TOPIC: A object, subject, tasks of the general pathology. The basic concepts of a pathology: illness, etiology, pathogeny

1. Object, a subject, structure of the general pathology.

2. The basic concepts of the general pathology: etiology, pathogeny, preillness, illness, pathological process, a pathological condition, pathological reaction.

3. A role of the reasons and conditions in occurrence of illnesses

1. Physiopathology is the science studying broken functions of a sick organism and putting task finding-out most of the general laws of occurrence, current and an outcome of disease. It concerns to medical and biologic sciences, connecting biological sciences (biology, biochemistry, anatomy, histology, physiology, etc.) with clinical disciplines (therapy, pediatrics, surgery, neurology, etc.).

Physiopathology is a section, a part of medicine - the sciences, the having main task, on the one hand, preservation and strengthening of health of the person, and with another the prevention of illnesses and treatment fallen ill. The medicine has arisen on a joint natural and social sciences (disciplines) and will consist of a science about health and a science about illness (pathology).

The consept " pathological physiology " for the first time used L.Gailliot, the textbook let out in 1819 under the name " the General pathology and pathological physiology " (" Pathologie general et physiologie pathologique "); R.Virhov (1947) used this consept, and has ratified its V.V.Pashutin, having issued " Lectures on the general pathology (pathological physiology) ".

Physiopathology as well as any other science has the subject and the method of studying.

Object of research physiopathology is the sick organism, and as a subject of studying serves:

- First, finding-out of the general and individual (concrete) mechanisms underlying resistency of an organism, occurrence, development and end of pathological processes and illnesses;

- Second, studying of typical pathological processes, which various combination defines a clinical picture of various diseases;

- Thirdly, revealing specific to separate bodies and systems of typical forms of infringements of functions and their restoration.

Thus, the subject physiopathology makes set of the knowledge which has been saved up at studying of essence of illnesses, the reasons and conditions of their occurrence, mechanisms of development and overcoming, and also set of knowledge of the basic components of illness (an inflammation, a fever, hypoxia, infringement of a metabolism, etc.) and the major laws of damage of separate bodies and systems.

General physiopathology includes the general nosology (the doctrine about essence of illness), forming the basic concepts and categories of the pathology, creating classifications and the nomenclature of illnesses and studying social aspects of a pathology; the general etiology - the doctrine about the reasons and conditions of occurrence of illness and principles preventive maintenance and therapy; the general pathogeny - the doctrine about mechanisms of stability, the general mechanisms of development of illness, mechanisms of recovery and dying and about principles of pathogenetic preventive maintenance and therapy; and also the doctrine about a heredity, constitutions and reactance.

- Individual pathogeny which studies mechanisms of separate pathological reactions, processes, conditions and diseases (nosological units). Individual pathogeny clinical physicians, opening the mechanism of concrete diseases at concrete patients (for example, pathogeny a diabetes study, pneumonias, a stomach ulcer of a stomach, etc.). Individual pathogeny concerns to concrete nosological forms.

- The general pathogeny assumes studying mechanisms, most the general laws underlying typical pathological processes or separate categories of illnesses (hereditary, oncological, infectious, endocrine, etc.). The general pathogeny is engaged in studying The mechanisms resulting in functional insufficiency Any body or system. For example, the general pathogeny. Studies mechanisms of development of intimate insufficiency at patients with a pathology of cardiovascular system: at heart diseases, a heart attack of a myocardium, ischemic illness of heart.

The general and individual pathogeny are closely connected with each other as opening and generalization of the general laws probably only on the basis of the analysis of individual forms of a pathology, and the doctrine created on this basis about the general pathogeny is used at disclosing mechanisms of concrete diseases and individual forms of their current.

Studying pathogeny is reduced to studying so-called pathogenetic factors, i.e. those changes in an organism which arise in reply to influence the etiological factor and further play a role of the reason in development of illness. The pathogenetic factor causes occurrence new: frustration of ability to live in development of pathological process, illness.

2. Before to give modern definition of concept "illness", it is necessary to define, that such "norm", "health", "preillness".

The category "norm" in biology and medicine is an optimum of functioning and development of an organism or set of biochemical, functional and morphological properties of the organism expressing optimum realization in the given individual of a specific genotype. Complexity in definition for each individual of criteria of norm, i.e. specifications, is connected to necessity to take into account age, a sex, the constitution, a racial accessory, area of residing, professional work, a feed, etc.

Definingvarious parameters of functioning of various bodies and systems of the person and comparing them with normative, it is possible to speak that the person is healthy or sick.

Frequently this concept define with various additions as absence of illness. Examples of these definitions:

" Health - a condition of full physical, sincere and social well-being, and not just absence of illnesses and physical defects ".

K.Marks - " Health is a set of physical and spiritual abilities which the organism has, the alive person of the person ".

N.N.Zajko - " Health is first of all a condition of an organism in which conformity of structure and function is marked, and also ability of regulatorial systems to support a constancy internal environments (homeostasis) ".

A.D.Ado - " Health or norm is the existence admitting the most full participation in various kinds of public and labour activity ".

Thus, the basic criteria of health are:

Steadiness of an organism with an environment,

Conformity of structure and function,

Ability of an organism to support a homeostasis,

High-grade participation in labour activity.

At " diagnostics of health ", no less than at revealing illness, a number of researches and measurements, comparison of the received results to norm is carried out. Thus, without concept of "norm" representation about health is impossible, i.e. health is a normal condition of an organism.

At action of some pathogenic factors allocate the period in ability to live of an organism which is characterized by sharp decrease in its adaptable opportunities at preservation of a constancy of the internal environment (homeostasis) - the question is preillness as a condition of an organism on the verge of health and the illness, able to proceed in the expressed form of any illness, or after a while to end with normalization of functions of an organism.

The consept "preillness" as though postulates, that occurrence of illness is preceded always with a state of health. Thus, preillness is a life of the organism faulty at which or appreciablly it is not reduced biological or social adaptation due to mobilization of adaptive mechanisms, or decrease in adaptation is shown only at interaction with separate factors of an environment which can be avoided.

R.M.Baevsky and V.L.Karpman is allocated with two phases of preillness:

I The phase is characterized by prevalence of nonspecific complaints at practically safe serviceability. In this phase of preillness infringement of a homeostasis occurs at a level of information and power processes that reduces adaptable opportunities of an organism.

II The phase of preillness is characterized by specific changes with the precise address of the future disease. Here anatomy and morphological structures in which alongside with metabolic there are already structural changes are well defined. It also is preillness in its clinical sense, area of conditions in an interval between health and illness where there is a transition of quantitative changes in qualitative, transition etiological factors in pathogenetic.

Preillness can be considered as the probability of disease realized by an organism which is caused by influence of external factors and decrease in adaptable opportunities of an organism. Decrease in functionalities of an organism does adaptation imperfect.

The consept illness is used in narrow sense for a designation of separate concrete diseases, in wider for a designation of the certain biological phenomenon, special forms of ability to live of an organism.

Various definitions of the term "illness" are offered many:

1. K.Marks - " Illness is the life constrained in freedom ".Р.Вирхов - " Illness is a life under abnormal conditions ".

I.V.Davydovsky - " Illness is the adaptation of an organism described by specific forms and levels of adaptive activity ".

A.D.Ado - " Illness is a life of the damaged organism at participation of processes of indemnification of the broken functions. Illness reduces work capacity of the person and is qualitatively new process ".

N.N.Zajko - " Illness is infringement of normal ability to live of an organism at influence on it damaging agents therefore its adaptive opportunities " go down.

From the resulted definitions of concept "illness" follows, that:

- The reasons of illnesses are pathogenic factors of the external or internal environment, and the leading part in occurrence of illness belongs to factors of an environment even if it and concerns hereditary diseases;

- For illness insufficiency of adaptive reactions of an organism is characteristic. They can even be significant strengthened, but are insufficient for maintenance of balance of an organism with an environment;

- Illness is characterized by decrease in work capacity and social utility of the person. Short-term decrease in work capacity owing to overfatigue, and also last months pregnancy should not count reduction of social utility of the person. It is necessary to mean, that downturn of work capacity as the attribute of disease, is not characteristic for illnesses of children and old men.

So, illness is the original vital process arising under influence of nocuous factors working on an organism and expressing in a complex of structurally functional and metabolic changes, and also infringement of functions and adaptability, restriction of serviceability and social - useful activity.

N.I.Losev defines the following of illness: " Illness is the dynamic condition of an organism described by infringements of normal current of vital processes, resulting to decrease in biological and social opportunities of the person ".

Дата добавления: 2014-01-13