HOPMA (in biology and medicine)

From Big Medical Encyclopedia

At all stages of development medicine (see) the steadiest there was N.'s understanding as standard, typical option as ideal sample. Distribution of the ideas of cybernetics and consideration of live organisms in quality biological system (see) generated idea of N. as an optimum of functioning and development of an organism.

Initial ideas of N. were connected with the general system of the mythological thinking interpreting harmony of the world and its destruction as result of influence of demonic supernatural forces. Such approach to N.'s understanding throughout many centuries was expressed in diverse forms of religious and idealistic concepts of the nature person (see).

Philosophical definition of N. was for the first time given by Ancient Greek thinkers, to-rye brought her out of category of a measure as the generalized expression of beauty, harmony, stability, usefulness, balance of elements. Aristotle considered N. and pathology in their unity. For it ugliness is an extreme manifestation of variability live. It arises not contrary to the nature, and contrary to only the majority of the natural phenomena.

In medieval medicine religious interpretation of N. as unattainable harmony of divine perfection of the person dominated. Close attention of doctors to studying of harmonious forms of the person brought into Renaissance to blossoming anatomy (see).

Studying of an anatomic structure of a human body promoted formation of idea of N. as special type of the morpho-physiological organization of the person. At the same time pathological was such sign, to-ry does not occur at the majority of individuals of this look.

According to typological representation of N. as N.'s identification with typical, standard, usual or average was widely adopted a nek-ry sample in medicine.

At the end of 19 century Yu. Kongeim suggested to define N. as the fact that «it is peculiar to the majority of individuals». The typological understanding of N. gained further development in connection with use in hmeditsinsky science of means of variation statistics.

It is undoubted that under certain conditions, especially during the studying of the mass phenomena, N.'s identification with typical, average option makes real sense. However still A. A. The pilgrim noted that if to canonize and absolutize average aspect of N., then it should recognize that he for Hindus is normal to die of cholera and plague in immeasurably bigger number, than to the British living in the same areas.

Normal development depends on specific, sexual, age and constitutional features. Cases of the return position of bodies in relation to the middle plane are described (heart on the right side, a liver — from left) and nevertheless no functional frustration at the same time are found. Pathological for one organism can be norm for another.

Dialecticians N. and pathologies generated objective difficulties in knowledge at a number of physicians of idea of N. as a subjective phenomenon. Such conclusion was a consequence of attempt to reach compromise between traditional idea of N. as average type and the developing ideas of variability of specific features of the person. Initial idea of N. as to average size in collision with the contradictory nature of variability of live leads to relativistic conclusions about N.'s dissolution in anomalies, to denial of N.

L.R. Grote put forward the concept that the norm is a certain ratio between work of separate bodies and functioning of an organism as complete system. The norm is the realized opportunity, but not average option. Each person, by words the Grotto, is the scale of the normality. This situation was one of the first justifications of the concept of a relyativnost of N. in medicine. Most with deep arguments and logically consistently this concept is stated in R. Williams's works. On the basis of the latest data on «molecular diseases», «chromosomal anomalies» and all extending in connection with opening of genetics, biochemistry and other sciences of the list of individual variety of signs he claims that practically each person represents in this or that relation a deviation from N. The similar position is taken also by P. Ramsey, to-ry comes to a conclusion about randomness and subjectivity of any general parcels that in each of us there is a N.

Denial of objective character of N. leads to the statement that our planet is inhabited by «various genetic monsters» and that in general all people are any disabled people, wellbeing to-rykh keeps on huge network of BC and hospitals. As a result natural is a conclusion that each person «is in a sense abnormal». In this regard in directly practical profession of a physician normative indicators are of great importance.

At establishment of standards quite often consciously distract from the existing variety of the phenomena and fix the nek-ry scheme or classification. Standards can meet objective standards only to some extent. If standards substantially depend on the subjective purposes, tasks, then norms are objective and is only a level historically determined by opportunities of science and practice. However and standards are not any. At their establishment sometimes consciously simplify real N., distracting from a variety of its signs. E.g., the All-Union conference of gerontologists accepted the following standards: persons at the age of 60 — 75 years — elderly, 75 — 90 years — old and St. 90 years — long-livers. A certain convention of the gradation fixed here does not mean that it is possible to refuse searches of true criteria of normal aging in each case (see. Old age, aging ). Absolutization of average norms (help norms, tabular indicators) can lead to theoretical mistakes, to a template in a wedge, thinking. That is why average approach can be added with idea of N. as an interval, to-rogo quantitative fluctuations of psychophysiological processes are capable to hold live system at the level of a functional optimum in limits, is an optimum zone, in limits the organism does not pass a cut on patol, the level of self-control.

The dialektiko-materialistic philosophy considering not isolated person, and system the nature — the person — society forms a methodological basis of a theoretical solution of the problem of N. From these positions normal and pathological development of the person is considered not only as disturbance to adaptation, i.e. coherences of processes at the level of organisms, but also as manifestation of inter-level interrelations of wider plan (populations, biocenoses, the biosphere in general). In this approach to a solution of the problem of N. the important tendency of modern science to synthesis of knowledge of the person is shown. K. Marx, expecting possibilities of synthesis of natural and social sciences in studying of the person, emphasized: «History is the valid part of history of the nature, formation of the nature by the person. Afterwards the natural sciences will include science about the person as well in what the science about the person will include natural sciences: it will be one science» (Marx K. and Engels F., Soch., 2nd prod., t. 42, page 124).

Special value in determination of normal development of the person has set of social factors. It is wrong to attribute universal character to purely biological definitions of N. Mental deviations from N., e.g., quite often have the expressed social determination, social manifestations and effects.

The normal person is not only biologically healthy being. Not all that is normally biological is at the same time and socially normal. Biol, adaptedness of the person is necessary and normal only in those limits in what it provides his optimum activity as the member about-va. The person is not born the ready member about-va, it becomes that in the course of training and education. This process of formation biol, individual identity (see) is also called socialization. The individual who acquired social norms, norms of public life and became personality (see), there is also a normal member of human community.

Normal development of the person is defined by the relations in a process of manufacture, in a family, in life; kind of work, rest, food, living conditions, rhythm and mode of life; the beliefs leading sometimes to subordination biol, life activities to the purposes of social development; habits and customs, results of influence to-rykh are quite often almost imperceptible.

Normal development of the person can be reached first of all in the presence of normal social living conditions.

The economic and social policy of the CPSU and Soviet state directed to the maximum satisfaction of the growing needs of the people promotes not only elimination of the factors which are negatively influencing normal development of people but also creation of conditions, to-rye provide harmonious development of physical and spiritual abilities of the person, serve protection and strengthening of health, all-round development of his personality.

See also Disease , Health , Pathology .

Bibliography: Marx K. and Engels F. Compositions, 2nd prod., t. 1, page 64, t. 3, page 3, etc., t. 4, page 136, 299, t. 20, page 14, etc., t. 25, p. 2, page 16, etc., t. 26, p. 3, page 85, t. 39, page 56, t. 46, p.1, page 11; Lenin V. I. Complete works, 5th prod., t. 12, page 73, t. 23, page 94, t. 26, page 223, t. 27, page 386, t. 29, page 55, etc., t. 39, page 67; D yurkgeyme. Norm and pathology, in book: Sociology of crime, under the editorship of M. Wolfgang, the lane with English, page 39, M., 1966; To l and a shouting and A. I. Ponyatiye's N of norm in development of the child, Vestn. USSR Academy of Medical Sciences, No. 11, page 26, 1968; Kongeym Yu. The general pathology, the lane with it., t. 1, page IX, SPb., 1878; A. A. O Reguluses to dialectics of norm and anomalies, in book: Vyakkerev F. F., etc. Sovr, probl. materialist, dialect., page 307, M., 1971; it, Dialectics and theory of medicine, page 71, JI., 1979; To about-rolkov And. And. and the Loop of the Tax Code about V. P. Philosophical problems of the theory of norm in biology and medicine, M., 1977, bibliogr.; Kupriyanov V. V. and Kulikov V. V. Dialektiko-materialistichesky approach to studying of norm, in book: Philosophical and social and hygienic aspects of the doctrine about health and diseases, under the editorship of G. I. Tsaregorodtsev, page 6, M., 1975; Marderstein I. G. To interpretation of norm in anthropotomy, Arkh. annate., gistol, and embriol., t. 49, century 12, page 83, 1965, bibliogr.; P e of t of l of e of the Tax Code about V. P. Philosophical questions of a ratio of norm and pathology, in book: The main filosofsk. vopr. sovr. biol, and medical, under the editorship of P. P. Goncharov and I. G. Eroshkin, page 86, L., 1967; it, Philosophical questions of the theory of pathology, book 1 — 2, L., 1968 — 1971; Petlenko V. P. and Reznik M. I. Philosophical bases of the theory of norm in medicine, Voyen. - medical zhurn., No. I, page 12, 1979; Stepanov A. D. Norm, disease and questions of health care, Gorky, 1975; Williams R. Biochemical identity, the lane with English, M., 1960; Philosophical problems of the theory of adaptation, under the editorship of G. I. Tsaregorodtsev, M., 1975; Frolov I. T. Progress in science and future of the person, M., 1975; The Person, Medicobiological data, the lane with English, M., 1977 (The international commission on radiological protection); Yu and y G. A. Spetsifika of a problem of the person as subject of medicine, Vestn. USSR Academy of Medical Sciences, No. 5, page 20, 1975; Galen R. S. a. G a m b i-n o S. R. Beyond normality, The predictive value and efficiency of medical diagnoses, N. Y. a. o., 1975; G r o t e L. R. Grundlagen arztlicher Betrachtung, B., 1921; Hartf ul G. Worterbuch der Soziolo-gie, S. 488, Stuttgart, 1976; H e i s t e r-m a n W. Das Problem der Norm, Z. philosoph. Forsch., Bd 20, S. 197, 1966; Cairo J. Bedeutung des Normbegriffes in Personallehre, in book: Biol. Person, hrsg, v. T. Brugsch and. F. H. Lewy, Bd 1, S. 191, B., 1926; Kneucker A. W. Die phi-losophischen Grundlagen des Normalen in der Medizin, Schweiz, med. Wschr., S. 684, 704, 1950; P i e p e r A. Norm, Handb, philosoph. Grundbegriffe, hrsg. v. H. Krings u. a., Bd 2, S. 1009, Miinchen, 1973; R a-m s e y P. Fabricated man, The ethics of genetic control, New Haven — L., 1971; Rautmann H. Untersuchungen iiber die Norm, Jena, 1921.

A. A. Korolkov, V. P. Petlenko.