Respiratory System Disorders and Therapy From a New - Louis Bolk ...

3.3.3. A Dynamic Concept of Disease
Traditionally, disease is characterized using data that can be substantiated by the physical
exam and supplementary techniques such as x-radiation, laboratory tests, bacteriological/
virological examinations, and others. The dynamic approach of Goethean phenomenology
offers the possibility to develop a dynamic understanding of disease. Diseases are then
described as specific dynamic disturbances of the healthy equilibrium (see also Ch.
5). In health, the body is in homeostasis. In illness, this homeostasis is disturbed. The
disturbance can cause a temporary dysbalance, such as we see in acute disease like
pneumonia. In chronic disease, the persistent disturbance of homeostasis necessitates
the creation of a new setpoint for the equilibrium. A good example of this is the blood
pressure. It normally oscillates around 120/80 mm Hg. This is the healthy balance in
homeostasis that may become temporarily offset by an acute shock. In hypertension, the
bloodpressure oscillates around a new, higher setpoint, for example 160/100 mm Hg.
This is a new, pathophysiological state of homeostasis also called allostasis. In chronic
disease, the healthy balance is chronically offset. The dysbalance has become the new
standard for the organism (fig.3.7.).
In general terms, health and disease can then be described as follows:
Health is a state of homeostasis with an equilibrium that oscillates around a midpoint;
acute disease is a temporary dysbalance of the equilibrium; in chronic disease there is
a persistent dysbalance in which the balance midpoint is reset.
Which type of dysbalance is involved can be indicated for each specific disease. Below is a
schematic representation of the dysbalance in asthma and pneumonia.
Bolk’s Companions RespiRatoRy system DisoRDeRs anD theRapy - 51