Health and disease are two basic States of life activities, which are also recognized by medicine.
Eternal theme. Since its birth, medicine has been devoted to discussing health and disease.
The essence of, and seek the boundary between the two. This trend and efforts, in modern biomedicine,
Learning models tend to be empirical and accurate. But the systematicness and complexity of life phenomena,
It determines that the demarcation between health and disease has great limitations and insurmountable difficulties.
Conditions. How to get out of this dilemma has become a difficult problem faced by contemporary medicine.
1 medical boundary between health and disease
Disease comes with life and is an eternal suffering in the process of human evolution. From the hair
From a biological point of view, human beings know about diseases much earlier than health.
At present, it is generally believed in the history of medicine that there is no distinction between medicine and witchcraft in primitive times. public
About the 5th century BC, inspired and influenced by natural philosophy, doctors in ancient Greece and China.
Learning gradually broke away from witchcraft and began to think rationally about health and disease.
And formed the medical model of natural philosophy. It believes that health and disease are a kind of
Natural process, the dynamic balance of life is called health, and vice versa.
Illness. Therefore, homeostasis and adaptation are the goals of healthy survival of organisms. Gu Xi
La and China medicine have taken the key first step of rational medicine.
The holistic and dynamic outlook on life still has great value in modern medicine.
Although the treatment practice has important strategic significance, it is not feasible. 16
In the 20th century, modern medicine rose on the basis of animal and human anatomy. For the next three years
For more than 100 years, it has relied on natural science theories and technical means such as physics, chemistry and biology.
Understand health and disease, thus forming a so-called biomedical model. This model
There are two remarkable characteristics: one is reductive analysis and accurate location of diseases. that
Second, the physical and chemical explanations of life phenomena and pathological phenomena.
On this basis, the biomedical model establishes the health view and disease view of physiological function.
The concept of disease, that is, the normal state of life body function, is regarded as a necessary condition for health.
Of course, the so-called "normal" is based on the * * * of species, which is statistically significant.
Yes Normality means health, which enables individuals to better complete their generations as a species.
The inherent function of a watch. On the contrary, disease is a disorder or disorder of function, and it is a loss of individuals.
A state in which life activities fail to fully fulfill their inherent species-specific functions.
Clinically, symptoms and signs are the labels of diseases or abnormalities, as well as.
Operating standards for distinguishing health from disease.
The boundary between health and disease in biomedical model, especially the reduction of disease.
Analysis and accurate positioning led to the establishment of a disease-centered medical system. it
① Department of Social Sciences, Guangzhou Medical College, Guangzhou, Guangdong 5 10 182
It has effectively promoted the technical intervention of modern medicine in diseases and greatly promoted mankind.
Health level. However, limited by the mechanistic view of nature, the understanding of biomedical model is one-sided.
The essence of life, the relationship between man and nature, and excessive admiration for reductive analysis.
Therefore, its understanding and demarcation of health and disease has its inherent defects and cannot be surpassed.
The more difficult it is.
2 Dilemma
The criteria for dividing the biomedical model of health and disease include two premises:
First, health and disease are completely opposite poles and can be defined each other;
Second, the judgment about health and disease is a factual judgment, which has nothing to do with value. however
Both of these premises are missing from the perspective of medical knowledge and clinical practice.
Face and arbitrariness.
In the reductive analysis of diseases, the biomedical model emphasizes that diseases are the rights of the body.
React to the harmful effects of pathogenic factors and mark symptoms and signs. 19
The theory of specific etiology established by Pasteur and Koch in the second half of this century is a biomedical model.
It provides the most "classic" concept of diseases: diseases are caused by specific reasons.
Clinical diagnosis unit with specific pathological changes and specific diagnosis groups. Obviously,
It is based on clinical diagnosis and treatment, and pays attention to the outcome of the disease rather than the process.
In fact, the occurrence of disease is a dynamic pathological process, which sometimes takes a long time to progress.
Symptoms and signs will appear. The disease existed before the symptoms and signs appeared.
It is called subclinical disease (or asymptomatic disease). For example: asymptomatic ischemic heart disease
There are no clinical symptoms, but doctors can diagnose them according to ECG. Therefore, simple dependence
Symptoms and signs define that the disease itself is too narrow. More seriously, on the contrary.
Ignoring the dynamic process of life makes him regard health and disease as two sides of the same coin.
With the help of the definition of disease, health is simply defined as "no disease, no disability and no injury". correct
This negative definition of health is reflected in medical practice, that is, the preservation and protection of health.
Neglect health. In this regard, Wilson has an incisive understanding: "We focus on
On the familiar signs of dysfunction, health is interpreted as disease-free, and it tends to exclude the opposite machine.
Can do a good job of person analysis. We know a lot about the abnormal, but we know a lot about the normal.
Very few. So our efforts to prevent diseases and promote functional improvement are put aside.
It is loose "[1] 122 Looking back at history, the ancient Greek medical tradition emphasized the dynamic balance of life as a whole.
Balance, stability and adaptation are the ways to keep in good health. The so-called treatment, the focus is also.
How to promote the recovery of life function or its "natural force" to a certain extent,
Demonstration, precise definition and technical intervention of modern biomedical model for sacrificial diseases
Tradition has gone from one extreme to the other. If we admit this disease,