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Friday, 9 February 2018

Dr. Hahnemann as the father of modern medical hygiene and sanitation

      Dr. Hahnemann as the father of modern                   medical hygiene and sanitation

  Hahnemann, lifestyle diseases, prevention & social medicine: A prelude to the Unsung Hero: 

   Behoves me only to preach upon the greatest of all corporeal blessings, health, which scarcely any take the trouble to seek after, and few know how to value until it is lost..... Samuel Hahnemann. 

Introduction

Lifestyle Disease


 A disease associated with the way a person or group of people lives. Lifestyle diseases include atherosclerosis, heart disease, and stroke, obesity and type 2 diabetes, and diseases associated with smoking and alcohol and drug abuse. Regular physical activity helps prevent obesity, heart disease, hypertension, diabetes, colon cancer, and premature mortality. 

 The term "Lifestyle" simply means 'the way people live'. At the same time, the term also represents a whole range of cultural & social values, behaviors, personal or group habits or attitudes and social/ personal activities. Lifestyle is learned through social interaction with immediate family, community exposure, peer groups, friends, school, place of work and mass media. 

  Lifestyle can promote health through adequate sleep, programmed nutrition, protection at vulnerable times, efficient working environments etc. More often than not, in the current scenario of disintegrating familial structures, technological advancements, globalization, consumerism, substance abuse, competitive working styles etc, they give rise to maintain a plethora of illness. 

Lifestyle Disease can include Alzheimer's disease, Atherosclerosis, Asthma, some kinds of cancer, chronic liver disease or cirrhosis, Chronic Obstructive Pulmonary Disease (COPD), type 2 Diabetes Mellitus, Heart Disease, Metabolic syndrome, Chronic Renal failure, Osteoporosis, Stroke, Depression, and Obesity. The main factors contributing to lifestyle diseases include bad food habits (high in animal products, fat, carbohydrates, less in fibers etc). Substance abuse (ranging from salt, sugar to smoking, alcohol, narcotic substances etc.). Physical inactivity, wrong body posture and disturbed biological clock or biorhythm (for example those working body posture and disturbed biological clock or biorhythm, for example, those working in nights shifts). According to a survey, 60% of all deaths worldwide in 2005, resulted from non-communicable diseases out of which 44% were premature. 

  In a country like India, where traditional still persist, the risk of illnesses and death are connected with lack of sanitation, poor nutrition, poor personal hygiene hence poor maternal and perinatal diseases, elementary human habits, customs and cultural patterns. A report, jointly prepared by the World Health Organization and the World Economic Forum, says India will incur an accumulated loss of $236 billion by 2015 on account of an unhealthy lifestyle and faulty diet. Another survey conducted by the Associated Chamber of Commerce and industry 68% of working women in the age bracket of 21-52 years were found to be afflicted with lifestyle ailments such as obesity, depression, chronic backache, diabetes, and hypertension. 

 Adoption of a healthy lifestyle with a properly balanced diet, regular physical activity and paying due respect to the biological clock is required to prevent or overcome these diseases. To decrease the ailment caused by occupational postures, in recent years, ergonomists have attempted to define postures which minimize unnecessary static work and reduce the forces acting on the body. 

 Dr. Hahnemann on LSD, Prevention & Social Medicine

".. As it is never good to overtax one's strength, he must stop working at 10 o clock, then talk with a friend for an hour and after taking his medicine, go to bed with his head free from ideas from books or other intellectual work, he must walk for three quarters of an hour to an hour every day, but not immediately after a meal, having to rest for three quarters of an hour to an hour first. Without reading, without writing without relaxing, without indulging in leisure, it's impossible for the chronically ill organism to recover even with the most suitable remedies. 

   The Park's Textbook of Preventive and Social Medicine states:

 "The great cholera epidemic of 1832 led... Edwin Chadwick's report on The Sanitary Conditions of the Labouring Population in Great Britain, a landmark in the history of public health, set London 7 other cities slowly on the way to improve housing and working conditions which led to the enactment of Public Health Ac of 1848 in England ". Only a few people in the field of the sciences of Hygiene, public health, town planning, epidemiology and preventive medicine, acknowledge that it was Hahnemann who first placed these branches on scientific bases long before. 

The Friend of Health
 Dr. Hahnemann published two very important articles by the name the "The Friend of Health" in two parts in which he advocated active role of person in health management and recommended the use of fresh air, bed rest, proper diet, state responsibility of health, epidemic management and control measures, occupational hazards, sanitation, public hygiene, hospital management etc. At a time when many other physicians considered them of no value."

Organon Of Medicine

Footnote 1 to 7 Aphorisms

 It is not necessary to say that every intelligent physician would first remove this where it exists; the indisposition thereupon generally ceases spontaneously. He will remove from the room strong-smelling flowers, which have a tendency to cause syncope and hysterical sufferings; extract from the cornea the foreign body that excites inflammation of the eye; loosen the over-tight bandage on a wounded limb that threatens to cause mortification, and apply a more suitable one, lay bare and put a ligature on the wounded artery that produces fainting; endeavor to promote the expulsion by vomiting of belladonna berries, etc. that may have been swallowed; extract foreign substances that may have got into the orifice of the body(the nose, gullet, ears, urethra, rectum, vagina); crush the vesical caclculus, open the imperforate anus of the new-born infant, etc. 

Aphorisms 77:

Those diseases are appropriately named chronic which persons incur who expose themselves continually to: 
. Avoidable noxious influences
. The habit of indulging in injurious liquors or ailments
. Dissipation of many kinds which undermine the health
. Undergo prolonged abstinence from things that are necessary for the support of life
. Reside in unhealthy localities, especially marshy districts, who are housed I cellars or other confined dwellings
. Are deprived of exercise on of open air
. Ruin their healthy by over-exertion of body or mind. 
. Live in a constant state of worry etc. 

 These states of ill-health, which persons bring upon themselves disappear spontaneously, provided no chronic miasm lurks in the body, under an improved mode of living, and they cannot be called chronic diseases. 

Aphorisms 94:

  While inquiring into the state of chronic diseases, the particular circumstances of the patient with regard to his ordinary occupations, his usual mode of living and diet, his domestic situation, and so forth, must be well considered and scrutinized, to ascertain what there is in them that may tend to produce or to maintain disease, in order that is their removal the recovery may be promoted. 

Aphorisms 204:

 If we deduct all chronic affections, ailments and diseases that depend on a persistent unhealthy mode of living, as also those innumerable medicinal maladies caused by the irrational, persistent, harassing and pernicious treatment of disease often only of trivial character by physicians of the old school. 

Aphorisms 208:

 The age of the patient, his mode of living and diet, his occupation, his domestic position, his social relations and so forth must next be taken into consideration, in order to ascertain whether these things have tended to increase his malady, or in how far they may favor or hinder the treatment. In like manner the state of his disposition and mind must be attended to, to learn whether that present an obstacle to the treatment or requires to be directed, encouraged or modified. 

Aphorisms 224:  Role of Psychotherapy:

If the mental disease not quite developed. the result from faults of education, bad practices, corrupt morals, neglect of the mind, superstition or ignorance; the mode of deciding this point will be that if it proceeds from one or other of the latter causes it will diminish and be improved by sensible friendly exhortations, consolatory arguments, serious representations and sensible advice, whereas a real moral or mental malady.

Aphorisms 225: Psycho-somatic ailments

 There are, however, as has just been stated, certainly a few emotional diseases which have not merely been developed into that form out of emotional diseases, but which, in an inverse manner, the body being but slightly indisposed, originate and are kept up by emotional causes, such as continued anxiety, worry, vexation, wrongs and the frequent occurrence of great fear and fright. This kind of emotional diseases in time destroy the corporeal health, psychosomatic degree. 

Aphorisms 226:

 It is only such emotional diseases as these, which were first engendered and subsequently kept up by the mind self, that, while they are yet recent and before they have made very great road the corporeal state, may be means of psychical remedies, such as a display of confidence, friendly exhortations, sensible advice, and often by a well-disguised deception, be rapidly changed into a healthy state of the mind (and with appropriate diet and regimen, seemingly into a healthy state of the body also). 

Aphorisms 238: Fever due to unhealthy environment

 This return of the same fever after a healthy interval is only possible when the noxious principle that first caused the fever, is still acting upon the convalescent, as is the case in marshy regions. Here a permanent restoration can often take place only by getting away from this causative factor, as is possible by seeking a mountainous retreat if the cause was a marshy fever. 

Aphorisms 244: Endemic Fevers

 The intermittent fevers endemic in marshy districts and tracts of the country frequently exposed to inundations. it sometimes happens that when these patients exchange, without delay, the marshy district for one that is dry and mountainous, recovery apparently ensues if they are not yet deeply sunk in disease, that is to say, if the psora was not completely in them and can consequently return to its latent state, but they will never regain perfect health without antipsoric treatment. 


Aphorisms 260: 

 Coffee, fine Chinese and other herb teas, beer prepared with medicinal vegetable substances unsuitable for the patient;s state, dishes of herb, roots and stalks of plants possessing medicinal qualities, old cheese, and meats that are in a state of decomposition, or that possess medicnal properties, ought just as certainly to be kept from pateints as they should avoid all excesses in food, and in the use of sugar and salt, as also spirituous drinks, undiluted with water, heated rooms, woolen clothing nest the skin, a sedentary life in close apartments, or the frequent indulgence in mere passive ezercise (such as riding, driving or swinging), prolonged sucking, taking a long siesta in a recumbent posture in bed, sitting up long at night, uncleanliness, unnatural debauchery, enervation by reading obscene books, reading while lying down, onanism or imperfect or suppressef intercourse in order to prevent conception, subjects of anger, grief, or vexation, a passion for play, over-exertion of mind or body, especially after meals, dwelling in marshy districts, damp rooms, penurious living, etc. All these things must be as far as possible avoided or removed, in order that the cure may not be obstructed or rendered impossible. Some of my disciples seem needless to increase the difficulties of the patient's dietary by forbidding the use of many more, tolerably indifferent things, which is not be commended. 

Aphorisms 261: 

 The most appropriate regimen during the employment of medicine in chronic diseases consists in the removal of such obstacles to recovery, and in supplying where necessary the reverse, innocent moral and intellectual recreation, active exercise in the open air in almost all kinds of weather(daily walks, slight manual labor), suitable, nutritious, unmedicinal food and drink. 


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