Essay on the concept of disease for students

LISHA

Disease
It is defined as any deviation from normal functioning or state of complete physical or mental wellbeing. Disease has several spectrum ranging from mild cases to severe illness. The end result
(outcome) of a disease may be recovery, disability or death.
Concept of causation
Previously, the 'germ theory of disease' was in vogue. According to this, diseases were thought to be
due to specific germ or agent. Now, the concept is that diseases occur due to multiple factors i.e.,
agent, host and environment. These three factors for the epidemiological triad. For example
tubercule occurs not merely due to the presence of tuberculosis bacilli; (agent). Other factors like
poverty, overcrowding, malnutrition etc. (environment) contribute to its occurrence. Also it is known
that multiple factors like excess of fat intake, smoking, lack of physical exercise and obesity are
involved in the causation of coronary heart disease If these factors are known, diseases can be
controlled or prevented by eliminating these factors.
NATURAL HISTORY OF DISEASE
Natural history of disease
Diseases occur due to a complex interaction between host, agent and environment. Natural history of
disease is the study of evolution of disease from the earliest stage of prepathogenesis to its
termination (in the form recovery, disability or death). Every disease has its own natural history. But
it need not be the same in all individuals. Natural history can be established by Cohort studies,
Cross-sectional and Retrospective studies.
Phases
The natural history of disease consists of two phases:
1. Prepathogenesis - the process in the environment
2. Pathogenesis - the process in man
Prepathogenesis
This is the phase before the onset of disease in man. The disease agent has not yet entered man But
the factors needed for its interaction with the human host are already present in the environment.
Potentially, we are all in the prepathogenesis phase of many diseases.
Environment
The causative factors of disease are AGENT, HOST and ENVIRONMENT. These three factors are
referred as epidemiological triad. The mere presence of these three factors is not sufficient to initiate
a disease. An interaction of all these three factors is necessary to initiate the disease process. In
prepathogenesis phase, the disease agent is already present but it has not entered man.
Pathogenesis
This phase begins with the entry of disease agent into man (host). There is a certain interval of time
before the onset of clinical signs and symptoms of the disease. This period is called incubation
period. During this period the disease agent multiplies and induces tissue and physiological changes.

6. metals. This is followed by late pathogenesis when there are clear-cut signs and symptoms. 1. Nutrient agents: They are proteins. protozoa and fungi. ketones etc. gases. drug abuse. radiation etc. 5. alcohol. If the phase of natural history is known. Physical agents: They are exposure to heat. . Biologic agents: They are living organisms such as bacteria. Disease agents may be broadly classified as: 1. vitamins and minerals. Social agents 7. Any excess or deficiency of these nutrients can result in diseases. 4 Chemical agents: They may be a) exogenous (present outside) such as fumes. b) endogenous (produced in the body) such as urea. sprains) and even in death. 3. etc.living substance or the excessive presence or absence of a force which may initiate or perpetuate a disease process'. Mechanical agents: Various mechanical forces may result in injuries (like crushing. Absence or excess of health factors. Chemical agents 5. appropriate level of prevention can be applied. 2. During this period. The disease agent is defined as 'a living or non. Physical agents 4. tearing. unhealthy life-styles. but it is not necessarily the same in all individuals. The final outcome of the disease may be recovery.nutrients etc can lead to a variety of diseases. viruses. cold. smoking. disability or death.Incubation period is followed by early prepathogenesis. 7. Biologic agents 2. dusts. Importance of natural history Each disease has its own natural history. Absence or excess of health factors: Excess or lack of hormones. Mechanical agents 6. Nutrient agents 3. fats. DISEASE AGENTS The first link in the chain of disease transmission is the disease agent. pressure. uric acid. Social agents: They are poverty. electricity. social isolation etc. the signs and symptoms are not clear-cut. carbohydrates.

blood groups. religion. Psychological environment. education. exercise. Physical environment: It refers to non-living things and physical factors such as air. The principle of health education is to change the attitude and false belief of people about diseases. immunological factors etc. 1. Demographic characteristics such as age sex and ethnicity. Control of these biological environments can protect the health of an individual and community. income. Life-style factors such as nutrition. Biological environment: These are the living things which surround man including man himself. radiation hazards etc. habits. moral. occupation. noise pollution. Biological characteristics such as genetic factors. Physical environment 2. light. Biological environment 3. customs. drug abuse. rodents and animals produce a variety of diseases and also transmit them. Living things such as bacteria. These factors also have an impact on health. housing etc. 4. viruses. noise. radiation etc. 2. Environment is classified as: 1. smoking etc. Alteration of physical environment has produced problems such as air pollution. lifestyles etc. 2. Psychological environment: It includes culture. ENVIRONMENT The environment in which man lives is an important factor in the causation of diseases. insects. The host factors are classified as: 1. All these pollutions produce a variety of diseases. 3. water pollution. beliefs. water. enzymes. use of alcohol. 3. attitudes. Social and economic characteristics such as education. .HOST The human host is supposed to be 'soil' and the disease agent as the 'seed'.