In the previous chapter forty CA were injured and their health estimated. Since injury causes disease, were all of them ill? Or only a few? How to tell? Health is a continuum . Some were healthier and other less. What is then the link between health and disease?
Normal and abnormal
Medicine regards health and disease as complementary. One is either healthy or sick. There is one state of health, and not a continuum Physicians do not know how healthy one is since they lack a health measure like that described in the previous chapter. Any change of structure , is regarded as disease. This requires a definition of a normal reference state or non-disease. Any deviation from the normal is therefore abnormal, or diseased.
There are two ways to define what normal is, . aesthetic, and scientific. Ancient Greek statues, depict normal individuals. Abnormal individuals were generally left out. According to the scientific approach, given a distribution of structure, the mean structure, is normal , and structures which deviate more than two standard deviations from the mean are abnormal, or sick. Prefixes, like normo-, hypo-, or hyper- indicate who is normal. Like in blood pressure. Normo-tension is normal and hypo-tension, and hyper-tension are not.
Disease is thus an arbitrary construct unrelated to health. Let's apply the medical reasoning to our injured CA set. The isolated CA-2 is our normal reference, and we note its esthetic appeal. Being experienced CA-urologists we note also the penis changes in four CA. Each such aberration (disease) deserves a medical name. The numbers on top of the CA are their injury times, and the numbers in brackets, are their health. Two CA marked by t =9, and t =33, are similar to the normal CA but healthier.
Is an important treatise by the French philosopher Georges Canguilhem. Normal and Pathological are arbitrary definitions by physicians, which ought to be avoided. There is a continuum of structural changes, neither of which may be regarded as abnormal. Our organism operates amidst a host of challenges, or injuries, not all of them may cause disease. Yet all initiate a creative response (solution) by WOB. In order to find out which change is a diseases, we have to ask the patient how he feels. If he feels 'dis-eased' he is ill and requires treatment. After all this is how the term disease was conceived. Unfortunately this important wisdom is ignored by medicine which treats structure and ignores health.