clinic

Tank dynamic model of disease – an interview –

Interviewer: Welcome to our program Mr. physician21.
Physician21: Thank you, Sir.
Interviewer: In your opinion, why is there a need for a model of disease?
Physician21: Well. There are indeed many views of disease that came up with the understanding of the disease process. In my new model I try to make use of all these views in one working model.
Interviewer: Great, then, let’s get closer to your model!
Physician21: The model considers the environmental variables, the physical elements including food and drinks, the emotional experiences and the personality.
Interviewer: Yes. Those 4 components are known to contribute to human health state. So, what is new in your model?
Physician21: The model assumes that everybody has a residual disease state at any point of time, and the disease is just an outbreak point of an already existing and ongoing process. The point is that one should take care to set that residual disease state as low as possible, so that such outbreaks would occur very infrequently.
Interviewer: What examples would you tell us in this respect?
Physician21: For example, the negative feelings such as hate and jealous, these are very inappropriate for one’s health. In the Islamic rituals, it is recommended for a sick person to give out money as alms or charity, and it is believed that this would directly or indirectly help cure the sick. This act can be understood in my model such that the act of giving money to the needy would creat a positive feeling or positive energy for the sick and the surrounding persons that would boost their readiness for cure and resolution.
Interviewer: So, your model emphasizes that health state comes from within the person, and encourages everybody to take care of naturally given health elements in those 4 discrete categories: environment, matter, emotions and personality.
Physician21: Yes, true. The process is very interesting and intricate. Everybody owns the keys for good health, just on realizing their proper use. The way one walks, talks, and behaves, all that speak either for or against the health state. So, one should be careful.
Interviewer: So, the progression of a disease state is largely controllable especially at its early beginning.
Physician21: Yes, of course.
Interviewer: You talked about positive and negative energy. is it the energy ‘halo’ of the body?
Physician21: Yes. According to physics matter can ultimately change to energy and both are interchangeable. Pictures, actions, meanings, thoughts, colors, sounds, clothes, objects and food can all take part in outshaping of the energy environment and feelings and, thus, health of the person.
Interviewer: Good. What about the biological and physio-chemical agents as disease causes in your model?
Physician21: These are called extraneous factors that may cause harm or not according to the basal disease or readiness of the person. So, they are not in the center of disease process in our model.
Interviewer: Thank you very much, Mr. physician21 for this great information.
Physician21: You are welcome, Sir. Thank you very much.

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clinic

Tank dynamic model of disease

tank dynamic model of disease

In science it is usual for a certain entity or process to describe a model that may describe, explain, or predict facts and phenomena concerning that natural entity or process. In this regard the disease process may not be an exception. Indeed, the disease process, and thence the cure method, is being regarded from several aspects that would complement each other in understanding the diseases and providing cure measures, or individually suggest an opinion that is not readily usable by other medical views.

In this essay, I shall present my own perception of the disease process with new name coinage, the tank dynamic model of disease.

1) What is a disease?

The disease is a deranged health status that can be subjective (addressed only by the person) or objective (addressed by the surrounding persons).

2) What are the basic common pillars of the disease?

The disease should have: 1- a complaint (picture), 2- a time onset, 3- a pattern, 4- a natural course, 5- opponents and proponents (things that oppose or favour), 6- cause(s), and 7- treatment(s).

3) What are the assumptions of this model of disease?

1. The disease is a dynamic process.

2. Everybody has a basal disease state at any point of time.

3. The matter and energy of an individual are interchangeable as explained by physics.

4. The disease ensues as an over flow of an already present and ongoing process in which a few unitary disease elements are in play, with or without the incidental superimposing an extraneous factor (a biological or a chemiophysical incident).

5. The unitary disease elements include: 1- sensual elements: environmental conditions and landscape, 2- emotional elements: fear, grave, happiness, hate, etc., 3- physical elements: exhaustion, tiredness, thirst, hunger, satiety, over- satiety, cold, hot, physical sexual overflood (stagnation), and 4- personal elements: shyness, honesty, intelligence (theoretical and social), sensitivity, etc.

6- The treatment of a disease condition comprises the timely and ordered measures according to the underlying contributing disease elements.

4) How is the disease process viewed in this model?

The disease has 3 phases: 1- preparatory phase, 2- shock or culmination phase, and 3- resettlement phase.

The disease may have one of 3 forms: 1- disease with mainly extraneous factor determinations (e.g. fever, malaise), 2- disease with mainly general physical phenomena (fatigue, fainting, hypertension, etc.), 3- disease with mainly neuropsychic phenomena (anxiety, depression, obsession, …). 

tank dynamic model of disease disease phases

5) How do the disease elements work?

The disease elements may work in triplets for many disease processes. Other more complicated disease elements’ contribution may be present.

6) Which diseases would you choose to explain as examples?

1. Bacterial sinusitis:

The disease elements can be: 1- physical stress (exhaustion, little food, little drinks, inability to properly clean the nose; e.g. lacking the hygiene paper tissue), 2- emotional feeling of pressure and shortage, and 3- environmental stress (hot, cold or dust). 

sinusitis tank dynamic model of disease 1

2. Renal colic 

renal colic tank dynamic model of disease 1

3. Fainting

fainting tank dynamic model of disease 1

clinic

Human health and filling in the gaps

There are seemingly no clear boundaries between health and disease of humans. From one side the judgement of one’s health may be subjective, and from the other side the feeling of being healthy or sick may be intermingled in the different parts of the same day. One of the most impactful insights in medical sciences is to find the appropriate definition of health and disease statuses. The definition of health laid by the World Health Organization states health as “the state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity.” Apparently and in practical terms no one on Earth would fit to the WHO definition as being a healthy human.
The human health, being the sum of several biological components or entities, should not be regarded apart from its inherent dynamic nature. It can, therefore, be considered and expressed in hand of mathematical probability estimation. The human health may be, accordingly, defined as the state of satisfactory physical, mental and social showing in average life conditions with or without auxiliary means in terms of lifestyle and/or medical treatment. Therefore, in light of this definition while health state judgment may be individually tailored and appreciated, the presence or absence of certain physical or psychological disease state would be regarded as a constitutional health element for every individual. For the delineation of such constitutional health elements, physicians and other health scientists may succeed in writing down all known conditions (or diseases) with their different possible classifications.
Such dynamic nature of human health should give a red alarm to physicians not to make statements on one’s health based only on some data in limited clinical sessions or visits. In many cases, closer observation and more rigorous data collection may be needed before the health state of an individual can be judged.
On handling certain health condition, the natural body resources and compensatory reserves (so-called natural healing power) should not be overseen, but rather boosted and encouraged. In other words, the medicines; if they are clearly indicated, should be given prudently so that such natural resources and reserves would still be desirably in action. The benefits of such prudent medical conduct include: 1) preservation and boosting of natural healing would ensure permanent or durable cure and reflect positively on longevity, 2) giving less medicines with less chances for side-effects and with lower cost, and 3) deliberate ‘undertreatment’, i.e. prudent treatment, would allow easy-to-follow life style and help avoid iatrogenic (of doctor origin) and accidental overdosing.

in-the-point (poems and essays)

The foul entity – an interview –

Interviewer: Hallo, everybody! Welcome to this episode of “medical views”. We have today an interesting topic that should deserve our attention. Let’s welcome our guest. Welcome back, Mr. Physician21, to our program.

Physician21: Thank you very much for this nice introduction. It is my pleasure to be here.

Interviewer: I think the topic of today have special importance as its name implies, ‘the foul entity’. How could you imagine it?

Physician 21: ‘The foul entity’ as I could imagine is a natural component of our world that can turn our life to a true hell. We people do not like to have problems but our life does need them, anyhow.

Interviewer: So, ‘the foul entity’ is the site or station where all devil would be knitted.

Physician21: Yes. That’s it.

Interviewer: You mean it implicitly that the problems we have in our lives would have similar patterns that can be foreseen in definite paths and models.

Physician21: You are right.

Interviewer: So, what is the significance of your view in attributing the entire devil to one thing, one station or one entity?

Physician21: The advantage is quadruple. First, you won’t handle people in some unpleasant situation but you consider a divinely present ‘foul entity’ that knit problems – by dimension – for our satisfaction. Second, here, people are only objectified in the course of ‘the foul entity’. Then, you ultimately do not condemn people who may or may not resolve any time. Third, according to that view problems – both from outside and from inside one’s self – can be better foreseen, received, interpreted and handled. Fourth, the existence of a ‘foul entity’ should lead to the belief in a much larger good ‘all’ that contains and maintains all good meanings and things. Of course, the attachment and belonging to such great good all would bring a great joy and relief every time one is aware of and protected from the bad effects of ‘the foul entity’.

Interviewer: This imagination sounds very beautiful when people do not condemn one another but only condemn the bad deeds and be aware of their divine source according to your view. How could ‘the foul entity’ affect someone in a bad way? And where would be the protection sought for?

Physician21: ‘The foul entity’ may work in different ways or models, for example, through the “bad chance” like when somebody calls you by mistake at midnight. In this case you should know it was not meant to bother you. The protection shields against the foul entity include, therefore, positive thinking, forgiveness, generosity, innocence, reflection, and good spirituality.

Interviewer: To summarize, ‘the foul entity’ as imagined by our guest is a natural component of our moral world that is needed to refine people’s ability and willingness to do well. So, it ultimately works for our benefit on the condition that we are able to divert its seemingly bad tricks and plots to the flourishing of our really good. Thank you very much, Mr. Physician 21, for this great idea.

Physician21: Thank you, Sir, for your extraordinary presentation.

in-the-point (poems and essays)

The foul entity

All the cares and problems I had seem to come from one “thing”, one “structure”, one “entity”; let it be the foul entity. This is because the problems and the embarrassments would happen in a similar pattern: misunderstanding, different views, variation, misfortune and harmful chance. But what if our whole life is based on naughty working of such “bad entity”? Would this also be a bitter makeup of our world?

The world seems to me to be basically nicely sounding, happy, enchanting and fruitful. Let it be the skies, they look wonderful. The nature in Earth is also beautiful with peaceful plants and innocent animals. The good is by far much greater than the bad; the good all is much greater than the small foul entity. But apparently we people would not be likely to survive or to advance only in that vast good all and the existence of such small foul entity would be, therefore, necessary. We have to taste bitterness, feel pains and strive for values and good answers and responses.

When I do well I become more attached to the good all and more apart from the foul entity. The reverse is also true. Here, I no longer have problems with people who would do bad because they become merely a phenomenon of the working of a divine foul entity that would harm only susceptible people who are somehow not protected from its harmful effects. Those harms are all undesirable things we may have in this life like disease, cares, shortage of resources and disability.

There are definite and finite protection rules for happiness and satisfaction against the automatic working of the foul entity. These include forgiveness, innocence, generosity, hope and prayers for one’s and everybody’s health and wealth.

At this time I feel how great I would be, how important and how valued. As the good all would be on my side when I do well and good. I am not in charge to change badly doing somebody or some bad circumstances but I am ready to understand that it is all about help and hope to evade a continuously working foul entity for the sake of people’s benefit and advancement.

clinic

Disease characterization and classification

 

disease characterization

In the medical field, a disease may be regarded as any objectively addressable deviation from the abstract normal. That abstract normal would be assigned a “neutrum” of customarily and/ or scholarly defined state of equilibrium and perfection.

Very remarkable is that the human normal is not shaped, as may be noticed in the phrase above, only by physicians or medical professionals, but also by thinkers, philosophers, scientists, creative minds and the general lay people.

In order for such “disease” to be defined or characterized a few parameters should be fulfilled.

  1. Type of the person in whom this disease may be seen.
  2. Onset of the disease.
  3. Course of the disease.
  4. Associates of the disease.
  5. Common outcome of the disease.
  6. Name of the disease.

These are 6 parameters that would be quite sufficient to characterize a disease on gross and perceivable measures by scholars and the lay as well. The knowledge about the cause(s) and underlying micro changes and molecular mechanisms fall to the interest of a few people including the health care providers.

Let’s talk briefly about each of these disease parameters in hand of common examples.

Type of patient includes:

– Age (child, adolescent, adult, and elderly),

–  Sex (male and female),

– Stature (stunted, average, above average)

– Body shape (slim, average, obese),

– Race (Caucasian, Negroid, Mongolian),

– Personality (easy, strict),

– Acquaintance (poor, average, high).

The relevance of patient’s type to the disease is understood by the fact that some diseases are more common in some patient’s types than in other types.

Onset of the disease

This means how the disease was noticed by the patient or the relatives.

– Sudden onset: the disease has commenced very acutely. Example: a thrombus formation in the leg (deep venous thrombosis, DVT).

– Gradual onset: the disease commence over relatively long time. Example: weakness in the leg due to a disc hernia.

Course of the disease

This describes whether the disease tends to increase, decrease or fluctuate as time passes (over relatively long time) without any interference from the patient’s side.

– Progressive course: e.g. progressive decrease in visual acuity.

– Regressive: e.g. so-called self-limiting disease that resolves gradually by itself such as common cold or flu.

– Intermittent course: this describes a disease that tends to appear from time to time.

Associates of the disease

These imply the relation of the disease to other things like food, drinking, activity, stress, posture, etc. Among the associates of the disease we can consider risk factor(s), e.g. obesity is a risk factor for type 2 diabetes mellitus, and precipitating factor(s), e.g. water restriction is a precipitating factor for renal troubles.

Common outcome of the disease

This is how the disease would most probably set its end.

– Self-limiting, self-curable: usually no treatment is needed.

– Ailing and incapacitating: treatment is needed.

– Life threatening or fatal: treatment is needed.

Name of the disease

This is important because it helps in reliably and efficiently preserving and communicating knowledge about disease.

The terms: “natural history of the disease” and “the full blown picture of the disease”, are helpful in presenting the disease as well characterized entity with its unique components and behavior.

In the realm of disease a classification system may be very necessary in order for easy sorting and recall to be in hand. It is anyhow not an easy job to classify diseases at any known or unknown factor, e.g. their causes. As medical practitioners and students we used to have medical terms such as:

– Infectious diseases and noninfectious diseases

– Organic and psychological diseases

– Genetic and acquired diseases

In addition to other terms like trauma, congenital, psychosomatic and constitutional.

From a practical and treatment-wise approach, I would classify diseases into two main classes: biologic and nonbiologic. In the former class some living organism, e.g. a bacterium, a virus, a parasite such as E. histolytica or a worm, is almost certainly accused for making the disease. In such a case the effects of such biologic invasion must be well assessed and specific treatment may be given as appropriate. Such a microbe- or parasite-oriented treatment may be in some cases life saving as the timely diagnosis and treatment are crucial for favorable outcome. For the latter class of diseases, in which such accusation of an invading organism is quite unlikely to bring about the disease, the treatment will be chiefly concerned with combating the illness through general and/ or specific treatments.

Now,     I wish to present a master for patient’s diagnosis that would be comprehensive and elegant as well:

* Moderate jaundice in otherwise apparently normal 3 days female neonate of type 2 diabetic mother for general treatment and investigation.

* Renal colic in other wise apparently normal 6 years boy for general treatment and investigation.

* Moderate fever (38⁰C) in reportedly hypertensive obese; easy taker 49 male adult for specific antibiotic treatment and advisable investigation.

* Slight Albuminuria (+) in otherwise apparently normal; tense taker 19 weeks primigravida, 32 female adult for mandatory weekly-monthly follow up.

This 5-site patient’s diagnosis comprised: 1) patient’s most relevant complaint or finding, 2) patient’s look and/or medical history, 3) patient’s type, 4) suggested treatment, and 5) investigation.

With the expected advancement of disease characterization more molecular designations will be available for common use that would reflect an increasing awareness of molecularly-oriented medicine.