The concepts of Illness and Disease

Note: These concepts, first published in 2011, have led to the book: Healthicine: The Arts and Sciences of Health and Healthiness which expands on them in detail.

As we live, and love, and work to understand and improve our health, we encounter illness and disease. We should take some time to understand the concepts and causes of illness and disease. What is disease, what causes illness?

It's always worthwhile to check the dictionary - and you can spend a lot of time checking different dictionaries and definitions.  I'll stick with Merriam-Webster.

Disease: trouble (obsolete); a condition of the living animal or plant or one of its part that impairs normal functioning and is typically manifested by distinguishing signs and symptoms; a harmful development (as in a social institution).

Illness: wickedness and unpleasantness (obsolete); an unhealthy condition of body and mind.

So, illness and disease can range from unhealthy bodily state, like a minor temporary dehydration caused by exercise, to a disease like cancer - which can kill an individual, to contagious disease that spreads through a population, to the diseases of crime and intolerance which can affect an entire society.  The word illness seems a bit more restrictive - but I'll use both interchangeably.

What is the cause of disease?

The generalized cause of all disease, is a deficiency or an excess. Although this might seem trivial, it is an important concept to the understanding of health and disease.

We can see in the image, that the defined transition from health to disease is very gradual.  The distinction moves very gradually from healthy to deficient, or from healthy to excessive. Of course a specific illnesses like a gunshot wound (excessive physical stress), can occur very quickly in time.
The specific cause determines the type and affects the severity of the disease.

A primary illness is one that has a single cause. A secondary illness is an illness that has two sequential causes, where the second cause is enabled by a primary illness. A complex illness is one that has more than one cause.

Another important distinction is the definition of a 'medical condition', which is diagnosed by a doctor based on  specific symptoms and signs.  A 'medical condition' is an illness or disease that passes a specific level of severity.  Note: Merriam-Webster does not define medical condition, an online search for medical condition takes you to the definition for disease. This a slightly different diagram shows the significance of a medical condition.

Note added Dec 30, 2011 "You can see in the above diagram that health includes, and is larger than illness."

To illustrate the variability of illness, you might have a gunshot wound through the tip of your fingernail - an insignificant illness for most of us, to a gunshot wound scraping the skin, requiring a band-aid, to a flesh wound, requiring a diagnosis and treatment by a physician, to a mortal wound. Each is an excess of physical stress, from minor to fatal. A medical condition does not formally exist until a physician makes a diagnosis.

In my blog, I often use the term 'wide grey' to define the gradual shading change seen as we gradually move from perfectly healthy to a serious state of deficiency or excess. I've deliberately used a gunshot wound to demonstrate the transition, and also to give an example of an illness that is very visible throughout the transition.  A medical condition is not a gray-scale.  It must be diagnosed, so there is a hard line where the existence of a medical condition is created by a physician.

It is unlikely that you would have the symptoms of a gunshot wound and not know the cause. There are many symptoms of illness where you do not know the cause.  And unless you are diagnosed by a physician, you might not know the name of the illness.

What is a symptom?  Merriam-Webster is a bit confusing on this definition: subjective evidence of disease or physical disturbance; broadly : something that indicates the presence of bodily disorder; a slight indication. I say it is confusing for two reasons.  Merriam-Webster's definition does not seem to recognize 'objective symptoms', which doctors generally seek for a more accurate diagnosis.  Also, it appears to restrict symptoms to indications of 'bodily disorders', thus excluding mental disorders, social disorders, etc. Although the third definition is vague and general enough to cover everything, perhaps even the symptom of dawn light as a symptom of the coming sunrise.

From the health point of view, a symptom is an indication that health is less than optimal.  Your health might be less than optimal - without symptoms.  However, once you experience, or someone, for example a doctor, detects something indicating that your health is less than optimal - that something is a symptom.

The hierarchy of health defines the layers and components of health from an overall view. Each component of health can range from perfectly healthy to deficient or excessive.

Many illnesses, in minor or severe states, have similar symptoms.  One of the most common symptoms is irritation or pain. It is important to remember that even the absence of pain can indicate an illness. Our sensations of irritation and pain can range from deficient to healthy to excessive.

As a result of the many hundreds, perhaps thousands of health components, and the overlapping of symptoms of illness, determining the cause of an illness is very complex.

Physicians can, and often do, diagnose the name of the illness, and prescribe treatment - without determining the cause.  Treatment, especially in an emergency situation, is more important than understanding the cause.

Identifying the cause is primarily useful for prevention of illness and disease.

What is the difference between healthiness and illness?

I view health as a natural state. And illness as an unnatural state.  And the transition, or wide grey area between health and illness as the way to measure health. It is important to measure health in order to study health scientifically.  Most of today's 'studies' of health are actually studies of illness - a powerful perspective to deal with illness, but a very weak perspective to understand health.

Perfect health is unattainable. The WHO (World Health Organization) definition of health is not useful to understand health, because it defines 'perfect health', saying "Health is a state of complete physical, mental and social well-being..."  This state cannot be attained.  Health must be measured. WHO spends lots of time and energy measuring illness - but health is not measured.  I believe this is partly because the WHO definition of health does not encompass the ability to measure health.

Because perfect health is unattainable - we can always measure the health of any health component, the health of an individual and even the health of a community.

Health is measured as between 100 (perfection) and zero (non-existent).  Health is the good stuff...

Illness is measured the other way. Illness is measured as zero (non-existent) to 100 (a confirmed diagnosis).  Illness is the bad stuff.

Are healthiness and illness opposites, or opposite ends of the same scale of life?  I don't look at it that way.  Our medical systems focus entirely on illness.  Only illness is measured, diagnosed and treated. Health is ignored, as if it only exists in perfection and as if nothing can be learned from studying health.

We should not confuse the good stuff (health) with the bad stuff (illness and disease).

I believe we must study health, separately from illness - to learn about health and improve our health.

That, in a nutshell, is the mission of this blog.  We need personal health freedom so that we can study health, learn about health, understand health better, and experience and improve our health as a result.

to your health,
tracy

Tracy is the author of two book about healthicine: 

www.personalhealthfreedom.com 

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Primary Illness and direct causes of illness

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Some illnesses are complex, the result of multiple causes. However, many are simple or trivial to understand, although they might not be trivial to treat or cure. Simple, or primary illnesses are those that have a single cause. The value in understanding these illnesses is in our ability to prevent them, once we understand the cause.

Secondary illnesses are illnesses that have sequential causes.  Complex illnesses are those that have multiple causes.

The basic primary illnesses flow right out of the hierarchy of health.  Because each of the layers in the hierarchy is dependent on the health of the layer below, a health deficiency, or excess in one layer can cause an illness in a higher layers, in other components of the same layer - and even, in exceptional circumstances in layers below.

So, the first list of primary causes of illness is the list of components in the hierarchy of health: genetics, nutrients, cells, tissues, organs, systems, body, mind, spirit and community - in deficiency or excess.

If this list seems short, remember that nutrition alone has over 100 components that are critical to health. We don't have a comprehensive list for nutrients. Nor do we have a comprehensive list for cells, when we recognize that some of the cells essential to health are bacteria that contribute to health.

A specific deficiency in nutrition might cause scurvy - which affects cells, bones, organs and systems, but only when it becomes severe.  Before that point, it is just a deficiency.

Technically, an illness is something that can be diagnosed, and sometimes treated. A simple excess or deficiency might not be sufficient to cause an illness.  There must be significant severity, and possibly duration, for an illness to develop and be diagnosed.

To this list, we can add other deficiencies and excesses.  A deficiency, or excess of growth can lead directly to illness.  There may be a 'deeper cause' of the growth deficiency or excess, making the illness a 'secondary illness', caused by one health issue, which caused another health issue. However, if the excess growth leads directly to the illness - it can be classified as a direct cause of illness, even it it is not the primary cause. In this case, the illness does not have a primary cause.

A primary cause of illness exists when a single deficiency or excess is the only cause of an illness. Vitamin C deficiency is the primary cause of scurvy.  A bullet in the shoulder can be the primary cause of a flesh wound.

A direct cause of illness exists when a single deficiency or excess is directly responsible for the illness. If that cause had prevented, or removed removed in time, the illness would not have occurred.

All primary causes of illness are direct causes of illness. Direct causes are not necessarily primary causes.

Can we create a list that categorizes all primary causes of illness? All direct causes of illness?  I don't know, but I have created a list that covers a majority.  I'll be happy to add to the list if you can tell me something I've missed.

Each individual cause of illness, primary, direct, or secondary is the deficiencies and excesses of some component of health. To the list of health components from the hierarchy of health, we should add:

The six senses: vision, hearing, touch, smell, taste and balance. A deficiency or excess of any of these senses may indicate illness and may cause further illnesses.

Pain: a deficiency or excessive ability to feel pain may indicate illness and may cause further illnesses.

Growth: a deficiency or excess of growth may indicate illness and may cause further illnesses.

Healing: a deficiency or excess of healing which includes the immune system, repair systems and growth systems may indicate illness and may cause further illnesses.

Stress: a deficiency or excess of stress may indicate illness and may cause further illnesses.

Like the components of health, each of these causes of illnesses is necessary to health. Illness appears when they are deficient, or when they are in excess.

With any illness, if we can clearly identify a single direct cause, we can work directly to prevent and possibly to cure the illness.

Primary prevention (or direct prevention) of illness is an action that directly tackles the primary causes of illness.   This is a fundamental health concept of prevention.

However, take care when reading the latest health news.  You might read that red wine has been shown in statistical studies to prevent heart disease.  Ask yourself, is this a primary prevention?  Does it prevent specific types of heart disease - those caused by a deficiency of red wine, in every case?  If so, then it is a primary preventative. If not - it is a statistically possible preventative but not a primary preventative.

This important concept, of primary, or direct illness, and primary or direct preventatives is very powerful.  If we have a primary preventative - then searching health for the hint of an illness - before a full blown illness develops, might be combined with the preventative to eliminate cases of the illness.

This can be especially effective for any illness where a cause results in minor health issues in the short term - but serious issues in the long term.

At present, we tend to focus our 'health' care on diagnosed illness, not on health.  So we tend to ignore causes that take a long time to develop into a diagnosed illness.  I'm not discussing 'cancers caused by smoking'.  Rather, I'm wondering what illness might be caused by a low level deficiency of a single nutrient, or a combination of nutrients - when the deficiency exists for years or decades.

We need a better understanding, and better studies of primary illnesses and direct illness so we can learn more about health - and how to improve health.  With this understanding we might learn the causes of some illnesses that are mysteries today.

Yours in health,
tracy

Tracy is the author of two book about healthicine: 

www.personalhealthfreedom.com