Dr Puneet Kumar Misra
Aim – The aim of article is to present the depth and width of stress/strain of stimuli on Constitution /Structure of human body
Need of subject – This is traditional concept stress pertain to the mental disorder
All organism include unicellular to multicellular formed by the constitute of cell. Cells makes tissue, tissues makes organ, organ makes system and system constitute the body of organism .but when we carefully see then we found that each cell of each system have their own anatomical as well physiological peculiarities or differentiation To perform activity of system to maintain the existence of the organism. something made up of arranged parts being held together in a given way such as organ or manner of arrangement of the parts that constitute a whole the makeup or the functional habit of the body, determined by the genetic, biochemical and physiological endowment of the individual and modified in great measure by environment factor .
This is a state of physiological or psychological strain caused by adverse stimuli physical, Mental, emotional, internal or external that tends to disturb the functioning of an organism and which the organism desires to avoid. Stresses of different types may induce changes in cells and tissues other than typical adaptations,cell injury and death. Metabolic derangements in cells and sub lethal, chronic injury may be associated with intracellular accumulations of a number of substances, including proteins, lipids, and carbohydrates. Most injurious stimuli produced the physical stress can be grouped into the following broad categories.
1) Physical Agents. 2) Chemical Agents and Drugs. 3) Infectious Agents. 4) Immunologic Reactions. 5) Genetic Derangements 6) Nutritional Imbalances 7) Environmental
Physical agents capable of causing cell injury include mechanical trauma, extremes of temperature (heat stroke, burns, deep cold and frost bit), sudden changes in atmospheric pressure & sun radiation.
Simple chemicals such as glucose or salt in hypertonic concentrations may cause cell injury directly or by deranging electrolyte balance in cells. Even oxygen at high concentrations is also toxic. Other potentially injurious substances are our daily companions: environmental and air pollutants, insecticides, and herbicides; industrial and occupational hazards, such as carbon monoxide and asbestos; recreational drugs such as alcohol; and the ever-increasing variety of therapeutic drugs.
Infectious Agents range from the submicroscopic viruses to the large tapeworms. In between are the rickettsiae, bacteria, fungi, and higher forms of parasites. These biologic agents capable of causing cell injury.
The immune system serves an essential function in defense against infectious pathogens, but Immune reactions of body from many external agents, such as microbes and environmental substances, are also important causes of cell injury .
Nutritional imbalances continue to be major causes of cell injury. Nutritional problems can be self-imposed, nutritional deficiency/excesses have also become important causes of cell injury
Environment Many diseases can be caused or influenced by environmental factors. Broadly defined, the term “environment” encompasses the outdoor, indoor, and occupational environments in which we live. In each of these environments the air we breathe, the food and water we consume, and the direct exposure to toxic agents are major determinants of the health of the population
Ageing The normal process of aging itself is accompanied by characteristic morphologic and functional changes in cells. Ageing is defined as a progressive generalized impairment of function resulting in the loss of adaptive responses to stress and a growing risk of age-associated disease
Cell injury and Adaptations
Adaptation are reversible functional and structural responses to more severe physiologic stresses and some pathologic stimuli, during which new but altered steady states are achieved, allowing the cell to survive and continue to function. Virtually all forms of disease start with molecular or structural alterations in cells under the effect of physiologic stresses and some pathologic stimuli. When the stress is eliminated the cell can recover to its original state without having suffered any harmful consequences If the limits of adaptive responses are exceeded or if cells are exposed to injurious agents or stress, deprived of essential nutrients, or become compromised by mutations that affect essential cellular constituents, a sequence of events follows that is termed cell injury. Cell injury concept first put forth in the nineteenth century by Rudolf Virchow, known as the father of modern pathology. We therefore begin our consideration of pathology with the study of the causes, mechanisms, and morphologic and biochemical correlates of cell injury. Injury to cells and to extracellular matrix ultimately leads to tissue and organ injury, which determine the morphologic and clinical patterns of disease. called homeostasis. Cell injury is reversible up to a certain point, but if the stimulus persists or is severe enough from the beginning, the cell suffers irreversible injury and ultimately cell death. Adaptation, reversible injury, and cell death may be stages of progressive impairment following different types of insults. The adaptive response may consist of an increase in the size of cells (hypertrophy) and functional activity, an increase in their number (hyperplasia), a decrease in the size and metabolic activity of cells (atrophy), or a change in the phenotype of cells (metaplasia). The adaptive response may consist of an increase in the number of cells, called hyperplasia, or an increase in the sizes of individual cells, called hypertrophy. Conversely, atrophy is an adaptive response in which there is a decrease in the size and function of cells. The end results of genetic, biochemical, and structural changes in cells and tissues are functional abnormalities, which lead to the clinical manifestations (symptoms and signs) of disease, as well as its progress (clinical course and outcome).
‘HIERARCHY OF SYSTEMS’ APPLIED TO ISCHAEMIC HEART DISEASE
Level in the hierarchy Example of effect
- Molecular ApoB mutation causing hypercholesterolaemia
- Cellular Foam cells accumulate in vessel wall
- Tissue Atheroma and thrombosis of coronary artery
- Organ Ischaemia and infarction of myocardium
- System Cardiac failure
- Person Limited exercise capacity, impact on employment
- Family Passive smoking, diet
- Community Consumption of health service resources
- Population Major cause of mortality and morbidity
- Society Policies on smoking, screening for risk factors
- Ecology Agriculture influencing fat content in diet
from Davidson Principal & practice of medicine 20th Edition page 95
On the above-mentioned definitions are much important
- Because when we observed above words structure/ constitution and stress/strain we image the superficial effect and try to see on the exterior of organism body and which impressions are seen on the exterior and we try to conclude the alteration and in most of the cases over thought is this that stress is a phenomena which mainly effected the state of brain particularly mental disorder
- But when we broadly study the effect of stress or strain on the Constitution /Structure then we found that some stimuli give the stress which feels the organism and few stress are unnoticed but both stress leaves the effect on the body.
- The normal cell is confined to a fairly narrow range of function and structure by its state of metabolism, differentiation, and specialization; by constraints of neighboring cells; and by the availability of metabolic substrates. It is nevertheless able to handle physiologic demands, maintaining a steady state.
- Severe physiologic stresses and some pathologic stimuli may bring about a number of physiologic and morphologic cellular adaptations, and it is rare peculiar phenomena for the body and which lead to the clinical manifestations (symptoms and signs) of disease.
- Which new but altered steady states are achieved, preserving the viability of the cell and modulating its function as it responds to such stimuli..
- Davidson Principal & practice of medicine 22nd Edition
- Harrison’s PRINCIPLES OF INTERNALMEDICINE 7th Edition
- Robbins and Cotran pathologic basis of disease. – 8th Edition
- Essentials of Rubin’s Pathology, 5th Edition
- Allen H.C- Keynotes and characteristics with compression of some of the leading remedy of materia medica.
- Boericke – Pocket manual of Homoeopathic meteria medica with repertory.
- Kent – Lecture on materia medica with new remedy.
- Kent – Repertory (Expended).
- KENT –Lectures On Homoeopathic Philosophy
- Organon of Medicine by R E Dudgeon & W Boericke (fifth &sixth edition combined) 5th aphorism
- Organon of Medicine by W Boericke(sixth edition) 5th aphorism