avoid” the criticism no steps are taken. This state is also indication of low self-confidence.

Well-adjusted and can accept criticism

Ability to receive criticism positively indicates balanced state of mind. The moment one overcomes the sensitivity of receiving criticism he / she can get well along with everyone around. Till the time there is intense sensitivity towards criticism often it is seen such individuals isolates themselves from others for a distorted perception of “I am targeted and am an object of laughter”.

Searches for Identity

Your sense of identity has to do with who you think you are and how you perceive yourself. It’s about how you define yourself. Both affect your mental health, your behavior and how you relate to other people.

It’s important to understand how we develop sense of identity because low or a poor sense of self can contribute to so many problems in our lives. It’s also important to understand what steps we can take if we need help in these areas.

People who don’t have a strong sense of their own identity may be easily influenced by others. They may have trouble in making decisions and may get involved in unhealthy relationships.

The parents must shape identity of their kids. One needs to support them while they try and wipe off negative self-talk. Often peers inculcate a negative thought in the child which kills self-identity. One need to be observant and replace precisely the negative thought with positive one in order to formulate a positive identity. If the child fails to understand his / her own value, one needs to subtly help the child to identify their own values with which they will grow positively in their identity. Such a treatment in Clinical Psychology is referred to as positive re-enforcement.

Case

We had a male child coming to us whose elder sister was a great performer and he use to get subdued in light of her performance. During his upbringing his parents could not focus much on the second child due to their professional commitments. Due to which the male child was poor performer in the school and the peers inculcated a negative identity in his mind that he is not so intelligent as compared to his sister. The fact of the child developing negative identity was brought to notice by us to his parents who subtly as per our instructions “wiped” away the negative self-talk and inculcated confidence with a thought that you are equally intelligent, however, your efforts are falling short. The moment you will increase the efforts you will achieve similar or more than what your sister achieved. The Positive Re-enforcement ‘therapy’ helped the male child to come over negative self-talk and he could build a positive identity and over a period of time his performance at school excelled equivalent to or more than his elder sibling’s performance.     

Strong Sense of Self Esteem

Self-esteem is how you value yourself. It has to do with your sense of self-worth. It’s important to understand how we develop self-esteem because low self-esteem can contribute to so many problems in our lives.

People that have poor self-esteem may be susceptible to a number of psychological problems like depression, anxiety and eating disorders. They may be more likely to become addicted to stimulants such as alcohol or other drugs. Low self-esteem is not the only cause of these problems, but it is often a contributing factor. Children and adolescents with poor self-esteem are more likely than other children to have behavior problems and have trouble getting along with authoritative figures.

The World Health Organization² defines mental well-being as, “Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.”

The WHO’s narration about mental well-being matches with the definitions or aspects of mental well-being considered till now based on Park’s Textbook of Preventive and Social Medicine.

Disease or Infirmity

We have seen earlier what dis-ease is. Whenever we are sick, we loose the sense of well-being and develop a feeling that something is not well or one does not experience fresh and energetic sense of being. Such a sense is many-a-times accompanied with body ache. In medical terminology we call it as malaise. Malaise as per dictionary is a noun and it means a general feeling of discomfort, illness, or unease whose exact cause is difficult to identify. That clearly indicates the first symptom experienced by us is on mental / emotional level. If it is not treated or if it is not feasible to take rest when we experience the sick sense the disease progresses further to evolve. In reality, an individual experiences stress in day-to-day living which lowers the immunity and consequently lowered immunity level attracts diseases.

Whenever one suffers from a sudden onset of disease which lasts for a shorter period of time it is labeled as an acute disease. Whenever a disease has slow onset and lasts for longer period of time it is labeled as chronic disease. Flue, diarrhea, pneumonia are few examples of acute diseases. On the other hand, diabetes, hypertension, thyroid disorders, asthma, PCOD / PCOS are examples of chronic disease.

Whenever an individual is suffering from a chronic disease few of the signs reflected on the physical level affect the bowel, bladder movement, disturbs sleep. If the early signs of physical disturbances along with disturbances on the mental level are not identified and addressed to, then the disease evolves further to the next level.

Research has proved time and again that there is a clear relation between stress and health. Thus, till we do not effectively manage stress achieving the health goal is too far away to be achieved to.

If at all you have any questions, feel free to get in touch with me.

References:

1. Park. Park’s Textbook of Preventive and Social Medicine. 23^rd Edition. January 2015. P 14 – 15.
2. World Health Organization. Fact Files accessed at: http://www.who.int/features/factfiles/mental_health/en/ on September 11, 2016.
3. Ashutosh Pradhan’s Clinical Experience since January 1993

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               Today we all are scared of catching the disease. We are making every attempt to be healthy. However, do each one knows what health is all about? This is the first article in Health series, as it cannot be explained in depth in one article.

Health

Often none of the non-medical or non-health related population is interested in knowing what actual is meant by the six-letter word health. However, I feel it is very essential to know the precise meaning and the determinants of health. Once one is aware of what is meant by health the target of achieving health is crystal clear and the path can be easily chalked out towards health.

Various Definitions

Merriam Webster’s Dictionary

Simple Definition of health¹ is the:

• Condition of being well or free from disease
• Overall condition of someone’s body or mind
• Condition or state of something

Full Definition of health¹

1

1. The condition of being sound in body, mind, or spirit; especially: freedom from physical disease or pain
2. The general condition of the body <in poor health> <enjoys good health>

2

1. Flourishing condition: well-being <defending the health of the beloved oceans — Peter Wilkinson>   
2. General condition or state <poor economic health>

3

A: toast to someone’s health or prosperity

WHO

The World Health Organization (WHO) defined health in its constitution dated back to 1948 as:

“A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.^{2, 3}”

Huber M. et al

Dr. Machteld Huber redefined Health on 2011 as:

Health as the ability to adapt and to self manage, in the face of social, physical and emotional challenges.^{4, 5}  

Dr. Huber describes the new concept as about ‘positive health’. The concept does not focus on the ‘state of complete well-being’. As per opinion of Dr. Huber the current World Health Organization (WHO) definition:

• Focuses on complete well-being, by which merely nobody is healthy.
• Has inadvertently promoted medicalisation, encouraging people and healthcare practitioners to be continually concerned with fighting disease, and neglecting opportunities for people to lead a meaningful life.

Resilience and self-management

Dr. Huber further feels that health is a dynamic phenomenon, and should be seen as an integral part of the art of living, rather than something we consider only when illness occurs. Of course illness must be treated where possible, but we should also focus on strengthening resilience, self-management and ‘health literacy’.

Wellbiance® Accepted Definition of Health

I am practicing on the basis of WHO’s definition of health since 1993. I differ with opinion expressed by Dr. Huber for her discussion about terms “complete well-being” as mentioned in the WHO’s definition of health. I personally feel that the WHO’s definition is highly ambitious as far as practitioners of modern medicine are concerned. When it comes to practitioners of yoga, homeopathy and Wellbiance®, the definition of health is achievable. With Wellbiance® through vehicles such as yoga, homeopathy independently as well as jointly, complete wellbeing is achievable. Deleting terms “complete well-being” from the definition of health is as good as defeating oneself against diseases. Simply because majority from the population is suffering from chronic diseases does not dilute your target of achieving complete well-being. Hence, I feel WHO’s definition of health is accurate and is time tested.

While we will discuss about Wellbiance® in details in the upcoming articles we will consider WHO’s definition of health as a accurate definition. However, we will use Dr. Huber’s new concept of resilience as a tool to achieve health as per WHO’s definition.

Health – as Specified in WHO’s Definition

Since we have accepted the WHO’s definition of health our goal of achieving health as per WHO’s definition of health, has now been clear. Now we must understand the definition completely so that the target “Health” will be crystal clear and we can chalk down the road map to our target.

Let’s re-read the definition:

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.^{2, 3}

If we defragment the statement above into key words following are the keywords:

1. State
2. Complete
3. Physical
4. Mental
5. Social
6. Well-being
7. Disease
8. Infirmity

Let’s understand the meaning of these keywords from the existing easy access definitions, meanings, explanations:

1. State⁷ – noun –
1. The condition of a person or thing, as with respect to circumstances or attributes e.g. a state of health.
2. A particular condition of mind or feeling e.g. to be in an excited state.
2. Complete⁷ – adjective – having all parts or elements; lacking nothing; whole; entire; full
3. Physical⁷ – adjective – related to body – we will understand it in depth to learn all physical aspects in terms of signs and symptoms of well-being
4. Mental⁷ – related to mind – we will understand it in depth to learn all physical aspects in terms of signs and symptoms of well-being
5. Social – always refers to the interaction of organisms with other organisms and to their collective co-existence, irrespective of whether they are aware of it or not, and irrespective of whether the interaction is voluntary or involuntary⁸.
6. Well-being – Well-being is a positive outcome about what people feel about their lives, such as the quality of their relationships, their positive emotions and resilience, the realization of their potential, or their overall satisfaction with life—i.e., their “well-being.”^{9, 10} Well-being generally includes global judgments of life satisfaction and feelings ranging from depression to joy.^{11, 12}
7. Disease – A disease is a particular abnormal condition, a disorder of a structure or function, which affects part or all of an organism¹³.
8. Infirmity¹⁴ – noun
1. A Physical weakness or ailment: the infirmities of age.
2. Quality or state of being infirm; lack of strength.
3. A moral weakness or failing.

With the defragmented understanding of the keywords, you may have had a glimpse of collectively what the definition of health comprises of.

The definition begins with the word state that means it has an affinity to change as per external impression and may not remain the same constantly over a period of time. Then it speaks about complete physical, mental and social well-being. Often in our day-to-day living we refer to only physical health and the other two components are completely missing from our awareness “radar”. We never think of or are aware of mental and social components. It would be a weird idea to have patient coming into a primary care physician and the patient states that I do not have social well-being. Even when it comes to mental well-being many a times the person is not aware of the derangements yet there is enough awareness now a days and people do visit a counselor or a psychiatrist. Why is this scenario prevailing? The basic reason why we never emphasis on the other two components and are constantly aware of derangements at the bodily level is because we have never been taught to gauze the other two levels on our own. We will go through each of the three components thoroughly to understand what it means being in the state of well-being and how to gauze the levels in health.

If at all you have any questions, feel free to get in touch with me.

References:

1. Merriam-Webster Dictionary. Definition of Health. Accessed at URL: http://www.merriam-webster.com/dictionary/health
2. World Health Organization. WHO definition of Health, Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. In Grad, Frank P. (2002). “The Preamble of the Constitution of the World Health Organization”. Bulletin of the World Health Organization 80 (12): 982.
3. World Health Organization. 2006. Constitution of the World Health Organization – Basic Documents, Forty-fifth edition, Supplement, October 2006.
4. Huber M. et al. How should we define health? BMJ 2011;343:d4163. PMID 21791490.
5. Huber M. et al. New Concept of Health. A short video published on YouTube – https://www.youtube.com/watch?v=qoJ_zywh9uM published on December 10, 2012.
6. Wikipedia – https://en.wikipedia.org/wiki/Health
7. com
8. Wikipedia – https://en.wikipedia.org/wiki/Social
9. Diener E, Seligman ME. Beyond money. Toward an economy of well-being. Psychological Science in the Public Interest 2004;5(1):1–31.
10. Diener E. Assessing well-being: the collected works of Ed Diener. New York: Springer; 2009.
11. Diener E, Scollon CN, Lucas RE. The evolving concept of subjective well-being: the multifaceted nature of happiness. In: E Diener (ed.) Assessing well-being: the collected works of Ed Diener. New York: Springer; 2009:67–100.
12. Frey BS, Stutzer A. Happiness and economics. Princeton, N.J.: Princeton University Press; 2002.

• Wikipedia – https://en.wikipedia.org/wiki/Disease

14. com – http://www.dictionary.com/browse/infirmity

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© April 2020, Dr. Ashutosh Pradhan – Consulting Homoeopath – Wellbiance Quality of Living Clinic