From Big Medical Encyclopedia

SOLIDARY PATHOLOGY (Latin solidus dense) — the doctrine, according to Krom essence of diseases consists in ratio distortion and the nature of the movement of solid particles of an organism. Represented implementation of the ideas of Ancient Greek atomist — Levkipp (5 century BC), Democritus and Epicurus explaining all real proceeding from properties of particles of matter, their movement and interaction. Page of the item arose and developed in fight against the doctrine about humoral pathology (see), in Krom the main role in developing of diseases was assigned to disturbances of a condition of liquids of an organism.

One of the first ideas of paramount value of solid particles in life activity and painful conditions of an organism were put forward by the Alexandria doctor Erazistrat. From positions of atomistics questions of medicine were considered also in Lucretius's poem «About the nature of things», in a cut, in particular, it was said about what nek-ry not seen by an eye of a particle («seeds») infectious diseases can cause. However the original founder S. of the item should be considered the Ancient Greek doctor Asklepiad who was engaged in profession of a physician in Rome. His pupil Temison from Laodikei improved the medical doctrine of Asklepiad, having given it the name of methodical system (school) in medicine (apprx. 50 BC). This school differed from two other large schools of empiricists and dogmatic persons existing at that time in the fact that her representatives calling themselves by techniques (Greek meta between, among-] - Greek hodos a way, the road), chose an average way between an empiriya and dogmatism.

The ideas of supporters of S. of the item reached us in Tseliya Avrelian's statement (3 — 4 century AD), to-ry in the treatise «De morbis acutis et chronicis» generalized achievements and Asklepiad, Temison's representations and other metodikov-solidarist. The Page of the item is the cornerstone Democritus's idea that the live organism represents something like a crystal lattice, in a cut more heavy, inert atoms alternate with mobile, light and round atoms of fire, developing to the uncountable canals having ability to be narrowed and extend. The atoms of fire forming soul set a cover in motion, they are imprisoned in a cut, i.e. a body, and give warmth to body tissues. When the living being dies, his body becomes motionless and is cooled because atoms of soul leave it and dissipate in space. Atoms of a human body are formed of air in lungs and of food in a stomach, then come to blood and are carried by it, getting into fabrics via the channels and a time which are available in them where are consumed for food and recovery of substance. Health is directly caused by a normal amount, * a harmonious relative positioning and the free movement of atoms that, in turn, depends on a normality and width of channels and a time. The movement of atoms which is carrying out work of creation and decomposition cannot be stopped without prejudice to an organism. Disturbance of this movement owing to excessive narrowing or relaxation, a contamination and obstruction of a time and channels results in stagnation, deviations of atoms from the correct arrangement, to mixing and change of dense parts, as is in S. of the item the next etiology.

Asklepiad's followers are doctors of methodical school — added original positions of S. of the item with the nek-ry ideas of humoral pathology. According to their representations life activity is provided not only a ratio of solid particles, but also liquids. The mutual combination of solid particles and liquids of an organism defines a condition of tension or relaxation of fabrics. The idea of a tone — balance (harmony), tension and relaxation was formulated. Nek-ry representatives of S. of the item connected maintenance of a tone with activity of a nervous system. Disturbance of a tone in the form of dominance of relaxation or tension causes an abnormal condition of a time of an organism and as a result — a course of a disease. At the same time several standard was allocated patol. states («communities»). The evasion of a time from their average measure which is expressed in their excessive reduction creates status strictus, and the evasion which is expressed in dominance of relaxation — status laxus. Certain representatives of methodical school marked out transient state — status mixtus. Also the nature of disease of communitas temporalis («a community of time») — acute or hron was considered. course, strengthening or weakening of symptomatology. «Community» according to these views characterizes a disease, defines its most typical manifestation. So, at status strictus falloff of allocations, a xeroderma and mucous membranes is observed; at status laxus — the return picture — strengthening of allocations, excessive humidity of covers.

Diagnosis consisted in reference of a specific case to certain «community» (standard patol. state). So, e.g., at spasms, tetanus, epilepsy, blow, an ischuria, fever status strictus was assumed, at a faint, bleedings, ponosa, vomiting, a sugar mocheiznureniye — status laxus, and at fever with a diarrhea, bleedings — status mixtus.

According to general idea about the reasons of health and diseases process of treatment was directed not so much to local displays of a disease how many on the general condition of an organism: the purpose of narrowing excessively expanded or expansions chrezkhmerno of the narrowed pores was set. In case of status mixtus combined the actions narrowing and expanding a time.

Asklepiad and his followers were opponents of routine empiricism in medical practice, uses of methods of treatment, strong and painful for the patient. They did not abuse laxatives and vomitives, excessive bloodlettings, to-rye often in itself were a cause of death or exhaustions of the patient. Asklepiad recommended treatment, simple and concordant with the nature, having put forward the principle «it is reliable to treat, soon and pleasantly» («tuto, celeriter, et jucunde curare»). He established that means, to-rye support and keep health, are most efficient also for recovery of health when it is undermined. Therefore, keeping all the best of traditions of gippokratik, S. supporters of the item struggled with diseases, applying the safest and at the same time least dangerous weapon — hygienic means. Their main care was to support, excite forces of an organism necessary for overcoming a disease and recovery of health. So, e.g., at hron. diseases they aimed to recover, alter and update an organism of the patient with the mode (regulation of meal and drink, exercises, a dream), i.e. the therapeutic actions borrowed preferential from area of hygiene.

Solidarista lifted diyetetiko-hygienic doctoring on big height, having developed the so-called cyclic method of treatment considering stages of a course of a disease. At the beginning of feverish diseases the rigid diet was ordered — meal was prohibited and drink sick concluded in darkness and contained in a full immovability. During the subsequent periods meal, drinks, walks in the fresh air, light, grindings was resolved. Climatic treatment and massage figured prominently, the movement in various types (walking, run, ride, driving by the boat, the active and passive movements in a stretcher, etc.), the strengthening means was recommended.

Considering one of the main conditions of health free and regular «dermal, invisible respiration» (perspiratio insensibilis) — allocation of an imperceptible perspiration, Ask-lepiad and his followers recommended to support this breath, as well as the general movement of atoms, caring for elasticity and purity of skin. For this purpose they appointed grindings, massage, physical exercises, cold, warm and hot water for ablution, bathtubs, a shower, douches and as drink. The hydrotherapy became in their hands an effective method of treatment.

Fessal, About Oran Efessky and Tsely Avrelian were the most famous representatives of methodical school, except Temison. The pupil Asklepiada Fessal developed the so-called changing method of treatment (metodus alterans) for recovery of the relative positioning of atoms which deviated norm, considerably improved a dietotherapy, deepened the concept of the teacher. He considered that the attention of the doctor shall be concentrated on need of strengthening of the general condition of the patient by means of the thought-over diet, improvement of environmental conditions, purity of air, gymnastic activity and loud reading, considerable restriction of all strong means. At pneumonia in the first three days abstention from food and drink, stay in moderately warm air, horizontal position was recommended; during 'acme — grinding of a breast, a wrapping in the rags impregnated with oil, prohibition of a dream; after acme — permission of a dream, bloodletting, emmer wheat soup, steam bathtubs, mix from honey and yolks, etc.

Soran Efessky was widely known as the obstetrician-gynecologist. It possesses a merit of development of a dietetics of infantile age.

Tsely Avrelian who generalized Asklepiad's works, Temison, Fes fat, Soran Efessky and other metodik offered the system of treatment of obesity which included gymnastics, swimming, sand bathtubs on the seashore, bread with bran as less nutritious, the use of food of times a day, a short dream, use of laxatives and artificial calling of vomiting.

The main ideas of S. of the item (the atomistic doctrine, the doctrine about a tone, etc.) were much more long-lasting than the most methodical school and gained during an era of Modern times further development in works of yatro-physicists of S. Santorio, J. Borel - whether, G. Burkhava, F. Goffmanna, etc. The Italian doctor and the physiologist S. Santorio in experiences on themselves in specially designed camera studied many years a metabolism, trying to compare the weight of the taken food and drink and allocations; he paid special attention to the imperceptible evaporation found by Asklepiad from the surface of skin (perspiratio insensibilis). «About medicine of balance» («De statica medicina», 1614) can read out capital work of S. Santorio further development of the ideas and S.'s traditions of the item from positions of mechanics.

Development of fundamentals of classical mechanics promoted distribution of a mechanistic explanation of all natural phenomena, including life activity of the person. The atomistic idea which is the cornerstone of S. of the item in this regard changed and gained mechanistic character. On its basis theoretical generalization, an explanation and scientific anticipation in all sections of natural sciences, including and medicine was based.

On mechanistic positions in interpretation of the processes happening in a healthy and sore human body there was a famous Dutch doctor Mr. Burkhave. In system of its views it is possible to find many provisions C. of the item. After Asklepiad G. Burkhave considered that health is expressed in the correct digestion of substances and the normal movements of an organism, a disease — in disturbance of these functions or even in their termination. According to its doctrine, the disease consists in abnormal increase or undervoltage of «fibers», from to-rykh the person (the solidaristsky idea of a tone) consists. Diseases, at to-rykh suffer fluid mediums of an organism, were explained by abnormal composition of their «juice» atoms.

The huge authority to G. Burkhava dominating in the European medicine more century forced doctors to pay attention to firm parts of an animal organism again. To G. Burkhava was the main herald of the theory of «a motive fiber the» (fibra motrix) which gained considerable development in works of his pupil it is mute. therapist F. Goffmann and ital. yatrofizik of J. Baljivi. These scientists considered that a basis of a structure of an organism are the threadlike particles — «fibers» possessing a tone — ability to be reduced and extend. They developed the «dynamic» doctrine about a normal tone as to a basis of health and about its disturbance as a cause of illness. F. Goffmann, like G. Burkhava, allowed along with changes in firm parts of an organism of change and in its liquids. In treatment F. Goffmann followed traditions of methodical school, advised to be careful of drugs and doctors, preferred hygienic and natural means, applied a diet, mineral waters. Therapy according to F. Goffmann comes down or to calm, emptying (at the raised tone and the strengthened movements), or to excitement, irritation (at the lowered tone and the weakened movements). He studied curative sources of Germany, promoted development of resort business.

Other pupil Mr. Burkhave is the Swiss scientist and the doctor A. Galler gave brand new sounding to S.'s ideas of the item, having replaced mechanistic approach to an explanation of the phenomena of life physiological. He for the first time formulated the main objectives of physiology as independent science and specified that the physiologist shall study laws of motion and transformations of material particles — «fibers» (fibers) and juice in a body of animals and the person. Jointly with the pupils A. Galler experimentally investigated properties of muscle fibers — elasticity, ability to react to irritation of the corresponding nerve and to direct irritation of a muscle. In this regard he claimed that characteristic property of any irritant is ability «to force an organism to pass from rest to the movement», noted dependence of reaction at most of an irritant, formulated the doctrine about irritability and sensitivity as the main properties of living matter.

The ideas and A. Gallera exerted G. Burkhava a great influence on theoretical generalizations of D. Diderot, P. Kabanis, Zhe Dametri and other philosophers materialists. The English doctor U. Kullen on the basis of A. Galler's opening, T. Villiziya, etc., shown a significant role of a nervous system in an organism, and the «dynamic» exercise F. Goffmanna proved «the nervous principle» as the Supreme regulator of all vital processes. Tension of a nervous system causes, according to U. Kullen, the convulsive phenomena, to-rye can variously be expressed; relaxation of a nervous system, on the contrary, causes an atony. It divided therapy according to this understanding into the anticonvulsant and counteracting atonies.

F. Goffmann's functionalism, doctrines about irritability and A. Galler's sensitivity, about «the nervous principle» of U. Kullen received unilateral treatment in J. Broun and F. B works of Ruse. In the work «Elements of Medicine» («Elementa medicinae») J. Broun defined excitability as the main essence of life. Health was defined by it as a normality of excitability, a disease — as increase or decrease in excitability, as a hypersthenic or asthenic state.

In Russia philosophy of S. of the item were apprehended by representatives of the anatomo-physiological direction in medicine: S. G. Zybelin, F. G. Politkovsky, E. O. Mukhin, I. E. Dyadjpovsky, S. P. Botkin and many others. And. M. Sechenov in theses of the thesis claimed that «at the real condition of natural sciences the only possible principle of pathology is molecular». At the same time domestic physicians refused opposition of these principles to achievements of other directions of researches and overcame their unilaterality.

In the middle of 19 century solidary and humoral pathology stopped the existence as the independent and contradictory directions of development of medicine. Their rational moments, the principles and provisions were transformed and entered components modern medical science and practice.

Bibliography: Borodulin F. R. Lectures on history of medicine, the Lecture 4 — 5, page 43. M, 1955; Kovner S. History of ancient medicine, century 3, page 715, Kiev, 1888; Merkulov W. L. Albrecht Galler, 1708 — 1777, L., 1981; M about r about x the island e L. Istoriya's c and a ratio of medical knowledge, M., 1903; Multano Sunday to ii y M. P. History of medicine, page 41, M., 1967; R about and N with to and y I. D. Development of natural sciences during an era of antiquity, M., 1979; Geschichte der Medizin, Einfiih-rung in ihre Grundzuge, hrsg. v. A. Metteu. I. Winter, B., 1968.

Yu. A. Shilinis.