WHO DEFINITION OF HEALTH

1
WHO DEFINITION OF HEALTH

• HEALTH IS A STATE OF COMPLETE PHYSICAL ,MENTAL
  AND SOCIAL WELLBEING AND NOT MERELY AN ABSENCE OF
  DISEASE OR INFIRMITY

2
CONCEPT OF SOCIAL MEDICINE IN HOMOEOPATHY

3

• Dr.samuel Hahnemann in his Organon of Medicine
  describes the Social aspect that can influence
  health in 77 and in his lesser writings.

4
77

• Those diseases are inappropriately named chronic,
  which persons incur who expose themselves
  continually to avoidable noxious influences, who
  are in the habit of indulging in injurious
  liquors or ailments, are addicted to dissipation
  of many kinds which undermine the health, who
  undergo prolonged abstinence from things that are
  necessary for the support of life,

5

• Who reside in unhealthy localities, especially
  marshy districts, who are housed in cellars or
  other confined dwellings, who are deprived of
  exercise or of open air, who ruin their health by
  observation of body or mind, who live in a
  constant state of worry,etc. These states of ill
  health , which person 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.

6
Concept of Social factors in preserving health-
Dr.Samuel Hahnemanns view from lesser writings

7

• Dr.Samuel Hahnemann gives a very clear picture
  about the social factors that can decide the
  health of the individuals and the community in
  the chapter titled
• THE FRIEND OF HEALTH

8
Under the subtitle The Bite of Mad Dogs he
wrote

• The part of the skin which, although not broken,
  may have been wetted by the saliva of a dog which
  has become suspicious from having bitten
  others, must be diligently rubbed with potash,
  and washed continually for an hour with the
  solution of the alkali. If a blister be
  afterwards applied to the spot, then all danger
  will be more than warded of.

9

• No dog should be trusted that bites people
  unirritated, and has a gloomy wild expression. It
  is far better to kill too many of these often
  useless beasts, than to allow one actually rabid
  to roam at large mans life is too precious,
  and should be held paramount to every other
  consideration. Merely to shut up for a few days
  dogs bitten by a mad one, is always dangerous, as
  examples are not wanting where they only become
  mad several weeks after being bitten.

10

• They must either be killed, or be kept in safe
  custody for at least four weeks, before they are
  trusted the former must absolutely be done in
  case the dog that inflicted the bite was very
  suspicious.

11
Under the sub title THE VISITER OF THE SICK

• The very probably contagious nature of prevalent
  fevers being conceded, it must be highly
  criminal, at least very imprudent, for the
  healthy lady to sit beside her deadly- sick
  gossip for hours at a time without the slighted
  necessity.

12

• The anxious lady that visit her sick friend
  can do her no manner of good all she can do will
  be to shew her a pocket handkerchief which she
  has moistened with her sympathizing tears,
  irritate her morbid nerves with chattering, help
  to spoil the air of the close sick-room with her
  breath, increase the noise that is often so
  hurtful to patients, disarrange the good order by
  her officious interference, give well meant but
  erroneous advice, and , what is of still greater
  consequence, Carry back the disease with her into
  her own house

13
Under the sub title THINGS THAT SPOIL THE AIR

• Flowers are an ornament to a room, and if we are
  content to deck one room with but a few of
  extreme beauty, and very few, on account of
  their perfume, it will not much signify it is
  rather praiseworthy than blameworthy. The more we
  refresh our senses in an innocuous manner the
  more lively and easy does our power of thinking
  become, the more capable and disposed for
  business are we, and the delight of the sight
  and the smell in flowers, the pried of lovely
  nature, is especially of this character.

14

• But an excess does harm in all things, so it
  does likewise here. A large bouquet of lilies,
  tuberous plants, love- flowers , centifolia,
  jasmine , lilac, and so forth, makes such a
  strong perfume in a small room that many
  sensitive persons have occasionally been made to
  faint by them.

15

• This does not depend so often on the antipathy
  of the nervous system to such odours as it does
  on the injurious property of such strong-scented
  flowers of quickly spoiling the air and rendering
  it unfit for respiration. Other writers have
  already called attention to this fact, so that I
  need not dwell longer on it, and will content
  myself with having repeated the warning.

16

• Six busy watchmakers do not spoil the air nearly
  so much as two workmen engaged in sawing wood. I
  would therefore advise that the workshops in
  manufactories, especially where much corporeal
  exercise is employed, should be built rather too
  high than too low, rather too airy than too
  close, and be they ever so cleanly and well
  situated they should be frequently aired. It is
  incredible in how short a time in such cases the
  air of the room becomes vitiated and unfit for
  respiration. The miserable, sick aspect and the
  great mortality of the workmen of many
  manufactories renders further proof of my
  proposition superfluous.

17

• Poverty has brought many injurious habits into
  this world, one of the worst of which is that
  where persons in the lower ranks of life,
  especially women, sit over a vessel filled with
  red hot charcoal, in order thereby to save
  themselves the expense of a stove in winter. The
  closer the room is shut up in such circumstances,
  and the more the external air is excluded, the
  more dangerous and fatal is this habit, for the
  air inside will thereby soon become a stupefying
  poison

18
Under subtitle PLAN FOR ERADICATING A MALIGNANT
FEVER

• The police officials ought to ascertain where
  any person has been suddenly taken ill in the
  town, or has suddenly complained of headache,
  rigour , stupefaction, or has rapidly become
  very weak and delirious they should report what
  they learn to the appointed physician, who, after
  a rapid but careful examination, during which he
  attends to the directions below for avoiding
  infection, sees that the patient is conveyed to
  the hospital. At the same time the police officer
  receives his fixed remuneration.

19

• The large hall of the hospital should be divided
  longitudinally by means of a partition of
  boards the one part so divided to form the
  patients ward, whilst the other and much
  narrower division forms a kind of passage, into
  which the bedstead of each patient, which should
  be placed on castors, may be pushed through a
  trap-door in the partition, in such a manner as
  that only the patient in the bed shall come into
  the passage, where on the trap- door falls to
  again. Here the physician examines the external
  and internal condition of the patient, in the
  presence of the surgeon, then he causes him to be
  pushed back into the ward, and the next patient
  to be brought forward, and so on.

20

• But before performing this examination, and
  indeed before the arrival of the physician, all
  the windows of the passage should be opened in
  order to air it. Before the patients are brought
  in, they must be closed.

21

• The attendants cook the meals for themselves and
  the convalescents, but they ought to be supplied
  daily with fresh meat and vegetables half a
  pound of the former should be reckoned as the
  daily allowance of each person. The male
  attendants should get about three pints of good
  beer a piece, the females somewhat less

22

• They should get double the amount of the daily
  wages usual in the town. It would be well to
  promise them additional remuneration in the event
  of the happy termination of the epidemic. It is
  inconceivable the power to prevent infection
  possessed by the beneficent emotions, hope,
  content, comfort, c as also by the
  strengthening qualities of good living, and of
  that liquor that is so refreshing to such people,
  beer!

23
Under the subtitle Suggestions For Prevention
Of Epidemics In General Especially In Towns

• When he is removed from prison, his cell must be
  prepared for the reception of future prisoners by
  washing anew the floor, the walls and the roof
  with hot water, and by placing a small stove in
  it, the funnel of which goes out at the window.
  With this the cell is to be heated very highly,
  so that the heat shall almost take away ones
  breath, and then the stove should be again
  removed, supposing it is not allowed to have one
  in the cell.

24

• It is great cruelty to shut up many prisoners
  together without allowing at least 500 cubic
  feet of space and air for each. If this be not
  allowed, the better ones among the prisoners are
  exposed to much annoyance by the bad behavior of
  the worse ones and it is incredible the rapidity
  with which that most destructive of all animal
  poisons, the virus of the most fatal pestilence ,
  is generated. Police authorities, be human!

25

• The low- lying houses that have been inundated by
  the water are a fertile source of epidemic
  diseases. The police authorities must see that
  every householder digs a deep ditch round his
  premises, and especially round his dwelling-
  house that he has all his windows and doors open
  for the greater part of the day that he
  occasionally lights fires even in summer and
  that in winter, at all events before he rises in
  the morning, all the doors and windoes are left
  open for an hour at a time.

26
Under subtitle ON THE SATISFACTION OF OUR
ANIMAL REQUIREMENTS, IN ANOTHER THAN A MEDICAL
POINT OF VIEW

• Man seems manifestly created for enjoyment. This
  is the language of the infant when it cries for
  its mothers breast this is the language of the
  shivering old man as he pokes the fire this is
  the language spoken by the child playing with its
  doll, of the girl eager for the dance, of the
  youth disporting himself in the bath, of the
  matron preparing for the domestic festival, of
  the delighted look of the father returning home
  from his daily work, as old and young run out to
  meet him.

27

• All creation around him is happy and rejoices
  why should man , endowed as he is with finer
  sensibilities, not do so likewise?

28

• Certainly he ought to do so. But in his choice of
  enjoyments and in the quantity of them he
  indulges in, he alone transgresses the bounds of
  moderation he alone of all living beings. No
  animal living in a state of a freedom partakes of
  any food except what is suitable for its nature
  and health it consumes no more than what it
  requires for its well being it drinks not after
  its thirst is quenched rests itself only when it
  is weary and indulges in sexual pleasures only
  when the period for the propagation of its
  species has arrived, and when its matured
  irresistible instinct attracts it to the
  delightful object of its desires.

29

• When we pass the boundary line beyond this
  moderation, as is so frequently the case among
  the higher and middle ranks of society, luxury,
  gluttony and depraved sensuality commence.
  Persons in easy circumstances are apt to imagine
  that the excessively multiplied indulgens in
  excitement of the senses of all kinds is to live
  in the true sense of the word. I have lived
  much says the enervated voluptuary to me it
  seems that he has lived little.

30

• To every human being only a certain amount of
  corporeal enjoyments has been allotted, which his
  nervous system is capable of partaking of and of
  indulging in only to that amount without
  prejudice to the health. The temperate man easily
  discovers these limits assigned to his
  organization by experience uninfluenced by
  partiality, and in the observance of the laws he
  has discovered he is happy, happier than the
  intemperate man can have any idea of .

31

• ROOTS OF HOMOEOPATHY
• IN HEALTH CARE
• SCENERIO IN KERALA

32

• STATUS OF TRADITIONAL AND ALTERNATIVE SYSTEMS OF
  MEDICINE THE HISTORY

33

• Historically, the relationship between modern and
  traditional medicine has taken
• four broad forms A monopolistic situation - in
  which modern medical doctors have the
• sole right to practice medicine (as in most
  developed western countries) a tolerant
• situation - traditional medical practitioners
  although not formally recognized are
• permitted to practice in an unofficial capacity
  (as in some of the developed and
• developing countries, like Canada) a parallel or
  dual health care system - both modern
• and traditional medicine are separate components
  of the national health system (e.g.
• India) and an integrated system - modern and
  traditional medicine are integrated at the
• level of medical education and practice.(e.g.
  Vietnam, China).
• The role of traditional
• systems has been taken seriously in those systems
  where they are integrated with the
• modern systems.

34

• In both industrialized and developing societies,
  use of complementary and
• traditional medicine is on the rise. In
  industrialized countries, the alternative systems
  are
• popular while in developing countries, it the
  traditional systems that are popular apart
• from the modern medicines. Many studies have
  established the increasing use of TAC
• medicines in both developing and developed
  countries. For example, Eisenberg et al.
• (1998) reported a research carried out by Harvard
  University it was found that 30 percent
• of Americans were using alternative systems of
  medicines in 1993, increasing to 40
• percent in 1998 a study by MacLennan et al.
  (1996) showed that 40 percent of
• Australians were using some form of the
  complementary medicines in 1996, which
• increased to 60 percent in 1999 studies on
  various African countries by Bannerman
• (1993), Shiferaw (1993), and Oskowitz (1991)
  showed that traditional medicines cater to
• a large proportion of the health needs in Africa.

35

• The influence of culture which varies from
  society to society in the selection of systems of
  medicines for treatment has been shown by varied
  studies such as that by Vissandjee et al. (1997)
  which showed the role of family structure and it
  s influence in deciding the medicines. Travel
  time and access was found to be important in the
  utilization of traditional systems of medicines
  as found in the studies of Troskie (1997),
• Boerma and Baya (1990), Visandjee et al.
  (1997) and many others.

36

• The gender and age factors were found to be
  important individual factors
• prominent in the choice of health care systems of
  medicines. There is much variation in
• patterns of use of traditional health care
  services across communities, regions, and age
• and gender groupings

37

• \Presently, the Government of Kerala has
  recognized and institutionalised the three major
  systems of medicine that are popular in the
  state Allopathy, Ayurveda and Homeopathy. The
  three
• systems have parallel organizational structures
  in terms of their specific training, research or
• functioning. Since entry into the profession is
  strictly on the basis of medical qualification,
• even the private sector provision of these
  systems is by qualified doctors rather than
  quacks.

38

• This has induced more faith in the people about
  the provision of non-western systems of
• medicine. Keralas government spends on an
  average around 6 percent of its health budget
• on traditional systems. Though large government
  spending and public action is often
• attributed with the credit of better health care
  results in Kerala, the role of non-western
• systems of medicine and traditional health care
  practices are of high importance as well.

39

• Kerala has an adequate supply of health care
  provision in all the three systems of
• medicine - the modern western system, the
  traditional indigenous systems and the western
• alternative homeopathic systems in both public
  and private sectors. Moreover, these
• different systems of medicines not only compete,
  but also complement each other in a
• situation where they are provided for in more or
  less equal balance. Kerala therefore
• provides an appropriate case to extract
  information for policy decisions in integrating
• different systems of medicines.

40
Provision of health care services according to
the systems of medicine

• Though the non-allopathic systems of medicine are
  recognized and
• institutionalised by the government, their
  provision is largely in the private sector. From
• among the Ayurvedic and Homeopathic systems, the
  proportion of physicians employed in
• the government sector has remained at around five
  to seven percent. But it should be borne
• in mind that the Ayurvedic system consists of
  practitioners such as the traditional vaidyans'
• (healers), who were not formally registered with
  any medical council.

41

• Ayurveda and Homeopathy are systems of medicines
  sponsored by the government in dispensaries at
  the primary level and hospitals at the secondary
  level. In the private sector, while Allopathic
• systems are organized into big hospitals, nursing
  homes, and clinics, the Ayurvedic and
• Homeopathic systems are smaller in organization,
  mostly into clinics, barring a few
• hospitals.

42

• An analysis of the private provision of health
  care services by systems of medicines
• shows that only 34 percent of the private medical
  institutions in Kerala (in 1995) were
• allopathic medical institutions, while 39 percent
  were Ayurvedic, and 24.7 percent were
• Homeopathic medical institutions. The share of
  the other systems of medicine (mostly
• Unani, Siddha, etc.) was very marginal. The
  sector with inpatient care (medical institutions
• with beds) is dominated by the allopathic or
  modern systems. The Ayurvedic and
• Homeopathic institutions are mostly of the
  consultation clinic and dispensary types.

43

• In this context, in order to understand the
  impact of these
• provisions in the health care scenario, it is
  important look at the population and
• geographical coverage of these facilities under
  the different systems of medicines.

44

• It shows that there are 20 medical institutions
  each in the
• Allopathic and Ayurvedic systems for 100,000
  people and another 12 in the Homeopathic
• systems. All together, there are 32 medical
  facilities in Kerala in the traditional and
• alternative systems of medicines together
  compared to the 20 in the conventional
• allopathic systems of medicines for one hundred
  thousand populations. This reinforces
• the importance of TAC systems of medicines in the
  provision of health care services in
• Kerala.

45

• Utilization of Health Care Services by Systems of
  Medicines

46

• An estimation made from the data provided
• by government sources show that more than 40
  percent of the outpatients used traditional
• / complementary systems of medicines in the
  government and private sector together

47

• Here again, as seen in the literature, it was
  found that non-allopathic medicines
• were used more for the treatment of chronic
  ailments than for treatment of acute ailments.
• While the modern system is the dominant system of
  medicine used, the use of providers
• among the non-Allopathic systems differed. For
  treating childrens diseases,
• Homeopathic medicines are preferred over
  Ayurvedic as the alte rnative, while the elderly
• use Ayurvedic compared to Homeopathic.

48

• It is evident that people choose different
  systems of medicines according to age,
• illness etc. However, to find out the real
  motives in the choice of a system of medicine, it
• is important to see the reason for their choosing
  a system of medicine

49

• It was found that the modern system of medicine
  was chosen for reasons related to
• illness and access, while the choice of Ayurveda
  and Homeopathy was deliberately made
• for the value of that particular system itself.
  It was evident that the reasons of cost and
• access were not particularly related to the
  choice of a particular system of medicine for
• treatment, which shows that there was not much
  differentiation in access to and costs of
• treatment in modern or traditional or alternative
  systems of medicines.

50

• It was found that for acute illness treatment,
  the non-allopathic system of
• medicine is less preferred compared to the
  chronic illness treatment. The chances of
  nonallopathic
• medicines being used for acute illness treatment
  is less than 30 percent of the
• chances of it being used for chronic illness
  treatment. The chances of using the traditional
• and alternative systems compared to modern
  medicines increase with the increased access
• to them and with lesser distance to travel.

51

• It is interesting to note that the use of
  traditional or alternative systems is more
• probable among the educated compared to the
  lesser educated. It is found that illiterates
• are less likely to use the alternative or
  traditional medicine compared to the graduates

52

• Similarly, the literate or primary
• school educated people are half less than likely
  to use traditional and alternative
• medicines compared to graduates while the high
  school educated have an almost 2/3
• chance of using these medicines compared to
  graduates. These trends are visible with
• regard to the analysis of the choice of Ayurveda
  or Homeopathic medicines separately
• over the Allopathic medicines.

53

• It was found that the reason for choosing the
  non-Allopathic medicines were
• basically due to the importance of the systems
  itself. It was found that the reasons of
• illness characteristics, quality of provision,
  age and gender factors, access related and cost
• related factors had less impact on the choice of
  the system of medicine for treatment

54

• It is also evident that the females are more
  likely to use the non-allopathic
• medicines, be it ayurvedic or homeopathic, than
  the males. The chances of unmarried
• people using Homeopathy were almost double the
  times for the married, which shows
• that for the treatment of childrens disease
  homeopathy medicines are more likely to be
• used.

55
Concluding Observations

• The analysis of the provision and utilization of
  TAC systems of medicines
• compared with modern medicines in Kerala
  highlights the need for management related
• aspects of different systems of medicines in
  different sectors in accordance with the care
• required for illnesses leading to improvement of
  health care of the population.

56

• THANK YOU