Acute and chronic disease and their classification(According to Homoeopathy)

Acute disease:

         Acute disease is sudden and violent onset, usually severe, intense, but always tends to a speedy termination.^1,2,3

Examples: influenza, smallpox, measles, whooping cough, cholera and hepatitis A.³ 

Chronic diseases:

      Chronic diseases are the disease that arises from chronic miasm comes on slowly, insidious and imperceptible beginning, slow progress with life long sufferings. Disease characterized by longer duration, often months or years.^1,2,3

Examples: cancer, heart disease, or diabetes.

Modern classification of acute disease:^4,5 

1. Individual acute disease: This disease is caused by transient explosion of latent psora, due to

a)      Excess in food

b)      Insufficient food

c)      Severe physical exposure

2. Sporadic acute disease: Caused by

a)      Meteoric or climatic influences and injuries agents

b)      Telluric agent such as soil and water

3. Epidemic acute disease:  It occurs continuously or recurrently in a particular geographic^.1 Epidemic acute disease attacks many persons with very similar suffering from the same disease. It excited by:

a)      Calamities of war

b)      Inundation, famine

c)      Acute miasm

Modern classification of chronic disease:^4,5

• Disease with fully developed symptoms

a)      Non miasmatic chronic disease

1.      Pseudo chronic disease

2.      Artificial chronic disease

b)      Miasmatic chronic disease

1.      Single disease: Psora, Syphilis, Sycosis

2.      Complex disease: Psoric sycotic, Psoric syphilitic, Syco syphilitic, Psoric syco syphilitic

• Disease with few symptoms

a)      One sided disease

1.      Only mental symptoms, such as, insanity

2.      Only physical symptoms, such as, headache

b)      Local disease

1.      Surgical disease

2.      Non surgical disease: dynamic disease appearance on the external part of the body

Dose and Potency in homoeopathic Remedy Selection

After selecting the proper medicine on the totality of symptoms the next duty of the physician is to give proper potency and proper dose to the patient for curing disease.⁶  To choose the optimal potency for the case the physician should have vast knowledge and these are the three main avenues of study in homoeopathy; cases, materia medica and philosophy. ⁵ This is the triangle that makes up all homoeopathic study and knowledge. Generally  Chronic illnesses (i.e. those that you've had for a long time) should be treated with high potencies (i.e. 30x - 200c.) and Acute conditions (i.e. those that are relatively new) with low potencies.³ If emphasis of the symptom is physiological then high potency is preferable.  Low potency are used in acute cases due to the predominance of certain common physical symptoms. High potencies can be repeated less frequently but low potencies can be repeated more frequently. ² In general, prescribing in acute cases repetition may have to be more frequent if the remedy action is quickly exhausted. Thus in general it can be said that the more severe the state of physical pathology, the lower the potency that should be used for the initial prescription.⁴ Low potency is often used in conjunction with the patient on conventional medication. The use of constitutional medicines in low potencies can be used to facilitate the response to the same remedy in higher potency. In line with this a low potency is often prescribed in tandem with a high potency in chronic disease.²

There is a General guidelines about potency and this are low potencies are given at high frequency; whereas high potencies are given at low frequency of dosage. If high potency is given at high frequency of dosages there is a risk of over stimulation and aggravation may occur.⁸

About acute diseases Hahnemann’s direction is, the medicine will give every six, four, three or two hours. In the most urgent cases, the medicine will give every hour or even more frequently. In chronic diseases, every correctly chosen homeopathic medicine, even one whose action is of long duration, may be repeated daily for months with ever-increasing success [when fifty-millesimal potencies are used].⁷

There are a few remedies which one should be cautious about giving high potencies. Medicines such as Lachesis, Aurum, and deep-acting nosodes (especially Medorrhinum) have strong tendencies toward physical pathology. For this reason, they should usually be restricted to lower potencies (30 or 200) unless the individual case is demonstrated to be quite free of physical pathology.4

If you are not 100% sure which remedy to take, usually a low potency, such as 6X, should be taken before a high potency and the patient observed carefully if symptoms improve, but not fully, the same remedy should be taken in a higher potency (such as 30C).³ Finally the secret of potency decision is one can use any potency of the remedy if the selected provided by him are sure that the selection is correct.

Factors should be considered in choosing potency:

Other factors are also relevant for choosing a potency, such as the homeopathic sensitivity of the patient (more sensitive patients take lower potencies), and the particular remedy being taken. 3 There is a unique problem of potency selection in oversensitive patients. These are patients who are excessively "nervous," reactive to all physical and emotional stimuli, usually lean and quick in their movements, restless, sensitive to odors and noise and light, and frequently suffering strongly from exposure to chemicals in the environment or in food. Such people are very reactive both to low potencies (on the physical level) and high potencies.4

      Susceptibility of the patient:

a)      Factors in relation to the disease

• Nature of the disease
• Intensity of the disease
• Seat of the disease
• Stage and duration of the disease
• Pathological condition
• Previous treatment of the disease

b)      Factors in relation to the patient

• Age
• Constitution and temperament
• Habit, occupation and environment

 

c)      Factors in relation to symptoms

• Degree of similarity and characteristic from of the symptom to which the medicine is similar
• Prescription predominantly determined by the mental

B.     Nature of the medicine

Health Administration in Bangladesh

 Definitions: Health administration is a branch of Public administration which deals with matters relating to promotion of health, preventive services, medical care and rehabilitation, development of health manpower and medical education and training.

Aspects of Public Health Administration:

  1. Organizational Structure

  2. Health manpower development

  3. Health planning and management

  

Functions of public health administration:

   The efforts of public health administration are directed towards raising the level of health of community by –

    1. Planning

    2. Organizing staffing

    3. Directing

    4. Coordinating

    5. Budgeting

    6. Reporting

Determinants of Health

   Some of the major determinations of health are as follows:

   
1. Genetic

  
 2. Environment

(a) Internal environment

(b) External or macro environment

•         Physical environment that has bearing on health

•         Biological environment that has bearing on health

•         Psycho – social environments

(c) Microenvironment (personal environment)

3. Lifestyle (ways of living)

 4. Socio – economic and political conditions

 5. Health and family welfare services:

      (i) Immunization of children

     (ii) Provision of safe water supply

     (iii) Maternal and child health care

     (iv) Other essential health related programs

Indicator of Health:

     1. Mortality indicators:

           (i) Crude death rate

          (ii) Expectation of life

          (iii) Infant mortality rate

          (iv) Child mortality rate

          (v) Under – five mortality rate

          (vi) Maternal mortality rate

          (vii) Disease – specific mortality rate

          (viii) Proportional mortality rate

2. Morbidity indicator

       (i) Incidence and prevalence rate

       (ii) Notification rate

       (iii) Attendance rate of out – patient departments, health centers etc.

       (iv) Admission, readiness and discharge rates in health service institutions

        (v) Duration of stay in hospital

        (vi) Spells of sickness or absence from work or school.

 

3. Disability rates

      (i) Number of days of restricted activity.

      (ii) Bed disability days

      (iii) Work loss days (or school loss days) within a specified period

      (iv) Limitation of mobility

      (v)  Limitation of activity

      (vi) Expectation of life free of disability

4. Nutritional status indicators

5. Health care delivery indicators:

     (i)  Doctor – population ratio

     (ii) Doctor - Nurse Ratio

     (iii) Population – bed ratio

     (iv) Population per health center/ sub center

     (v) Population per traditional birth attendant

 6. Health care utilization rate

7. Quality of life indicators:

     (i) Infant mortality rate

     (ii) Life expectancy at age one

     (iii) Literacy rate



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Immunity

Definitions:

    
Immunity is the relative ability of the body to resist almost all types of organism or toxins that tend to damage the tissues and organs.

  
 Immunity is also defined as the ability of the body to recognize, destroy and eliminate the antigenic material foreign to its own. It is normally a defensive mechanism of the body.

    
Antigen: An antigen is a substance which when introduced into the system is capable of including an immune response leading to the formation of antibody with which it reacts specifically.

     
Antibody: An antibody is a modified globulin (immunoglobulin) produced in response to an antigen with which it reacts specifically.

     
Immunization: It is a technique by which immunizing agents are introduced into the body for the production of antibody to prevent diseases.

  

    
Toxin: It is the product of bacterial metabolism and is toxic, i.e., inhibitory or lethal to the cells of the host.

   Toxin may be –

    (i) endotoxin

    (ii) exotoxin

  
 Toxoid: It is a derivative of the toxin which is devoid of toxigenicity but still possessing the antigenicity.

   Toxic are used for the purpose of immunization.

   Examples: Tetanus toxoids, diptheria toxoids.

Classification of immunity:

• Innate or nonspecific

Genetic

Mechanical

Humoral

Cellular

• Acquired or specific

a. Active

1. Natural
2. Artificial

b.Passive

1. Natural
2. Artificial